PSYCHOLOGY OF AGING
Material for the Final Examination
RELATIONSHIPS
I. Family.
1. Function.
2. Assumptions regarding the elderly.
1. Change in family structure.
– Extended Family.
– Nuclear Family.
– Modified Extended Family (MEF).
2. Less support for the elderly.
a. Characteristics.
1'. Proximity.
2'. Amount of interaction.
3'. Quality of interaction.
b. Generational Stake Hypothesis.
C. Family Life Cycle.
1. Stages
– Nine stages.
– know last three.
2. Problems associated with ‘launching’ children,
a. 'Empty Nest' phenomenon.
b. Off-time Departure.
c. Refilling the nest.
3. Late-life marriages.
a. Devitalized marriages.
b. Intimate long-term relationships.
– post-conformist ego development.
II. Grandparenting.
A. Grandparenting roles.
1. Family watchdog.
2. Arbiter.
3. Stabilizer.
4. Historian.
B. Grandparenting styles.
1. Remote grandparents.
2. Companionate grandparents.
3. Involved grandparents.
– non-interference.
C. Grandparents at risk.
A. Grandparents as primary caregivers.
– off-time event.
B. Grandparents of divorced children.
– matrifocal orientation of the family.
III. Sexuality.
A. Desexualization.
1. Myths.
2. Reality.
a. Gender gap.
b. Partner gap.
B. Influencing Factors.
1. Physiological.
a. Men.
1'. Changes.
2'. Advantages.
b. Women.
– Menopause
1'. Physiological changes.
1'. Cassation of menstruation.
2'. Decreased production of estrogen and progestin.
3'. Ovaries cease releasing ova (eggs).
2'. Sexual implications.
a'. Thinning of vaginal wall.
b'. Decreased vaginal lubrication.
c'. Changes in the libido.
– Hormone Replacement Therapy (HRT)
– Testosterone patch.
– Intrinsa.
2. Psychosocial.
a. Boredom.
b. Concern over economic pursuits.
c. Fatigue and overindulgence.
d. Drugs.
1'. Alcohol.
2'. Nicotine.
3'. Other drugs.
e. Lack of privacy.
f. Illness.
g. Lack of a partner.
IV. Dependency.
A. Definition.
B. Models.
1. Lack of Competence.
2. Learned Helplessness.
3. Differential Contingencies.
– Dependency-support scripts.
4. Selective Optimization With Compensation.
a. Selection.
b. Optimization.
c. Compensation.
SENSATION/PERCEPTION/COGNITION
I. Model.
II. Sensation.
A. Response Bias.
– Signal Detection Theory.
B. Audition.
– Presbycusis.
1. Speech.
– Elderspeak.
2. Tinnitus.
C. Vision.
1. Presbyopia.
2. Cataracts.
3. Macular Degeneration.
4. Dark Adaptation.
– Senile miosis.
5. Decreased sensitivity to colors.
D. Taste and smell.
III. Cognition.
A. Definition.
B. Operationalization.
– Intervening variables.
C. Information Processing Model.
1. Sensory Stores.
a. Iconic memory.
– Icon.
– Masking Studies.
b. Echoic memory.
– Echo.
– Dichotic Listening Studies.
– Half-sets.
2. Short-term Store (STS).
a. Capacity.
1'. Storage capacity.
2'. Processing capacity.
– Automaticity.
b. Search.
– Sternberg paradigm.
– Memory set.
– Probe digit.
– Slope.
– y-intercept.
c. Transfer to long-term store.
– Search set.
– Rehearsal.
1'. Maintenance.
2'. Elaborative.
– Production deficit.
– Mandler sort.
– Visual mediating task.
– Paired-associates.
d. Retrieval from LTS.
– Probe.
– Intrusion errors.
INTELLIGENCE
I. Definition.
– Higher mental processes.
II. Research Design.
– Cohort.
A. Cross-sectional.
1. Cohort effect.
2. Cohort definition.
B. Longitudinal.
1. Period effect.
2. Selective attrition.
III. Intelligence Factors.
– Factor analysis.
A. One-factor theories.
– g-factor.
– FSIQ.
B. Two-factor theories.
1. Verbal-performance (Wechsler).
– VIQ
– PIQ
– Classic age pattern.
2. Crystallized-fluid (Horn & Cattel, 1965).
C. Multi-factor theories.
– Thurstone’s Primary Mental Abilities (PMA).
– Seattle longitudinal study (Warner Schaie)
IV. Survivability.
A. Definition.
B. Terminal drop.
C. Critical loss.
WISDOM
– The Berlin Model (Baltes & Staudingen, 1963).
I. Definition.
II. Acquisition.
A. Age.
1. Cognitive Mechanics.
2. Cognitive Pragmatics.
B. Experience.
1. Factual Knowledge.
2. Procedural Knowledge.
3. Life-span Contextualism.
4. Relativism.
5. Uncertainty.
III. Life dilemmas.
PSYCHOPATHOLOGY
I. Senile Dementias.
– Senile Dementia of the Alzheimer's Type (SDAT, or more commonly, AD)
A. Statistics.
B. Signs and symptoms.
1. Neurological.
a. Neuronal cell loss.
b. Senile plaques.
– Amyloid.
– Amyloid precursor protein (APP).
c. Neurofibrillary tangles.
d. Neurotransmitter deficits.
– Choline acetyl transferase. (ChAT).
– Acetylcholine.
2. Psychological.
– Reisberg’s seven stages.
– Retrograde amnesia.
– Anterograde amnesia.
– Early dementia stage.
C. Etiology.
1. Trace metals.
2. Genetic.
3. Prions.
– proteinaceous infectious particles (“pree’-ons”).
– Spongiform encephalopathies.
– Scrapie.
– Bovine spongiform encephalopathy.
– Creutzfeldt-Jacob Disease.
– Kuru.
D. Diagnosis.
1. Magnetic Resonance Imaging (MRI).
2. Neuropsychological testing.
3. Odor identification.
E. Prognosis.
– 36-hour day.
– Sandwich generation.
F. Prevention and treatment.
1. Medical.
a. Prescription drugs.
– Cognex and Aricept.
b. Over-the-counter medications (OTCs).
1'. Vitamin E.
2'. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
c. Telomerase.
– Apoptosis.
d. Estrogen Replacement Therapy (ERT).
2. Psychological.
a. Obtain clarification of the patient’s wishes.
b. Use cuing and scheduling.
c. Simplify the environment.
d. Socialization/group therapy.
e. Orientation therapy.
f. Family counseling and support groups.
II. Acute Confusion.
A. Definition.
B. Signs and symptoms.
– Sundowner Syndrome or Twilight Syndrome.
C. Etiology:
1. Depression.
2. Sudden environmental changes.
– Transfer trauma.
3. Iatrogenesis.
– Polypharmacy.
D. Psychological treatment.
III. Depression.
A. Symptoms.
– Beck’s criteria.
1. Specific alteration in mood.
2. Negative self-concept.
3. Vegetative changes.
4. Regressive or self-punitive wishes.
5. Changes in activity level.
B. Etiology.
– Loss.
C. Treatment.
IV. Suicide.
A. Statistics.
– The most at-risk group for suicide in the United States is older white males.
B. Etiology.
1. Loss of power.
2. Loss of social support.
3. High success rate.
4. Less likely to seek help.
5. Depression & Hopelessness.
C. Prevention.
1. Routine medical screening for depression.
2. Training outreach workers to recognize the signs of depression.
3. Correct misunderstandings.
CARING FOR YOUR PARENTS
I. Approaching the problems.
A. Deciding when to discuss.
B. Strategies.
1. Bringing up the subject.
2. Learning about the options.
3. Filling out advanced directives.
II. Living assistance.
A. Types of senior living arrangements.
1. Nursing homes.
a. Services provided.
b. Two types.
1'. Skilled nursing facilities.
2'. Intermediate care facilities.
c. Nursing Home Reform Act (1987).
– Resident's Bill of Rights.
2. Residential care facilities.
3. Assisted living facilities.
4. Subsidized senior housing.
5. Retirement communities.
– Continuing care retirement communities (CCRC).
6. Day care centers.
III. End-of-life Care.
– without an advanced directive, every attempt will be made to Prolong life.
– Nancy Cruzan.
– The U.S. Supreme Court decision.
A. Living wills.
– Luis Kutner.
B. Durable Power of attorney (health care proxy).
– Differences between a durable power of attorney and a regular power of attorney.
– Advantages.
C. Patient's Self-Determination Act (PSDA).