OT 333 Final Exam Study Guide PDF

Activity Analysis and OTPF ========================== - **What is OT domain v OT process** - **Domain is what we do** - **Process is how we do it** - **What are the five components of OT domain?** - **Occupations: everyday activities that people do as individuals, in families, and...

Activity Analysis and OTPF ========================== - **What is OT domain v OT process** - **Domain is what we do** - **Process is how we do it** - **What are the five components of OT domain?** - **Occupations: everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life** - **Contexts** - **Performance patterns** - **Performance skills** - **Client factors** - **What is context? What are environmental factors (extrinsic) v personal factors (intrinsic)?** - **Context: a broad construct comprised of environmental and personal factors which influence engagement in occupations** - **Environmental factors: aspects of the physical, social, and attitudinal surroundings in which people live and conduct their lives. Influence functioning and disability and have positive and negative aspects** - **Personal factors: the unique features of a person that are not part of a health condition or health state and that constitute the particular background of the person's life and living. They are internal influences affecting function and disability and are not considered positive or negative but rather reflect the essence of the person.** - **What are performance patterns? Distinguish between habits, routines, roles, and rituals.** - **Performance patterns: acquired habits, routine, roles, and rituals used to engage in occupations, influenced by time** - **Habits: specific, automatic adaptive, or maladaptive behaviors** - **Routines: established sequences of occupations or activities that provide a structure for daily life** - **Roles: help define who a person, group, or population believes themselves to be on the basis of the occupational history and desires for the future** - **Rituals: symbolic actions with spiritual, cultural, or social meaning which contribute to identity and reinforce existing values and beliefs** - **What are performance skills? Distinguish between motor, process, and social interaction skills.** - **Performance skills: observable, goal-directed actions** - **Motor: moving oneself, interacting with objects** - **Process: organizing objects, time, space, applying knowledge, and adapting performance** - **Social interaction skills: using verbal and nonverbal skills to engage with others** - **What are client factors?** - **The specific capacities, characteristics, or beliefs within a person** - **Values, beliefs, and spirituality** - **Body structures** - **Body functions** - **Distinguish between values, beliefs, and spirituality.** - **Values: principles considered to be worthwhile** - **Beliefs: ideas held to be true** - **Spirituality: experiencing meaning through reflection and intentionality** - **Distinguish between body functions and body structures.** - **Body functions: physiological function of body systems** - **Body structures: physical anatomical body parts and their components** - **Occupation v Activity v Task** - **Activity: general, objective, no specific context** - **Considers the typical demands of an activity as it is usually completed** - **Occupation: personal, subjective, highly specific context** - **Considers the specific person and context, in addition to the demands of the occupation itself** - **Task: the sequence of events that happen during the activity** - **Why do we use occupation as a treatment modality?** - **Improved motivation and engagement** - **Coordinating body systems** - **Improved generalizability** - **Analyze activities to: educate clients, examine therapeutic properties, find the "just right challenge", inform intervention focus** - **What characteristics are included in each step of the Sequence & Timing section of a formal activity analysis?** - **An action verb** - **How the action occurs** - **Objects used** - **Time elements** - **Amounts used** - **Grading v Adapting** - **Grading: increasing or decreasing activity demands to ensure a just right fit** - **Adaptation: changing an aspect of the activity to improve participation** - **Who does the term "occupational therapy practitioners" refer to?** - **Occupational therapists and occupational therapy assistants** - **What are the nine major categories of occupation?** - **ADLs, IADLs, health management, rest and sleep, education, work, play, leisure, social participation** - **What is the difference between occupational analysis and activity analysis?** - **Occupational analysis: experienced by a single person; personally constructed, one time experience with unique context** - **Activity analysis: more general, culturally shared idea about a category of action** **Major Developmental Theories** ================================ - **Distinguish between growth, development, and maturation.** - **Growth: physical and biologic changes; observable and quantifiable** - **Development: changes in behavior; sequential and predictable** - **Maturation: stage of full functionality; a part of growth and development** - **Know the key characteristics of Erikson's Psychosocial Stages of Development.** **Characterized by a battle or conflict within the ego to overcome** - **Trust vs mistrust: birth to 1 year** - **Autonomy vs shame/doubt: 1 to 2 years** - **Initiative vs guilt: 3 to 5 years** - **Industry vs inferiority: childhood (6-12)** - **Identity vs identity diffusion: adolescence and emerging adulthood** - **Intimacy vs isolation: young adult** - **Generativity vs stagnation: adult** - **Ego integrity vs despair: older adult** - **Know the key characteristics of Piaget's theory of cognitive development and Schaie & Willis' stages of adult cognition.** - **Sensorimotor: birth to 2 years** - **Preoperational: 2 to 7 years; symbolic** - **Concrete operational: 7 to 12 years; logical** - **Formal operational: 12 years and up; abstract** **Week 9 Review Points \| Early Childhood** =========================================== 1. **Know the age range associated with early childhood and preschool.** - **Early childhood: 2-6** - **Preschool: 3-5** 2. **Be able to describe overall trends seen in growth and development during early childhood.** - **Steady increase in height and weight** - **Child becomes slimmer** - **Increased muscle mass and loss of baby fat** 3. **Know the function of the corpus callosum and understand its relationship to cognitive development in early childhood, including brain lateralization.** - **Corpus callosum: improved communication between left and right sides of the brain** - **Improved efficiency** - **Handedness (eyes, ears, feet, hands) maternal link** - **Lateralization: right and left sides of brain are not symmetrical** 4. **Discern between when handedness begins to present v. when hand-dominance is firmly established.** - **Handedness typically shown by age 4** - **Should be firmly established by age 7** 5. **Identify trends in emotional regulation and behavioral regulation associated with ages 2-4. Contrast this to socio-emotional aspects of school-readiness (by ages 5-6). Understand the relationship between these cognitive skills and prefrontal cortex maturation.** - **Ages 2-4** - **Poor impulse control** - **Emotionally responsive** - **Prone to temper tantrums** - **By age 5** - **Much better impulse control and emotional regulation** - **Reflects prefrontal cortex maturation** 6. **Be able to describe sensory integration.** - **Children seek out necessary sensory experiences** - **Some children have difficulty tolerating some sensory inputs** 7. **Know what the largest sensory organ in the body is.** 8. **Articulate the relationship between tactile functions, proprioception, and fine motor skills.** - **Constantly filtering out extraneous tactile sensory information** - **Tactile sensory system informs fine motor precision** 9. **Know the vestibular system's function and components. Be able to identify the two otolith organs (utricle and saccule) and distinguish between the function of otolith organs and semicircular canals.** - **Proprioception: awareness of where our body is in space; during a resting position** - **Information of joint position sense and joint motion** - **Allows us to know where we are in space** - **Allows motor performance with vision occluded** - **Otolith organs** - **Utricle and saccule** - **Linear acceleration; gravity** - **Semicircular canals: angular acceleration (rotational movements)** - **Promote: postural and head control, orientation of head in space** - **Righting and equilibrium reactions** 10. **Be able to describe the trends in gross motor control associated with early childhood and know the sequence of gross motor skill development.** - **Posture: to develop better movements** - **Center of gravity over base of support** - **Stability versus mobility** - **Flow: smooth** - **Calibration: amount of force** - **2 years: beginning to run, walk backwards; jumps down from step** - **3 years: jump off floor with both feet; walk up and down stairs; pedal a tricycle** - **4 years: catch a ball; hop on either foot; pour juice without spilling** - **5 years: gallops; throws a ball overhead; walks up/down stairs carrying an object** - **6 years: skips in rhythm; completes a backward roll; able to learn and perform a cartwheel** 11. **Articulate barriers to precise fine motor control in early childhood and identify influences on fine motor skill acquisition.** - **Barriers** - **Smaller movements are harder to master** - **Require bilateral integration (using both halves of the brain)** - **Young children have short, fat fingers, which makes dexterity more difficult** - **Handedness is not yet firmly established** - **Influences on fine motor skill acquisition** - **Neuromuscular function** - **Sensory integration** - **Musculoskeletal system integrity** - **Postural control** - **Experience in prone** - **Experience building up intrinsic hand muscles** 12. **Distinguish between types of bilateral movements.** - **Symmetrical** - **Same movement with both hands** - **clapping** - **Reciprocal** - **One side completes a movement that is then repeated by the other side of the body (alternating movements)** - **crawling** - **Leading and supporting** - **Dominant hand manipulation, nondominant hand stabilization** - **Drawing** 13. **Identify power grasp patterns and types of precision grasp patterns.** - **Cylindrical grasp** - **Spherical grasp** - **Hook or snap** - **Lateral pinch** - **Three-jaw chuck** - **Pincer (tip to tip) (pad to pad)** 14. **Know each of the types of in-hand manipulation and the sequence in which these skills develop (which skills are easier, which are harder). Identify examples of each in-hand manipulation skill and identify when each is typically developed.** - **Translation** - **Finger to palm (12-15 months)** - **Palm to finger (2-2.5 years)** - **Shift: ability to move something linearly along the finger surface** - **Linear movement along finger surface** - **Separating paper (3-5 years)** - **Shifting fingers on a pencil (5-6 years)** - **Simple rotation** - **Turning an object in finger pads 90 degrees or less (2-2.5 years)** - **Complex rotation** - **Turning an object in the hand 360 degrees (6-7 years)** - **In hand manipulation with stabilization** - **Requires good lateralization of radial and ulnar aspects of hand (6-7 years)** 15. **Identify expected vocabulary expansion for ages 3-5 years.** - **Age 3: 1000-5000 words** - **Age 4: 3000-10,0000 words** - **Age 5: 5000- 20,0000 words** 16. **Distinguish between fast mapping and slow mapping, identify which grammatical error is typical in early childhood, and understand the influence of reading on language and grammar skills.** - **Fast mapping: linking words they hear to an initial guess of meaning, connecting to other related categories of words** - **Slow mapping: building on memories of words and modifying their understanding as more is learned** - **Grammatical error:** - **Over regulation: the tendency to apply rules when not needed** - **With plural and past tense** - **Highly influenced by experience (reading)** 17. **Know which of Piaget's stages of cognitive development is associated with early childhood and be able to articulate which cognitive skills we would expect with this stage of development.** - **Preoperational stage** - **Uses symbols (words, images) to represent objects** - **Egocentrism** - **No conservation during preschool years** 18. **Identify trends in early childhood memory.** - **Likely to forget what they were planning to do** - **May ask questions repeatedly** - **Working memory is developing** 19. **Know the components of self-concept, identify whether children in early childhood typically have higher or lower self-esteem, define prosocial behavior, and articulate the relationship between prosocial behavior and the development of empathy.** - **Self concept: understanding of who I am** - **Self image: appearance** - **Ideas of self: personality, chracter traits** - **Self-esteem: evaluation of self worth** - **Higher self esteem** - **Prosocial behavior?** - **More empathy with prosocial behavior** 20. **Identify the four parenting styles identified in lecture and the major characteristics of each.** - **Authoritarian** - **Authoritative** - **Permissive** - **Abusive** 21. **Identify which of Erikson's stages of psychosocial development aligns with preschool development and articulate what this means.** - **Initiative vs guilt (3 to 5)** - **Thrive in an environment where they can explore, make decisions, initiate activities** - **Conflict with ego** - **Want to be able to do something on their own and if they can't do it they feel bad about themselves** 22. **Describe each of Mildred Parten's Six Stages of Play (distinguishing between key characteristics of each) and know what age range is typically associated with each of them.** - **0-3 months: unoccupied play- playing with physical movement, hands feet, not with toys** - **3 months to 2 years: solitary play, play without involvement of others** - **2-3 years: onlooker play,** : **watches play of others; may engage in conversation about play, but does not engage in play near others** - **2/3 years-4 years: parallel play, plays individually but in close proximity to others; may mimic play strategies** - **4-5 years: associative play, plays together and enjoys peer company, but play is not organized/structured** - **6-7 years: cooperative play, playing cooperatively with others, working together to achieve a goal** 23. **Articulate the difference between physical play, sociodramatic/ symbolic play, and constructive play, and identify some skills practiced through each.** - **Functional play: unoccupied play** - **Constructive play: preoperational** - **Imaginative play: preoperational** - **Games with rules: concrete operations** - **Physical play: taking turns, develop motor skills, hand-eye coordination/foot** - **Sociodramtic: explore and rehearse social role, regulate emotions, navigate conflicts** - **Constructive: problem solving, fine motor, school-readiness** 24. **Distinguish between the 7 principles of universal design and identify examples of each.** - **Equitable use: design is useful and marketable to people with diverse abilities** - **Flexibility in use: the design accommodates a wide range of individual preferences and abilities** - **Simple and intuitive use: use of the design is easy to understand, regardless of the users experience, knowledge, language skills, or current concentration level** - **Perceptible information: design communicates necessary information effectively to the user, regardless of ambient conditions or the users sensory abilities** - **Tolerance for error: the design minimizes hazards and the adverse consequences of accidental or unintended actions** - **Low physical effort: the design can be used efficiently and comfortably and with a minimum of fatigue** - **Size and space for approach and use: appropriate size and space is provided for approach, reach, manipulation, and use regardless of user's body size, posture, or mobility** 25. **Define "flow" in relation to motor development.** **Week 10 Review Points \| Middle Childhood** ============================================= 1. **Know the age range associated with middle childhood.** 2. **Identify trends in physical growth and development noted during middle childhood, describe growth distribution (trunk v. limbs) associated with middle childhood as compared to early childhood and identify how this influences motor skills and coordination.** - **Variations in physiques: malnutrition, genetic factors, environmental exposures** - **Physical development affect friendships which are partially based on physical appearance and competence** - **By age 6, build is predictive of adult proportions** - **Rate of growth slows down: 2-3 inches per year** - **Limbs lengthen, early childhood was the torso** - **Muscles become stronger** - **Mastery of motor skills and improved sports performance** - **No difference between male and female athletic performance** 3. **Identify cognitive skills which develop during middle childhood and are important for school participation.** - **Selective attention: active listening during school, taking notes, ignoring distractions** - **Pre frontal cortex development: improved self-regulation of emotions** - **Advancement in working memory: actually engaging with that info during an activity** - **Metamemory: awareness of ones own memory, conscious implementation of memory strategies** - **Cognitive monitoring: self-examination of next steps; how you are going to get things done** 4. **Define "coincidence-anticipation (CA) timing" and describe its relationship to performance in sports requiring hand-eye coordination (like softball).** - **Coincidence adaptation timing: understand relationship between movement and time** - **Important for sports hand-eye coordination** 5. **Describe what a "cognitive map" is and identify why this is important.** - **Mental picture we have of our environment: ability to picture location in mind** - **Helps with spatial orientation** 6. **Define "kinesthetic perception" and know the difference between proprioception and kinesthesia.** - **Kinesthetic perception: perception of body movements; gross motor movement in sports** - **Proprioception: knowing where your body is without looking** - **Kinesthesia: awareness of position and movements of parts of the body** 7. **Distinguish between size constancy and figure-ground discrimination.** - **Size constancy: awareness that things are the same size even if one is closer to you and looks bigger** - **Figure-ground discrimination: distinguishing something from the background** 8. **Articulate why hand dominance is important.** - **Associated with brain maturation and lateralization** - **Failure to develop hand dominance:** - **Impaired motor coordination** - **Decreased dexterity** - **Barriers to participation in school: impacts academic performance** 9. **Know what intelligence-quotient (IQ) testing is, why it\'s used, and what some of its barriers are.** - **IQ test: an aptitude test to measure intelligence/ability to learn in school** - **WISC and Stanford Binet test** - **Barriers:** - **Does not consider rate of development, culture, family, school, genes** - **Difficult to measure potential without achievement** - **Culturally biased** 10. **Identify which of Piaget's stages of cognitive development is associated with middle childhood and describe what this means relative to expected cognitive skills for this age range.** - **Concrete operations** - **Characterized by conservation and reversibility** - **Logical thinking** 11. **Distinguish between the different types of conservation. Define what is meant by the term "reversibility" according to Piaget.** - **Conservation of number: 2 rows, 1 row mor spread out, still contains same amount** - **Conservation of length: 2 sticks of equal length, move one stick, the sticks are still same length** - **Conservation of area** - **Conservation of matter: 2 equal balls of clay, squeeze one, they both still have the same amount of clay** - **Conservation of liquid: 2 equal glasses of liquid, pour one into a tall skinny glass, they still contain same amount of liquid** - **Reversibility: understanding that items modified can return to their original form** - **Needed to understand addition/subtraction** 12. **What is the zone of proximal development? How does Vygotsky view the relationship between peers and skill acquisition?** - **Zone of proximal development: skill acquisition, zone of proximal development is when learner can do something with the guidance of someone else** - **Peers, teachers, and cultural context provide bridge between children's developmental potential and skills needed** - **Children apprentices in learning-watch, play and engage in daily interactions** 13. **Identify which of Erikson's stages of psychosocial development aligns with middle childhood development and articulate what this means.** - **Industry v inferiority** - **Trying to master skills valued in own culture** - **Social worlds beyond family contribute to perceived industry v inferiroty** - **Self- concept** - **Stress** - **Asynchronous development: cognition and physical development might not align** - **Where we rank according to our peers matters** 14. **Identify characteristics of "cliques".** - **Special vocabulary, rules of behavior, dress codes** - **Popularity** - **An "in" group and an "out" group** - **Develop cliques between ages 9-11** - **Subculture: something that makes you fit in with that group** 15. **Distinguish between "neglected" children and "rejected" children.** - **Neglected: not disliked, but received little attention by peers** - **Not necessarily damaging, especially if other supportive social environments available** - **Rejected: disliked by peers, usually because of antagonistic/confrontational behavior** - **Often mistreated at home** - **More likely to be disruptive, aggressive** - **More likely to misinterpret social situations** - **May become withdrawn and anxious** - **Likely to have emotional/behavioral difficulties later in life or struggle to maintain stable relationships** 16. **Define cooperative play (one of Mildred Parten's Six Stages of Play).** - **Playing cooperatively with others, working together to achieve a goal (organized)** - **When a child plays together with others and has interest in both the activity and other children involved in playing, they are participating in cooperative play** 17. **What do we mean by "games with rules"? What level of operations does Piaget state is required for participating in games with rules?** - **Games with rules means organized games** - **Need to be in concrete operations** 18. **What is the definition of bullying?** - **Any unwanted aggressive behavior by another youth or group** - **Power imbalance** - **Repeated** 19. **What are warning signs of bullying?** - **Low self-esteem, avoidance of school, depression, suicidal thoughts, cuts and bruises, headaches, envied by others, jumpy when using phone** 20. **What is the role/influence of bystanders?** - **May reinforce/assist in bullying** - **May intervene to try to stop it** - **May ignore or be unaware of it** - **Witness 80% of bullying, but only intervene 20% of the time** - **When someone intervenes, bullying stops by 50%** 21. **Why is it important to cultivate a positive school climate?** - **Builds brain and architecture and enables children to learn more** - **Allows brain to focus on what is important** - **Allow kids to feel safe and want to come to school** - **Healthy brain development** - **Keeps kids engaged** **Week 11 Review Points \| Adolescence** ======================================== 1. **Know the developmental start and end of adolescence and the generally associated age range.** - **Marked by start of puberty, ends when you leave the house** - **Ages 12ish to 18 to 21 ish** 2. **Be able to generally describe the onset of puberty and associated physiological changes.** 3. **Know what the Tanner Scale is, how many stages are included, what it measures, and which stage indicates prepubescence v. reproductive maturity.** - **Tanner scale are the stages of puberty; progression of prepubescent to mature** - **Stages 1-5** - **1 is prepubescent** - **5 is mature** 4. **Know generally how long puberty lasts from start to finish.** - **Lasts between 2-5 years** - **2-4 years after first visible signs, all major events are over** - **Can happen as early as 8 or as late as 14** 5. **Distinguish between primary and secondary sex characteristics.** - **Primary: characteristics directly involved in reproduction: ovaries and testes** - **Female: first menstrual period** - **Male: spermache: onset of sperm emission, first ejaculation** - **Secondary: characteristics not directly involved in reproduction** - **Rapid physical growth** - **Breast development and widening of hips** - **Voice changes** - **Broadening shoulders in men** - **Face and body hair** - **Muscle development: more significant in men** 6. **Be able to articulate the distribution of physical growth occurring during adolescence. Which structures typically grow first? How does this impact motor coordination?** - **Differences in motor capabilities arise in this stage** - **Uneven jump in size of almost every body part** - **Increased bone length and density** - **Limbs before torso** - **Feet and fingers before arms and legs** - **Torso lengthens last** - **Rapid weight gain and increase in muscle mass** - **Greatest time of growth other than infancy** - **WIDER, TALLER, STRONGER** 7. **Be able to describe what the striatum is and how it impacts adolescent decision-making. Consider rate of myelination of the striatum v. maturation of the prefrontal cortex; how does the asynchronous development of these structures impact cognition during adolescence?** - **Striatum: reward system; movement** - **becomes more myelinated more quickly than prefrontal cortex** - **more programmed to seek out rewards without thinking of the consequences** 8. **What do we mean by adolescent egocentrism?** - **Excessive self-consciousness** - **Preoccupied with what others think** - **Can lead to significant insecurity** - **Imaginary audience (opinions of onlookers)** - **Personal fable: it won't happen to me** - **Not in a way where you think you are better** 9. **What paradox is described on page 307 (Cronin & Mandich) relative to adolescent health and decisionmaking?** 10. **What is temporal discounting/invincibility fallacy? To what do we attribute this phenomenon? Summarize the relationship between adolescent reasoning and decision-making (page 310, Cronin & Mandich).** 11. **Identify which of Piaget's stages of cognitive development is associated with adolescence and describe what this means relative to expected cognitive skills for this developmental stage.** - **Formal operations** - **Abstract thinking, hypothetical, the "ideal", metacognition, development of deductive reasoning** - **Conceptualize things that do not directly impact them** 12. **Distinguish between deductive and inductive reasoning. Which of these types of reasoning develops during adolescence?** - **Deductive: drawing specific conclusions from general observations** - **Develops during formal operations** - **Indictive: making generalizations based off previous specific life experiences** - **Age 7** - **Always doing** 13. **Identify which of Erikson's stages of psychosocial development aligns with adolescence and articulate what this means.** **Identity versus role confusion** - **Exploring one's place in society** - **Extensive exploration of the self** - **Who am I** 14. **Describe possible outcomes of identity formation, including what is meant by role achievement, foreclosure, moratorium, and identity diffusion.** - **Identity formation = exploration and commitment** - **Role achievement: I've thought about it and I know what I should do with my life** - **Foreclosure: low exploration** - **Unwilling to go through crisis** - **Commits to what is comfortable** - **I've made a choice without thinking** - **Moratorium: high exploration, low commitment** - **Trying to figure out, makes temporary choices to postpone future commitment** - **I know I need to figure out what to do and I'm thinking about it** - **Identity diffusion: unwilling to go through crisis or commit to the future** - **Lack of commitment to goals/values** - **Leads to stagnation** - **No game plan** - **I don't know and I don't care** 15. **Describe changes to the parent-child relationship dynamic which occur during adolescence, and articulate factors which contribute to building/maintaining a positive relationship.** - **Relationship tension: adjusting to new dynamic, generation gap, may lead to increased parent-adolescent bickering** - **Child wants space and privacy** - **Values are different** - **Building a positive relationship** - **Adolescents need freedom to feel competent and loved** - **A warm, supportive relationship with open communication is positively correlated with the adolescent becoming a more confident, well-educated adult** 16. **Describe deviancy training and peer pressure.** - **Deviancy training: one peer shows another how to rebel against social norms** - **Peer pressure: can be positive or negative** - **Strong until age 14** 17. **What is gender identity? What is sexual orientation? (Cronin & Mandich)** - **Gender identity: the understanding of oneself as a man or women** - **Sexual orientation: enduring pattern of attraction that may be emotional, romantic, sexual, or some combination of these to other people.** 18. **What is intimacy? (Cronin & Mandich)** 19. **Describe expected occupational performance during adolescence. What are some examples of ADLs that become important during this period of development? What occupations are frequently associated with adolescence?** - **ADLS should be well established and independent** - **More focus on appearance** - **Some changes based on physical changes: shaving, feminine hygiene, deodorant** - **Rest and sleep: should be getting 8-10 hours** - **IADLs** - **Increased home management responsibilities: chores** - **Care of others: helping with younger siblings or older parents** - **Meal preparation** - **Community mobility (driving)** - **Education** - **Increased choices** - **Increased academic requirements** - **Work** - **Want or need to work** - **Builds self-esteem, compete with school, work commitment** - **Social participation** - **Hanging out** - **Going out** - **Electronic communication** - **Family interactions** **Week 12 Review Points \| Young Adulthood** ============================================ 1. **What is the proposed new developmental stage of emerging adulthood? How is it characterized? What is the associated age range, and when does emerging adulthood end?** - **Emerging adulthood: new proposed stage** - **Approximately 18 to 25** - **Extended transition into adulthood** - **Personal development and continued identity formation** - **Not universal, made possible by the postponing of major life decisions; the privilege of continued personal development and identity exploration** 2. **What age range typically defines early adulthood? Why is this a flexible age range?** - **21 to 34** - **Possibly extends as late as age 40 based on individual factors and role attainment** 3. **Be able to describe and distinguish between the five features of emerging adulthood.** - **Identity explorations: explore various possibilities in love and work to provide clarity on who we are; our values, beliefs, and priorities** - **Instability: frequently changing location of residence (one of the most stressful life events)** - **Instability in school, work, residence, relationships** - **Self-focus: enhanced understanding of the self** - **Identification of values, beliefs, and how we fit into the world** - **Necessary prior to establishing long-term engagements with others** - **Feeling in between: most individuals feel caught in between adulthood and adolescence, characterizing the transitional period of emerging adulthood** - **Possibilities/optimism: nearly a decade to explore possibilities** - **Emerging adulthood is associated with cultures which allow postponing of adult responsibilities** 4. **Summarize the trends in physical development associated with young adulthood.** - **Peak physical performance:** - **Peak muscular performance between 20-30 years** - **Prime cardiovascular fitness** - **Most body structures and fully matured** - **Skeletal bone growth complete by 25** - **Brain continues to develop and mature until 25** - **Optimal speed of reaction time:** - **Attained between 19-26** 5. **Summarize common health compromising behaviors associated with emerging adulthood (and adolescence) and be able to articulate how this relates to cognitive development.** **Trend of poor attention to health maintenance, heightened stress, and risk-taking behaviors** - **With peak physical fitness comes:** - **Less attention to health** - **Greater willingness to push our limits** - **Adoption of unhealth/maladaptive habits and routines** - **Risky driving** - **Prefrontal cortex not mature until 23-25 which is why there are risky behaviors** 6. **Know the age typically associated with prefrontal cortex maturation and be able to articulate the related impacts on cognition.** - **Pre frontal cortex matures 23-25** - **Emotional regulation: inhibition, moderating socially appropriate behavior** - **Personality expression: goals, values, personality** - **Decision making: impulse control and consideration of long-term consequences** - **As this region of the brain matures (later in emerging adulthood) we see less risk-taking behaviors** - **Planning complex behavior: organization, prioritization, time management** 7. **Define neuroplasticity and recognize the relationship between learning and continued brain development.** - **Neuroplasticity: ability of the brain to create and reorganize synaptic connections** - **Continues throughout adult life, but slower** - **Learning physically changes the brain** 8. **Distinguish between fluid and crystallized intelligence.** - **Fluid** - **Think on your feet; problem solve negatively impacted by time constraints** - **Peaks in early adulthood** - **Closely tied to working memory** - **Ability to process and respond to novel information** - **Crystallized** - **Structured, set in stone** - **Based on previous life experiences** - **Continues to develop through middle adulthood** - **Relies on long term memory** - **Ability to use previous experiences to inform current decision making** - **Clinical judgment** 9. **Summarize the physical performance and cognitive developmental changes associated with early adulthood.** 10. **What are the seven stages of age-related cognitive development proposed by Schaie and Willis (2000)?** **Legacy creating, reintegrative, reorganizational, executive, responsible, achieving, acquisitive** - **Achieving aligns with early adulthood** - **Confronting significant life decisions** - **Apply knowledge for attainment of long-term goals** - **Education, career, relationships** 11. **What is stress? Why are stressors common in early adulthood?** - **Stress: the body's response to things that disrupt daily routine** - **Common because a lot is changing** 12. **Identify the greatest limitation of Piaget's theory of cognitive development and be familiar with the additional proposed stage of post-formal thought.** - **Failure to look across the entire human lifespan or consider adult cognitive changes** - **Post formal thought** - **Recognition that world exists in shades of grey; that life is complex and full of contradictions** - **Acquired through life experience** - **Beyond problem-solving; seeking answers to factors underlying world issues or personal concerns** - **Uncovering concerns or potential crises before they appear (problem-finding)** - **Philosophical; rooted in reflection** - **Develops between 20-40 years; not achieve by everyone** - **Flexible thinking, recognition of alternatives** - **Dialectic thought** 13. **Understand key differences between formal and post-formal thought.** - **Formal thought: absolute, a more black and white view of the world; Problem solving** - **Post formal: Recognition that world exists in shades of grey; that life is complex and full of contradictions** 14. **Identify and describe each of the five characterizing components of post-formal thought.** - **Self-knowledge: reflect on oneself to more effectively process and understand the world around you with open-mindedness and curiosity** - **Ability to relativize: seeing the world not as a dichotomy of absolutes (black and white), but rather, as a series of complex relationships (shades of grey)** - **Cognitive flexibility: arises from recognitive of many possible alternative solutions and perspectives; the ability to restructure one's knowledge in response to changing circumstances and contexts** - **Integration of emotion and rational analysis: finding a balance between our emotions and rational thinking to respond effectively to complex situation** - **Dialectic thought: ability to consider a thesis and its antithesis and arrive at a synthesis** - **Most advanced cognitive process** - **Integrate and synthesize information from a variety of competing beliefs, ideas, and experiences** 15. **Identify which of Erikson's stages of psychosocial development aligns with both emerging adulthood and young adult development and articulate what this means for both.** **Identity versus role confusion- for both emerging and young** - **Exploring one's place in society** - **Extensive exploration of the self** **Young adulthood: intimacy versus isolation** - **Confidant, a source of trust and stability** - **May be romantic relationship, but not necessarily** 16. **Know what is meant by the terms, "launching period" and "boomerang effect."** - **Launching: period of leaving home** - **Boomerang: move out of house, but come back** 17. **Articulate the difference between formal relationships, informal relationships, family relationships, intimate relationships, and romantic relationships.** - **Formal: professional relationships** - **Creating and maintaining formal relationships is new in emerging** - **Navigation of formal relationships predicts vocational success** - **Informal: throughout life, friends defend against stress and provide jot** - **Friends, new and old, are particularly crucial during emerging adulthood** - **Most single young adults have larger and more supportive friendship networks than married young adults** - **Family** - **Intimate: includes trust and disclosing information, doesn't have to be romantic** - **Physical intimacy, nonverbal communication, self-disclosure, presence, cognitive intimacy, affective intimacy, commitment, mutuality** - **Romantic: traditionally viewed with the end goal of commitment** - **Dating, committed, casual, situationships, ethical nonmonogamy** 18. **Be able to describe each of the eight aspects of intimacy (Eryilmaz & Atak, 2009).** - **Physical intimacy** - **Nonverbal communication** - **Self-disclosure** - **Presence: want to spend time with each other** - **Cognitive intimacy: engage in conversation** - **Affective intimacy: emotional connection** - **Commitment** - **Mutuality: both putting equal effort** 19. **Be familiar with Sternberg's Triangular Theory of Love and be able to describe the difference between intimacy, passion, and commitment.** - **Intimacy:** - **Linking** - **Passion:** - **Infatuation** - **Commitment:** - **Empty love** 20. **Be able to identify which type of love is considered the "ideal" for long-term monogamous relationships, according to Sternberg's theory.** - **Intimacy + commitment = companionate love** 21. **Identify mental health challenges associated with young adulthood; Be able to define resilience and be familiar with protective factors.** - **Identity crisis: uncertainty or confusion over identity and how we fit into society** - **Stress** - **Mental illness** - **Major depressive disorder: mid 20s** - **Bipolar I disorder: early 20s** - **Schizophrenia: men: late teens early 20s, women: 20s early 30s** - **Greater prevalence in females, young adults 18-25, adults reporting 2 races** - **Young adults less access to mental health treatment** 22. **What is "occupational identity"? How is this related to educational and vocational pursuits associated with early adulthood?** 23. **Describe Ginzberg's developmental theory of vocational choice. What stage is associated with early adulthood?** **Vocational choice in adolescence is influenced by (1) the reality factor, the constraints in the actual work world like the amount of required travel or the expectation of shift work; (2) the individual's aptitudes and access to educational opportunities; (3) the emotional appeal (or lack of appeal) that the individual has for a work environment, such as a desire to work with animals or a desire to build machines; and (4) the individual's values, learned from family and society about the importance of work and the acceptability of certain types of work** ** He proposes that the career development process reflects the interaction of people's abilities, personality traits, and self-concepts with the demands and skill required for specific careers.** **Fantasy, tentative, [experimentation ]** 24. **Describe expected occupational performance during emerging/young adulthood. Which IADLs are developing/become important during this period of development?** - **Establishing vocational identity** - **Improved financial security** - **Improved long-term health** - **Subject specific skills and knowledge** - **Improved reasoning and reflection** - **IADLS** - **Home management working on the most** - **Developing: skills needed to manage domestic life** 1. **Acquisition of necessities** 2. **acquisition of goods and services** 3. **household tasks** 4. **caring for household objects** 5. **assisting others** **Week 13 Review Points \| Middle Adulthood** ============================================= 1. **Distinguish between biological, psychological, and social aging.** - **Biological aging: relates to the condition of individuals organ and body systems** - **Psychological age: an individual's ability to adapt, solve problems, and cope with life events** - **Social age: refers to habits, beliefs, and attitudes** 2. **Know that middle adulthood is the largest developmental period, spanning approximately 50% of the human lifespan.** 3. **Know the age range associated with middle adulthood (\~40-65yrs).** 4. **Summarize general changes in physical appearance and body composition noted in middle adulthood.** - **Collagen decreases by about 1% per year** - **By age 30: skin is becoming thinner and less flexible; wrinkles become visible** - **Hair turns gray and gets thinner** - **Increase in body fat: middle age spread** - **Height decreases by late middle age** - **Lean muscle mass, muscle force** - **Cardiovascular changes** 5. **What is the relationship between osteoporosis and decreased estrogen levels associated with menopause?** 6. **What is osteoarthritis and which joints does it typically affect?** 7. **Know that aerobic capacity is the maximum amount of physiological work an individual can do (maximum rate of energy production through oxidation of energy sources) and recognize how aerobic capacity changes with age.** 8. **Know that cardiovascular fitness is a protective factor against many health challenges associated with aging.** 9. **Distinguish between presbycusis and sensorineural hearing loss.** - **A loss of hearing that is associated with senescence (condition of process of deterioration with age; loss of a cells power of division and growth)** - **Usually does not become apparent until after age 60** 10. **How is visual accommodation challenged as a result of a normal age-related physiological change? What is the name (and etiology) of the resulting visual deficit?** - **Peripheral vision narrows faster than frontal vision (less able to see slight variations in shades)** - **Color vision shifts from vivid to faded more quickly than does black and white** - **Nearsightedness (myopia): increases gradually beginning in ones 20s** - **Farsightedness: hyperopia; structural change in the eye** - **Presbyopia: decreased flexibility of lens as a result of aging; difficulty focusing on near items** 11. **How does contrast sensitivity change as a result of aging and what are some functional implications?** 12. **Distinguish between myopia (nearsightedness), hyperopia (farsightedness), and presbyopia.** - **Nearsightedness (myopia): increases gradually beginning in ones 20s; cant see far away** - **Farsightedness: hyperopia; structural change in the eye ; cant see upclose** - **Presbyopia: decreased flexibility of lens as a result of aging; difficulty focusing on near items** 13. **What is menopause? When does it typically occur? What is andropause?** - **Time in middle age (around age 50) when a woman's menstrual periods cease completely** - **Lower production of hormones** 14. **How does frequency of risk-taking behaviors, including illegal drug use, change from early to middle adulthood? Identify two characteristics of middle adulthood that serve as potential explanations for this trend.** - **Abuse of illegal drugs decreases markedly** - **Abuse of prescribed drugs increases (opioid addictions because older adults more likely to have pain)** - **Alcohol use is more frequent, less amounts; some health benefits** - **Tobacco use is down worldwide; continues through adulthood** 15. **What is atherosclerosis? How does this contribute to risk of heart disease? (recorded lecture 24:10).** - **Buildup of plaque, clogs arteries in the heart** 16. **What is selective expertise? How is this related to vocation during middle adulthood?** - **A lot of skill and knowledge in a particular task** - **Fine our niche and excel in what we are good at** 17. **What stage(s) of Schaie & Willis' stages of cognitive development is (are) associated with middle adulthood?** - **Executive and responsible** - **Responsible stage: work, family, community (responsible for all)** - **Executive stage in not universal** 18. **Distinguish between adaptive coping and palliative coping. Which is most closely associated with an internal locus of control? (recorded lecture 36:00).** - **Adaptive: I can effect change; attempting to solve the problem** - **Palliative: manage emotional response; cant change stressor, but try to male yourself feel better** - **Locus of control: a perceived sense of control over a situation; more likely for adaptive coping** 19. **Identify which of Erikson's stages of psychosocial development aligns with middle adulthood and articulate what this means.** - **Generativity vs. stagnation** - **Parenting is the peak form of generativity** - **Generativity: develop and use their personal skills, express creative energy, aid and advise coworkers, support education and health of their families, contribute to the community** 20. **What is meant by "ecological niche"?** - **People choose their particular social context** - **Adults select vocations, mates, and neighborhoods, and they settle into chosen routines and surroundings** - **Most extensive social networks of our life** 21. **Identify the "Big Five" personality traits (OCEAN; recorded lecture 42:50)** - **Openness: imaginative, curious, artistic, creative** - **Conscientiousness: organized, deliberate, conforming, self-disciplined** - **Extroversion: outgoing, assertive, active** - **Agreeableness: kind, helpful, easygoing, generous** - **Neuroticism: anxious, moody, self-punishing, critical** 22. **What is a "social convoy"?** - **Collectively, the family members, friends, acquaintances, and even stranger who move through life with an individual** 23. **What is meant by the term "sandwich generation"?** - **Caught between caregiving for children and your parents** 24. **What is occupational balance? What is role strain? Why does role strain tend to peak in middle adulthood?** - **Occupational balance: fulfilled with our occupations** - **Role strain: overload of many roles we have; most active in our life with many different roles** 25. **Distinguish between each of Super's stages of adult career development. Which best aligns with middle adulthood?** **Fantasy, exploration (adolescence), establishment (early adult), maintenance, disengagement** - **Maintenance aligns best: work way up ladder, social network** 26. **Know that, in contrast to stressors experienced during early adulthood, stressors experienced in middle adulthood are more likely to be chronic.** 27. **What is occupational deprivation?** - **Inability to engage in valued occupations as a result of external circumstances** - **Causes: homelessness, chronic poverty, impact of natural disaster, incarceration and parole** **Week 14 Review Points \| Middle-Late Adulthood-Transitioning to Retirement** ============================================================================== 1. **What is an occupational transition?** - **A major change in occupational repertoire in which one or several occupations change, disappear, and or are replaced with others** - **May be a major influence on what people do and how they organize their time** - **Expected/awaited vs. unexpected/unplanned** - **Desired vs. feared** - **Common transition in middle-late adulthood: worker to retiree** 2. **Define and provide an example of an occupational form. How is [work] an example of an occupational form?** - **Occupation form: paid work** - **Occupying persons time and space for about 50 years** - **Loss of personal value and meaning of paid work: positive and negative** - **End of occupational form:** - **Affects organization of persons whole life** - **Provides new opportunities to expand some occupations and develop new ones** 3. **Know that a period of adaptation is expected during a time of occupational transition.** 4. **In what ways do occupations (and occupational transitions, like retirement) impact identity?** - **Outcome is occupation identity** - **End of occupational form: provides new opportunities to examine some new occupations and develop new ones; affects organization of persons whole life** 5. **According to the study shared during this lecture, what was the most [positive] characteristic of work identified?** - **Having social contact and fellowship** 6. **According to the study shared during this lecture, what was the most [negative] characteristic of work identified?** - **Giving life an unpreferred external structure** 7. **Did the majority of people in this study hold a negative or positive interpretation of work overall?** 8. **What is narrative reasoning?** - **Telling and interpreting stories to inform patient-centered clinical practice** - **Exploring what something means to an individual** 9. **Distinguish between a progressive slope, stability slope, and regressive slope.** - **Progressive: participants look forward to retirement** - **Mainly have a negative interpretation of work** - **Stability: participants anticipated no change in quality of life after retirement** - **Regressive: participants narrated a potential decrease in quality of life after retirement** - **Positive interpretation of work** 10. **Describe the *paradox of freedom*.** - **In last years of work, may not have had energy for leisure and needed evenings and weekends to rest** - **When working, wished for more freedom in schedule, for leisure occupations** - **Now have freedom for leisure, and miss what was valued at work** - **Miss having a structured routine, socialization, sense of purpose** - **Paradox of freedom = occupational imbalance** - **Going from occupational imbalance as a worker to occupational imbalance as a retiree** 11. **How does retirement influence the rhythm of life?** - **Slower rhythm of life** - **Meanings of occupations changed because temporal context changed** - **Things may not be so special anymore; cottage example** - **Gliding into a new time structure** - **Some found slower pace difficult** 12. **Presence of what factor contributes to the smoothest adjustment to retirement?** **Engaging occupation** - **Done with commitment, enthusiasm, perseverance, passion** 13. **What are the six characteristics of engaging occupations?** **1.Infused with positive meaning** - **- enjoyable, interesting, challenging** - **- strengthen/maintain social contacts** - **-reaffirmed worth or identity** **2.Intensity** - **- length and regularity of involvement** - **-not sporadic** - **-past and future** **3.Coherent set of activities** - **- set of activities that form an interrelated whole** **4.Goes beyond personal pleasure** - **- commitment or responsibility, personal duty** - **-complete tasks and participate, even when may not want to** **5.Occupational community** - **- some connection to people with common interest** - **-discussion, planning, problem-solving** - **-sense of being part of a group** **6.Analogues to work** - **- may think and talk about occupation like it is work** - **-performed with seriousness and commitment** - **-complex, involve several activities** 14. **What is the relationship between *routine engagement in physical activity* and the *rate of functional decline* in middle adults with chronic conditions?** - **Staying active had less of an effect on disabilities: stayed healthier longer** 15. **Are caregivers more or less likely to return to work after retirement?** - **Less likely** - **Helping a spouse with ADLs or IADLs reduced offs of going back to work by 78%** 16. **What is the relationship between social participation and perceived life satisfaction in spouse caregivers over age 65?** - **Importance of social participation for life satisfaction** - **Caring for a spouse is related to lower life satisfaction due to decreased social participation = worse health outcomes** - **Being a spouse caregiver who has social participation is related to higher life satisfaction than spouse caregivers who are not involved in social activities, and non-caregivers** 17. **What is the relationship between social participation and health outcomes in older adulthood?** - **Social participation allows for better health outcomes** **Week 15 Review Points \| Older Adulthood** ============================================ 1. **Know that older adults are the fastest growing population in the US and be able to summarize how this change is reflected in age-based US demographic data and population projections over time.** 2. **Be able to define ageism and elderspeak.** 3. **Know the age range associated with older adulthood and distinguish between "young-old", "old-old", centenarians, and super centenarians.** - **Young old = 65-80** - **Old-old= 81+** - **Centenarians = 100+** - **Super centenarians = 110+** 4. **Distinguish between primary and secondary aging.** - **Primary aging: universal and irreversible physical changes that occur in all living creatures as they age** - **Secondary aging: specific conditions which become more common with aging but are not universal. Associated with lifestyle, environmental factors, and genetic vulnerability** 5. **Summarize general changes in physical appearance noted in older adulthood.** **Skin** - **Epidermis thins and melanocytes decrease** - **Decreased collage and elastin** - **Loss of tissue support for capillaries (bruise)** - **Decreased production of oils, decreased water content** - **Age spots (lentigos) and hyperpigmentation** - **Hair changes: finer, brittle, greying** **Body composition** - **Changes in BMI (gaunt face, increased body fat)** - **Decrease in muscle mass (sarcopenia)** - **Posture (lordosis, spinal stenosis)** **Cardiopulmonary** - **Reduction in cardiac output** - **Aging vasculature** - **Reduced respiratory capacity** 6. **Identify and distinguish between common health conditions frequently experienced by older adults.** - **Hypertension: high blood pressure** - **Congestive heart failure: decreased efficiency of heart, cannot pump or fill** - **Coronary artery disease: narrowing coronary arteries limiting blood flow to the heart** - **Chronic obstructive pulmonary disease: long term exposure to irritants resulting in damage to the airways** **Common visual impairments** - **Age related macular degeneration: degeneration of macula -- central vision loss** - **Glaucoma: changes in intraocular pressure causes optic nerve damage and visual field loss (peripheral to central)** - **Cataracts: lens becomes more opaque and discolored; loss of lens transparency** - **Diabetic retinopathy: high blood sugar damages blood vessels in the retina; results in blurry vision and can lead to blindness** **Other sensory changes** - **Hypogeuia: decreased sensitivity to taste** - **Hyposmia: decreased sensitivity to smell** - **Hearing loss** - **Decrease in fine touch and pressure/vibration sensation** - **Presbyatasis: feeling of unsteadiness and graviational insecurity with age** 7. **Define sarcopenia.** 8. **Define frailty and terminal decline.** - **Frailty: people often over the age of 85, who are physically infirm, very ill, or cognitively disabled** - **Terminal decline- most common in the months preceding death; physically dependent; an overall slowdown in cognitive abilities in the weeks and months leading up to death** 9. **Summarize sensory changes associated with aging.** - **Hypogeuia: decreased sensitivity to taste** - **Hyposmia: decreased sensitivity to smell** - **Hearing loss** - **Decrease in fine touch and pressure/vibration sensation** - **Presbyatasis: feeling of unsteadiness and gravitational insecurity with age** 10. **Distinguish between programmed aging theories, random error theories, and successful aging models.** **Programmed aging theories: life expectancy is predetermined; DNA cannot replicate indefinitely** - **Hayflick limit: proposed slowing of cell replication** - **Programmed longevity: switching on/off genes** - **Endocrine theory: hormones control pace of aging; biological clock** - **Immunological theory: immune system declines over time; susceptibility to disease** **Random error theories (stochastic theories): random events occurring over time that lead to aging** - **Wear and tear theory: cells wear out** - **Somatic mutation theory: random chromosomal changes/mutations decrease cell viability** - **Cross-linking theory: cross linking proteins damage cells and tissues** - **Free radicals theory: accumulation of free radicals cause cell damage** **Successful aging theories** - **Emphasis: importance of adaptation and emotional well-being** - **Subjective experience: quality of life matters more than absence of disease** - **Quality of life in older adulthood: physical fitness, mental health, social support, and leisure participation matter** 1. **Avoiding disease and disability** 2. **High cognitive and physical function** 3. **Engagement with life** 11. **Describe changes in cognition associated with aging and identify protective factors.** - **Global mental function tend to remain intact in normal aging** - **Specific mental functions** **Attention:** - **Inhibitory control, vulnerable to distraction** - **Post-error slowing** - **Decreased selective attention** **Memory:** - **Slower processing reduces working memory** - **Episodic memory, source memory, and flashbulb memory impacted first** - **Emotional memories tend to endure** - **At every age, recognition is better than recall** - **Protective factors** - **Health and wellbeing** - **Training and education** 12. **What stages of Schaie & Willis' stages of cognitive development are associated with older adulthood? Be able to define and distinguish between them.** - **Legacy creating: approaching end of life, state of relative comfort with life, and end of life; life reviewed, personal legacy** - **Reintegrative: less likely to waste time on tasks that are meaningless to them** - **Reorganizational: reorganizing life to accommodate transition to retirement, planning for potential future increase dependence** 13. **Identify which of Erikson's stages of psychosocial development aligns with older adulthood and articulate what this means.** - **Heightened interest in the human experience, connection, and leisure pursuits** - **Life review: reflecting on time spent** - **Integrity: ultimate task in human life; embracing the value and uniqueness of our own lives and life itself in the face of death** 14. **What is meant by Vaillant's late-adult "keeper of the meaning" task?** 15. **Distinguish between the four distinct grandparenting styles.** - **Remote grandparent: don't talk to that much; not really involved** - **Companionate Grandparent: closer than remote, but not involved in discipline; there as a friend** - **Involved grandparent: substantial part of upbringing** - **Surrogate \[arent: steps in and fully adopts parenting role** 16. **Summarize the significance of familial and spousal relationships during older adulthood.** - **Friendships** - **Social circles shrink with retirement** - **Less casual contact with friends** - **Increased reliance on spouse** - **Filial responsibility** - **Maintaining relationships with adult children buffers against negative psychological impacts of physical impairment/health deterioration** - **Older adults continue to support their adult children** - **Social media fosters improve connection with extended family and loved ones not frequently seen** 17. **What is "post-error slowing"?** 18. **What is the relationship between weightbearing physical activity and bone mineralization? How is this an important consideration in the management of osteopenia and osteoporosis?** 19. **What are baroreceptors? What is the clinical significance of age-related decline in baroreceptor sensitivity?** 20. **Be able to distinguish between types of housing options and the level of support they provide.** - **Independent living** - **Assisted living: provide support with ADLs no medical intervention** - **Skilled nursing facilities: medical intervention; highest level of support** **Week 16 Review Points \| End of Life** ======================================== 1. **Be able to describe thanatology and terror management theory (TMT).** - **Thanatology: the study of death, the psychological and social challenges associated** - **Terror management theory: humans have an innate drive for self-preservation** - **Humans manage their fear of dying by developing cultural worldviews which offer meaning, purpose, and a sense of living on after death** - **We create aspects of our lives that will outlive us, because the knowledge of our own mortality is innately terrifying** 2. **Be able to describe trends in US demographic data in relation to how death has changed over time and causes of death over the lifespan.** - **Death occurs later** - **Cause of death is altered** - **Dying takes longer** - **Shift in perception of what happens after we die** 3. **Know the leading cause of death for men and women in the United States.** 4. **Distinguish between how children, adolescents, young & middle adults, and older adults perceive death.** - **Young children may take certain explanations literally** - **Grief presents differently than in adults** - **Fatally ill children, dear of abandonment** - **As children age, they become more inquisitive, seeking specific facts about dying** - **Terror management theory: promotes risky behavior** - **Maladaptive perceptions: if they believe they will die young, they are more likely to engage in risky behavior** - **Immature decision making: temporal discounting increases risk for impulsive behavior, not a developed prefrontal cortex** - **They fear death the most** - **Work and family responsibilities** - **Social obligations** - **Decreased anxiety towards death/dying** - **Acceptance of mortality and altruistic cocnern for those who will live on after us** - **Prioritization of valued social, volunteer, philnathropic, and leisure pursuits** 5. **What is "end-of-life\" care?** - **End-of life care consists of both palliative and hospice care that can occur during the final stages of life.** 6. **What is the difference between *palliative* care and *hospice* care?** - **Hospice care: anyone with a terminal illness who doctors feel has a life expectancy of 6 months or less; stop curative treatment** - **Palliative care: anyone with a serious illness; reduce pain** 7. **What is the goal of occupational therapy services during end-of-life care?** 8. **Who makes up the "unit of care" during end-of-life?** 9. **Define "advance directive" and distinguish between living will and health care proxy.** - **Living will: an advanced directive where someone states they do not want life-sustaining medical treatment** - **Health care proxy: giving someone the power to make medical decision on their behalf in the event they are unable to do so themselves** 10. **Identify the 6 characteristics of a "good" death.** - **Peaceful** - **Quick** - **Painless** - **After a long life** - **In company of loved ones** - **In familiar surroundings** 11. **Know Kübler-Ross' Five Stages of Grief and characteristics of this model identified during lecture.** - **denial** - **anger** - **bargaining** - **depression** - **acceptance** - **meaning as a proposed 6^th^ stage** - **lacks empirical evidence** 12. **Identify trends in how individuals process death & choose to spend their remaining time.** - **A lot of individuality** - **Most dying people want to spend time with loved ones and talk honestly with medical professionals and religious leaders** - **Response to one's own perspective death is highly individual. While many want open, honest conversations, not everyone will want the whole truth or be open to details of their condition/prognosis** 13. **Distinguish between grief, bereavement, and mourning and articulate the role of rites, customs, and religion in end of life.** - **Bereavement: state of having lost a significant other; umbrella term** - **Grief: personal response to that loss** - **Mourning: public expression of that loss (often marked by rituals/religious ceremonies)** - **Rituals, religions: those who belief they will die soon are more likely than others to belief in life after death; helps them through grief** 14. **Know characteristics of typical and complicated grief.** - **Complicated grief: grief that impedes a persons future life** - **Absent grief: the bereaved individual cuts themselves off from the community and does not partake in customs that allow and expect grief, leading to social isolation** - **Disenfranchised grief: certain people, although bereaved, are prevented from mourning publicly by cultural customs or social restrictions** - **Incomplete grief: circumstances interfere with the process of grieving** 15. **Know which of Erikson's Stages of Psychosocial Development, Vaillant's Theory of Adult Development, and Schaie & Willis' stages of cognitive development are associated with end of life. Articulate what this means in relation to occupations, roles, routines.** - **Heightened interest in the human experience, deep connection with others, reflecting on time spent, developing wisdom** **Valliant: integrity** - **Ultimate task in human life; embracing the value and uniqueness of our own lives and life itself- in the face of death** - **Legacy creating: approaching end of life, state of relative comfort with life and end of life; life review and personal legacy**