Developmental Trends in Psychometric Intelligence
(Person-environmental interactions) Lewin's equation
B=f(P,E)
B= Behavior
P= Person
E = Environment
Behavior is the function of both the person and the environment
Competence and Environment Press
Competence is
theoretical upper limit of person's capacity to function such as : physical health, sensory-perceptual skills, motor skills, cognitive skills and ego strength
Competence and Environment Press
Environment Press is
Environmental Press =
physical, interpersonal, or social demands that environments put on people
Environments can be classified on the basis of the varying demands they place on the person
Ex: Physical demands walking up stairs, interpersonal demands adju
Competence and Environmental Press
Model
Higher competence will show higher performance over environmental conditions
Competence and Environmental Press
Adaptation Level
Behavior and affect are normal level,
slight increase = improve performance aka zone of maximum performance potential
slight decrease = creates a Zone of Maximum Comfort (people live happily without worrying about environment demands)
Maladaptive if too s
Preventive and Corrective Proactivity (PCP) Model
PCP Model:
The PCP model explains how life stressors (life events, chronic illesses) and lack of good congruence in person-environment interactions results in poor life outcomes.
Preventive and Corrective Proactivity (PCP) Model
Two types of proactive adaptations: (Preventing/eliminating Stressors)
1) Preventive adaptations
2) Corrective adaptations
1) Preventive adaptations:
actions that avoid stressors and increase or build social resources (ex: increasing ones social network)
2) Corrective adaptations
actions taken in response to stressors and can be facilitated by internal and external resources
Stress and Coping Framework
Interaction with the environment can produce stress (Lazarus, 1984).
Evaluating one's situation and surroundings for potential threat value
Harmful
Beneficial
Irrelevant
Coping Response = avoiding harmful situations
Outcome may be positive or negative
Common Theoretical Themes and Everyday Competence
Common Theoretical themes: interaction between person and environment
Everyday Competence:
person's potential ability to perform a wide range of activities considered essential for independent living.
Broader than just ADL or IADL
Necessary determinate fo
Aging in Place
The idea of aging in place reflect a balancing of environmental press and competence through selection and compensation
Older adults place strong emotional and cognitive bonds with residences that help transform house into home
Cluster Housing (aging phil
Deciding on the Best Option
(addressing issue of optimal housing environment)where elders should live
- must be determined whether the individual has significant cognitive or physical impairment requiring intervention or support
- The individual needs to be an integral part of the decision making.
- Get a physician's diagnostic evaluation
Home Modification
Helping people deal with tasks of daily living by modifying the environment
Hook for car keys near the door
Hand rails in bathrooms
Door handles that are easier to grasp
Widening doorways
Lowering countertops
Wheelchair ramps
Adult Day Care
Designed to provide support, companionship, and certain services during the day
Goal is to delay placement in more formal care setting.
Goal of Adult DayCare
Goal is to delay placement in more formal care setting.
Three types of adult day care
Social services, meals, recreation, and minor health care
More intensive health care, therapy, for serious medical problems
Specialize care for dementia or developmental disabilities.
Profit (22%) or non-profit (78%)
Congregate Housing
least expensive form of supported living for older adults
Apartment complex for older adults
Shared meals
Affordable
Differs from assisted living in level of services provided
(Many traditional congregate housing complexes do not include individual kitche
Most Congregate Housing Require Residents must be capable of independent living and:
Not require continual medical care
Know where they are and oriented to time
No evidence of disruptive behavior
Able to make independent decisions
Be able to follow specific service plans
Assisted Living
A supportive living arrangement for people who need assistance with personal care but are not physically or mentally impaired to require 24-hour care.
Assisted Living
Has three essential attributes:
-As much like a single family house as possible
-Emphasizes personal control, choice, dignity, and autonomy
-Should meet routine services and special needs
-Utilize checklist to ensure the selected facility meets specific requirements of the individual
-C
Types of Nursing Homes
Two levels of care are defined in federal regulations.
1) Skilled nursing care consisting of 24-hour care, including medical and other health services
2) Intermediate care also 24-hour but at a less intensity
Who is Likely to Live in Nursing Homes?
Health issues and functional impairment
-Average resident has significant mental and physical problems ( Main reason for placement 80%)
-One third of residents have mobility, eating or incontinence problems.
- 30 to 40% (text book 50%) show signs of clinical depression.
Characteristics of Nursing Homes
The competence-environmental press model
Goal is to find the optimal level of environmental support for people of low levels of competence
Characteristics of Nursing Homes
In selecting a nursing home relatives should keep the following in mind:
-Level of skilled nursing care
-Be mindful if facility is primarily Medicare or Medicaid
-Is the director and upper staff fully licensed?
-Is the care plan put in place by professionals?
-Ask questions about staff educational levels and staff turnover.
Special Care Units
Does the facility have well-designed special care units for people with dementia?
- Yes, supportive environment for people with moderate to severe dementia requires certain specialized design and intervention features. Provides programs that help the person function at highest level possible.
- Special care units must have the right le
Can a Nursing Home Be a "Home?"
What can be done to foster the sense of "home?
Yes, but with some important qualifications.
- Being included in the decision and selection of a specific nursing home
- Having prior knowledge of, and positive experience of a specific facility
- Defining the home in terms of family and social relationsh
How Not to Communicate with Residents
- Patronizing speech (treating like child)
- Infantilization or elderspeak (Secondary babytalk no use of person first name, endearment, simplified expressions, short imperatives)
- Terms of endearment�"Honey" "Sweetie"
- Assumption of greater impairment t
Decision-Making Capacity and Individual Choices
How well can a nursing home resident make decisions regarding their care?
-Cognitive impairment
-Patient Self-Determination Act (PSDA)
-Provide written information at time of admission concerning their right to make treatment decisions
- (Living will )
-Patients normally give the decision to family members.
New Directions for Nursing Homes
The Eden Alternative
- Starts from the premise that skilled care environments are habitats for people rather than facilities for the frail.
- Operates under ten principles.
New Directions for Nursing Homes
The Eden Alternative
Ten Principles
1) 3 plagues of loneliness, helplessness, & boredom
2) elder-centered community commits to creating human habitat revolves around plant animals children
3) Loving companionship, elders needs access to human and animal companionship
4) Opportunity to give
New Directions for Nursing Homes
Green House Project (Eden Alternative)
- Radical departure from the idea of large residential facilities (shift to more homelike setting by participation in daily chores)
- Encourages residents to participate in their care through helping with daily tasks
- Personal dignity is maintained and q
New Directions for Nursing Homes
The Pioneer Network
- Similar values to Eden Alternative
- Older persons are valuable to society.
- Treating all people with dignity.