Competencies (what you're going to learn):

Objectives (how you're going to learn it):


Memory and Learning

It is a widespread belief that as the brain grows older, a person's capacity for reasoning begins to decline. In actuality, there is very little truth to this. A senior citizen's intellectual capacity remains the same well into old age and as little as 1% of the population will live long enough to be affected by senility. While the elderly are just as intelligent as younger people, they sometimes process information more slowly or must repeat a new skill several times before the steps become second nature. Anybody who receives an inbox full of forwarded email jokes from an elderly relative is well aware that the saying, "old dogs can't learn new tricks" is completely untrue!

Poor memory is a stereotypical malady of the senior citizen, but the truth is not as bad as people tend to believe. If your elderly loved one is not experiencing dementia or has not suffered a brain injury or some other cognitive illness, then his or her "forgetfulness" probably consists only of brief memory lapses. These lapses are normal occurrences in later life and are more a source of annoyance rather than an area for concern. A healthy senior's long-term memory is just as good as anyone else’s; so if it seems as though your loved one is forgetting important things—such as doctor's appointments or where she left her glasses—it is probably because this information did not remain in his or her short-term memory bank long enough to be transferred and stored in the long-term memory.

Please visit the DANA Foundation webpage, Cognitive Skills and the Aging Brain: What to Expect, authored by Dr. Diane Howieson, a neuropsychologist and associate professor emerita of neurology at the Oregon Health & Science University. 

Also read this Emory University Alzheimer's Disease Research Center Fact Sheet on Cognitive Skills and Normal Aging.

Takeaway:


Person Environment Fit

While the idea of “Person-Environment fit” was originally used to describe a worker’s congruence with the work environment, in recent years, it has also been used to describe the fit of the elderly into various environments—retirement communities, assisted living facilities, and into their social environments in general.

There are four main ideas of Person-Environment Fit theory that we should consider:

  1. Fulfillment—Individual emotional and spiritual needs or values are fulfilled.
  2. Interactionism—Interplay between personality characteristics of the person and others.
  3. Similarity—Congruence between the elder and the environment.
  4. Compilation – How do the attributes of fulfillment, interactionism and similarity support and reinforce one another?

Person–environment fit theory offers a framework which enables caseworkers to assess and predict how characteristics of the elder and their surrounding environment determine the elder’s engagement, performance and well-being in her or his environment. In understanding the characteristics above, we can construct a model to develop interventions to prevent misalignment and/or increase fit.

Person Environment fit should be measured from two angles:

NEEDS-SUPPLIES FIT: refers to the degree to which the needs of the individual and their ability to use their skills and abilities, are supplied by the surrounding environment. A good question to ask is: Is the individual satisfied in this environment?

DEMANDS-ABILITIES FIT: refers to the degree to which the environment matches the elder’s skills and abilities. A good question to ask is: How does this environment help/hinder the elder’s ability to live a fulfilling life?

Of course, these two types of fit can overlap. For example, a poor balance between the elder’s skill set and the surrounding environment may leave the individual feeling frustrated, alone and unfulfilled.

Person-Environment fit can be used to measure and monitor the perceptions of fit among residents in care facilities of all levels. Using the basic fit questions can assist care givers and case workers in establishing measures of wellbeing and satisfaction, and can help staff to make adjustments as needed.

Person-Environment fit should be noted throughout the course of an elder’s life, as the elder’s skill levels change and (potentially) decrease. Utilizing this kind of basic approach can help to ease an elderly person into a new stage of care and can also can be a good indicator for measuring conflict within a new environment.

Person-Environment fit can also be utilized in the selection and assessment context. In shopping for a care facility, considerations should be made for how an elder will fit into the existing environment, and for how the environment will support healthy aging.

Incongruent person-environment fit can lead to serious conflicts and decreased life satisfaction for elderly persons who are already experiencing physical and emotional changes which are often beyond their capacity to control. Increased levels of stress and lack of interest are natural outcomes of person-environment conflicts. Disparate person-environment fit inevitably leads to stress. If an elder does not have the same motives, values or beliefs as a care facility where they are placed, conflict, stress and dissatisfaction will occur.

Here is a handout of the basics of Person-Environment Fit for your review. 

Watch this fascinating TED Talk, by Mileha Soneji, who came up with a brilliant way to help her uncle, who suffers from Parkinson's Disease. This will bring into focus the importance of fitting people to their environment: 

Additionally, here is a short TED Talk by high school student Kenneth Shinozuka about a simple device that he developed to help keep his grandfather safe:

Takeaway:


Mental Health

Just as we need to think about the physical well-being of our elders, so do we need to consider their mental health. Depression is not a normal part of growing older. Depression is not just having “the blues” or the emotions we feel when grieving the loss of a loved one. It is true and treatable medical condition. However older adults are at an increased risk for experiencing depression when compared to the general population. One thing we can do if we are concerned about an elder in our lives is simply offer to go with him or her to see a health care provider to be diagnosed and treated.

The good news is that the majority of older adults are not depressed. Some estimates of major depression in older people living in the community range from less than 1% to about 5% but rise to 13.5% in those who require home healthcare and to 11.5% in older hospital patients. As a person who has chosen a profession that will have you working closely with the elderly, you may need to do some preliminary mental health assessments of clients or patients who you suspect may be clinically depressed.

How to Know if it is Depression

Someone who is depressed has feelings of sadness or anxiety that last for weeks at a time. He or she may also experience:

As previously stated, older adults are at increased risk for clinical depression. We know that many older adults have at least one chronic health condition, often many more. Depression is more common in people who also have other illnesses (such as heart disease or cancer) or whose function of daily living becomes limited/impaired.

Sadly, older adults are often misdiagnosed and undertreated. Health care providers may mistake symptoms of depression natural reactions to illness or life changes that may occur as we age. This may lead them to see depression as something that does not need to be treated. Older adults themselves often share this belief and do not seek help because they don’t understand that they could feel better with appropriate treatment. Once diagnosed, most older adults will see an improvement in symptoms when treated with anti-depression drugs, psychotherapy, or a combination of both.

Takeaway:


Aging, Cognition and Perception

If you feel that your loved one's forgetfulness is interfering significantly with his or her ability to function, you should research the signs of onset dementia. Also, be aware that certain reversible conditions affect the memories of people who are both young and old. A few of these include:

Unfortunately, some older people will have legitimate conditions which will impact their cognitive abilities. Alzheimer's is one such disease. Watch below as Dr. Sam Cohen discusses what we know about this debilitating disease: 

Takeaway:


Successful Aging

We probably all know people who are older than us, and to whom we look up to as role models. As we age, we may think, "I hope I am able to age as gracefully." One thing for us to consider: successful aging doesn't happen overnight! Successful aging is a mix of many things, and it is a process. What can you do to ensure that you (and the people around you) maximize your potential to age successfully? Consider these things:

Tips for Successful Aging

Review this handout on successful aging for additional information.

Jane Fonda says we “need to revise how we think of aging… the old paradigm was: you're born, you peak at midlife, and then you decline into decrepitude. Looking at aging as ascending a staircase, you gain well-being, spirit, soul, wisdom, the ability to be truly intimate and a life with intention.” Her perspective honors the aging process. Fonda believes (as do mental health advocates and practitioners) that a positive attitude is the key to successful aging. Listen to her discussion about "Life's Third Act:"

Takeaway:


Research on Intellectual Development

Some people still believe that personality is genetically "set in plaster" by early adulthood, but there is new research which suggests this may not be the case.

The Stanford University research shows that as people reach middle age and beyond, they tend to care more about their work, responsibilities, and those in their lives. Published in the Journal of Personality and Social Psychology, the conclusions were reached after analyzing self-reported answers to an online questionnaire completed by 132,000 American and Canadian adults. The participants rated themselves on personality traits known by psychologists as the "Big Five:"

  1. Conscientiousness
  2. Agreeableness
  3. Neuroticism
  4. Openness
  5. Extroversion

Lead researcher Sanjay Srivastava, PhD, psychologist at Stanford University, says he was surprised by the findings. Though previous research has suggested that personality changes less and less over time, the researchers found that certain personality traits change gradually but consistently throughout life—and on average, peoples’ personalities are getting “better” as they get older. The study adds to evidence that personality may not solely result from biology, but changes over time as the result of life stages, experiences, social environment, and gender.

Srivastava asserts that these findings should reassure people who may be worried about aging.  "As you get older," he says, "you can get better... at least in certain traits."

The researchers found that conscientiousness—being organized, disciplined, and well-planned, especially at work—increased most strongly in the 20s for both men and women, and these personality changes slowed by age 30 but didn't stop. Agreeableness—being warm, generous, and helpful—accelerated most in the 30s in both men and women and climbed more slowly in the 40s, with women recording higher overall levels. Meanwhile, rates of neurosis tended to decrease with age in women (but didn't change much in men over time). And both sexes had small declines in their levels of openness, but split on extroversion—women became less gregarious with age while men became slightly more outgoing.

Overall, the findings of this research are positive with regard to aging and personality changes, which definitely throws a wrench in our preconceived ideas about “crotchety old people!”

Takeaway:


Conclusion

Not only is it up to us, but it is also up to others to help foster a health emotional and physical environment for ourselves and others throughout the process of aging. The scholars and speakers above have taken an active role in thinking about what it means to get older, and what they can do to help themselves and others along the path.