HDE Midterm Study Guide PDF

For some terms, it’s appropriate to ask: does it change with age, and if so, how? You will learn the materials more deeply if you apply the information to situations, for example, by generating examples of how the term could be used to understand age-related situations and behaviors “in the wild.”...

For some terms, it’s appropriate to ask: does it change with age, and if so, how? You will learn the materials more deeply if you apply the information to situations, for example, by generating examples of how the term could be used to understand age-related situations and behaviors “in the wild.” Work and Retirement (Chapter 7) Theories of Career Development *Italy #1 ranked in their career giving them meaning in life* Overall Labor Participation Rate= Labor force/(the non-incarcerated,16+ age) population size Life-span/life-space theory: concept that individuals develop careers in stages, and that career decisions are not isolated from other aspects of their lives Holland’s Six Basic Types of Vocational Interests (1973) - Career choice is driven by interest - Vocational preferences 1. Social 4. Enterprising 2. Investigative 5. Artistic 3. Realistic 6. Conventional Donald Super’s Theory (1953) - Career choice is driven by desire to achieve full self-concept realization - Expression of “true” inner self - Career develops through stages 1. Growth 4-14 2. Exploration 15-24 3. Establishment 25-44 4. Maintenance 45-65 5. Disengagement 65+ Holland’s SIREC Theory of Career Choice - Workers seek occupation where there is congruence between their personality type and occupation Six basic types of personality-interest constellations 1. Social 3. Realistic 2. Investigative 4. Enterprising  5. Conventional Savickas (2005) career construction theory - Three parts: - (Occupational) Vocational personality focus on the “what” - Career-related abilities, needs, values, & interests - Career adaptability is about the “how” - Resources for coping with current & imminent vocational development tasks, transitions, trauma - Life theme responds to the “why”, career choices & the significance of those choice; expresses the uniqueness of the individual in a particular context Albert Bandura’s social-cognitive theory- often applied to career development - Self-efficacy, the belief in one’s ability to succeed - more to career success than selecting the type of job that closely matches your own abilities and interests U.S is Facing a Shortage of Workers - There won't be enough young workers to replace retiring workers - Retirement of Baby boomers - Last wave will be 65 in 2029 Paradox: - Many older adults want to work but are not applying or not being considered for open positions Barriers: - Policies and practices that are tailored to that 1960 pyramid (social security, medicare) - Ageism - prejudice, stereotyping, & discrimination against people based on age 75-and-older age group - Responsible for 66% of the population growth, but only 25% of labor force growth Ageism at Work - 78% of workers, ages 40-65, have seen or experienced age discrimination - This may affect job satisfaction & decision to retire - Older adults have more trouble finding work if they are employed Age Discrimination in Employment Act of 1967 - States that employment of older persons should be based upon their ability rather than age; applies to 40-65 year olds - 1978 – protects up to age 70  - 1986 – mandatory retirement abolished; except for “when reasonably necessary” (more on retirement next class) - 1990 – age cannot be used as factor in downsizing How Can We Build a Healthier Older Workforce? - Address ageism - Provide adequate training opportunities - Adapt jobs to enable working while managing health conditions and disabilities - Support ways to balance caregiving responsibilities with work *about ⅔ of full-time, full year works employed in their early 50s have been involuntarily separated from their jobs before retirement Urban Institute study found: - Digital skills may be the missing puzzle piece that would allow older Americans to apply the other skills and assets they have to their jobs and other aspects of their lives *Low-income Older Adults are least likely to participate in Training Programs- Less resources Defined Benefit and Defined Contribution Plans Half of America's private sector workforce is not covered by any retirement savings plan; - their retirement will be anchored only by Social Security and whatever they have managed to save on their own The other half have one of the two main employer-sponsored retirement savings strategies: a traditional lifetime pension or a 401(k)-style investment plan - Twice as many workers have 401(k)s than have lifetime pensions, a complete reversal from 25 years ago Retirement- Workforce Exits Crisp - work full time one day, & become unemployed the next Phased - reduced workload or less stressful job Bridge Employment - leave workforce & then take a part-time job or a less stressful full-time job Blurred - may include a repeated moves in and out of the workforce Social Security - 90% of workers in US are covered - Funded by payroll taxes collected under authority of the Federal Insurance Contributions Act - Current workers pay for current retirees Retirement Crisis  - The growing racial divide in retirement wealth contributes to worsening inequality in overall household health Personality (Chapter 8) Five Factor Model (Big 5) OCEAN 1. Extroversion 2. Neuroticism (Emotional Stability) 3. Agreeableness 4. Conscientiousness (v. Lack of Direction) 5. Openness to Experience *Whether or not personality changes in adulthood into later life depends on which approach is being used* Rank Order Consistency - Degree to which the rank order of individuals on a certain trait is maintained over time - Emphasizes the role of genetics in shaping personality *the stability of individuals’ rank order within a group over time is called differential continuity Mean-level stability - Degree to which the absolute level of a trait is maintained over time Mean Levels- - Assume genetic and environmental factors interact to shape personality Structural consistency (similarity of factor structures over time) Individual differences in change Association between Personality Traits & Occupational Outcomes - why? Personality-to-achievement associations may reflect: - “Attraction” effects or “active niche-picking,” whereby people choose education and work experiences whose qualities are in line with their own personalities - “Recruitment effects,” whereby people are selected into achievement situations and are given preferential treatment on the basis of their personality characteristics - An active role that individuals sometimes take in shaping their work environment - The consequences of “attrition” or “deselection pressures,” where people leave achievement settings (e.g., schools or jobs) that do not fit with their personality or are released from these settings because of their trait-correlated behaviors - The direct effects of personality on performance; personality traits may promote certain kinds of task effectiveness through (e.g., efficient information processing or creative problem solving) Association between Personality Traits and Mortality – Why? - Personality traits may affect health and ultimately longevity through at least three distinct processes. Personality may be related to: - Pathogenesis or mechanisms that promote disease (e.g., reactivity in response to stressful experiences) - Physical-health outcomes through health-promoting or health- damaging behaviors (e.g., those low in conscientiousness may smoke or have poor eating habits) - Reactions to illness (e.g., coping with illness or stress, following prescribed treatments) Erikson’s Model of Psychosocial Development - Suggests that personality is determined by the interaction between an inner maturational plan & external societal demands - Epigenetic principle: each stage on the developmental ladder, from birth to death, has its own special time and lays the foundation for the next stage p - Identity development involves dealing with eight “crises” or dilemmas that foster change Life-Story Model- McAdams - Conceptualization of identity as an internalized & evolving narrative which provides a sense of meaning, coherence, & temporal continuity to one’s life Theory of Ego Development (Loevinger) - The self or ego strives to make coherent meaning of day to day life experiences - Adulthood brings a series to transformations in cognitive complexity stages that are critical to understanding adaptive processes - Each stage builds on the one that precedes it, however, rate of development across stages is variable & is NOT highly associated with age Possible Selves and Aging A sense of self allows individuals to - make meaning of & organize experiences, thoughts, feelings, & actions - motivates behavior by providing incentives, standards, plans, strategies, & scripts for behavior - is integral to the experience of aging because it provides continuity in the face of age-related change Age differences: - Older adults tend to report fewer possible selves than younger adults - OA are more likely to have possible selves in the domains of health, leisure, & lifestyle - OA are less likely to have possible selves in material & occupational domains & family-related fears Stress, Coping, and Resilience (Chapter 10) Arousal and Performance (Yerkes and Dodson) - Inverted U-model Acute Stress Response (fight or flight) Walter Cannon - Physical emergencies & psychological emergencies evoke release of adrenaline into the bloodstream General Adaptation Syndrome - Homeostasis - Alarm reaction/acute stress response stage - Resistance stage - Exhaustion stage (after this is Death) Stress Appraisals Primary Appraisal - Cognitive appraisal of stressor and relevance to self - Whether harm/loss, threat, or challenge has occurred or will occur Secondary Appraisal - Do I have the resources to deal with the threat? - Estimation of positive resolution Three Types of Stress - Major Life Events - Daily Hassles - Chronic Role Strain Frequency of Types of Major Life Events Change in with Age Young Adults - Marriages, births, divorces, layoffs Middle Aged Adults - Parental caregiving/deaths, start of chronic illnesses, career pressures, demands of children Old Adults - Widowhood, death of friends, institutionalization of spouse, chronic illnesses, caregiving Elder Abuse - Physical abuse - Sexual abuse - Emotional abuse - Financial abuse  - Neglect Prevalence - Typical victim is a 75-year-old female with debilitating physical & psychological impairments - 1 in 6 community-dwelling older adults experienced some form of abuse in the prior year - 66% of perpetrators of abuse of community-dwelling older adults are family members (most often the victim’s adult child or spouse) - 81% of long-term care staff surveyed in one study had witnessed at least on abusive incident in the preceding year Two Theories of Elder Abuse Situational Model - Stressful situations cause the caregiver to abuse the older person is viewed as the source of the stress - Mistreatment is an irrational response to stressful situations Social Exchange Theory - Assumes that social interaction involves an exchange or rewards & punishments between people & that all people seek to max rewards & min punishments - The abuser perceives inequity but is dependent on the older person - Sense of powerlessness leads to maltreatment Family Caregiving - Unpaid caregivers provide $58 billion worth of care in CA and represent 2/3s of the care that older adults receive in their homes (1/3 is paid caregivers: personal care assistants, home health aides, certified nursing assistants) - 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months - 15.7 million adult family caregivers care for a person with dementia (PWD) - 29% of the U.S. population provides care for a chronically ill, disabled or aged family member or friend during any given year (20 hrs/wk) Factors that Increase Family Caregiving Stress: - Older age - Pre-existing health problems - Caring for a loved one with dementia - Being forced to delay their own education or career plans - Marital problems - Financial problems Informal (unpaid) Caregiving Statistics - Over 11 million family & other unpaid caregivers cared for a PWD in 2023 - Economic value of these services estimated at $347 billion - 41% of caregivers have a household income of $50,000 or less - Most caregivers (66%) live with the person with dementia in the community *7 in 10 dementia caregivers report that coordinating care is stressful *more than half of caregivers (53%) said navigating health care is difficult 2 in 3 caregivers also have difficulty finding resources & support for their needs Coping - Refers to the thoughts and acts people use to manage the demands of stressful transactions Major Forms of Coping Behaviors Problem-focused coping (directly addressing the problem/feel like you have control over the situation) - Instrumental Action - Gathering info - Cognitive Strategies - Making a plan of action, dividing problems in manageable bits Emotion-focused coping - Expressing or suppressing emotion - Assigning blame - Wishful thinking - Escape/avoidance Meaning-focused coping - Reframing the situation - Downplaying the loss Social-focused coping - Seeking emotional support - Being emotionally there for someone - Seeking instrumental support - Actively creating ways to transcend a problem Coping and Racism - Black individuals most often use active strategies when coping with racism, which helps coping with racism, which helps to diminish the loss of agency that accompanies racism - Preferences for coping strategies depend on the type of racism experienced Coping-strategies Model  Institutional- active coping & strategies (problem solving) Interpersonal- spiritual center coping Cultural- collective coping & social support Successful coping- - Coping Flexibility - ability to use a variety of coping skills - Goodness of Fit - ability to apply the skills that are best for the situation at hand Death and Bereavement Defining Death - A process of transition that starts with dying & ends with being dead Dying: period in which an organism loses its viability Physical Death: 1. Non-receptivity & non-responsivity 2. No movements or breathing (no heartbeat) 3. No reflexes 4. Flat encephalogram Physician-Assisted Suicide is NOT: Terminal sedation - Practice of sedating a terminally ill competent patient to the point of unconsciousness, then allowing the patient to die of her disease, starvation, or dehydration. Withholding/withdrawing life-sustaining treatments - When a competent patient makes an informed decision to refuse life- sustaining treatment, there is virtual unanimity in state law and in the medical profession that this wish should be respected. Pain medication that may hasten death - Often a terminally ill, suffering patient may require dosages of pain medication that impair respiration or have other effects that may hasten death. It is generally held by most professional societies, and supported in court decisions, that this is justifiable, as long as the primary intent is to relieve suffering. Patient Self-Determination Act (1990) - Requires all healthcare agencies to recognize the living will & durable power of attorney for health care Right to Know: - Despite legal consensus that patients have the right to refuse treatment - Palliative Care (Information) Act - Legislation requiring healthcare professionals to inform patients of their end-of-life care options Hospice: - When a person’s terminal illness is not responding to curative treatment, hospice care is an option - Provides comfort and support (life expectancy of six months or fewer) - More than 80% of hospice care in the U.S takes place in the home; but many hospices also offer in-house facilities Medicalization of Death: - Death in high-income countries have largely become “medicalized” moving more and more into the purview of the healthcare system Advance Care Planning - A variety of plans that doctors & loved ones can use when the individual is in a vulnerable position, due to a serious illness or accident, where they are unable to choose between different care options Advance Directive - A document in which the individual gives instruction about their health care, if they cannot speak for themselves - Allows the individual to maintain a voice in their care, even if they become incapacitated POLST - Portable medical Orders for Sustaining life and Treatment - Medical order for people who have chronic health conditions &/or those who are seriously ill or medically frail The Value of Death - Lancet Report - The high cost of end-of-life interventions burden families and the health system - In high-income countries 8-11% of annual health expenditures are spent on the less than 1% of people who die in that year - When families & communities are sidelined in the dying process, we lose what the commission calls the “value of death” - the gift in caring for the dying, which gives us an appreciation for life & strengthens relationships The Lancet Commission identified a new vision of how death and dying could be, with five overarching principles: 1. The social determinants of death, dying, and grieving are addressed; 2. Dying is understood to be a relational and spiritual process rather than simply a physiological event, and the quality of relationships between health care professionals and patients shifts from the transactional to those based on connection and compassion; 3. Networks of care lead support for people dying, caring, and grieving;  4. Conversations and stories about everyday death, dying, and grief become common; 5. Death is recognized as having value Bereavement - Real or symbolic loss of a significant object, which may be human or non-human, tangible or intangible - Process of getting over another person’s death - An individual process - Grief has been pathologized, an abnormality that must be expertly dealt with - Death & bereavement is a part of life Bereavement & Equity in the US - The cause & context of the death as a risk factor for bereaved persons’ adjustment is important - “Deaths of despair” - due to suicide, drug overdose, alcohol abuse, etc Subjective Well-Being and Life Satisfaction Factors related to SWB & Life Satisfaction - Education & Income - Cohort (age) - Work satisfaction (career experiences) - Family - Place of residence - Productivity & engagement: (how well older adults are connected both inside & outside the workforce) - Well-being: the state of being physically & mentally health - Equity: the difference in economic security & well-being between the “haves” & have-nots” - Cohesion: social connectedness between generations - Security: retirement support & assured physical safety Society-Level Metric of Successful Aging 1. Productivity & engagement a. A successfully aging society facilitates the engagement of older persons in society, either through work for pay or volunteering 2. Well-being a. provides health care informed by a sophisticated understanding of the health care needs of older person 3. Equity a. distributes resources equitably across the older population, thus lessening the gap between the “haves” and the “have-nots” 4. Cohesion a. Maintains social connectedness & solidarity, within & between generations 5. Security a. Provides economic & physical security for older persona