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Flashcards in Chapter 5 Deck (36)
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Lewin: person-environment interactions means

 behavior (B) is a function of both the person (P) and the environment (E)


Competence is defined as

  • the upper limit of a person's ability to function in five domains: physical health, sensory perceptual skills, motor skills, cognitive skills, and ego strength


Environmental press refers to


Changing balance between competence and environmental press is a major factor in older adults' decisions to relocate 

  • physical, interpersonal, or social demands that environment puts on people is called _____
  • Example of physical walking up 3 flights of stairs
  • Example of interpersonal - adjusting behavior
  • Example of social - dealing with customs such as dressing up for a wedding



Competence-environmental press model offers 2 options for coping 

1) develop new skills to help memory, for e.g.

2) lower the environmental press by modifying the environment to make a task easier 


Adaptation level is 

  • the area where press level is average for a particular level of competence is called ____ ; this is where behavior and affect are normal. Slight increase in press tend to improve performance; this area on the figure is labeled the zone of maximum performance potential 


zone of maximum comfort 

  • Slight decreases in press create the zone of _____ in which people are able to live happily without worrying about environmental demands

Too many environmental demands on a person with low competence and too few demands on a person with high competence both result in maladaptive behavior and negative emotion 



  • when people choose new behaviors to meet new desires or needs, they exert control over their lives is called _____
  • More likely in people with high competence


Docility is

  • when people allow the situation to dictate the options they have and have little control is called ______
  • More likely in people with low competence
  • The less competent a person is the greater the impact of environmental factors 2


What is the Preventative and Corrective Proactivity Model? PCP Model


  • _______ adaptations are actions that avoid stressors and increase or build social resources
  • Example increasing one's social network by adding friends
  • _______ adaptations are actions taken in response to stressors and can be facilitated by internal and external resources
    • Changing one's diet after a heart attack
  • OA tend to engage in more corrective than preventative; but many that start as corrective become preventative 

    Example exercise after heart attack 


How does the stress and coping framework apply to the interaction of older adults with their environment?

Schooler argues that presence of social support affected how you perceive threat in environment

Example: if you live alone then a certain environment can be more threatening than another 


what are common themes in the theories of person-environment interactions 

all theories agree the focus must be on interactions between the person and the environment - no single environment meets everyone's needs 


Everyday competence is

  • _____ is a person's potential ability to perform a a wide range of activities considered essential for independent living; it is not the person's actual ability to perform the tasks 
  • form basis for deciding whether they are able to make decisions for themsleves 


Ecology of aging 

  • environmental psychology which seeks to understand the dynamic relationship between older adults and the environment they inhabit; this is called _____
  • Seemingly small changes in a person's environment can result in major changes in behavior - that can lead to needing to live in a more supportive environment


Aging in Place 

  • _____ reflects a balancing of environmental press and competence through selection and compensation
  • throughout life people compensate for change; _____ refelcts a continuationi of that process 
  • resulted in rethinking housing options for OA 
  • Example of compensation is Renny's stair chair elevator
  • Having a "home" as opposed to a "house" provides a strong sense of self-identity 

  • Key factor is sense of belonging 


Cluster housing

  • _____ combines aging in place philosophy with supportive services
  • The residents can use assisted services as they need them such as transport, housekeeping, meals
  • Usually not covered by medicaid so cost is a factor


Deciding on the best option 

  • 1) do they have significant cognitive or physical impairment requiring intervention or support
  • 2) assessment of family and friends to offer support is needed
  • 3) can you provide care in the current home situation or move?
  • Can you modify the home or bring in support helpers?
  • Throughout the process, the person needs to be involved as much as possible - especially if it means that they will be moving
  • Degree to which they understand options
  • Why options are being pursued
  • Long term meaning of decision being made


  • Home modification


  • examples of ____ :
  • Bath rails
  • Chair for stairs
  • Lowering countertops
  • trying to address activities of daily living ADL 


Adult daycare

  • _____ is designed to provide support, companionship and certain services during the day


  • Primary caregiver might be employed
  • Can be independent or nonprofit
  • May provide transport to and fro
  • Enhances self-esteem and encourages socialization
  • There are 3 levels
  • Just social, meals recreation
  • Above with medical
  • Above with intense medical for dementia etc


Congregate Housing

_____ is :

  • often subsidized
  • Shared meals and activities
  • Level of medical assistance is lower than assisted living
  • Do not provide 24 hr services on site
  • The residents need to have it mostly together as they aren't really equipped to deal with major problems
  • Example: know the date, medically stable not disruptive, able to make independent decisions


Assisted living

  • _________ are housing options that provide a supportive living arrangement for people needing assistance with personal care but who are not so impaired that they need 24h care
  • 3 main qualities
  • 1) The resident's apt is designed to be as much like a single dwelling as possible - privacy, bathroom, indoor, outdoor access / independent apartments
  • 2) promotes dignity, personal control, autonomy and choice so they can have a normal good quality of life
  • 3) should meet routine and special services like transport, socialization, daily checks,hosekeeping, laundry, reminders for medication, recreation, entertainment, security


Two kinds of nursing homes

  • 2 kinds of _______
  • 1) Skilled nursing care is 24 hr medical and health care
  • 2) intermediate care is similar but less intense  - have fewer on staff and maybe not as high level practitioners


Who is likely to live in a nursing home

  • Over 85
  • EU woman
  • Cognitively impaired and significant physical issues
  • 30 - 50% have clinical depression
  • Widowed or divorced
  • No siblings or children living nearby
  • Usually a last resort after other options have been explored so the decision to move into one is not easy
  • Decision often fast after a hospital discharge


Characteristics of a nursing home

  • 4 characteristics of ________
  • One way to evaluate them is to apply the competence environmental-press model so you can find support for people with low level of competence : need to base the quality on 4 factors
  • 1) quality of life - food, comfort
  • 2) quality of care - staff availability
  • 3) safety - staff, built for older people
  • 4) other issues - are the outdoor areas


Most important and common attribute of nursing home is

  • that they have a person centered approach  based on promoting residents' well-being, personal control, respect - research shows significant improvement for poe perceived higher self-control as well as decreased need for drugs
  • They can decorate their own room
  • Choose who to sit with at meals and what they want from the buffet
  • Does not use one size fits all


What are special care units and why are they important?

  • ______ are for people with bad dementia
  • Supportive and therapeutic set of programs
  • Staff has special skills with dementia
  • Decorations is done to help residents remember things - color coded
  • Wrist, ankle bands for elevators


make nursing homes feel like real homes 

  • Having the time to think about and participate in the placement decisions
  • Having prior knowledge and positive association with a facility
  • Defining home in terms of family and social relationships
  • Establishing a continuity between home and nursing home through activities or similar living arrangements
  • Things that contribute to satisfaction are: Facility
  • Staff
  • Resident factors


Patronizing speech is

  • ______ is inappropriate speech to older adults based on stereotypes of incompetence and dependence - baby talk for adults, volume, intonation, repetition, closed-end questions
  • communication enhancement model has been proposed as a framework for appropriate exchange 


infantilization or elderspeak

  • Secondary baby talk also called ______ or ______ involves the unwarranted use of a person's first name, terms of endearment, simplified expressions, short imperatives, s assumption that the person has no memory and cajoling as a way to demand compliance
  • Is viewed negatively by older adults
  • Particularly resentful as indicative of lack of respect


Suggestions for figuring out a way to talk to OA 


communication enhancement model has been proposed as a framework for appropriate exchange 

  • Face them
  • Ask open questions and listen
  • Ask about their expertise
  • Ask about their living situation
  • Allow them to exert control over the visit
  • Listen even if they are repetitive and avoid judgement
  • Talk about things they want to remember
  • So a joint activity
  • Record the visit
  • Bring children
  • Stimulate their senses: sing, read, wear bright clothes
  • Hold their hands - friendly touch is great


Describe the issues associated with the decision-making capacity of nursing home residents: 

  • PSDA patient self-determination act

5 requirements re advance directives of the ____________


  • Provide written information about the right to accept treatment and advance directives
  • Maintain written policies about directives 
  • Document the completion of advance directives in the person't medical chart
  • Comply with state law about advance directives
  • Provide community and staff education re the advance directives