Understanding Development: Key Concepts in Psychology
School
University of Windsor**We aren't endorsed by this school
Course
PSYC 2500
Subject
Psychology
Date
Dec 10, 2024
Pages
88
Uploaded by ChancellorTeamCamel6
Week One Introduction & Research MethodsDomains of Development ● A way we can think of how development thinks● Physical ○ The way the brain, body, and senses grow ○ Physical is the growth and development ■ Hair■ Weight ■ All about our bodies ● Motor ○ The way someone develops control over their body’s movements ■ gross motor skills● Large coordinated movements ● Larger muscle groups acting together ○ Running ○ Walking ○ Jumping ■ Fine motor ● Small muscle movements ● Painting ● Brushing hair ● Things like writing, my wrist moving in slow motions, the grips of our fingers ● Small localized movements ● Social ○ The way a person develops relationships with others and understands others’ behaviours○ Looking at relationships with others ○ Understanding of self ■ Attachment types ● Feelings of security with caretaker ○ Building relationships ● Emotional ○ The way a person experiences and develops an understanding of their own and others’ emotions ○ A person's understanding of their emotions and others' emotions ● Cognitive ○ How a person thinks, reasons, explores and understands the world around them
○ Thinking ○ Reasoning ○ Perception ○ How someone explores and understands the world around them Dynamic systems ● Dynamic systems ○ All those domains interact with each other (physical, motor, emotional, social, and cognitive)○ They aren’t acting on their own ○ The idea that none of it lives on its own○ They affect each other ■ Trauma has a huge impact on memory ● Social and emotional ● Even environment ○ It is one of the foundations of developmental psychology ■ Changes in memory Forces of Development ● We can group things in biological Ecological Systems Theory / Sociocultural Model of Development ● Developed by Urie Bronfenbrenner (1917 - 2005) ● Many different systems interact within the individual and outside of the individual ● The main idea is that many different systems interact with each other ○ Everything affects everything theory ○ Developing in contexts ○ Everything is affected by society
● Individuals have their own characteristics ○ Hair ○ Colour○ Religion ● Microsystem ○ Immediate environments ○ Where is this person spending their time ■ Work■ School■ Home■ Room ● Exosystem ○ Indirect broader environment ○ Our economic ○ Political and educational systems ○ Mass media/ national news, etc ● Mesosystem ○ The interaction between the microsystem and the exosystem ○ Everything in the ecosystem, the structures, all of those influence the smaller circle, the microsystem● Macrosystem ○ The norms and values of the culture ○ People's actions, stories, art, relationships, how people spend their time ● Chronosystem ○ The time period of someone developing Bronfenbrenner’s systems
● Microsystem ○ smallest circle: family and friends● Mesosystem ○ Interaction between microsystem and exosystem● Exosystem ○ The political system, education system, government system ● Macrosystem ○ Overarching beliefs and cultural systems● Chronosystem ○ Largest circle or linear arrow: timeIntersectionality ● Developed by Kimberle Crenshaw, a leading scholar of critical race theory, Professor at UCLA School of Law and Columbia Law school ● 1989 law paper ● Race and gender bias can combine to create additional harm – now applied in other ways● Looking at the combination of race and gender Paul Baltes’ (1987) Key Features of Adult Development ● Multidirectional○ Our development is going to be growing and declining at different rates and at different times/directions ○ We get better at stuff, we get worse at stuff, it all goes in different directions ● Plasticity ○ Many skills can be learned or improved but there is a limit ○ We can improve across the lifespan but there will always be a limit ○ We can get better at things to a point ● Historical Context ○ The time period we are born in has a big influence on us ● Multiple Causation ○ Development is shaped by many horses interacting with each other ○ Dynamic systems (same things)A Life-Span Approach ● Early experiences are important for understanding later development ● Many early theorists thought that development stopped at 16 ● Early vs. late phases ○ Early phases ■ Early childhood development ○ Late phases
● Interact with our later development Resources and Support (Baltes et al., 2006) ● Biological resources & aging ● Aging and external resources ● Available support for older people ● The older we get the more our biological resources decrease ○ Cognitive ○ Functional functions ○ Decreasing the amount that is available to us ■ Memory ● Less structural things available for aging people ● Society is not as accessible as it seems ○ It gets worse as we get older What does this all mean?● As we grow older, we have to send more of our internal and external resources to maintaining our functions and dealing with natural biological losses due to aging, meaning we don’t have as many resources left over for growth ○ Learning a language at an older age ○ Spending resources on internal and external ○ Don’t have much resources or room for growth ● Selective optimization with compensation (SOC) model ● Age-related decline Gerontology ● Gerontology○ Focus on 2 parts○ Take a lifespan approach ○ Unique variances ○ Individual people’s experience ○ Human common experiences ■ Menopause Ageism ● Ageism ○ What drives ageism? Why does it exist ■ Different experiences ■ Different expectations ■ The older person has different skills ■ Different perceptions
■ Stereotypes of what people believe about older people ○ How does ageism show up in society?○ Microaggressions ■ Easily explained away ■ Have a good reason behind the aggression ● Dirty looks ● Makes the person feel bad ● Still hurts ■ Not limited ■ Mistreatment ■ Overt aggressions ● Verbally aggression Cohorts ● A group of people in the same age group ○ Gen-Z○ Millennials ○ Covid babies ■ Etc…● Three different influences ● Normative age-grades influence ○ Influences on a person’s life marked by age and time ○ Many people experience them ○ Rituals around them depend on different cultures ■ Turning a certain age ■ Reaching a certain point in age ● Puberty ● Emerging adults ● Adulthood ● Teenagers ● Legal age ■ Rite of passage ● Normative history-graded influences ○ Events that many people in a culture experience at the same time ■ Wars ■ Covid ■ Great depression ■ Strikes ■ Inventions of the internet, social media ● Non-Normative influences
○ Events that are important to an individual but not experienced by more people ■ Personal life achievements Three Types of Aging ● Primary Aging ○ Normative disease free again during adulthood that all people will experience ○ Regular human development ■ Having a uterus and going through menopause ■ Our cognition slowing down ■ Normal human stuff● Secondary Aging ○ Changes that are not inevitable ○ Are related to disease, lifestyle or environment ○ Related to that person’s lifestyle ■ Having different generations ● Tertiary Aging ○ Before someone passes they go through this ○ They will decline rapidly when on the verge of dying ■ They were doing fine and then things changed very fast Ways to Think about Age ● Chronological Age○ Calendar times ○ How old in years■ “This is my 14th-month-old child” ● Psychological age ○ The functional level that people use in day-to-day life ○ Navigate the environment, go to work, hobbies ○ What is the functional age of their psychological processes ■ Someone might have a disability and be psychologically younger ■ If someone is older and has dementia then they would be psychologically older than their chronological age ● Sociocultural age ○ Based on the roles individuals adapt in their societies and their culture with other people ■ Someone considered an elder who passes on wisdom and knowledge, who has endurance that there is beauty in being alive for so long ● “Biological clock” vs. “Social Clock”○ The biological clock refers to someone’s physical age and development and is possible and not possible.
■ Talking about having kids ○ The social clock is related to someone’s society and culture and assumptions and what people “should” be doing at a certain agePeriods of Adulthood Research Methods ● Ethics Regulation ○ 3 governmental research agencies in Canada published guidelines for ethical research ○ All research labs, colleges, and universities in Canada must abide by these ethics guidelines ○ Each institution has an ethics board ● Ethical Guidelines1. Seek to do research that benefits humanity 2. Minimize risks to the research participants 3. Describe the research to participants so they can give informed consent 4. Avoid deception and if deception must be used, debriefASAP 5. Keep results anonymous or confidential 6. Give a debriefing afterward about the research purposes● Observations and Hypotheses ○ At this point in the field of psychology, we’re not making hypotheses from very limited information in most cases ○ Most studies fill in “gaps” in the existing literature and build off of previous studies ○ Gaps can include but are not limited to ■ Issues with the sample, such as size, location, demographics, attrition, etc ■ Methodological issues ■ Data Collection Limitations ■ New variables could be explored■ New connections can be made ● Meta-analyses
○ Developed in the 1970s partially as a way of reducing biases in narrative reviews○ Effect sizes calculated ● Running an experiment ○ A study has to be approved by the institution’s ethics review board○ Recruitment of participants or collection of animals (subjects) ○ Data collection ○ Data analysis Common Data Collection Methods ● Task-Based ○ Asking participants to complete tasks that are related to what you’re studying ● Considerations ○ Are you measuring what you think you’re measuring ○ Is ability affecting the task? ○ Are there any cohort effects that might alter the results ● Systematic Observation ○ Watching people and carefully recording what they do or say, usually through audio/video recording ○ Naturalistic observation ■ Benefits vs. downsides ○ Structured observation ■ Benefits vs. downsides ● Considerations○ Researchers can influence the results just by being there ○ Observer bias ○ Observer influence ● Self-Reports ○ Self-report measures are any measures where a participant is asked to give their response to a question ○ Questionnaire data○ Interviews ○ Likert scale surveys ● Considerations ○ Language & Memory ○ Response bias ○ Over- and under-estimation Biophysio Data ● Measuring biological, or physical data, such as heart rate, hormones ○ Such as cortisol to measure stress, skin conductance, breathing, neurological data
● When used alongside other measures, biophysio data can help corroborate conclusions and lead to stronger results ● Considerations ○ Susceptible to technological issues, lab issues, measurement issues, researcher error in collection ○ Participants may feel less comfortable with submitting bio-physio data, especially if it involves machinery or DNA ○ It may require a longer time commitment for participants ○ Usually expensive to do and takes more training to do properly Evaluation ● Reliability ○ The results are consistent and can be attained repeatedly over time ■ Cronbach’s alpha ■ Cohen’s kappa ■ Inter-rater reliability ● Validity ○ A measure is truly measuring what it's supposed to measure ■ Construct validity ■ Concurrent validity ● Sampling ○ It is also important to be mindful of the research sample, as the sample can impact the results ■ Are the study results generalizable?■ Broad groups are called populations, whereas smaller groups within the population are called samples ■ Ongoing problem of over-generalization of results Research Design ● Correlational ○ We can’t manipulate our topic ethically, so we measure two variablesas they happen naturallyand compare the 2○ Measured using a correlation coefficient, r○ r values range from -1 to 0 to +1. Closer to 0 means unrelated. Closer to -1 or +1 means more related, with +1 meaning a positive correlation and -1 meaning a negative correlation○ Remember: positive and negative don’t mean “good” or “bad” here, they just mean the direction of the relationship
○ We can’t understand the cause when we look at correlations. Correlation does not equal causation! Experimental ● In an experimental design, the researcher manipulates one or more variables ○ Independent vs. dependent variable ● Example: exam results on different colours of papers Longitudinal vs. Cross-sectional ● Longitudinal ○ The same group is tested or observed multiple times at different pointsin their lives● Weaknesses○ It's expensive ○ Attrition ○ Selective attrition ○ Practice effect ● Cross-sectional ○ Instead of following the same group for a long time, researchers observe and test multiple smaller groups at one-time point ○ Benefits ○ Major weakness ● Longitudinal-sequential ○ This is like a mix between longitudinal and cross-sectional. Instead of following the same group for a long time, researchers observe and test multiple smaller groups over a shorter time■ Example: I want to study development from age 5-20. I could do a 15-year-long longitudinal study, or in a longitudinal-sequential design, I
would study a group of 5-year-olds, 10-year-olds, and 15-year-olds for 5 years.○ This has the same benefits and downsides as a cross-sectional study but with the added benefit of having longer-running data for the participantsMethods of Data Analysis ● Quantitative ○ Involves statistical analyses, such as t-tests, Anova’s, regressions and correlations ○ Statistical significance ○ Combines the 2 methods, often to corroborate either method ■ Measuring scores on a depression inventory and interviewing the person about their depression symptoms ● Qualitative ○ Involves coding, often based on recurring themes that come out of the interview data ○ Coding is based on defined, field-wide coding theories (week 2) Lecture 2 – Neuroscience Neuroimaging ● Structural imaging vs. functional imaging ○ Structural is highly detailed pictures of the brain■ CT scans, MRIs, x-rays ■ CT scans can be done on any part of the body ○ Functional imaging shows the actual brain activity ■ Pet scans, fMRI● Similar to MRI but it is functional ● Going to capture the imaging of the changes in the brain that are occurring in real-time ● We can tell differences in brain activity, can tell about areas we are expecting to light up ● Uses of imaging ○ Normative age-related changes ■ Healthy brain - no disorder ○ Different areas that are affected by the brain ○ Explain changes ■ If you have an image from a previous time and a newer one you can explain the difference over time○ Different mechanisms in the brain ■ Mapping of the brain
○ Design intervention ■ We can design interventions when we have more information ○ Imaging tools are developing all the time, they are constantly improving, and they are pretty expensive (MRI, CT scans, etc). Methodologies ● Neuropsychological (GO BACK TO THIS ONE AND GET MORE INFO)○ Older healthy adults (compare the area of damage on the brain)○ Adults with any conditions (compare the area of damage on the brain)● Neurocorrelational ○ Comparing behaviour to the brain’s structure and functioning ○ Compare their scans to other people’s scans and look at the damage which will tell me a valuable amount of information ● Activation imaging approach ○ Real-time changes ■ Statistic imaging ■ Using fMRI is better for this approach ■ Behavioural changes and the actual structure of the brain ■ Looking at it in real-time Parts of the Brain ● Neurons ○ A brain cell ● Dendrites Axon ● Neurofibers ○ Talking about within the axon○ That's where the information is carried within the branches ● Terminal Branches ○ The chemicals that carry information● Neurotransmitters ● Synapses ○ The gaps between the neurons ● Myelin sheath ○ The fatty layer covering the axon ○ Fatty waxy layer ○ Having that insulation is going to protect it and aid it in the transition ○ It will help the information move faster ● White matter ○ The deeper layer of the brain ○ It is the subcortical
○ The network of neuro fibres that make up the denser inner part of the brain ○ It is about half of our brain ● Ventricles ○ Captivities of the brain ○ They produce and transport cerebral spinal fluid ○ Airbags Filled with fluids ○ Things can move and process more smoothly when they have that fluid move easier ● Cerebral cortex○ The outer layer of the brain ○ Has two hemispheres ● Corpus callosum ○ Bottles that connect the brain ● Prefrontal & frontal cortex ○ Largerley in control of the executive functioning and control ■ Decision making ■ It’s in charge of inhibiting our responses ■ Regulate our emotions ● Cerebellum ○ Back of the brain ○ Controls coordinations ■ More popular with aging adults● Limbic system ○ Emotion, memory ○ Hippocampus ■ Middle of the brain ■ Memory ■ Highley affected as we age ■ Normative memory changes when we get older ■ Non-normative like dementia ○ Amygdala ■ Fight or flight response ■ Emotion processing ■ Threat detection ■ Able to detect and perceive threats in our social environment
Age-Related Changed ● Normative changes ● Number of Neurons ○ It will decline ○ Huge amount of brain cells and things even out when we get older but as we get older into adulthood the amount of brain cells declines● Number & quality of dendrites ○ The ability to have connections between brain cells will decrease ○ Fewer dendrites on our brain cells could affect our memory recall, our processing speed, our ability to learn new things and remember things, less information processing● Fibre tangles in axon ○ Things get wrapped around each other ○ Slower processing speed ○ If things get tangled, everything just slows down rapidly ● Protein deposits ○ In the neurons, around the neurons ○ Natural body debris ○ Things become less efficient ○ The more protein we have in and around the neurons, the less efficient our processes will be ● Normative aging vs. nonnormative ○ Same structural functions but at different speeds and severity for both ○ Asking different questions ● Declines in dopamine → higher-load tasks vs. lower-load
○ Higher effort processing ■ Memory recall, long-term memory recall ○ Lower effort ■ More related to brushing our teeth, riding a bike ○ Tend to see more issues the older we get ● Abnormal serotonin processing ○ Lower production ○ Lower uptake ○ It's not how the brain usually processes things ○ Normative age decline ○ It is related to Sizoprehnia and something else Brain size ● 4 to 5 percent of our brain size decreases a decade ● Around Age 70 we start to see some increases in the brain size ○ More in the prefrontal, cerebellum, and hippocampus Cerebral cortex● Tends to thin out ● More related to slower and less efficient information processing Ventricle size ● Going to become bigger ● Like those empty spaces that are cushions filled with fluids White Matter Hypertintensisties (WMH) ● Declining white matter health, seen as bright white spots on MRIs ○ Looks like holes in the brain ● Diffusion Tensor Imaging (DTI) ○ To look at the structure of the brain ○ Look at the health of the brain ○ Determine what these white matter are ○ Looks at the way the water diffuses through the brain ○ When we look at scans, we cannot see the water diffusion through the scan, but by using the DTI we can see the structures of the cells within the brain● Not just related to normative aging, but to clusters of illnesses and disorders ○ They are related to dementia and strokes, and lifestyle things such as smoking, hypertension, diabetes and risks of falling ○ That goes together to create a more challenging more holistic picture of health and what is affecting what. ○ Points to the potential that all of those things can be related● Can be mitigated by overall lifestyle changes ○ For example smoking
■ If smoking is related to dementia, we can try to make interventions to prevent people from smoking Structural Changes —> Behavioural Changes ● Emotion processing ○ Positivity effect ■ Older adults pay attention to the emotional meaning rather than just the non-emotion content ○ Older adults show different, additional brain patterns in processing emotional information compared to young adults ■ The brain changes as declines but there is evidence that the brain keeps developing ■ We never really stop developing, meaning we can keep creating these brain patterns ● Theory of Mind & Executive Function ○ Our understanding that other people have different perspectives, thoughts, and emotions than us ○ It's what allows me to look into something and realize that everyone sees or thinks differently ○ It is important for the baseline for empathy ○ I can start to wonder about that perspective and consider how we have different thoughts, opinions and emotions ○ Foundationally important ○ ToM declines after 75 ○ Executive functioning ■ Starts to decline somewhere around the age of 75 as well ■ Difficulty switching tasks ■ If someone struggles with executive functioning it will be difficult to switch between tasks ● Depression for example can make this hard ■ Difficult ignoring information ○ Prefrontal cortex volume ■ The volume of the prefrontal cortex decreases ■ Decreases will lead to normative changes ○ Blood vessel functioning ■ Decreased blood vessel functioning Memory ● Medial temporal lobe → very important for memory ○
● Normative aging = decreased volume, worse for Alzheimer’s & chronic stress ○ We see these changes with Alzheimer's or people who are exposed to chronic stress ○ Chronic stress can have such a toxic hold on the body ○ The more connections we find, the more interventions we can use ● fMRIs in older adults with mild cognitive impairment show different memory patterns ○ Different memory patterns within their brains look different ○ They are in different areas ○ The brain is trying to work around the structural changes or roots○ The brain is trying to attempt, it wants to reroute, but the new roots are not as effective ○ This suggests that the brain compensates, tries to adapt and grow as we age ● Unilateral activity in younger adult brains, but activation across the brain in older adults = compensation ○ Parieto-Frontal Integration Theory (P-FIT) ● Intelligence is based on individual differences in brain structure and function in the parietal and frontal areas of the brain ○ Spacial awareness (Intelligence)■ Able to navigate within this space ○ ● As we age, our brain reconfigures the neural pathways we use ○ Our brain is going to reconfigure to complete tasks and use our different types of intelligence if something isn’t working. This is why there is a difference in intelligence The CRUNCH Model ● Compensation-related utilization of neural circuits hypothesis ● The brain adapts to normative decline by recruiting additional neural circuits compared to younger brains ○ If the brain is having a hard time with something it will pick up additional help from other brain circuits which is why scans might look different ● Older adults may recruit activity across the brain rather than in one hemisphere ○ ● More difficult tasks = more brain activity until the crunch point○ As tasks get more difficult the brain is going to recruit more cognitive circuits, but internally there will be no more help, which will then decline your doing during tasks ● Older people reach the crunch point before younger adults
○ Reach that crunch point later ○ When older we use more resources (cognitive) to help with resources which by then we will reach our crunch point quicker ○ Younger adults will reach crunch point later, when younger we have more resources but that means we have to use less and put more effort in before reaching our brain limit ○ For older adults, we have fewer cognitive resources and we are kinda using them all up to finish tasks, we are going to reach our crunch point a lot sooner The STAC-r Model ● Scaddolding theory of cognitive aging-revised ● Across the lifespan, our brains compensate for cognitive decline by recruiting additional brain areas and creating backup neural pathways ● Takes life-course factors that increase or decrease resources into account ● Neural resource enrichment vs. neural resource depletion ● Increase our resources or decrease our resources ○ By resources, we can think of it as energy (brain power), processing speed, quality of milen sheens● Enrichment ○ Having more neural resources ● The image shows the flow model ○ Intellectual engagement in the environment around us○ Education ○ Fitness ○ Mutlilanguism ○ Having higher ability will start you with more resources ○ APOE■ A gene ○ Low ses ■ Socio economic status ● Education ● Income ● Access to clean water ● Tend to be related ● Experiencing poverty and violence ○ Neuroticism ■ Personality factors ● All these can be reasons someone will reach their crunch point a lot sooner
Plasticity ● Capacity is not set in stone and can be improved ○ We have structural evidence that the brain continues to develop ○ Recruits across both hemisphere ○ How the brain changes and develops over times ● Evidence of this with compensation and reorganization of pathways ○ How the brain struggles and picks up help from across the brain ○ It is trying to find a different way to accomplish the task The Paper ● Due Oct 28 ● Take a conversational approach ● Explaining research to someone who has never taken a psych class ● Broad
● Textbook or lecture but has to be a course material and 3 extra articles (peer review)● example: alzemhier ○ What is the disease ○ What to look out for in this disease ○ How to decline the surge of this disease (week 3) Lecture 3 – Physical Changes Across AdulthoodBiological Theories Why do we age?● No theories explain 100%● Why do you think we age?○ The process of aging we can see but we don’t have one specific thing about how or why we age Metabolic Theories ● We all have a finite amount of energy and as we get older we use it all up ● How our energy gets used ● The energy our bodies have for functions, we use up as we live longer ● There is no biological proof that this theory is a leading theory Cellular Theories ● A little more proof of it● Cells can only replicate so many times and at some points, they stop replicating ● Cells stop dividing over time and this has been seen to happen● A connection with chromosomes ● Chromosomes have these protective tips called telomeres, every time cells replicate these telomeres get worn down. When the telomeres get short, there can no longer be safe cell division so it stops Genetic programming Theories ● The environment can have an effect on aging. Genetics can be altered by the environment ● Aging is programmed into our DNA. These changes are going to happen to our bodies at some point. ● Innate and programmed, cell death is somewhat essential for the growth process to happen● They are not immune to the facts of the world around them, they do get influenced by the environment around them
● There is evidence that there are aging-related disordersEnvironmental Interactions ● Advantages of cellular theories○ Stress, trauma, environmental factors, discrimination ○ Nature, exposed to lead? Also means societal factors such as discrimination, inequitable resources● DNA Methylation ○ It is a protein process getting disrupted by various factors but we can see that the DNA structure is still intact ○ We can use DNA meth so that our bodies can have a different biological age than chronological age ○ Our bodies can be older than our chronological age ○ Older biological age than chronological age ○ When people are exposed to protective factors (social support, being highly resourced, medical care,) ○ Offers us at least one explanation for how people age differentlyWhat is Clear?● Aging is not “just” biological ● Environmental, psychological, societal, and sociocultural factors all have an effect ○ Aging is not just programmed in our DNA, it is a combination of a lot of things■ Such as psychological, biological, etc. What causes wrinkles & other age-related skin changes?● Age-related skin changes ○ The outer layer is more fragile ■ Becomes thinner, more sensitive ○ Our collagen loses flexibility ■ Skin loses the plump bounce-back ○ Elastin fibres stop keeping skin stretched out ■ That will result in sagging ○ Underlying fat diminishes■ Those will decrease or disappear ● What affects the speed of aging ○ Sun exposure ■ The major one is the age issue ○ Smoking ■ Takes a toll on the skin, dehydrates and causes wrinkles ○ Diet
■ Nutrients from fruits and vegetables ○ Moisture ■ Keeps the skin hydrated, drinking water ○ Repetitive facial movements Melanoma ● Keep an eye on moles vs. melanoma● A - asymmetry ● B - irregular borders ● C - colour ● E - evolving over time ● “Ugly duckling”● Can get mole mapping done at a dermatologist● People of all skin colours can get skin cancer Hair & Voice ● Hair ○ Gradual hair thinning occurs with age across genders ■ Gradual hair thinning, at temples or top of the head○ Genetics and lifestyle linked to when the hair follicles stop producing pigment ■ You can see on various chromosomes what could code for baldness ■ Losing pigment and going gray is related to genetics (parents)● Voice ○ Laryngeal, respiratory, and muscular changes lead to differences in aging voices○ Lower pitch, breathier, more trembling, slower and less precise pronunciation, lower volume ■ People also tend to speak slower and stumble across their words ■ Voicebox – weaker over time ■ Respiratory changes – lose capacity or air capacity ■ Having less muscle – weaker muscles■ Make it harder to produce words, less strength to produce voice Height & Weight ● Height ○ Height relatively stable until 50s ■ After age 40 we start to see, we get shorter ■ Depends on certain factors though, but on average you lose 1-3 inches○ Height decreases○ Why does height decrease?■ In spinal compression, the discs start to compress and get smaller
■ muscle changes – postural changes, which can change the way we stand and sit ● Weight ○ Usually, weight gain in middle age then weight loss in later life○ Changes in metabolism, activity levels ■ Metabolism will change over our life spans ■ Don’t need as much fuel, don’t require as many calories ■ Activity levels changing – people as they age will become less active, wear and tear Mobility● We lose muscle as we age, but doesn’t usually become noticeable until about age 70● By about age 80, we’ve lost about 40% of our strength ○ Depends a lot on activity levels throughout your life ○ By age 80, you start to notice differences in your strength ● Usually more muscle loss in the legs compared to the upper body○ It contributes to the risk of falling○ The risk of falling is something that seems like such a small thing but has major implications ● Loss of bone mass begins in the late 50s and slows down in the 70s ○ It might be related to hormones, specifically people who have higher levels of estrogen often lose bone mass quicker ● Hormones, lifestyle, genetics ○ The returning factors ○ If a bone is less dense and strong, it can break easier, and heal slower, and the breaks that happen to the bones are less clean ● Major bone change issues? ● Joint changes ○ The cartilage in and around starts to break down, if you lose all of it then you have bone on bone which can cause pain and inflammation ○ Break in cartilage which can lead to arthritis in middle-age ○ Strengthen the muscles around them and the joints around them ○ Holistic approach to the body to avoid joint changes Psychological effects of physical change ● Changes in appearance ○ How someone sees themselves ○ Seeing oneself as more mature – confidence boost ○ Limiting oneself to act or be the age you are ○ People will be treated differently due to ageism and stereotypes
● Changes in ability ○ Either they can be more motivated or less motivated depending on their view of life and their health ○ Feeling like a burden and not wanting to ask people for help ○ The concept of self might have to change the older we get Vision● Structural changes ○ As we get older, less light can pass through the eye ○ More difficulty with focusing, the muscles stiffen. When the muscles stiffen it has a harder time adjusting and even a slower time adjusting ○ The older we get the harder it is for us to see in the dark ○ Harder time adjusting to changes in light ■ Going from a dark room to a light room ● Retinal changes ○ The region of the eye where the light is focused starts to regulate ○ We need that part of the eye to focus, when that part of the eye regulates we start to lose proper vision, our vision becomes more blurry since it’s the centre of the eye ○ Diabetes can exacerbate aging in the eyes, specifically through the arteries○ Increases fluid retention in the eye, in the release can lead to vision loss ● Related to depression and decreased social interaction Hearing ● Major issues across the lifespan are loud noises ○ Protect hearing, especially from loud repetitive noises ○ Having loud exposure to the ears is what can lead to hearing loss● Hearing loss starts gradually, then accelerates around 40○ Neural loss is the loss of some of the nerves which process and receive sound ○ Less nutrients, when we have less oxygen going to our cells○ structure of our ears that vibrate, will change by either breaking down, becoming less efficient, or becoming bad at processing sounds ○ Difficult to be in social situations when your hearing is changing ○ These difficulties tend to be worse with people of lower socioeconomic status – why? – due to resource difficulty, less access, and getting hearing aids for example. Less access to better quality medical care ● Related to depression and decreased social interaction Somatosensory● More complex than just “touch”
● Pressure and aging ● Temperature and aging ● Chronic pain ● Brain changes make dizziness and vertigo more common ○ Feeling our body and space○ Everything that goes into our bodies in space in the world around us ○ The surfaces of our body that don’t have hair start to require more pressure to feel touch, unlike the ones that have hair ○ The reason we need more pressure is due to cell receptors ○ Hair assists us in feeling touch, so we don’t see that big of a difference ○ Temperature and aging – we have difficulty regulating our body temperature ○ More likely to develop and experience chronic pain ○ 80% of chronic pain ○ Vertigo - feels like everything around you is spinning even if were standing stillTaste & smell ● Gradual decline in ability to taste ○ this varies depending on the individual and taste (same thing with smell)● Medications and diseases can affect sense of taste ○ more impactful because as we age it makes it more likely that we will experience an age, and this medication could affect our taste and smell. Because of some diseases, some people can lose their sense of taste and smell (examples - Alzhimers and Parkinson's)● Some decline after 60 in ability to smell ● More common in some diseases ○ Covid is also a good example of people losing their sense of smell and taste ○ Function and safety ■ it is bad to have a decrease in smell and taste because it keeps us safe (smelling gas, or eating something that gas gone bad without even knowing), loss of an experience Cardiovascular system ● Late 40s-early 50s: less muscle tissue to contract the heart○ decrease in muscle tone and density. The muscle is going to become weaker which means it contracts the heart less strongly and regularly● Arterial walls harden ● Cardiovascular disease is quite common, more common for men (cis and trans) than women (cis and trans)○ There might be something going on with testostérone (cardiovascular)● Congestive heart failure
○ Where the heart enlarges and causes inflammation ● Angina pectoris○ when a person cannot get enough oxygen to the heart, caused by physical exertion (chest pains) ● Myocardial infarction/heart attack○ where the blood supply to the heart is badly reduced or cut off● Atherosclerosis○ Where there is a build-up of fat ● Cerebrovascular accident/stroke○ is when the blood flow to the brain is cut off, it starts with the heart by not sending enough blood to the brainRespiratory system ● Air sacs deteriorate, so we take in less air starting in the 20s○ This means we start taking in less air starting in our 20s● How much is normative and how much is environmental?○ Air quality is horrible nowadays due to machines and industrial stuff – pollution ● Chronic obstructive pulmonary disease (COPD) is quite common● Emphysema○ This is where the membranes of the air sacks of the brain start to get destroyed around the lungs, can’t be reversed, and can be helped but not fixed. ○ People start to have a hard time exchanging oxygen and carbon dioxide. The bronchial tubes collapse● Chronic bronchitis○ it's a reoccurring bronchitis that happens to people over the age of 45, and people who live in highly polluted places. ○ Treatment is similar to the treatment of asthma by using an inhaler.● Vaping also leads to respiratory issues, not just cigarette smoking Reproductive system changes ● Uterus, Ovaries, Vagina○ Menopause ■ This usually happens around age 40 or so, and usually around mid-50s, things come to a stop. Ovulation stops, without ovulation there is no period and there is no fertility○ Decreases in estrogen & progesterone■ The link to osteoporosis and bone density loss ■ An increase in heart disease and memory loss ○ Attitudes toward menopause differ by culture ○ Changes to vagina and sex life
■ The vaginal walls will thin out and the size of the vagina decreases, and decrease in lubrication but there are modern things that can help ■ These changes can make maintaining an active sex life difficult ■ These changes will happen however the maintenance of an active sex life will maintain in lubrication ● Testes, Penis, Prostate○ Gradual decline in testosterone ■ No cut off for fertility ○ Sperm changes ■ A decline in the numbers and quality of sperm ■ Even if a sperm is present, it might not be as healthy which would cause a sperm to die ○ Prostate changes ■ Prostate does enlarge ■ Cause problems when peeing ■ The risk of prostate cancer can occur more likely but treatment is available ○ Changes to penis and sex life ■ There tends to be more difficulty in achieving an orgasm the older someone gets ■ More difficulty reaching an orgasm when getting older Autonomic Nervous System: regulates involuntary processes like body temperature, heart rate, breathing, etc.● Body temperature ○ Older adults have a much harder time regulating their core body temperature○ Do not sweat as much○ Involuntary processes that are happening ○ Older adults have a much harder time keeping their core body temperature stable ○ Too hot and too cold○ Caused by the decline of all body systems (sematic body temperatures)○ Older people don’t sweat as much – which isn’t good because they have less ability to cool themselves down ○ Older adults are more at risk of having a heat stroke due to not being able to sweat when getting older ● Sleep ○ More sleep difficulties in all aspects ○ Napping related to higher wellbeing○ Have a harder time sleeping (adults)○ Wake up too early, bathroom○ Not feeling rested as much
○ Napping can be regional because it can be a good thing but at the same time it can be a bad thing○ Is napping going to make their sleeping at night more difficult or better?(week 4) Lecture 4 – Longevity What plays into poverty ● Genetics○ A general trend where people might die earlier or live to an old age ● Environmental factors ○ Exposure to pollution, chemical things in our environment ○ Things we are exposed to in our daily lives ● Systemic factors ○ Chronic stress levels, access to high-quality health care, income and income inequality – can a person afford medications, discrimination – through systemic housing practices, an intrapersonal piece in discrimination – negative impacts● Personal factors, lifestyle factors ○ Personal factors in personality – lifestyle factors in smoking Measuring Longevity ● Average longevity ○ From birth: projected age at which half of people born in that specific died ○ Can examine projected longevity based on averages ■ The average life expectancy of someone born in 2000 – this is the projected age that half the people born in the year 200 have died ■ Use this to calculate the expected lifespan of people● Maximum longevity ○ The oldest age that any individual lives ○ Without external factors: 120-150■ This is with everything and everyone is perfect – perfect conditions in a human being ○ With genetic theories & research: 120○ Oldest recorded person = 120Measuring life expectancy ● Active life expectancy ○ Living to old age while remaining independent ■ Taking care of oneself, remaining relatively mobile, having adaptations, being able to be independent ● Dependent life expectancy
○ Living to old age while requiring significantassistance from others ○ It can be temporary or permanent ■ Someone may fall and injure themselves and be in a care facility while recovering and then moving back with their family – temporary ■ Someone may fall and injure themselves and live with others who are being taken CARE OF, won't be able to go back to being independent – permanent Impacts on longevity ● Poverty affects all these environmental factors Systemic/structural disparities ● Canada has one of the highest life expectancies in the world, but it’s not the same across different groups ● Cisgender women tend to live longer than cisgender men ● Location○ The more remote someone lives, the less of a life expectancy they have to live● race/ethnicity ○ Areas of higher concentration (Indigenous peoples) have a lower life expectancy ● Education ○ Life expectancy tends to be lower for high school graduates compared to those with higher education● Income ○ People tend to have a lower life expectancy with a lower incomeWhat is health?● How would you define health?○ It's not just not being sick, holistic overall wellness factors, mental, physical, and social level● WHO definition:○ Complete physical, mental, and well-being, not just the absence of disease ● Illness○ Presence of physical or mental disease or impairment
Quality of life ● Health-related vs. non-health-related ○ Tend to think of health factors○ Health ■ Every aspect of life that is affected in everyday lives ● Sleep○ Non-health ■ Anything that is a person’s environments ● joy, engagement with culture, the activities – a lot broader● A more holistic approach to understanding people’s perspectives on their overall wellness and enjoyment of life ○ For someone who is getting a lot older (the 90s) the majority of their friends and family are not with them anymore – a lot of friends and family are passing or have passed – they could be in good health – still fully functioning – but their non-health-related things in life are that they were very lonely – lack of community The immune system ● Cells defend against other harmful cells ○ Things such as cancer, viruses, harmful bacteria● Antibodies are released into the blood ○ These fight back against infection – comes from vaccinations, bone marrow and other infections – prep our body to fight an infection● Nonspecific immunity ○ All the other stuff that our bodies do to protect us against infection ○ Sneezing, stomach acid that clears up bad things, natural killer cells that keep an eye out for tumour growth and parasites and fight back if they sense them ● Differences in the immune system with age○ Different infection rates according to age ○ At a certain age, the body takes longer to fight the infection because there is a shift within the cells because they become “weaker”. Older people need stronger doses when it comes to vaccinations Stress and health ● Chronic stress○ Decreases our immune system effectiveness – lots of bad things – it makes it easier for us to get sick – the effectiveness of our immune system decreases greatly when we are under stress
● Stress shortens telimeres → gene expressions → aging ● Stress and coping paradigm ○ the idea that there is a relationship between the person and their perceptions of their stress in a given moment ● Flow chart ○ A person is stressed ■ ○ Perceive their coping – what they can do about it. This is either not that bad or not a big deal and this will lead to a positive emotional response or a person thinking negatively about it and can’t cope with it or figure it out and lead to a negative response ○ Feeling good about it or not feeling good about it ○ This increases their risk of physical and psychiatric disease ● Stressors (Envrionmental Demands● Appraisal of demands and adaptive capacities ○ Perceived stress ■ Negative emotional responses ■ Physiological or behavioural response ■ Increased risk of physical and psychiatric disease ○ Benign or positive appraisal ■ Positive emotional response Chronic vs. Acute conditions ● Acute ○ Develop over a short time & cause rapid change ■ It doesn't last a long time○ Flu, colds, etc → Short illness and knocks you out for a few weeks○ Treated with medications or allowed to turn its course ● Chronic ○ Longer time (at least 3+ months)○ Residual functional impairment
■ A person's functioning changes for the worse after experiencing a chronic condition ○ May require longer-term care○ Often no cure, the focus is on management and helping the person live their life with the highest quality of life possible and be comfortable Impacting factors ● Physical ○ Genetic and, biological differences in the person’s body, and the body changes in the course of aging – arthritis, bones changing ● Psychological ○ Personality and coping ● Sociological ○ The larger scale of systemic factors● Life-cycle○ Some conditions occur at a specific time point in someone's life ■ With arthritis, this happens more in someone who is 50 and 60■ Skin cancer tends to pop up later ● Our reaction will vary on where we are in life– having a chronic condition on the onset of being 30 might be different than being 60● The chronic condition changes us, we can perceive ourselves to have a certain type of lifestyle and if we experience a chronic condition early on, it changes everything in the future Diabetes● The pancreas doesn’t produce enough insulin, which causes issues with metabolizing carbs - excess glucose in the blood ● Type 1 vc. Type 2○ Type 1 is from childhood – insulin-dependent, the child will NEED to take insulin to manage ○ The onset for type 2 is in adulthood, it can be managed through diet, exercise and meds● Type 2 in adulthood ○ The symptoms aren't as prominent as type 1 ○ It is caught during screening for other things or annul physical checkups○ Group 1: we tend to see people affected in their late middle age and they can get cardiovascular issues ■ Artery blockages and heart attacks – have a big effect on life and ○ Group 2: we tend to see people acquire diabetes in their later life and have mild problems from it
○ The treatment of the effects differs from each person's experience ● Risk factors ○ Genetics ○ Lack of access to quality food○ Unequal access to healthcare● Effects ○ Nerve damage○ Eye issues ○ Kidney issues ○ Strokes ○ Cognitive issues ○ Cardiovascular issues ○ Skin problems ○ Poor circulation● Stigma and weight & prevention ○ The social message of diabetes is how it is preventable and related to obesity○ Mostly conversations about losing weight ○ There can be a stigma of the person being a “failure” because they got diabetes Cancer ● On average, two in five Canadians are diagnosed with cancer in their lifetime, with 1 in 4 passing due to it ● Most commonly diagnosed cancers in Canada ○ Breast cancer ○ Lung cancer ○ Prostate cancer ○ Colorectal cancer● Risks ○ Increase with age ○ Over time we are exposed to environmental pollutants ○ Genetic structure changes over time ■ Gene mutations on chromosomes ■ Now we have to identify if someone is a chromosomal carrier of cancer – increases the risk ○ Food quality ○ Reasons we don't know ● Treatments ○ Monochrome antibody treatments ○ Immune response modulations○ Reprogram the cancer cells metabolically – cell division change
○ Radiation therapy and chemo to the area that is affected ○ Surgical removal ● Prevention ○ Preemptive removals for potentially affected areas ■ If someone is a carrier for the chromosomal mutation that can lead to breast cancer, the person can have a mastectomy (removal of the breast tissue to prevent it)○ Prostate and Avoiding Prostate Cancer ○ Gallbladder○ Avoiding risk factors where possible – environmental, smoking ○ Skin cancer – being aware of sun exposure ○ Routine screening – especially when we are older ■ Colonoscopy, Breast exams Incontinence ● Happens after a stroke or a UTI ● Urinary and/or bowel ○ Older adults○ Very very common ● Stress incontinence ○ The inability to resist the urinary flow during coughing or sneezing, lifting something heavy ● Urge incontinence ○ Central nervous system issue after a UTI or another issue○ The urge comes too fast or too sudden with not enough time ● Overflow incontinence ○ The contraction of the kidney leads to a swelling of the bladder ○ More common if there are tumours or prostate enlargement – some meds (antidepressant, antipsychotic and various narcotic painkillers● Functional incontinence○ Where a person is unaware of their need to go to the bathroom ○ Tend to be seen in people with dementia, Parkinson's and nerve damage ● This can lead to embarrassment ● Very treatable ○ Pelvic floor exercises – part of normal adolescent in schools and health classes ○ Prevent issues from childbirth and age ○ Can be used to decrease the occurrence of incontinence happeningPain management
● In older age, pain becomes a usual part of daily life, but it’s incorrect to assume that older people need to just deal with it ● Pharmacological vs. nonpharmacological treatment ○ Used together but other lifestyle changes and chopping skills ● Narcotic vs. nonnarcotic○ Narcotic ■ Things like opioids – morphine and codeine ○ Nonnarcostic ■ Over the counter – Tylenol and Advil ○ Used with caution ■ Too high of doses with both because the liver and kidney can only take so much ● Opioid risks ○ Can be very effective at relieving pain however they can be highly additive and very harsh on the body ○ 21 deaths per day in Canada○ Very little research on long-term benefits ○ Being prescribed too much can lead to others taking them in the home ● Non-opioid treatments ○ Cortisone injections ■ They have to be limited – should only get 3 every 6 months or 3 every year – too many can create bone problems ○ Radiofrequency ■ A needle is put in the affected area and radio waves are transmitted ○ Nerve stimulators that can be put in the affected area ■ The signals block the pain ○ Surgery to improve the affected area ■ Disk issues to replace the disk or trim the disk to prevent further infection● Less invasive methods ○ Physical therapy ○ Massages ○ Use of temperature ■ Heating pads or ice packs ○ Ointments ○ CBD products ○ Acupuncture and pressure ○ Psychological things Medication use ● Older adults on average use the largest number of medications
○ 6-7 meds per day ● Generalizability & safety issues in medication testing ● Interaction effects ○ If you're taking more than 1 medication then you need to make sure nothing interactsAge-related changes in how medications work ● Absorption ○ As we get longer it takes longer for medications to be absorbed into our bloodstream○ It can lead to more because we don't feel it or less if we do feel it ● Distribution ○ Less medication binds with our plasma proteins ■ This process makes the medication ineffective at any age ○ When we’re older, less of it binds with the plasma proteins, and more of it has a chance to get into our system – this creates a toxicity that builds up in our system and becomes toxic more easily ○ These changes can be seen in our normative change in our body when we have lower body water and more fat tissue ○ This makes it more likely to have a toxic build-up of meds ● Metabolism ○ We become less effective in getting rid of medications in our bloodstream which means that the drugs stay in the boy longer ● Excretion ○ Our kidneys eliminate toxins through our urine and other bodily things (sweat) ○ As we get older our kidneys are less effective and cant eliminate things effectively ● What changes to a medication schedule should doctors consider due to these changes?○ Giving the lowest dose possible ○ Making sure other meds arent interacting Polypharmacy (use of multiple meds)● What are some possible challenges with taking multiple meds?○ Bad interactions ○ If a person takes a med and theres a side effect, that side effect might need to be medicated – 3 pills –○ When a person is given a complex medication schedule ○ Might take one at the wrong time – risk for errors with lots of meds ● Bad interactions ● Needing to treat side effects ● A more complex schedule = more room for error
Ways to help with taking medications ● Smartphone apps help monitor schedules and track adherence ● Keep the number of meds to a minimum if possible ○ Is the doctor's responsibility but you also need to advocate for yourself or a loved oneDisability Model: Compression of Morbidity ● This time between disability onset and death is becoming a shorter amount of time ○ Diagnosed with a disability or dealing with it – a short time passes and they pass away● Why?○ Adults become disabled later in life and are disabled for a shorter window of time ● There’s not much evidence for this! In actuality:○ Chronic diseases are diagnosed earlier in life ■ Due to multiple factors – maybe people are dealing with chronic diseases in life due to environmental changes ○ Chronic diseases are becoming less disabling due to technology and health system support ■ This makes it easier to catch diseases earlier in life■ This can also help them and make them live longer with a higher quality of life Disability Model: Verbrugge & Jette ● More comprehensive model ● Includes risk factors and intervention strategies:○ Individual factors and intraindividual factors ○ Increasing a person's risk for disability ○ Ways a person can be assisted – it falls into extra and intra-individual ○ Extra means outside – environment and healthcare ○ Intra means the inside – behavioural and personality
● Extra-Indiviual factors ○ Medical Care and Rehabilitation ■ Surgery, physical therapy, speech therapy, counselling, health education, job retraining ○ Medications and other therapeutic regimens ■ Drugs, recreational therapy, aquatic exercise, biofeedback, meditation, rest, energy conservation ○ External supports ■ Personal assistance, special equipment and devices, standby assistance and supervision, daycare, respite care, meals on wheels○ Built, physical and social environment ■ Structural modifications at job and home, access to the building and public transportation, improvement of air quality, reduction of noise and glare, health insurance and access to medical care, laws and regulations employment discrimination ● The Main Pathway ○ Pathology ■ Diagnoses of diseases, injuries, or congenital or developmental conditions ■ Risk factors ● Predisposing characteristics: demographic, social, lifestyle, behavioural, psychological, environmental, biological ○ Impairments ■ Dysfunctions and structural abnormalities in specific body systems: musculoskeletal, cardiovascular, neurological ○ Functional Limitations ■ Restrictions in basic physical and mental actions: ambulate, reach, stoop, climb stairs, produce intelligible speech see standard print ○ Disability ■ Difficulty doing activities of daily life: job, household management, personal care, hobbies, active recreation, clubs, socializing with friends and kin, child care, errands, sleep, trips● Intra-Individual Factors○ Lifestyle and behaviour changes ■ Overt changes to alter disease activity and impact ○ Psychological attributes and coping ■ Positive affect, emotional vigour, prayer, locus of control, cognitive adaptation to one’s situation, confidence, peer support groups ○ Activity accommodation
■ Changes in kinds of activities, procedures for doing them, frequency or length of time doing themFunctional health Status (How well someone is functioning in daily life)● Hierarchy of loss → strength, balance, coordination, manual dexterity ○ In this order, we lose our abilities ● Classification of functioning, disability, and health ○ Developed from the Verbrugge & Jette model○ Assessment of functioning in daily life○ Interacting and mediating roles ● Activities of daily living ○ Basic self-care tasks – brushing your teeth, hair, showering, putting on shoes, eating food● Instrumental activities of daily living ○ Require more cognitive engagement and planning and very culture-dependent ○ Western European cultures dominated areas like the USA and Canada – going grocery shopping, paying bills, making appointments – your admin tasks for your life – the things that keep you functioning in the world ○ It could look different in different cultures – collecting water● Physical limitations ○ Functional limitations – how far can someone walk, and can they go up the stairs? – these impact the daily functions (week 7) Lecture 5 – Environment and Ecological Systems Person-Environment Interactions● Psychologist Kurt Lewin defined developmental person-environment interactions in 1930s○ B= f(P,E)○ Peoples behaviour is an equal of the person and their environment ○ A person’s behaviour is a function of their environment ● People are in constant interaction with their environment○ By directionally ■ The environment is having an impact on the person and the other way around as well ● Perceptions of environment are important○ For example: depression ■ A lens someone with depression sees the world
Aging & Decision-Making● As people age, they interact differently with their environment and need to make decisions○ Our interactions change ○ Cognitive○ Various health differences ○ As we get older and our needs and interactions change, we need to start making decisions Theory 1: Competence & Environmental Press (Tricky to understand) ● Competence ○ The ability to function in developmental domains ○ If someone is competent in a cognitive domain they are functioning without any age related deficits ○ Competent in mobility – able to move that does not require too many accommodations ○ Very able to do certain things but there is no expectation to do it ■ Cooking dinner - can cook dinner and that used to be expected of them but now they are getting older and told to just sit down and relax ■ They want to do things, but everyone is not expecting anything from them ● Environmental Press○ Press - pressure ○ Our environmental pressures■ Physical pressure■ Interpersonal pressure ■ Socio-culture demands ○ Any demands that the environment is putting out ■ What is the demand of transportation? ● The pressure on them an the environment ● When there’s a mismatch, the person suffers in effect and potentially in performance○ Mismatch meaning that someone has very high competence in something but the press is very low or the opposite ■ They can’t meet to the pressures that are being asked of them ■ Can’t do something that is being asked from them
● When there’s not a mismatch, we can adapt. When there’s a mismatch, we can’t. ● Individual situation basis● Proactivity vs. docility ○ Lower competence levels, feeling like you can’t do it and you give up (Docility) where as Proactivity is the opposite, you have high competence levels ○ How people make decisions, why they do and if they can make the decisions ○ Introduces the idea that not everyone has endless options, we are limited by our environment and competence levels ○ Theres this give and take, we don’t have endless choicesTheory Application● How can we use this information to help aging people?○ Fuller indegradtion through our day to day lives Theory 2: Preventive & Corrective Proactivity (PCP) Model ● Life stressors + person-environment mismatch + risk/resilience factors = outcomes ○ Examples:■ Trauma/discrimination/chronic stressors + no proactive adaptations + risk factors = negative outcomes■ Trauma/discrimination/chronic stressors + proactive adaptations + resilience factors = positive outcomes● Preventative adaptations vs. corrective adaptations○ Preventive – avoiding a stressor ○ Corrective – after something bad happening you make a change Theory Application● How can we use this information to help aging people?
Theory 3: Stress & Coping● Schooler (1982) applied the Stress and Coping Framework to person-environment interactions● The main difference: our assessment of a potential stressor is evaluated within our particular environmental contextTheory Application● How can we use this information to help aging people?Theory 4: Everyday Competence ● Looks at potentialfor independent living, not currentability. ● Incorporates ideas from previous 3 theories, as well as cultural factors ● Major outcomes are psychological and physical wellbeing● Everyday ability to manage problems is strong indicator of aging health statusTheory Application● How can we use this information to help aging people?Environmental Psychology● Our age-related changes are improved or made worse by our environment● Can we think of some examples?What is an Age-Friendly Community?● A community that enhances quality of life for aging individuals through security, encouraging participation, and adapting structures to be inclusive of the needs of aging peopleWorld Health Organization Age-Friendly Community Guidelines1. Outdoor spaces and buildings2. Transportation3. Housing4. Social participation5. Respect and social inclusion6. Civic participation and employment7. Communication and information8. Community support and health services● Think about your community and the needs across different aging domains. Do you think your community is age-friendly? Why or why not?● How can we help advocate for age-friendly spaces for all?
Aging in Place and in the Community● Why is it important to create age-friendly communities, help people age in place, and help people remain engaged within the community?Options for Aging in Place● Major decision with two options● Family members may have opinions, or there may also be a lack of family involvement● What are some barriers?Housing Options● There are more than two options – not just at home vs. nursing home!● Active adult communities ● Barriers ● The aging person/people musthave as much control and input as they can have in the situation!In-Home Aging● Modifications to the current home ● At-home care providerCongregate Housing● Sort of like a senior living dorm ● May have nursing care and social activities on-site● High demand makes it difficult to get in sometimesAssisted Living● One step further than congregate housing ● Ideally, they provide independence, respect for autonomy, allow as much control and freedom as possible● CostsTypes of Long-Term Care Facilities● Skilled nursing facilities● Special care facilities● Nursing homes/long-term care facilitiesWhen to Decide a Nursing Home?● Most families do not take this decision lightly, usually chosen as a last option● Need for placement● Timing of placement
● Costs and barriersLong-Term Care● Long-term care facilities are regulated by the Ministry of Long-Term Care● There has been an increase in government investment in Long-Term Care● Admission processLong-Term Care and Feeling “At Home”● How “at home” someone feels in a long-term care facility/nursing home can vary widely ● Depends largely on the quality of the home, the staff who work there, and personal factors● Encouraging residents to reminisce about home can help them to adjust to their new residenceAgeism and Elderspeak● One issue that can come up in any context but especially in long-term care facilities is the use of elder speak● Often received very negatively● Some parts can potentially be helpful, but not others(Week 8) Lecture 6: Cognition Types of processing ● Automatic ○ Anything that is automatic processing doesn’t require much attention or energy ○ They start as a more effortful process○ Demand level ○ Some get better with practice and some seem “pre-wired” in our brains ■ We don’t have to practice, it just comes naturally ● Recognizing a familiar face ○ Difficult to change ■ We don’t think about them, they tend to happen automatically ○ Many of these start as effortful processing ■ Get better with practice but not all the time ● Muscle memory ■ Driving, writing, typing, biking, etc. ○ Can become automatic over-time ● Effortul ○ Require more demand on our attention and energy ○ You have to think about what youre doing
○ Demand level ○ Awareness ■ Aware of what were doing because it takes so much effort ● Learning a new skill rerquires all of your attention to be able to perform it afterwards with no instructions○ age -related apparent here ■ Older people start to have issues with effortful tasks first ■ Older people have difficulty with multitasking ■ Less neurological energy Steps in Memory Processing Encoding ● Taking the information and transforming the information into a way to what is already connected into something in storage ○ Previous memory ○ Like a picture○ The encoding process puts it all together Storage● Moving information into either short or long term memory Retrieval● Remembering stuff● Pulling that information out of storage Types of Memory ● Sensory memory ○ Hearing something, seeing something, feeling the environment, taking in your surroundings ○ Spacial awareness ○ Our bodies are taking information all the time ○ Sensory information that we gather from our senses ● Working memory ○ Short term and active
○ Active processes of getting new information and using ■ Someone telling you their phone number ■ Storing it in your brain for kike 10 seconds and then using it in the same moment ● Short term memory ○ Information that is stored in the memory but not for too long but can be easily forgotten ■ What did you eat for breakfast two days ago ● Long term memory ○ Remembering things that occurred long time ago○ Episodic memory ■ Daily life events ■ Recent memories ● Going to the doctors office last week■ Fragile type ■ Older people struggle with this first ○ Procedural memory ■ This uses automatic processing ■ Things that we automatically remember ■ Muscle memory ■ Things we remember when were put back into the same situation ● Riding a bike, driving, writing, etc.. ○ Semantic memory ■ Basic factual knowledge ■ Ingrained knowledge ■ Specific knowledge that someone has learned ○ Autobiographical memory ■ Combination if eposiodic and procedural ■ Knowledge about ourself ■ Knowing the facts of your own life ■ High emotion Working Memory changs ● Over decline in working memory ability ○ Changes person to person and same thing with situation ○ Holding on to information for like 10 seconds and remembering it, that eventually get worse the older we get● Spatial vs. verbal ● why ?
Long term memory changes ● Episodic ○ Decline begins around 75 or so ● Semantic ○ Increase from about 35 to 55○ Decrease again around 65● “Feeling of knowing” events (tip of the tongue) ● Why is semantic more stable than episodic ○ Episodic puts more workload on our working memory ○ Semantic does not put a lot of workload Age-related differences in encoding & retrieval ● Encoding ○ Declines in encoding related to decline in automatic strategy use ○ Changes in brain activity ● Retrieval ○ Encoding difficulties ○ Prefrontal cortex and hippocampus ○ Less extensive neural networks Impacts on memory ● Regular physical exercise ○ Improve cognitive performance ○ Reduce age related brain atrophy○ What they are capable of doing ○ Inidivudally based ● Multilingualism ○ Multiple languages can be this protective factor of cognitive declines ○ The more languages someone speaks increases protective factors of cognitive decline Ways to help● Using familiar material ○ Trying to teach someone something or help them● Allowing for practice or rehearsal ○ Given more time to rehearse they can do it ○ Less decline in working memory when they have that practice ● Using compensatory strategies ● Internal○ Inside that persons brain
○ Use imagery ○ Use rehearsal ● External○ Outside of the person ○ Using a calendar or a phone, a checklist, etc Age-related difference in Thinking ● In general, older people are more able to take more information into account when making decisions ● As people get older, they tend to integrate more complex thinking about situations● They tend to see things as less cut and dry ● Resources & higher-level decisions ● Integration of emotion Decision Making ● When based on many pieces of working memory to mke a fast decision = not very effective ● Usually, older adults have time to make a decision Age-related Differences in Decision Making 1. Require less information to make a decision and search for less information a. They have life experience b. Life experience has shown them how different options are most likely to end up 2. Tend to avoid risk and choose a safer option 3. Use less details and just skip to “the bottom line” a. Get the jist of information 4. Often feel overwhelmed by too much information or options a. Due to working memory load 5. May expect or rely on support from friends, family, and professionals for big decisions6. When asked to evaluate their options, they focus more on positive information rather than negativity Decision Making ● Because underlying thought processes change, so do the ways that older adults approach decisions ● More likely to vary their method based on the context ● Often take interpersonal goals into account ● In one study (Blanchard-fields et al, 2007) rated as more effective than younger adults across all types of problem-solving situations
Expertise ● What makes an expert? ● Expert traits ○ More creative ○ Flexible ○ Curious ○ More efficient ○ More accuracy ● Age-related changes ○ Peaks in middle age 40s-60s○ Takes time to build expertise ○ A decline after middle age ● Even if they cannot physically do the tasks anymore, the reasoning usually stays expert Lifelong Learning ● Older adults tend to○ Require a “bigger picture” explanation more ○ Enter with more experience ○ Be more willing to learn about more concurrent things than abstract things ○ Be more motivated by internal factors than external factors ● Essential for building and maintaining expertise in a topic ● Can help address sociocultural issues in aging ○ Emphaziing multugenerational learning ○ Expanding perspectives, worldviews, and engaging in a culturally-dynamic environment Wisdom● Four traditional characteristics of wisdom○ Deals with important matters of life and the human condition ○ Superior knowledge, judgement, and advice ○ Extraordinary scope, depth, and balance ○ Well-intended and combines mind & virtue ● Expanded upon by Grossman & colleagues (2020) Consensus Model (Grossman et al., 2020) 1. Intellectual humility, recognition of one’s own limits 2. Recognition of others’ perspectives and broader context outside of the issue at hand 3. Uncertrainty and change 4. Integration of different opinions and a preference for compromise ● Argues that there are very few universally wise perspectives
(Week 9) Lecture 7: Social PersonalityKey Social & Emotional Changes Social and Emotional wellbeing ● Socioemotional selectivity theory ○ Idea that our place in life is going to determine what we most find important ○ The place were at in life has an effect at what we find important and what isn’t important ○ Related to cognition ■ Decision making when older ○ As people get older, people make decisions based on persving relationships ○ When we get older we focus also on experiences and maintaining relationships ● Positivity Effect ○ As people get older thet tend to focus on the positive pieces of information ○ Positive events more than negative events○ Related to cognition, they focus on the positive memories and decisions that they have made in life ○ General trend that we tend to see across all aging adults Changes to social life ● Shrinking Circles ○ This is related to the social circle ○ The idea that as people get older their outer circle starts to decrease ■ People pass away ■ Moving away■ A person inside the circle, closest friends and family ■ Our social circles get more distant as out social circles become bigger ■ Tend to be left with the people they are most close to ● Paradox of well being ○ The idea that even though as people age their cognition and health might start to decline, they will still report that they are happier or just as happy as younger people Self-beliefs ● Self-percepion of aging ○ Is a persons own perspective of their againg process ○ People often see themselves as younger than they actually are
● When someone is confronted with a stereotype about aging, they react in a couple of different ways ○ Integration of stereotype/labeling theory ■ Older adults are more likely to integrate a stereotype into their perception (how they see themselves) unlike younger adults ○ Rejection of stereotype/resilience theory ■ People in general usually tend to want to distance themselves from a negative stereotype ■ They don’t want to integrate a negative stereotype into their perception ■ Older adults are more likely to distance themselves from their age group when a stereotype is relevant to them ● Positive self perceptions and wellness○ Seeing oneself and aging more positively tends to be related to better health, longer life, etc. ■ Two different people begin to see age related decline. The first person takes a resilience approach by saying “sure im having some issues but i can still do so many things and use many tools” that is a positive self perception, postive outcomes. ■ Person two has the same issues but this person is panicking, negative thoughts, anxiety thoughts which would be a negative self perception, negative outcomes. Personal Control ● The degree to which we believe we are in control of our performance within a given situation ● How much we feel that we are in control of our performance within a situation ○ How i am acting in a situation has an impact ○ My actions are within my control within the situation ○ Low personal control ■ Performance in the situation is out of my control ● Relates to many aspects of life & wellbeing ○ This personal control factor is related to a lot of different aspects ■ Physical and mental health ■ Livig situations ■ Adaptions to new living situations ● Too high = not adaptive ○ When they are piercing that they hve more control than they think they do, they can get hurt and won’t ask for help when needed. ○ Having trouble with driving ■ But doesn’t ask for help
■ Does not have much control in this situation, but they believe that they have everything in control ■ They are overestimating their control ● Culturally robust Emotional Intelligence ● Understanding your own emotions and understanding other people’s emotions ● Increases with age ○ We can hold multiple perspectives and see ours and other peoples emotions ○ Tend to see this across culturals ○ Helpful with getting along with others ● Helpful for getting along with others, may play a key role in wellbeing Story, Culture, and Memory ● Collaborative Cognition○ Older adults tend to use this when they are remembering something ○ Working together to remember things – on tests, recalling a memory○ If someone asks someone if they took their medicine ● Collective or communicative memory ○ These are shared longer termed memories ○ They tend to spam 3 or 4 generations ■ For example; history, cultural history ○ Older people are a huge part of maintaining in building collective or communicative memory ● Cultural memory ○ Shared symbolic heritage ■ Food, traditions, music, dances, art, rights and passages, holidays ■ The things you think of when you think of cultural ○ Less physical ■ Values and beliefs ■ Telling people how things used to be or how things can be in the future ■ Sharing stories of their experiences ● Older adults are more fluent & detailed in storytelling contexts compared to young adults Erikson’s Stages ● Erik Erikson (1902 - 1994) ○ Key developmental theorist ○ 8 stages from infancy through late adulthood ○ In each stage, people face a “conflict” which must be overcome. Negative consequences if conflict is not overcome
Stage 7 ● Generativity vs. Stagnation (40s-60s) ○ Having a life purpose ○ What is your life purpose? ○ Creating something we can outlive○ Being present in the world in a meaningful way ● Life purpose and “midlife crisis” ● Higher generativity = positive emotion, higher life and work satisfaction What is generativity? What is happiness? ● What is generativity? ● What is happiness? ○ Feeling good○ Comfy ○ Chill ● Hedonic happiness ● Eudaimonic happiness ● There are many ways to be generative and have “purpose and meaning!” ● Generativity in the 2SLGTBQ+Self-belief and Generativity ● What kinds of things encourage generativity? ● Commitment scripts ○ An early memory of feeling blessed or fortunate regardless of circumstances ○ Caring for others, feeling sensitive to others needs ○ The idea of being lucky in some sort of way ● Redemption sequences ○ A bad experiences really helped this person grow and become a better person ○ They used the bad experience as a learning mechanism ■ They learned from the experience ○ Going through a difficult thing doesn’t make someone more mature■ It just depends on the persons outlook and takeaway ● Going through difficult things dosn’t automatically make someone more mature, it depends on their outlook and takeaway Stage 8 ● Integrity vs. Despair (late 60s+) ● Integrity ○ Mean being at peace with thier earlier life
○ Being at peace with their expereinces, decisions and where they have come in life ● Despair ○ The opposite ○ Having regrets over things in their lives○ Feeling like their life was wasted and nothing ● Generativity and close relationships linked to integrity ○ Tend to be linked towards integrity ○ Higher generativity ○ Having a life purpose ○ Fueling the soul that makes them want to get up in the mornings ○ Having close relationships ● Integrity and wellbeing Sandwich Generation ● Many middle-aged and older adults take care of both their adult children and their aging parents ● Economic difficulties● Income difficulties ● Education expectations ● Mostly aged 40-60, women, higher income, married Effects of Caregiving on Sandwich Generation ● Emotional ○ A lot of people report that both children and parents rely for support ○ Feel stretched because of how much support is needed ● Financial ○ Providing financial support to both kids and parents ○ They tend to have more things that they are paying for ■ Paying for kids college ■ Paying for assisted living for parents ● More likely to report feeling rushed or having less time, more likely to report “extreme stress”○ Their time is split in multiple different places ■ With their kids and their parents Grandparenthood ● Being a grandparent● What is the role of a grandparent? ○ To help younger generation ● Mediation
○ Help with family stress ○ Emotion regulation ○ The “go between” – child and parent budding heads● Stability ○ Help to keep the family close, stablize the family ● Communication ○ Pass on family narraitives ○ Keep the family up to date on family news or drama Grandparents-grandchild relationship ● Distance can make things difficult, but technology can help ● The age of the grandchild can affect the relationship ● Family and cultural expectations around the role of the grandparent are important ● Closeness and involvement factors Grandparenting Styles ● Influential ○ Very close with the grandchild and perform parental roles – advice, discipline ● Supportive ○ They are still close and involved, but they don’t do parenting type activities ○ They don’t discipline, do homework, or pick-up the kids from school ● Authority-oriented ○ The grandparent provides discipline but they aren’t close and aren’t that involved ○ Just discipline ● Passive ○ Not as involved as influential or supportive ○ They are present but usually only on holidays or once or twice a year ■ Wish you a happy birthday but thats it ● Detached ○ Uninvolved ○ Not close ○ Not in the picture ● Influential and supportive roles are more often taken by maternal grandparents than paternal grandparents Benefits of Grandparent-Grandchild Relationships ● Benefits for grandchild ○ Fewer problems ○ Better adjustment during stressful event ● Benefits for grandparent
○ Generaitivity – having a purpose○ Closeness ○ Increased activity ○ Cognitive peace – help with jogging memory and cognitively active – pride peace○ Proud of your family ○ Assistance Caregiving Grandparents ● Legislation and grandparent custody ● General social survey (GSS) data every 5 years, last report = 2022 ○ Almost half of Canadian adults aged 45+ are grandparents○ 1 in 10 children live in a multigenerational household with grandparents, 14% of Indigenous/First Nations children ○ 21% of grandparents reported providing care to their grandchildren in the past year Grandparents and Custody ● Reasons why a grandparent can gain custody in Canada 1. Parental incompetence or Absences 2. Parental death 3. Child’s best interest ● The effects of caregiving on grandparents Big 5 Personality Traits ● Openness ○ Ability or willingness to try new things ○ Explore new things ● Conscientiousness ○ Planning ○ Falling through with plans ● Extraversion ○ Do you recharge with people or alone ● Agreeableness ○ Going with the flow with things ○ Maintaining the status quo ○ Not bringing up if something is wrong ● Neuroticism ○ Range of emotions ○ How emotional someone gets over things
○ Are they easy to get sad, mad, happy, etc● Not the only model, but one of the most population Personality & Aging ● Over time, personality traits tend to strengthen ● Age-related personality changes ● Personality and neuroscience TESSERA Model ● Triggering Situations, Expectancy, States/State Expressions, ReActions Model● Explains how short- and long-term changes to personality happen1. A challenging situation happens2. There are expectations about how the person should act in that situation3. The person may adapt to the situation in a short-term way4. They receive feedback from the environment/situation5. This repeats and can create long-term changes over timePersonality & Health ● Personality Factors Affect Our Health ○ Chronic stress is related to chronic illness ● Downside to neuroticism ● Benefits of openness and conscientiousness ○ Grow more emotionally ○ Try new things ● Considerations about measuring? ○ Self-report bias Identity ● Starts really forming in adolescence, but develops across the lifespan ● Life stories change over time & interact with social, cultural, gender, racial/ethnic contexts & backgrounds Life stories ● Most common themes ○ Agency ○ Communion ○ Beliefs and values ○ Collaborative memory with others helps to shape life story 2SLGBTQ+ Identities
● While much focus is usually on adolescents and young adults, older adults can also discover more about themselves as they age, and they may “come out” ● Co-horts ● Why come out later? ● Midlife may offer a new period of introspection ● Benefits ○ More financially independent ○ Might already have children or a family ○ More emotional stability and self-acceptance ○ Change in emotional intelligence○ More freedom to make more decisions (Week 10) Lecture 8: Mental Health FINALMental Health & Psychopathology ● What is mental health? What is psychopathology?○ Mental health is a holistic term and has to do with someone's mental like wellness and their wellbeing ○ Psychopathology is a lot of people trying to move away from this word ● Birren & Renner (1980)○ Positive self attitude ■ Positive attitudes towards themselves ● Self-esteem○ Confidence ○ Accurate perception of reality ■ Oriented toward what's going on in the world and hat is really happening ■ Hallucinations would fall under inaccurate ○ Mastery of environment ■ Being able to navigate within the world ■ Getting around and being able to function while doing day-to-day things ○ Autonomy ■ Being able to function as an individual ■ By oneself ○ Personality balance■ Not having major personality shifts ● Wild mood swings ○ Growth & self-actualization ■ Being able to learn new things and grow ■ Becoming the person you want to be ● What is the problem?
○ The major problem is that they are largely western based ○ Not often cultural sensitive or relevant ■ Hallucinations in certain cultures, can be seen as a mental illness ■ Whereas in other cultures, this can be seen as a part of growth? Spiritual? Normative? Is it harmful?■ Shift in focus ■ Practitioners trying to be more understanding with this shift Hechanova & Wealde (2017)● Five main cultural components that need to be taken into account:○ Emotional expression ■ Painful memories creates more pain ■ Harmful to talk about things ■ A person's belief around an expression should be taken as an important topic ○ Shame ■ Talking about one’s problems ■ Shameful to talk about family problems ○ Power & Relationship ■ The power differential and the balance between the therapist and the other person ■ Having that power imbalance in the therapy room can exacerbate or make it worse for some issues ○ Collectivism ■ The way a person experiences ■ Focusing on a collective rather than the individual that can affect mental health and the therapeutic practices ○ Spiritually and religion ■ This can affect what is viewed as a symptom ■ It can also offer coping strategies as well for a person Mental Health Factors● Physical/biological ○ There are neurological actors ■ How brain changes can affect our behaviours ○ Genetic factors ■ Genetic components ● Dementia ● Bipolar disorder ● Schizophrenia
■ Neurodivergence that have genetic components ● Normative ● Neurological differences ○ Autism ○ ADHD○ Some problems with physical components ■ Mental health components ● Vitamin deficiencies ● Psychological ○ Age related changes to memory, personality and cognition ○ Can underline different changes ● Sociocultural ○ Is the behaviour normative for the person's culture before assuming things about the person's behaviours Multidimensional Assessment ● Focusing on multiple aspects of someone’s life rather than just diagnosing from the DSM ● The DSM being the diagnostic manual ● Done by a team of different professionals ● Each member of the team is taking care of different aspects that they specialize in ○ Physiatrist ■ Psychopathology ○ Therapist ■ Holistic things ○ Nurse/Doctor ○ Social workers ● Screening vs. Diagnosis ○ Screening/Diagnosis■ Is not a final diagnosis ■ Is an instrument that is used to see if someone is qualified for further questions and services ● Mental status exams ○ And if somebody fails a mental status exam, it’s not okay○ They will take the results and try to further understand the results by doing further testing (cognitive, performance testing) ○ BCAP■ Brief childhood abuse potential ● A test that determines is a parent is at risk for abusing a child
● Catch potential difficult situations early before any abuse happening ● Used as a tool to see if this person qualifies for further support, questions, services. ● Combination of performance tests and daily life functioning Assessment Bias ● What drives bias in assessment?○ Stereotypes ■ When someone has a stereotype of a person, they might expect a person to answer a certain way that they believe about that person based on a stereotype or assumption ○ Positive vs. negative bias ○ Positive ■ Someone might have this stereotype that older people are whacky and eccentric ■ This person is experiencing mental health issues but the person doing the assessment just follows their assumption and writes it off as this is just how older people act and they don;t end up diagnosing the person’s problem ○ Negative ■ Somebody holds an identity based stereotype and might diagnose something that isn’t happening or diagnose something that isn’t treatable ■ If somebody holds racial ethnic stereotypes of gender stereotypes, the person doing the assessment might jump to dementia instead of mild cognitive impairment if the person doesn’t listen to the patient ○ Physical health issues ■ Under the umbrella of negative bias ■ When somebody is experiencing a lot of physical health issues as well as negative or physical health issues, this can make doctors overlook their mental health issues. ■ They don’t think to look for mental health, it kinda gets written off which is a form of bias Methodology ● It’s important to use many methods to assess ● Why?○ Different methods can corroborate together ○ They can give evidence for the other methods ○ Having different methods to assess helps fill in more information
○ Helps with seeing someone’s performance across different contexts ● Different methods ○ Clinical interviews ■ You talk to the person what is going on what them ○ Self reports ■ Fill out some surveys about themselves ○ Interviews with families and friends ■ Answer questions or fill out surveys about the patient ○ Neurological testing ■ Imaging FMRI, MRI○ Biological testing ○ Observation and performance Depression● The belief that “all older adults are depressed” is a stereotype ○ Ageist stereotype ○ Rooted in false narratives about aging ○ Older adults tend to be less depressed than younger adults ● Risk factors ○ People with chronic health conditions ○ Chronic pain○ Nursing home residents ● Higher for women, variable by race/ethnicity ● Symptoms specific to aging adults:○ Pacing or fidgeting ○ Difficulty sleeping ○ Social withdrawal ○ We see this with adults more who are aging and experiencing depression Depression continued ● Genetics account for 40-50% of the risk of depression in adults ○ Half of the risk of developing depression is genetically based ○ Higher rates of depression in people whose relatives also diagnosed ○ Age-related changes in brain structure ■ Different chemicals as people age ■ Different changes in neurotransmitter levels and their functioning especially with serotonin and norepinephrine ■ Later in life we tend to see that these changes in neurotransmitter levels is what’s more related to development of depression later in life ● Other major causes
● Treatments ○ Medication ■ Target the neurotransmitters ■ Focus on their efficacy and uptake of the neurotransmitter ○ Therapy ○ Lifestyle changes ■ Going for walks ■ Doing yoga ■ Can help alleviate some of the symptoms Anxiety Disorders ● Types of disorders ○ General anxiety disorder or generalized anxiety ■ Long-term anxiety ■ Comes and goes ■ Hard to predict and hangs around ○ Panic disorders ■ Panic attacks ■ Different phobias ■ Different situations ○ Agoraphobia ■ Fear of panicking in spaces where it is impossible to leave or it is shameful or embarrassing to leave ● Being in an elevator ● An event that you can’t leave ● People who have this often barely leave their house because they are afraid to have this when they leave the house ○ Anxiety social disorder ■ Anxiety focused on social situations ○ Separation anxiety disorder ■ Being separated from someone ■ Severe anxiety around separation from someone for an adult ● Not wanting their spouse to go on a business trip because of being afraid to not be able to cope ● Again, women more likely than men ○ Assessment bias ○ If the male practitioner holds gender biases, they might not diagnose a man with anxiety or depression because they don’t believe the man is experiencing these disorders ● In some cases, anxiety is reasonable, so may be difficult to work through
○ A person’s anxiety can be reasonable in a situation ○ If somebody is afraid of spiders, and they live in the desert and they encounter a spider, they will have a relatively reasonable phobia which will cause anxiety ○ Lead to difficulties when facing or feeling anxiety ○ When an anxiety is getting in the way of someone daily life, not being able to function, severe distress it becomes difficult ● The most common later-life symptoms ○ The most common for aging adults are ■ Stress■ Impairment ■ Uncontrollable worry ■ Sleep issues ■ Muscle tension● Treatments ○ Therapy over medication ○ Anxiety medications have more risk for older adults Alcohol Abuse ● Alcohol abuse rates are much higher for men○ Why?■ There is a connection to gender and society piece ■ Written off for men compared to woman ● Longer term heavy drinking = worse outcomes ● Drinking norms differ by country ○ Binge drinking peaks at the age of 21 in America ● Triggers for developing a drinking problem in later life ○ Retirement ○ Losing a spouse ○ Experiencing chronic pain ○ Losing their home ● This may lead to issues with medications ○ If someone is taking medications that are normative for aging there can be bad interactions with alcohol if someone is drinking and taking medications ● Older adults are more at risk for alcohol abuse due to normative biological changes ○ These biological changes also make it so that way it takes less alcohol to feel the effects of alcohol○ Medication still stays in the bloodstream ○ As they get older, if they keep drinking, their body is changing, it takes less alcohol to get them drunk, it stays in their bloodstream longer than when they were younger
○ These normative biological changes can create drinking issues, if they keep drinking Types of dementia ● Dementia ○ Is the umbrella term for these illnesses Delirium● Rapid-onset confusion and reduced awareness of the environment ● Cognitive changes ○ Attention difficulties ○ Memory trouble ○ Difficulty orienting with different tasks ○ Speech ■ Starts rambling and becoming incoherent ● Causes ○ Medication side effects ○ Bad interactions with medication ○ Being exposed to toxins ○ Sleep deprivation ○ Dehydration ○ Stroke ● About ⅓ of cases are preventable, almost all cases are reversible and treatable once the cause is found, though in some cases there can be permanent brain damage or even fatality ○ Depending on the person’s situation ■ If they are experiencing delirium, and take the wrong amount of medication, it can lead to fatality Alzheimer’s Disease ● The most common form of progressive, degenerative, and fatal dementia, accounting for 60-80% of dementia cases ○ It’s the most common○ Worse over time ○ Degenerative ■ The person declines and there are physical declines that happen ■ It is fatal ● Once it progresses far ● It is more prevalent in women and older adults ○ Woman live longer than men
○ Risk of alzheimer’s since they live longer ● Early onset ○ Under 65● Later onset ○ Later, after 65● Symptoms ○ Memory loss ○ Difficulty Daily life problems ○ Familiar tasks ■ Something someone does all the time becomes difficult if they don’t remember how to do it ● As simple as making coffee ○ Confusion with time and place ○ Difficulty with words and visual ○ Poor judgement ■ Falling for internet scams ■ Donating way too much money to a cause when they don’t have that much money ○ Social withdrawal ○ Changes in mood and personality ○ Misplacing things ○ Symptoms tend to be bad in the evening ■ This is known as sundowning ● In advanced stages, causes incontinence and immobility ○ People can become bedridden ● Assessment is extensive ○ Screening vs diagnosis ○ Really want to rule out other treatable diseases since alzheimer’s has no cure other than managing symptoms Neurological Causes for Alzheimer’s ● Rapid cell death ○ There is dramatic brain shrinkage that happens in the hippocampus, in the cortex ○ Then the basal forebrain ○ The hippocampus is responsible for memory so we see a huge reduction of the volume in these areas of the brain ● Neurofibrillary tangles ○ The neurons are made up of different neuro fibres○ The fibres in the neurons get tangled up
■ They get tangled up because there is so much phosphate that binds with the proteins in the neuron ■ The phosphate binds with the proteins, tangles up all of these nanofibers■ This makes it hard for nutrients and information to travel through the neuron ■ Eventually because of all of this tangling up, it eventually kills the neuron, it chokes it off and it dies ● Neuritic plaques ○ There are these proteins called beta amyloid proteins ○ They clump up with neuron detritus so like neuron junk ○ The neurons tangle up and kind of fall apart and they get killed○ These beta amyloid proton proteins kind of clump up with all of the neuron junk and they clog up the areas on and around all of the neurons ■ Kinda like how the plaque builds up in the arteries and then it restricts the blood flow and the blood flow can’t get through ○ All of the neurons get clogged up and the information can’t pass through ○ These neurons changes are similar to normative again ● Neuro changes are similar to normative aging, but more rapid and more dramatic Genetic causes of Alzheimer’s ● Early onset (before 65) is often related to gene mutations responsible for beta-amyloid protein production ○ Related to problems with the beta-amyloid production ■ Could be getting produced too much, or not enough which causes problems ● Later onset (after 65) is often related to 9 different genes which are responsible for different processes ○ When take all of these gene mutations, together they paint a more complex idea of what is going on with the 3 causes ● One chromosomal trait related to neuritic plaques ○ This trait, there is new research that if a person was exposed to covid, it might increase the risk of that chromosomal trait expressing ○ There is already a risk, if someone carries that chromosomal trait, it is going to affect those neuritic plaques ● Beta-amyloid deposits could be linked to infection and inflammation Alzheimer’s Treatment ● Currently, there is no cure, no prevention, no treatment, only care and alleviation of symptoms ● Most behavioural interventions
○ Using calendars ○ Using a memory intervention named space retrieval ■ Where a person is taught to remember things at different intervals ● Most effective when paired with broad social support & service provider support ○ Good success ○ Positive reinforcement ○ Friends, community, family ○ Special care nurses, doctors ○ Having a team behind them tends to be the most helpful Other Types of Dementia ● Vascular dementia ○ Caused by numerous small strokes ○ Multiple stroke over time that are small ○ Faster progression ○ Progression tends to be 2-3 years ● Lewy body dementia ○ Protein accumulation ○ Neuron death ○ Mobility issues ■ Visual hallucinations ■ Tremors ● Parkinson’s ○ Starts as a movement disorder ○ Hand tremors ○ Difficulty walking ○ Difficulty with fine motor skills ○ Largely due to dopamine production in the brain ○ Medications can manage symptoms ○ Even brain implants that can target dopamine (kinda like a peacemaker for the heart)● Huntington’s ○ Progressive ○ Very severe ○ Genetically based ■ Only need one parent for it to be passed on ○ Involuntary movements ■ Muscle jerking ■ Twitching■ Hallucinations
■ Depression ■ Paranoia ■ Mood swings ○ High rate of depression and suicide ● Alcohol-related dementia ○ Caused by excess alcohol use over time ○ Mild cognitive impairment ○ Could even lead to dementia ○ If drinking is stopped, then dementia will stop ○ Just depends on when u stop ● HIV-associated neurocognitive disorders ○ Brain infections and inflammation due to the progression of HIV○ Pre-exposure prophylaxis which can reduce people’s risk of contracting HIV● Other types of dementia ○ Disorders in the parkinson’s family ■ Neurological disorder that is treated antibody treatments ■ Pretty rare ○ A Lot of rare neurological illnesses that are similar in these categories Week 11 (Lecture 8): Relationships, Career, & Leisure)Single vs. Marriage ● Deinstitutionalization of marriage ○ It's no longer considered as mandatory to get married as it was years ago ○ Marriage for a lot of people was considered expected and mandatory ○ For a lot of people, this isn’t the case anymore but it all depends on culture ● Choosing to be single ○ A lot of people choose to be single ○ Many reasons ■ Commitment issues ■ Financial ■ Lifestyle and priorities and values ■ Fear Cohabitation ● Living with someone without the commitment of marriage ● Many people live together without being married ● Increase in serial cohabitation ● Varies by culture & generation○ Many cultures which do not agree with this
○ Not allowed in some generations as well● Why?○ Older and do not want to remarry ○ Financial reasons ○ Seeing if their partner is compatible to live with ○ Fear of divorce ○ Previous marriages didn’t end well ○ Economic reasons ● Common Law ○ A couple has basic similar rights to being married without being married ○ Where the couple is cohabitating together for 12 months and more, this couple has these rights ■ Buying a house together, they are allowed to go through a similar divorce process to divide their assets like any married couple would Queerplatonic Relationships● Often seen in the LGBTQ+ community ● Often people might want this if they’re aromantic or asexual ● A relationship that has all these similar commitments to a marriage but no romantic or sexual connection together Pathways of Marriage ● Divorce “danger zone”○ The first four years or so of a marriage where there is a higher chance of divorce ● U-Shaped curve of marital satisfaction ○ At the beginning of the relationship where many relationships start off great (honeymoon phase) and overtime there will be a decline in marital satisfaction ○ When a couple decides to have kids, the satisfaction decreases since it increases marital stress ○ When the children leave the home, then the marriage’s satisfaction starts to increase again ○ When someone retires, you see an upswing in the marriage, but then there is a downswing in the marriage when one of the partners is sick○ It goes down because your partners needs are changing, it is becoming when one partner is sick, the relationship altogether changes for the worse ● “Sweet spot” of attitude and disenchantment ○ When you look at relationship health and coping, there should be a balance between optimism and realism ○ Having the idea that were not perfect but we can communicate our problems, which balances it out
○ When someone is too hopeful and thinks everything is perfect, it can lead to things crashing down and finally facing their problems ○ It can also lead to learning helplessness, they feel like they can’t fix anything and that everything is difficult Relationship phases ● Bernard Murstein’s stimulus-value-role theory (1999)○ Stimulus phase ■ Someone is meeting this new person and they are assessing this new person ● “Am i interested in this person”? Are they interested in me”? ○ Meeting someone and going on a first date with them ○ Going to a coffee shop, noticing a person who is cute and assessing them by asking those questions ○ Value-comparison phase ■ “Does this person match up with me”● Values ● Likes and dislikes ● Interests ● Hobbies ■ Do they connect? Do they agree to anything? ○ Role phase ■ “Okay can we work each other into our lives” or “what do our lives look like with this person in our lives?” ● Homogamy ○ People who are more similar to us or who we tend to be attracted to ○ “Opposites attract” but typically this doesn’t work ○ Higher homogamy is a predictor of higher successful marriages The secret to lifelong passion ● Engaging regularly with each other in interesting and exciting ways○ Going on car rides ○ At-home movie days ● Having growth experiences together○ Things that help this couple grow ■ Cooking class ■ Reading a book together and discussing it ● Examples from the research ● Exchange theory
○ The idea that couples tend to find more harmony together and stay together longer when one of the people in the couple contributes something to the relationship that the other person can’t get from outside ○ Each person in the relationship brings something to the table ○ Something that this person couldn’t provide for themselves so they found someone who could provide what they were looking for, lacking.Divorce ● Divorce rates in Canada ○ Divorce rates have been going down over the years ○ That’s because less people are getting married now○ Less people get married less people get divorced ● Reorganization of life ○ Logistically and emotionally ○ Logistically ■ Shared assets ■ Cars ■ Houses ■ Kids ■ Animals ○ Emotionally ■ You built this life with this person, you have to reorganize your emotions and psychology about not being around this person anymore ● Common feelings post-divorce○ Many people report feeling relief and feelings of liberation ○ Many people also report an increase in sexual connections and attraction ○ Increases in testosterone after divorce Risk factors for divorce ● Negatie vs. positive comments ○ Negative comments out-weight positive comments which are never a good sign● Behaviour during conflict ○ Eye-rolling○ Sarcasm ○ Expressions of contempt ■ Any expression that visually shows that you do not like this person ■ Slamming doors ■ Stomping around ● Sensitivity ○ Not being sensitive for the other partners space
○ Smothering ○ Micromanaging them ○ Controlling them Divorce in middle age ● Divorce initiation and outcomes ○ When woman report initiating the divorce, we often see feelings of growth and optimism ○ When woman report that the spouse initiates the divorce, we see feelings of roominitation and remorse and vulnerability ○ Rumination is when you can’t break the thought through ■ a deep or considered thought about something.● Common feelings ○ Feelings of freedom ○ Happiness ○ Liberation ○ Independence ○ We see this more during middle age ● Financial difficulties ○ When someone has been relying on their spouses income/salary ○ Make it more difficult to be financially independent when getting divorced during middle age Defining work ● How do you define “work”○ Doing something to earn money ○ Getting Experience – exposure ○ Not necessarily having a job – doing work around the house – something thats effortful – putting ourselves to use ○ Getting something in return and putting something effortful out – working with hands, skills, mind ○ People want their work to provide for their needs – financial compensation or experience to get ahead in their career ○ Helps them grow personally and is meaningful in some way ○ Can have different values or ideas – just wanting to make money ● Meaning-mission fit○ The idea that when employers have a better alignment between their mission and their employees they provide a workplace that's more holistically supportive than their employees well-being – a balance between the company mission and what
the employees need and that the employers can better provide holistically for the employees – not just money ○ If they are providing with just money than the wages are good enough ○ Looking for an employer that cares about the employees well-being – stable wages, benefits, work-life balance, safe environment (emotional, psychological harm) Workplace expectations ● There are generational changes in expectations for employers○ Generational shift ○ Millennials and GENz tend to be secure than the other generations (boomers and gen x) ○ It is important that an employer responds and meets to the employee needs● More understanding now of burnout and work-life balance ○ People tend to send more boundaries because they feel they are not worth something important○ Job satisfaction ● Age-related trends ○ In middle adulthood we tend to see job satisfaction for white collar jobs – office jobs ○ We don't see this for blue collar jobs – trade based, physical jobs, construction ○ Differences in promotion – more opportunities for salary raises in white collar than blue collar ○ White collar jobs are stable pay based ○ Blue collar jobs are hourly and not well respected – not many benefits or perks, more physical, plumber, electrician, factory worker – could see wear and tear thats job related ● Employee-employer relationships more complex ○ Dispositions that older generations have is go to work and go home – this could be pre social media and other things like technology ○ Today, there are more interferences with social media – could be fired from something someone posted on social media and entering more boundary less careers ○ The balance between work and life is harder to leave work at work and life at home – a lot of people are on call and are expected to check their phones ○ More smart phone technology ○ This is also due to more frequent job changes – people don't stay in the same job as much as they did in the past – this could be because of the employer
expectations – this leads to less loyalty in a place and employers feel less loyal to a place ○ In younger generations they tend to have a less of an expectation when being loyal to a company Influences on work life happiness ● Privilege to choose a job and goes to it because it's available ● MilL and genZ people tend to believe that job related chances are due to luck ● Does your career match your personality?○ Someone is introverted but gets a customer service job ○ Someone is extroverted and loves to talk to someone but gets a job that remotely at home and talks to nobody ○ If there is a mismatch you could be less happy – vice versa ● Does your workplace satisfy you?○ Intrinsic career rewards ■ Workplace provides you with some benefit to you but it is internal – not concrete, not outside of you ■ Someone is passionate about helping children and gets a job at a nonprofit and helping kids in their city – helping kids and making a difference in their life – aligns with values and beliefs○ Extrinsic career rewards■ External ■ Something thats concrete – the pay is really good, good benefits and retirement, time off – hybrid flex schedule ● Do you feel efficacious in your job? ● Efficacious○ I believe I'm doing a good job – feeling effective – can you do your job well? 1. Role overload a. Your feeling like you’re being given too much to do the job well – the role is overloaded b. Lots of tasks that is being expected of you c. Forgetting what you’re supposed to do because you have too much on your plate 2. Role Ambiguity a. The idea that the manager is being unclear – don’t know what they’re asking of you and don’t know how to do the job that is being expected of you3. Role Conflict a. You can’t balance different parts of your life that is competing for your life and energy
i. Family work conflict – you’re expected to do all the tasks at work but they are not accommodating what you have to do outside of work as well ii. Kids could be sick but the parent can’t take the time off and they work from home Retirement● Why do people retire?○ Could be by choice where they reach a certain year mark ○ Health issues or job loss ● May involve the loss of part of one’s identity ○ This surrounds their careers ○ They BECOME their career as their identity ● Often involves financial decision-making ○ Pension program where you become a certain age and the government gives you x amount per month ○ Sometimes this isnt enough to life on ● Adjustment is dependent on multiple factors Adjusting to retirement ● What factors are related to better adjustment?○ Having better financial security ○ Government pension – retirement funds – match funds and put money into an account for you ○ When there is more financial stability they can adjust better ● Health and adjustment ○ Good health = good adjustment ○ Larger support network – friend and family ○ Internal motivation – learn and try new things ○ If someone retires for their health issues their health tends to decline after their retirement ○ If they didn't, then their it is not related ○ Arthritis – further issues ● Many older adults seek part-time employment and volunteer work ○ Stay active ○ Provides them with resources Age-related changes to leisure activities ● High energy vs. low energy activities and age ○ Younger adults tend to do high energy activities
■ Snowboarding, skiing, jogging, ○ Older adults tend to do low energy ■ Shuffleboard, staying still – watching movies ● Activity level across the lifespan ○ Life long mountain climbers when they are older ○ People have more physical activity leisure when they are in early adulthood and has positive effects in later adulthood Benefits of Leisure activities ● Promote better mental health ○ Negative events can distract from a better mental health ○ Leisure activities can help generate optimism – giving someone something to look forward too ○ Help us connect with ourselves across our life – if we do something when we were younger and we do it when we are older – being a painter ○ Personal transformation – learn things about themselves – help us improve various parts of ourselves, more patient and determined ○ Give people a goal or a purpose – milestone to hit ● Higher marital satisfaction, better relationships, & social acceptance ○ Marriage couples can have activities outside their relationship ● Emotional investment in a place Week 12 (Lecture 9: Dying, Bereavement, Healthy Aging)Death and Dying● Thanatology ○ Study of death and dying processesWhat is death?● The cultural definition varies widely around the world ● Clinical death○ Lack of heartbeat○ Lack of breathing ● Whole-brain death ○ Used in most countries, but varies in culture and religion ○ Loss of function of the entire brain that cannot be fixed■ Brain loses all of its function ○ All of the reflexes in the brain stem stop working ■ can’t be fixed ○ Breathing has also permanently stopped
■ They need external assistance to breath■ Can’t breath on their own ● Persistent vegetative state ○ Brain stem function continues ○ The person still has a heart breath and can breath but has no conscious ○ The person does not recover Bioethics ● The study of our interaction and values as people and advances in science ● The interaction between our beliefs, our humanity and advances in science technology ● Finding the balance between the two ○ As science advances we become capable of more things● Balance between individual choice, minimization of harm, maximization of good● Euthansia ○ Ending a life for reasons of mercy ○ Active euthanasia ■ Diliberty ending someone's life based on their wishes or made by someone who has the legal authority to make that decision ● Medical assistance in dying ● Assisted suicide ■ The person is choosing this and it is being acted out ○ Passive euthanasia ■ Allowing someone to die by withholding the treatment ● Withholding something that would assist them with continuing to live ○ Removing life support ○ Ending cancer treatment ● Medical assistance in dying (MAID) in Canada (2021)○ 18+ decision-making society ○ Eligible for public health care ○ Make a voluntary request that is not due to external pressure ○ Have a serious incurable illness, disease, or disability (excluding mental illness until 2027), be in an advanced state of irreversible decline in capability, and have suffering that cannot be alleviated under acceptable conditions Process of Dying● Kubler-Ross’ Stages of Dying ○ Denial ■ “This can’t be happening”○ Anger
■ Anger over what is happening ○ Bargaining ■ “Please let me live until whatever… event”○ Depression ■ Being sorrowful over what happened ○ Acceptance ■ Accepting what happened ○ (meaning-making was added in 2019 by co-author Kessler. This refers to how we make meaning from a loss)■ How we make meaning from a loss ■ Our healing and processing can lead to different understanding and processing of why this is happening Critiques to the Theory ● Interpretation of the framework ○ Better explanation for possibilities about the death and dying process● Progression through the stages ○ Most people do not progress through these stages in a linear direction ○ They bounce from one stage to another ● Use of the framework ○ Use it as a guideline by understanding the emotions the person is going through ○ Understanding that a person can go through all of the emotions all at once or through different times What is a “Good Death?”● Minimizes pain and suffering ○ Not “scary” not “painful or traumatizing” it is as peaceful as it can be ● Depends on the perceptions that someone takes on the individual that passes away ● Different cultures have different beliefs about death ● Maximizes psychological security and control, minimizes fear and anxiety ○ This person has some psychological control about death ● Be close emotionally to the people we care about ● Have the sense that there was integrity and purpose in our lives Helpers of Death ● Palliative care○ Beginning of treatment often during a terminal illness ○ The goal is to help someone feel more comfortable during that treatment process ○ Cancer – number 1
○ Medical care and physical care – dealing with side effects and dealing with treatment, psychological care, and social care ○ Could be in a centre or the person’s home ○ The length of this could be up in the air – the treatment could work and prolong the person's life● Hospice care○ This begins at the end of treatment to make them more comfortable in their final days ○ A recognition that the person is going to pass away just a matter of when ○ After palliative care and the treatment is not going to work ○ medical , physical, psychological, social care ○ Could be in a centre or in a home ○ Depends on what a family can do – emotionally and logistically– if it is at the home then the family members must be at home to help with the hospice process ● Death doulas ○ Provide logistical support – drawing up wills and legal paperwork – helping with the hospice process and getting things in order – things in order for a funeral – what’s your funeral plan? How do you want this to look? ○ Coaching aspect of coordinating visits with family and friends ○ May help with planning a meal training/ planning ○ Advocate piece – speaking up for the person who is dying and also the people who are surviving ○ Mostly emotional and spiritual support and some of the logistical support as well Bereavement, Grief, Mourning ● Bereavement ○ State or condition that is caused by a loss through death● Grief ○ The feelings that come up after the loss – sadness, anger, confusion ● Mourning ○ How we express how we express the feelings, the practices that we do – cultural, rituals ○ Families to families, culture to culture ○ Within the culture you could have different practices from a different culture ○ Actions and expression ● The process of grieving is an active coping processes ○ Grieving takes time and the involvement ○ Ackonolde the reality of the loss – understand that it happened instead of living in denial
○ Working through the emotional turmoil ○ Adjust to the environment where the deceased is absent (reorganizing the time you spent, where you live, your practice) without the person in it ○ Loosening ties to the deceased – finding effective ways to say goodbye to the personGrief● Grief is highly variable ● Muller and thompson (2003)○ Coping■ People talk about different things they did to try and deal with the loss that happened ■ People are going to find different ways to deal with loss ■ Coping madic to find themes for death ○ Affect■ Emotional reaction to the death ○ Change■ The ways that survivors lives change ■ Rearranging your lie without this person in it ■ Share feelings with overcoming ○ Narrative ■ The stories told about the dead■ A lot of people talk about their relationships ■ How this person was is a key thing to talk about when talking about someone who died ○ Relationship■ Very similar to narrative ■ “Who was the deceased to them” or “what relationship did the survivor have with the deceased”Symptoms of Grief ● Psychological symptoms ○ Sadness ○ Emotional instability ○ Anger ○ Frustration ○ Resentment ○ In the fear of things ○ Anxiety ○ Insecurity
○ Helplessness ○ Relief ■ Depending on that person’s way of passing due to their pain or terminal illness ■ Abuse ● Physiological symptoms ○ May not be as apparent ○ Fatigue ○ Changes to our sleep■ Insomnia ■ Having trouble falling asleep ○ Hypersonia ■ Too much sleep○ Feeling really sluggish ○ Appetite changes ■ Increases in appetite or a decrease ○ Muscle aches ○ Increase clumsiness ○ Lowered immune system ■ Can be due to stress● Dates may reintroduce grief symptoms after initial symptom reduction○ Anniversary reaction ■ Grief reactions get worse during special occasions ● Birthdays, holidays, anniversaries ● Grief looks different for different people ○ What may look strange may not be strange Understanding Grief ● Four component model (Bonanno, 2009)○ Context of loss■ Taking into account whether the death was expected or not■ The circumstances involving the death○ Meaning associated with the loss■ What does the loss mean for this person’s death ■ Day-to-day considerations ● Someone driving you to get groceries everyday, but now they aren’t around to drive you around ○ Changing representation of the lost relationship over time ■ How someone feels about their relationship with the deceased person over time and how it changes over time
○ A broad understanding of coping mechanisms used and ways of regulating emotions ■ Understanding that people will cope in different ways ● Situations that cause grief ○ People can mourn the loss of something they never had ○ Just the loss of not having a regular day-to-day type of thing ○ The loss of what is normal or what could have happened ○ Grieve the loss of normalcy ○ Grief over good things ■ Grief over the good things that happen as well■ Moving away, happy to be moving out but grieving about the old life ● Anticipatory grief ○ Feel grief surrounding an impending loss○ Anticipating a loss that will be happening ○ Knowing a loss is happening so we start grieving ○ Form of anxiety ○ If someone is sick and knowing that they might pass away soon ● Ambiguous loss ○ When there is no closure during a death or a loss ○ There is no closure, you don’t know what happened○ No understanding of the outcome ■ Missing persons ■ You don’t know what happened to this person ■ Someone who has dementia ● There are physically there but not mentally, they don’t remember anything and can’t recall anything Dual Process Model and Model of Adaptive Grieving Dynamics ● Grief isn’t something to be moved through and overcome, it is a processes of forever finding balance ● Dual model ○ Idea is that people zigzag back and forth between moving on and disengaging ○ They engage with the grieving process, they are trying to move on and then they back off ■ May be involved in grief support, and then they distract themselves ■ You bounce back and forth between the two ● Adaptive grieving model ○ The griever is moving between the stages, they are all over the place ■ Lamenting ● Someone experiences and expresses their emotions
● Sadness, crying, telling stories about the dead ■ Heartening ● Experiencing and expressing the grieving responses that are uplifting and pleasurable ● Telling funny stories and good memories about the dead ■ Temperting ● Shutting down the acceptance of the person who is dead ● Avoiding integration ● Avoiding acceptance of reorganizing their life ■ Integrating ● Is when the person comes to terms with their changed realities without this person ● They have reorganized their lives without this person ● They are accepting the loss ○ Main takeaway ○ Grief isn’t something you take and overcome ○ You don’t just stay on one side of the box, you bounce back between all of these steps Widowhood and Mourning ● Mourning pathway ○ During the first couple months, it is very common for the surviving spouse to rethink about the deceased's last couple hours and days ○ To keep replaying the final days, hours, the last of their time with them ○ Especially true if the death was sudden ○ Tend to see this across baseline ○ See it more intense more highly experienced if the death was sudden ○ A decline in wellbeing for the surviving spouse during the first year, and then it goes up during the second year ○ High self efficacy ■ I can do things ■ Re-organizing ■ Being able to learn how to do things that you didn’t do when your spouse was around ○ Low self efficacy ■ Feeling like i can’t do things on my own ■ Tanks ■ It goes way down■ I can’t do all of these things without my spouse ● Widowhood mortality effect
○ There is a higher risk of death for the surviving spouse ○ Also a rate 2 out of 5 people after experiencing the loss of their spouse that they will experience depression or experience death themselves ● Social support ○ Friends ■ Tends to be most helpful, not from family who is related to the deceased ■ Friends who have lost a spouse also are most helpful ■ Shared mourning Ways for Managing Grief ● Come back to the present when thoughts start to race. Try mindfulness techniques, such as naming five objects within the room. Practice breathing techniques ● Have patience and compassion for yourself, your emotions, and your grieving process. Recognize that your process will look different than someone else’s. Try not to judge your emotions-grief often will make unexpected and difficult feelings come up ● Acknowledge your pain. Pushing it away often makes it worse or prolongs it● Reach out for in-person support whenever you can and whenever necessary. Remember you’re not in it alone. If you need emergency help, contact immediate support1. Try to get back to a sort of daily routine. Having routine can give us control over our daily lives when we feel happiness 2. Practice regular hygiene-change your clothes daily, shower regularly, brush your teeth daily, even if you’re by yourself or staying home 3. Express your feelings somehow. Talk to other people, write in a journal, listen to music that helps you express your emotions, etc. 4. “Chunk” your time. Try to get through each day, each week, each month, in as small of chunks as you need. Sometimes just getting through the day is a challenge, but if you can focus on just one day, it’ll feel less overwhelming 5. Try to find an activity to keep focusing on, such as a hobby or a show you like Healthy Aging ● What is the future of Aging?What is healthy aging ● In december 2020, United Nations declared healthy aging as a human right ● Priorities ○ Ensuring healthy aging for al people ○ Combating ageism ■ fighting against it in all its forms ○ Build and promote age friendly environment ○ Integrating care
■ Holistic care ● All the domains of development ■ Long term care so that people can have that support ■ Alleviating social isolation and loneliness ● connecting people and communities and reducing the aging – the experience ● Healthy aging ○ Avoiding diseases ○ Help people be engaged in their lives and help them boost their functioning across all domains ■ Physical functioning , cognitive functioning, etc Salutogenesis (Antonovsky, 1979)● The idea of focusing on the positive things and emphasizes the things that support people and promote help ○ Prevention, thriving ● Sense of coherence ○ The idea of supporting life that is comprehensible or able to understood that life if meaningful to people and life that is manageable for people ■ Where there is a meaning and purpose in someone’s life ● Interaction between sense of coherence, life experiences, and generalized resistance resources (GRRs)○ GRRs■ Generalized resistance resources ■ Our resources that help us deal with stressors ■ Individual, environmental ● they help us cope and avoid the stresses in order to manage them ■ Internal ● might have the skill of mindful meditation ■ External ● having a friend to talk to ● Importance ○ This shifts the focus from the negative ○ Used in different contexts Strategies for Healthy Aging ● Physical movement ○ Having just the right of movement ○ Moving around ○ Exercising
● Nutrition ○ Vitamins and minerals ● Sleep○ Enough sleep ● Quit smoking ○ ● Avoid excessive drinking○ Regular binge drinking all the time ○ Not promoting a healthy diet● Go to the doctor regularly and get preventive screenings ○ Preventive screening ○ Getting cancer screening ○ Getting a Pap smear● Social engagement ○ Staying as engaged with other people as much as possible ○ Boost motive ● Monitor & manage stress & mood ○ Try to reduce chronic stress as much as possible ● Engage in leisure activities and generativity-building activities ○ Things that give one’s life a purpose or meaning ● Stay cognitively active○ Brain puzzles on your phone○ Doing crossword puzzles ○ Just getting your brain thinking