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Sociology 120
Introduction to Gerontology

FINAL EXAM REVIEW

Overview

The Final Exam is comprehensive and consists of 75 multiple-choice and true-false questions.

Remember this review can help you summarize the text chapters throughout the class.

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Chapter 1: The Growth of Social Gerontology

Ageism

A form of discrimination against the elderly.
It attributes characteristics to all members of a group solely because of one characteristic they share- in this case age.
Negative attitudes develop from anxiety about our own aging and many of these fears arise from misconceptions about what happens to our bodies, our minds and our social status as we age.

Gerontology

Is the study of the biological, psychological and social aspects of aging.
Gerontologists view aging in terms of these three processes as well as chronological age.
Chronological age, or years since birth, is not necessarily related to a persons physical health, mental abilities or social status.
Geriatrics is focused on how to prevent and manage age related diseases and is only a small part of the field of gerontology.

Interest in Gerontology

The most important factor affecting the current interest in gerontology is the growing size of the elderly population.
People are living longer.
Life expectancy is the average amount of time one could expect to live if born in a particular year. Women still live longer than men but in the last 10 years this sex difference in life expectance has declined

Active vs Dependent Life Expectancy

Distinguishes between merely living a long life and living a healthy old age
Personal health habits like exercise and a healthy diet can improve your chances of an active life expectancy.
Illustrates that not all gains in life expectancy are postitive

Life Span vs Life Expectancy

Life span differs from life expectancy, it refers to the maximum number of years a species is expected to live if environmental hazards were eliminated.

Demographic Trends

The population aged 85+, referred to as the oldest old, has grown more rapidly than any other population in the US.
Today ethnic minorities comprise 15% of the population over 65; they include a smaller proportion of elderly and a larger number of young adults than the white population.
Socialization into old age is difficult because there are few role models of successful aging to follow.

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How the Older Population is Studied

A key point that complicates research in aging is distinguishing age changes, the ways people normally age over time, from age differences, the ways one generation differs from another.
Most research focuses on age differences, by comparing people of different chronological ages at the same point in time. These studies are called cross sectional and are the most common studies in gerontology.

Terms Your Should Know

Valid refers to results which accurately reflect the concepts that they are intended to measure, that is valid measures mean the same thing to all groups participating in the research.
Reliable refers to results that remain the same in repeated measurements of a phenomenon.
Representative refers to selecting a sample for the research that accurately portrays the older population.

Chapter 2:Historical and Cross-Cultural Issues in Aging

Sociocultural Gerontology or an Anthropology of Aging

The experiences of aging are not the same today as they were in other times. Experiences differ not only historically but also cross-culturally.
This field has begun to differentiate what aspects are universal or biological and which are shaped by the socio-cultural system.
Greek and Roman cultures first defined age in chronological terms, with old defined as 65+
Only elite members of society benefited from this increased status with age in Greece.
In most societies the elderlys status is largely determined by the balance between their perceived contributions to society and the cost of maintaining them. Age related status is more related to knowledge of traditional skills, control of information, property rights and political power than just chronological age.

Modernization Theory

Modernization theory is one of the explanations advanced for the decline of status of the old in our society. It states that as society becomes more modern, older people lose political & social power, influence & leadership.
Fischer disagrees w/ the modernization theory. Know that he suggests that the emphasis on youth can be attributed to our cultural values of liberty and equality.
He also noted that as wealth became a source of identity in the US it created countervailing forces to a sense of community that had been founded on the power of elders. Thus an age equality that had initially replaced veneration of elders was later supplanted in the 19th & 20th C with a growing veneration of youth and a contempt for old age.

Chapter 3: Biological & Physiological Context of Social Aging

Kidney & Bladder Function

With age our kidneys decrease in volume and weight, as a result renal function can decline up to 50% with age.
Of any organ system renal function declines most dramatically with age, irrespective of disease.
Urinary incontinence is common among the elderly. It results from reduced bladder capacity (by as much as 50%), brain changes that effect the sensation to void and nervous system diseases.

Musculo-Skeletal System

Our muscles and bones decrease in size with age.
The spine becomes more curved and discs in the vertebrae become compacted.
A loss in height is intensified by a disease called osteoporosis which makes bones less dense and more prone to fractures.

Changes in Sensory Function

There is variability in the rate and severity of sensory decline but we will see changes in vision, taste, touch, hearing, smell, mobility and kinesthetic sense with age.

Cataracts

Cataracts are the second leading cause of blindness in the US.
As with the collagen in other parts of the body, the collagen in the lens of the eye thickens and hardens with age. This does not happen uniformly, therefore there is uneven light refraction through the lens and sensitivity to glare results. The lens becomes more opaque, less light can enter, thus compounding the problems of poor vision in low light.
The most severe clouding, to the point that light cannot enter is a cataract.
Cataracts can be surgically removed with the lens and a lens implant can be put in its place. This is the most common surgical procedure performed on people over 65.

Adapting to Vision Change

Reading small print, adjusting to glare and dimly lit environments, tracking moving targets and locating a sign in a cluttered background are all more difficult as we age.
The best strategy for an older person experiencing vision problems is to modify the home environment to make it meet their changing needs- Use non-glare coverings, clear out the clutter, use three-way bulbs that can be adjusted, mark or remove changes in floor surfaces.

Hearing

Because hearing is close to speech, its loss disrupts a persons understanding of others and even the recognition of ones own speech.
Loss of hearing appears to be significantly affected by environmental causes.
Hearing loss can be of several types, involving limited volume and range or distortion of sounds perceived.
Age related hearing loss results in problems with hearing high frequency sounds, distinguishing among sibilants, and distinguishing background noises from relevant information.
In contrast low frequency hearing loss has minimal impact on speech comprehension.
Hearing aids do not always help. Many older people stop wearing their hearing aids because they magnify the background noises as well as the ones the listener is trying to hear. An older adult may also feel a greater social stigma wearing a hearing aid.

Taste & Smell

Recent studies have found only minimal age related changes in taste, but age related changes for smell are greater.

Kinesthetic System

Lets the individual know their position in space- because of age related changes in the nervous system, older people demonstrate a decreased ability to orient their bodies in space and to detect externally induced changes in body position.

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Chapter 4: Managing Chronic Diseases and Promoting Well- Being in Old Age

Health Promotion

Health promotion programs should attempt to improve the general environment as well as the individual's health practices.
Altering an individuals health practices can improve their life expectancy because as many as 80 percent of the chronic diseases that afflict the elderly are related to social, environmental and behavioral factors, particularly poor health habits.

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Chapter 5: Cognitive Changes with Aging

Cognitive Functioning

Intelligence: theoretical limit of an individuals performance.
It is determined by biological and genetic factors and influenced by environmental opportunities.
A distinction is made between fluid and crystal intelligence- fluid intelligence consists of skills that are biologically determined, independent of experience; crystal intelligence refers to the knowledge & abilities one acquires via experience.

Recall and Recognition

Recall is the process of searching through vast stores of information in the secondary memory (long term memory).
Recognition requires less search, information is matched to the question.
Most researchers have found age related differences in recall but not in recognition.

Learning and Memory

Learning is the process by which new information is encoded into ones memory.
Sensory Memory is the 1st stage of receiving information through the sense organs.
Primary Memory is a temporary stage of holding and organizing information.
In order to retain information we must rehearse it and then it goes to our secondary memory.
Older learners can be helped by a supportive environment that offers positive feedback and real world conditions.

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Chapter 6:Personality and Mental Health in Old Age

Personality Theories

Eric Erickson's psychosocial model has 8 stages beginning with trust vs mistrust and ending with ego integrity vs despair.
Freud suggests that one's personality is developed by adolescence.
Carl Jung feels an individual must find meaning in inner exploration and in an afterlife.

Stress

Cognitive appraisal or the way a person perceives the significance of an encounter serves to minimize or magnify the importance or stressfulness of an event by attaching meaning to it.
A strong social network can provide emotional support and help relieve stress.
One's level of functioning and their locus of control will also affect their response to stress.

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Chapter 7: Love, Intimacy and Sexuality in Old Age

Sexuality

Is defined as a quality of the person, an energy force that is expressed in every aspect of being.
In old age sexuality if often expressed in ways other than genital contact, but it normally is an important part of relationships in late adulthood

Age Changes in Women

The climacteric, a loss of reproductive ability, takes place in 3 phases: premenopause, menopause and postmenopause.
Although 80 percent of women aged 45 to 55 experience some discomforts most find that these changes do not interfere with their daily activity or sexual functioning.

Age Changes in Men

Male menopause or viropause differs from menopause in 2 ways: it comes later, after age 50 and progresses at a slower rate.
The length of time between orgasm and subsequent erections increases.
Sexual response is altered but sexual performance remains.
Impotence is a chief cause of older men's withdrawing from sexual activity. Sexual dysfunction is common and treatable. Physiological factors should be ruled out first.

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Chapter 15:The Resiliency of Older Women

Women and Aging

The primary reason older women have become a focus of research is that they form the fastest growing segment of the population, especially among the oldest-old.
Women's experience with aging differs from mens in patterns of health and life expectancy. The greatest problem faced by women today, especially for women of color, is a lack of adequate income.

Health Status

Previous family and work patterns affect a woman's access to health care and information.
Older women who are never or sporadically employed generally have inadequate health insurance.
Eighty-five percent of older women have chronic non-fatal diseases, combined with a lack of funds and you can see why more elderly women are institutionalized.

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Chapter 8: Social Theories of Aging

SocialTheories

Address the basic question of the optimal way for older people to relate and adapt to their environment.
The 3 major Social Theories you will need to recognize are: Activity, Disengagement & Age Stratification/Role Theories.

Activity Theory

The dominant theory of social gerontology.
Assumes people who are active are more satisfied and better adjusted.
Successful aging entails staying involved in as many roles as possible and finding substitutes for lost roles.
Limited in that it fails to account for role of personality, socioeconomic status and lifestyle variables that affect one's activity level.

Disengagement Theory

Challenges assumption that the elderly have to stay active to be adjusted.
Views process whereby people decrease their activity levels, seek more passive roles, interact less frequently and become preoccupied with their inner lives as normal.
Limited in assuming disengagement is inevitable, functional and universal. Not supported by empirical research. Neither activity nor disengagement address the historical or cultural context of aging.

Role Theory

One of the earliest attempts to explain adjustment to aging is Role Theory.
Roles, i.e. mother, businessman, etc. identify and describe the person. Roles are identified with age or a stage in life.
Age norms serve to open or close roles to people of different ages- They are a belief that people of a certain age can and ought to do only certain things.

Age Stratification/Role Theory Continued

Life course dimension is our chronological age or stage in the life cycle.
Historical dimension is what is termed cohort. The events shared by people born at the same time allow them to share a common historical and environmental past.
Limited because it stresses chronological age and gives little importance to appearance or level of functioning.

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Chapter 9: The Importance of Social Supports: Family, Friends and Neighbors

Social Supports

Informal, reciprocal relationships are a crucial aspect of an older person's well-being and autonomy. Informal social supports include friends, neighbors and acquaintances and can become more important in times of cutbacks of formal services.
Family members are a primary source of emotional and physical support for the elderly.
Most elderly live with a spouse, children or other relatives. The majority of elderly live close to at least 1 adult child and see them frequently.

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Chapter 10:Opportunities and Stresses of Informal Caregiving

Sandwich Generation

Women compose nearly 80 percent of caregivers. The sandwich generation is faced w/ the competing responsibilities of work , parent and child care.
Women can now expect to spend more time taking care of their elders than raising their children.

Caregiver Stress

In some cases stress can become severe and lead to family conflict, abuse or financial exploitation of the older adult.
Elder abuse is an all-inclusive term representing all types of mistreatment or abusive behavior.
Abuse is not readily discernable and is typically concealed either by the caregiver or the care recipient underlies the low reporting rate.

Fiduciary Abuse

Very common- it happens when the caregiver takes the money of the elder. The group that is at most risk of elder abuse is the oldest-old woman.

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Chapter 11:Living Arrangements & Social Interactions

P-E Theories of Aging

An individual is more likely to experience life satisfaction in an environment that is congruent with his or her physical, cognitive and emotional needs and abilities.
Murray's theory of personality provides the earliest framework for the P-E Models. He saw the individual in dynamic interaction with the environment.
The theory assumes that behavior varies as a function of personal and environmental characteristics.

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Chapter 12:Productive Aging: Paid and Non-paid Roles and Activities

Patterns of Work and Retirement

Among those 65+ about 16 percent of men and 9 percent of women are in the labor force.
Part-time work may reflect job satisfaction, a desire to feel productive or attachment to one&339;s work. However, it more often reflects economic necessity.
Adequacy of income and good health have been found to be the most important factors in determining when a worker will retire and in adjusting to retirement.

Activity Patterns

Many people lack experience in satisfying nonwork activities at earlier phases in their lives.
Societal values are changing regarding leisure.
Leisure can provide a meaningful substitute to the work role for some older adults, while others find that keeping busy and utilizing work-like activities for leisure gives them satisfaction.
Compared to younger people, older people are more likely to engage in solitary and sedentary activities.

Religion

Spirituality defined as trust and faith in a greater power is an effective way to cope. One can be spiritual without being religious.
Religious activities and attitudes have been associated with life satisfaction and adjustment in old age.
Religion seems to be more important to older than to younger people- but this group of older people probably also valued religion when they were young. Contrary to stereotype, we do not become more religious as we age.

Political Life

Political acts range from voting to participation in a political party or political action group.
Stage in life cycle, cohort effects and historical or period effects make analysis of political behaviors complex.
Older people are generally stable in their political beliefs or change their beliefs slowly.
How a person thinks and acts politically can be traced largely to environmental and historical factors not to that person's age.
The largest and most influential senior organization the AARP, was organized on a short-term basis to promote specific pieces of legislation and not to intervene continually in the political process on issues affecting older people- like meeting the needs of low income elderly.
Legislation comes not from organizations but from lawmakers and citizens who feel the elderly are deserving.

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Chapter 13: Death, Dying, Bereavement and Widowhood

Death

Death is associated with old age.
Before the 20th C most people died at home. Now over 75 percent of all deaths occur in institutions.
More insulated from death, more people are uncomfortable talking about it.
The elderly think and talk about death more and typically have fewer fears about death than do younger people.
A number of factors explain this lessened fear- know them

Kubler-Ross

One of the most widely known frameworks for understanding dying.
There are five stages: denial and isolation; anger and resentment; bargaining and an attempt to postpone; depression and a sense of loss; acceptance.
Criticisms:Stages are not invariant or universal. Patients can move between stages or be in more than one at a time. Dying people have a variety of reactions, not orderly stages. Reaching the stage of acceptance is not a goal..

The Right To Die

Euthanasia is hastened death-know the difference between passive and active euthanasia.
Issues revolve around 3 kinds of patients: terminally ill who are conscious; the irreversibly comatose, and the brain-damaged at a low level of existence.
Clear legal standards do not exist for hopeless cases.
Public feels patients should have the right to refuse and terminate treatment (passive) and there is a growing acceptance for assisted suicide (active).

Advanced Directives

All 50 states have laws authorizing the use of some kind of advanced directive, a patient's oral and written instructions about future medical care in the event of their inability to speak for themselves.
Living wills can direct a doctor to withhold life-sustaining procedures in the event of an irreversible terminal illness.
Hospice is a philosophy of care for the terminally ill which provides care and support to the person and their loved ones.

Spouse's Death

Requires more readjustment on the part of the bereaved than any other stressful life event. Most older women by age 70 are widows.
The key problem faced by both widowers and widows is loneliness
Widowhood is more difficult for women because they are more likely to have financial hardships and are less likely to remarry than men.

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Chapter 14: The Resiliency of Older Ethnic Minorities

Ethnic Minorities

Two primary variables in being old are gender and ethnic minority status.
Ethnicity involves culture, social status and support systems. It may or may not involve minority status.
All such populations share the following characteristics: a special history, young outnumber the old so the median age is lower, they face more economic and health problems than whites do.

African Americans

Become better survivors after age 85.
Although only 8 percent of the total population they represent 36 percent of the elderly poor.
In spite of poverty blacks have a greater sense of life satisfaction than whites- probably because of their extended family, which is characterized by shared living arrangements- often for economic necessity and older female family members as caretakers. Of all elderly blacks are the least likely to be in nursing homes and whites most likely.

Latino Americans

Are the largest ethnic population after African Americans and are a highly diverse culture That is, Latino groups do not all share the same cultural heritage.
The Latino older population is projected to grow at a much faster rate than their white or black counterparts-the percent of oldest-old will triple by 2050.

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Chapter 16: Social Policies To Address Social Problems

Older American's Act and Title XX

Are the primary source of social services funds for the elderly
The Older American's Act is overseen by the Administration on Aging- it seeks to alter state & local priorities to ensure the elderly receive an appropriate share.
The Older American's Act established the State Units and Area Agencies on Aging.

Older American7#39;s Act & Title XX Continued

Title XX was established in 1974 to provide services to all age groups. It is an entitlement program based on means testing.
Title XX was one of the initial decentralization efforts. Because income is an eligibility requirement, the elderly compete with diverse groups for funding.
Decentralization has served to decrease revenues under Title XX for the elderly as needs increase

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Chapter 17: Health & Long-Term Care Policy & Programs

Medicare and Medicaid

In 1965 legislation of the above indicated a change in philosophy- that our society had a responsibility to provide health care for the elderly.
Medicare serves people 65+- major payment source for hospitals and physicians .
Medicaid is a federal & state program for the needy regardless of age- carries the stigma of welfare- major payment source for nursing homes and as such is the fastest growing category of Medicaid.

THE END. I hope that you enjoyed the class!

Remember Coastline College has a Certificate Program in Gerontology which can improve your resume or jump start a new career.

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