Adult Development and Aging Biopsychosocial Perspectives, 4th Edition Solutiom namual

Adult Development and Aging Biopsychosocial Perspectives, 4th Edition BY Whitbourne, Whitbourne

Chapter 1 Themes and Issues in Adult Development and Aging As the opening chapter to the book, the material covered here provides the orientation to the course.

There is enough material in this chapter to cover two to three lectures. During the first lecture, it is particularly important to provide students with a sense of excitement about the field. Reflect on your own enthusiasm for teaching this topic and, if appropriate, relate personal experiences that have led you to want to become involved in adult development and aging. It would also be useful to find out why students have chosen to taken the course, as it is quite likely that many of them are there for personal reasons as well.

Lecture Guidelines There is a logical break between the theoretical issues in the first part of the chapter and the demographic material presented at the end. The lecture on demography can begin with a discussion of current issues relevant to aging, such as the effect on the population of the "graying of America". A discussion of the "Baby Boomers" would also be interesting, as many of the students have parents in this generation.

Videos and Films There are many potentially relevant materials to include in the lectures based on this chapter. Keep your eyes open for news items that concern aging in the U.S., Canada, and the world relevant to the economy, social trends, and population dynamics. Ageism can be illustrated by showing scenes from humorous portrayals of aging characters in a stereotyped fashion, such as the Simpson's, a classic cartoon series with a wealth of material on aging. Non-stereotypic older adults can also be shown to counter these negative representations such as older persons engaging in activities that would not normally be associated with aging. There are two excellent films by PBS: “The Way We Get By” (http://www.pbs.org/pov/waywegetby/) and Frontline “Living Old” (http://www.pbs.org/wgbh/pages/frontline/livingold/view/).

Because there are many statistics to summarize in the demography section, it is helpful to provide anything that will put a human face to the numbers.

There is an excellent series available on YouTube divided into five parts, called “The World’s Oldest People”: http://www.youtube.com/watch?v=Bjd8_9dtLHo Discussion questions The biopsychosocial perspective Why is the biopsychosocial perspective important?

How does the material in this course relate to other courses that students have taken which employ an interdisciplinary perspective?

Four principles of adult development and aging Do you feel that you are a different person than you were when you were younger?

Do you know of individuals who illustrate the principle of individual differences in development?

What are the important intraindividual dimensions that psychologists should study?

What are the implications for the field when you consider that the only people we can study in old age are those who survived?

How can you be a survivor?

Name some changes that you think are age-related and see if they are in fact age- or disease-related.

How many of the CDC "Five Ways to Shorten Your Life" lifestyle habits do you follow?

The meaning of age How would you define a person as an "adult"? Do you feel that you qualify as an adult? What are appropriate criteria to use for this distinction other than or in addition to age?

What are the pros and cons of using these age-based divisions?

How could the alternative indices of age be implemented in a practical sense so that they would replace chronological age?

Can you come up with examples of the three types of influences on development?

Social factors in adult development and aging How is identity affected by gender?

Why is race a difficult concept to measure?

Do you feel that the U.S. Census measure of race is an appropriate one? What might be its problems?

How has your social class affected your own life so far?

How do you think social class will affect your life in the future?

What sorts of influences do you think that social class has on people's lives and why is it important in development?

How has your religion affected your own development?

Why do you think religion has not been examined in previous research on adult development and aging?

The Baby Boomers grow up: Changes in the middle-aged and older population in the United States and the world What are the implications of an aging population?

Will the aging Baby Boomers change the way that we think about aging?

What are the implications of changes in the racial and ethnic distribution of the aging population?

Chapter 2 Models of Development: Nature and Nurture in Adulthood Lecture guidelines This is a heavily theoretical chapter and can be tough going for students who are eager to move on to learning more concrete information about adult development and aging. Depending on the nature of the class and its size, the lecture can be oriented toward more or less theoretical aspects of the material by providing a conceptual orientation (more theoretical) or concrete examples (less theoretical).

Because this material previews much of what is to come in later chapters, it is also possible to use this chapter as a way to plant the "seeds" for these later concepts and discussions.

Depending on the length of the class, it is advisable to break this chapter into two or more lectures, dividing it along the lines of biological vs. psychosocial theories. Biological theories can occupy an entire class period, particularly when combined with videos (see below). Some students may need extensive background in concepts of genetics. These will be important for later chapters, particularly Chapter 5, in which the genetic contributions to Alzheimer's disease are discussed. The psychosocial theories provide an opportunity to present some substantive material that may be of greater inherent interest to students in psychology and other social sciences as it previews concepts that will not appear until much later in the course, such as personality development and family issues.

Videos and films The topic of developmental models is an important one to break up with relevant videos and films because the concepts are inherently dry and theoretical for some students. There are ample resources on biological theories of aging. The best ones that I have found are on the PBS series called “NOVA Science Now”: http://www.pbs.org/wgbh/nova/sciencenow/ which aired several segments about the genetics of aging. A popular movie that contains interesting twists about age and time is “The Curious Case of Benjamin Button.”

To illustrate concepts of ageism, you can also show here an y of many episodes from “The Simpsons” featuring older adults. There is also an excellent example in the Seinfeld episode called “The Old Man,” in which the characters each confront and older adult who is depicted in a funny but stereotypical fashion.

Examples of identity assimilation and identity accommodation can also be provided from film or television shows in which characters either resist changing (identity assimilation) or change excessively (identity accommodation) in response to an event that challenges their identities. A good example of identity assimilation is "Driving Miss Daisy" which, in the first scene of the movie, shows the struggle she experiences as she is faced with accommodating to her loss of the ability to drive.

Discussion questions

Models of individual-environment interactions How does the notion of contextual influences on development relate to concepts such as gender, race, and socioeconomic status?

How do "nature" and "nurture" interact in development throughout life?

Which model do you feel is most appropriate for understanding development?

Why is it important to an interactionist model to emphasize the concept of reciprocity?

How has your life involved niche-picking?

Can you think of examples from your life when an action you took or decision you made had an outcome on a later event?

Psychological models of development in adulthood Do you feel that Erikson's theory provides a reasonable framework for understanding development throughout life? What are its weaknesses and what are its strengths?

Some critics of Erikson's theory feel that the theory is narrowly focused on heterosexual relationships in adulthood. Others argue that Erikson made an unreasonable distinction between development in men and women in that he suggested that intimacy precedes identity for women. What do you think of these criticisms?

Why is identity balance considered an optimal way of reacting to the aging process?

Provide some examples of age-related thresholds either in your own life or in the life of other people you have known. How did the people involved adapt to these thresholds?

Why are psychological models of development necessary? What do they add to biological theories?

Sociocultural models of development How does the life course perspective relate to the concepts of social clock and age-graded normative influences discussed in Chapter 1?

How does the ecological perspective link models of development that focus on external processes to those that focus on processes within the individual?

Why do you think disengagement theory was popular at one time?

Do you know anyone who exemplifies disengagement theory? Activity theory? Continuity theory?

What type of involvement in society would make you happiest when you get older? Why? How do older minority individuals (especially women) manage to cope with discrimination?

What is your social clock?

Do you think that the social clock is helpful or harmful when people think about themselves and their lives?

Biological approaches to aging in adulthood Is aging necessary?

What would the world (or universe) be like if there was no aging?

What will be the implications of mapping the human genome?

What would you like most to learn about the genome and how would this information be of relevance to you?

Can aging be programmed by our genes?

What if the process of replicative senescence could be stopped?

Which is your favorite biological theory? Why? What products are being sold on the market based on these theories of aging?

Chapter 3 The Study of Adult Development and Aging: Research Methods Lecture guidelines This chapter is the third and final chapter that serves as background for what is to follow in the rest of the course. Given that the topic is not one that inherently of great interest to students, some imagination is required to keep students motivated. It is recommended that the instructor make ample use of charts and diagrams to provide explanations of the various research designs. Furthermore, examples of specific research studies can be inserted throughout the lecture on design to illustrate the advantages and disadvantages of particular methods.

Videos and films As stated above, it is helpful to use some imagination in planning the research methods lecture because the material is not of strong inherent interest to students. Suggested videos would include recent studies from the national news media using cross-sectional or longitudinal designs. A segment from “49 Up”( http://www.imdb.com/title/tt0473434/)can be used to illustrate longitudinal research. “Neil” is a particularly interesting case.

Discussion questions: Can you define independent and dependent variables? Think of examples from research and label the variables as independent and dependent.

Can you think of examples of an experimental study? Are studies on aging experimental or quasiexperimental?

Why is it that cohort, time of measurement, and age cannot truly be separated from each other?

Can you give some examples of cohort and time of measurement effects?

Prior to showing the box with disadvantages and advantages ask students to state what these might be.

Can you provide examples of cases where sequential designs would be important in the study of aging?

How would you interpret the age gradients for intellectual ability from the SLS? Which designs seem to make more sense to you and would you use in conducting your own research?

Why do researchers maintain that it is not possible to draw cause-and-effect conclusions from correlational research?

What types of variables and problems are best studied through correlational methods?

What are the advantages to using multivariate designs in research on adult development and aging?

Is it truly possible to infer causal relationships from multivariate models? (This is a rather advanced question.)

How might an older adult feel when tested in a laboratory situation?

For what type of research questions would qualitative methods be particularly well-suited?

In what areas would archival research be of particular value? Why? What types of special considerations might be needed in conducting surveys on older adults?

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What can researchers do to reduce the subjectivity involved in a case report?

How could a focus group help a researcher begin to identify issues that can then be addressed in subsequent empirical studies?

If you were a consultant in a nursing home, how might you use observational methods to answer questions about the factors that affect the adjustment of residents?

Why is it necessary to establish the appropriateness of measures for different age groups of adults?

Why is it necessary to protect the rights of research subjects?

Under what sorts of conditions would it be necessary to keep subjects unaware of the purpose of the study until it had been completed? What steps should be followed in such conditions to ensure that subjects are protected?

How will HIPAA change the way that health information is used in research?c

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Chapter 4 Physical and Sensory Changes in Adulthood and Old Age Lecture guidelines This chapter contains a great deal of information about specific aspects of the physical aging process.

The purpose of the lecture is to present highlights of the most significant information so that students will know how to focus their efforts in reading and studying the chapter. Charts can be made and shown in lecture as a guide for students to summarize significant age changes within each area of functioning.

Specific suggestions within each of the areas of the chapter outline include those areas of information that seem most important. As essential as it is to present factual information, however, the instructor's goal with this material is to allow students to gain an understanding of how theoretical principles relevant to the biopsychosocial perspective apply to physical functioning. Furthermore, it is valuable to highlight this material with videos and films that will allow students with a minimal background in biology to understand how these changes occur within the person. Finally, a goal of this section of the course is to encourage students to adopt some of the practices that are recommended within the category of "use it or lose it" (i.e. exercise). Students will also gain a more optimistic approach to the aging process if they see specific ways in which they can "control" their own rate of aging.

Videos and films There are ample resources available to supplement these lectures. One outstanding video is the National Geographic program, “Inside the Living Body:” http://channel.nationalgeographic.com/episode/inside-the-living-body-3111/Overview You can also find videos of Jack LaLanne on YouTube. Students are fascinated with his story and at 95 going on 96, he is an excellent model of the value of aging and exercise.

Illustration of brain plasticity can be obtained from the PBS series “Stealing Time,” which though somewhat dated has an excellent interview with Scheibel and Diamond that is still relevant: http://www.imdb.com/title/tt0450505/ (it is not currently available through PBS but may be available through online retailers).

Discovery Health channel produced an excellent video with Dr. Oz called “The Brain: Owner’s Manual,” that includes surgery for people with essential tremor.

Discussion questions: Appearance Why might people be concerned about the effects of aging on the face?

What evidence can you find from popular cosmetics products to support the notion that people are concerned about this aspect of the aging process?

Why do fair-skinned people in Western society place value on having a tanned appearance?

Why are people in our society so concerned about their hair turning gray?

What social factors make it difficult for men (and women) to experience hair loss?

Mobility Do you exercise on a regular basis? Why? How could older adults be encouraged to exercise on a regular basis?

How much can loss of muscle strength be slowed by exercise?

Do some adults seem obsessed with muscle strength? Why do you think they are so obsessed?

What is the research evidence in favor of strength training as a way to compensate for sarcopenia?

What are the risks of bone loss in adulthood?

In addition to exercise, what other measures can people use to slow or compensate for bone loss?

What types of activities do young adults engage in that could lead to a higher rate of joint damage in later life?

Vital bodily functions How do normal changes in the cardiovascular system affect the daily life of the middle-aged and older individual?

Given what is known about the negative effects of smoking on the respiratory system, why do you think people continue to engage in this bad habit?

Do you know people of college age who smoke (or do you)? How do you feel about this behavior when the effects of smoking are so widely known to be negative?

Given that age-related changes in the urinary system are relatively minor, why is it that the media portray older adults as suffering from incontinence?

Rather than teach people with urinary incontinence bladder control methods, why do health care practitioners have them use adult diapers?

Why are adult diapers given so much attention in the media when urinary incontinence affects only a minority of older adults?

Given that aging has little inherent effect on digestion, why are there so many advertisements directed at middle-aged and older people having to do with supposedly age-related digestive problems?

What are the psychological and social factors that can contribute to nutritional and digestive problems in older adults?

Bodily control systems Which forms of hormone replacement therapy would you consider using?

Critique advertisements that make unsubstantiated claims for the value of hormone replacement therapy. Why do people believe these ads even though the scientific evidence in their favor is so thin?

Why is the menopause given so much negative attention by the media? How might this attention alter the way that women experience the menopause?

If you were a woman going through the menopause, would you consider estrogen replacement therapy?

Why or why not?

Given the risks of testosterone replacement therapy, why is it considered by some people to be an attractive option?

How might cohort effects alter the results of studies on age differences in testosterone levels among men?

With the complexity of the immune system and its interaction with lifestyle factors, how will it be possible for researchers to separate the effects of aging from those due to cohort?

What are the implications of changes in the immune system for other areas of functioning in later adulthood?

Nervous system How do brain imaging technologies help to advance the field of research on age changes in the nervous system?

Which model do you think has more support from the literature, the neuronal fallout or the plasticity model? Why? Why is an older adult more likely than a younger adult to be a "morning person"?

Are you a morning or an evening person? How do you think your lifestyle as a college student affects your circadian rhythms?

If you were a clinician working with an older adult with sleep problems, what steps would you recommend to intervene? Would you prescribe sleeping pills? Why or why not?

Sensation and perception What is the effect on public perceptions of older adults when heat- and cold-related deaths are given attention in the news?

What steps should public health officials take to ensure that older adults are not victims of extreme temperatures?

To what extent are temperature-related deaths due to normal aging and to what extent are they do to other factors including disease?

What are the implications of prevalence data on sensory impairments in later adulthood?

Do you know people who need to wear bifocals to correct their vision for presbyopia? How do they feel about wearing bifocals?

Do you know anyone who has had cataract surgery? What was the experience like?

Have you heard of macular degeneration prior to learning about it in this course? Why is such a common condition given such little attention?

Why have older adults traditionally been embarrassed about hearing loss and reluctant to wear hearing aids?

What effect on communication does hearing loss have for older adults?

What are the effects of prolonged exposure to loud music on the hearing of young people? Will we see an increase in hearing loss among this generation of young adults?

What steps can middle-aged and older people take to avoid falling?

Can you balance for a minute on one foot holding onto the other foot behind you? (Try this as a class exercise.) If not, this is something you should work on to improve your own balance.

Do you know any older people who have experienced loss of taste or smell sensitivity? How have these changes affected their daily lives?

How do changes in position and movement contribute to increased risk of falling in older adults?

Do older adults feel more or less pain than younger adults, and what factors seem to affect the willingness of older adults to state that they are in pain?

CHAPTER 5 Health and Prevention Lecture guidelines As with the previous chapter, there is extensive biological material in this chapter. However, many of the topics lend themselves to discussions within the framework of the biopsychosocial perspective, as these diseases show significant sociocultural variations. The material should be divided into two to three lectures, with an entire lecture devoted to Alzheimer's disease, which is a major interest for most of the students in the course. The slides contain many illustrations and clarifications that will allow the instructor to move through the technical aspects of this material relatively quickly. More time can then be spent on discussions focused on psychological issues such as ways that people can prevent these diseases and the ways that these diseases interact with identity processes. Distinctions between normal aging and disease can also be made at frequent points throughout the lectures.

Videos and films Given the explosion of interest in health in all areas of the media, it should be very easy for instructors to find videotape segments to illustrate lecture material. Cancer, heart disease, AIDS, musculoskeletal diseases, and Alzheimer's disease are major areas of focus in many television news programs, magazines, and PBS or Discovery Channel documentaries. The problem is not finding these resources, but deciding on which ones to use.

Here are several good choices: ABC’s “Life to 150” with Barbara Walters: http://abcnews.go.com/Health/Longevity/ For the lecture on dementia, there is an excellent scene from “The Notebook” in which Noah and Allie have dinner and a brief dance in the nursing home that highlights the features of the symptoms of Alzheimer’s Disease (provide a handkerchief alert if you plan to show this scene).

NOVA Science Now also has an excellent segment on Alzheimer’s disease featuring the research of Tanzi and collaborators on genetic contributions.

Discussion questions Why do variations exist by sex and race in chronic diseases?

What are the relative contributions of genetics and environmental factors in causing differential rates of diseases across age, sex, and racial subgroups of adults?

Can you define the major chronic diseases in your own words?

How do chronic diseases differ from changes associated with normal aging?

Diseases of the cardiovascular system If you found out that you were at risk for heart disease based on your genetic predisposition, what steps would you take to lower chances of developing the disease?

Why do you think so many people in the U.S. fit the technical definition of "obese"?

Who is most likely to take advantage of preventive efforts to avoid heart disease?

How might public health efforts be better directed at reducing the risk for heart disease in this country?

Cancer What are the most common forms of cancer?

Why do people ignore the evidence linking certain behavioral lifestyle choices to cancer risk?

How can prevention strategies be made more effective in helping adults to avoid the risks of cancer?

Do you know people with cancer? What has their treatment process been like?

Disorders of the musculoskeletal system How does osteoarthritis differ from rheumatoid arthritis?

What measures can people take to prevent osteoarthritis?

How does the disease of osteoporosis differ from normal age-related changes in bone?

What do you think about the advisability of taking hormone replacement therapy to prevent osteoporosis compared to other preventive measures?

Diabetes How does Type 1 diabetes differ from Type 2?

How can the spread of diabetes be slowed through education?

What measures can be taken to motivate people to comply with treatment of Type 2 diabetes?

Why might it be difficult to encourage people to watch their diet and exercise patterns as a way of controlling diabetes?

Respiratory diseases Are anti-smoking advertisements successful in reducing the rate of cigarette smoking in the U.S. population? How could they be made more effective?

Dementia and related neurological disorders What is the difference between dementia and Alzheimer's disease?

What are the political implications of the published prevalence rates of Alzheimer's disease?

What will be the implications of discovering the genetic causes of Alzheimer's disease?

If genetics are thought to be such a strong influence on Alzheimer's disease, how can we explain the findings from the studies showing environmental effects?

If a test is developed that can predict whether a person has a high chance of developing Alzheimer's disease, would you want to take that test and find out the results?

What would be the effects on society of discovering a medical cure for Alzheimer's disease?

Do you know anyone who is a caregiver for a person with Alzheimer's disease? What are the daily challenges this person faces?

Clarify that there are forms of dementia other than Alzheimer's disease and that some are reversible.

Why is it important to distinguish Alzheimer's disease from other forms of dementia?

Why might a depressed person appear to have Alzheimer's disease?

Why is it important to differentiate Alzheimer's disease from delirium?

CHAPTER 6 Basic Cognitive Functions: Information Processing, Attention, and Memory Lecture guidelines Students who do not have an extensive background in cognitive psychology will find the material in this chapter somewhat tough going as it is not necessarily of inherent interest to the average undergraduate. However, with some imagination from the instructor, this material can readily be brought to life. It is important to give students as much of a concrete feel as possible for the nature of the tasks used in the experiments described in this chapter. Therefore, it is worth trying to replicate some of the stimulus materials so that students can see what was required of subjects in the experiments. It is also possible to draw out the practical implications of the material by showing how people use these cognitive skills in everyday life. Once they see the practical relevance, students will naturally be curious to see how aging affects these abilities. Helping to clarify the material in class will also be appreciated by these students, because they will find it difficult to study on their own and may be concerned about what will appear on the tests. The more the instructor can summarize findings and make clear what is important, the more that students can focus on the big picture in this area, such as the hypotheses that have been advanced to account for the effects of aging. For those students who are interested in cognitive psychology or are taking a course in this area, motivation will be far less of an issue. Nevertheless, the practical implications are worth exploring particularly as they relate to changes with age.

Videos and films The PBS documentary series "Stealing Time" contains an excellent interview with Timothy Salthouse, showing how he does his experiments and presenting his views about cognitive agingThe area of driving and aging lends itself well to illustrating in class. There have been several news programs focusing on the driving abilities of older persons, showing laboratory studies of driving as well as intervention studies in which older drivers are given classes to improve their skills. For a humorous look at aging and driving, the movie "Ferris Bueller's Day Off" includes a brief scene in which an older woman behind the wheel is driving erratically. Although a negative portrayal of aging, this scene can be a touching-off point for discussing attitudes toward aging drivers. Students can be asked to state whether they think such representations are fair or unfair portrayals.

Discussion questions

Information processing Although there is consistent slowing of reaction time in adulthood, is this slowing (on the order of 1/2-2 seconds) significant in its effects on everyday life?

Does the general slowing hypothesis seem sophisticated enough to you to serve as an explanation of the effects of aging on cognition?

Do you have difficulty with attention and concentration? How does this affect your ability to learn and remember?

How would you feel if you were a participant in an experiment involving these procedures? Do you think your performance would reflect your abilities to use attentional processes in your everyday life?

What real-life situations are comparable to those used in studies involving shifts of attention?

Do you think you are good at divided attention tasks? How easy or difficult is it for you to study when other people are talking or playing music?

To what extent is sustained attention needed in everyday life?

What are the implications of age differences in sustained attention?

Which attentional task is most difficult for older adults? Why might this be the case?

What is the major area of support for each theory of aging and attention?

Which theory do you think fits the experience you have had with older adults? Why? Driving and aging Should older drivers be required to take road tests? Why? Would you feel more comfortable in an airplane piloted by someone 60 and older or someone who is 30 years of age? Why? Are most older drivers good at regulating their own driving habits? Have you had an encounter with an older driver who was unsafe?

Given that younger drivers mix speed and alcohol, why does society have such negative attitudes toward older drivers?

Do you agree that making intersections into rotaries would help reduce auto accidents? Why or why not?

Memory What happens to people who do not have the ability to remember events from their lives?

Do you feel that your memory is changing as you get older? (College students often will say that they feel they are getting "senile"!)

Can you think of examples of using your working memory?

Do you feel your working memory has changed?

How would age differences in working memory affect other aspects of cognition?

Why do you think that certain memory tasks such as implicit memory are retained in later life?

Do you feel that the events in your life now will be ones that you remember for many years into the future? What do you think you'll remember and what do you think you'll forget?

What strategies do you find useful to help your memory?

Do you think you have a good memory or a bad memory? How does this affect the way you feel about yourself?

Why do you think some memory interventions work with older adults and some do not?

CHAPTER 7 Language, Problem-Solving, and Intelligence Lecture guidelines This chapter has a great deal of material that can be readily brought to light by involving students in hands-on activities. There is also the potential to involve non-traditional students in discussions of adult learners. As with the previous chapter on cognition, it is advisable for the instructor to be as concrete as possible in presenting the material used in studies of intelligence by having them answer and discuss practice questions from the instruments used in these studies. Furthermore, there are many figures presented in this chapter, and it would be worthwhile for the instructor to go through these figures in detail so that students can learn as much as possible from the data they present.

It is also possible to have some fun with this chapter in the section on problem-solving in a high-tech world. Ask your students to name instructions that they have struggled with lately and then ask them to imagine how a middle-aged or older adult who is not technologically inclined would deal with these same problems.

Another area that has great potential for expansion is the section on the Communication Predicament and "elderspeak." The infantilizing speech directed toward older adults is a phenomenon that can be observed in many service settings. Students involved in service learning can be involved in seeking out their own examples of this type of situation. Such experiences can touch off discussions of why infantilization occurs and what effects it may have on older adults. If instructors wish to devote more time to this topic, there is an infantilization exercise described in a Teaching of Psychology article written by me and one of my former graduate teaching assistants, Erin Cassidy (see reference in the Introduction). We found this to be a powerful teaching tool that really drove the point home. If your students are in service-oriented majors, such as nursing or human services, it might very well be worth the time and effort it takes to show them the dangers of infantilizing speech.

Videos and films Once again, the PBS documentary series "Stealing Time" provides an excellent resource for this class.

There is a five-minute segment with K. Warner Schaie and Sherry Willis in which they describe their research based on the Seattle Longitudinal Study. This is very vivid way to begin the section on intelligence because it brings to life the many statistics that will be presented in the data from their study.

Look also for any recent news stories on video games and older adults; in early 2010 there was a segment on NBC’s Nightly News showing the benefits of Nintendo Wii playing; it may be possible to find another similar story to show during class.

On the lighter side, in the section on wisdom, it is possible to show one of many popular movies in which an older person provide wise advice to a younger person. One particularly poignant choice is "The Wedding Singer" (which also depicts intimate relationships in later life very positively as well). The

scene to show is the one in which the grandmother gives advice on sexuality to the Adam Sandler character as he is giving her a voice lesson at the piano. The scene ends with the grandmother feeding him meatballs. Students love this movie and particularly this scene. However, there are many other examples throughout a wide range of movies that will get across the same point.

Discussion questions Language How is language important in your everyday life?

What does language signify about a person's cognitive abilities?

How might memory changes affect a person's ability to use language?

Why might experience enrich a person's language abilities?

Have you noticed the tendency for older persons to talk about their past experiences? How does talking about past experiences with your friends make you feel?

When have you seen older people spoken to with elderspeak? How do you think this makes them feel?

Everyday problem solving What problems have you had to solve in the last 24 hours? What types of processes did you use?

Do you think that life has gotten more complex with advances in technology? How might such changes particularly affect older adults?

What factors make it hard or easy for you to solve problems?

How do you feel when you have successfully solved a problem?

Can you think of an example you were affected by the “attraction effect”?

What factors make it more likely that you will take your time to solve a problem rather than rush to a solution?

How the does faster problem solving of older adults fit in with the slower reaction times that they show in other tasks?

Can you think of a case when you used post-formal operations in dealing with a problem?

Why might adults be more likely to engage in post-formal than formal operations? What features of adult life lend themselves to post-formal operations?

What leads adults to use dialectical thinking? What might the advantages be compared to the seeking of a "right answer"?

How might personality relate to the ability to use dialectical reasoning?

Intelligence Do you feel that you are an "intelligent" person? Why or why not?

What is the practical value of being able to define and measure intelligence?

Why is it of interest to study intelligence developmentally?

Are definitions of intelligence overly narrow in focusing on academic skills?

Why were these five abilities chosen to by Thurstone to represent all of intelligence?

What might these tests fail to measure?

How do fluid and crystallized intelligence relate to each other?

Is fluid intelligence really "culture fair" as was originally intended by Cattell?

Why do you think that alternative theories of intelligence were proposed? Do they provide a more realistic approach to intelligence than those based on more traditional intelligence theories?

Do you think that the findings from the SLS are encouraging or discouraging with regard to age changes in intelligence?

Why would people who are more flexible in their personality have higher intelligence test scores in later adulthood?

How do the findings from the SLS relate to the concept of dialectical thinking and post-formal operations?

Do the findings of intervention studies support or refute fluid-crystallized theory in that it was possible to train fluid abilities in older adults?

What are the implications of training studies for the findings of studies more generally on intelligence and aging?

Do you agree with the definition of wisdom provided by Baltes? How does it fit with the definition provided by Sternberg in the balance theory of wisdom?

How does the Baltes approach illustrate plasticity in adult intelligence?

CHAPTER 8 Personality and Patterns of Coping Lecture guidelines In many ways, this chapter follows a traditional format of a personality theories course, with the opening sections focusing on theories presented from psychodynamic through cognitive, followed by research conducted from these alternative perspectives. However, the orientation of the chapter is toward how these theories and research apply to adults and the aging process, thus distinguishing it from a standard personality course which is typically non-developmental. In particular, the issue of personality change vs. stability is a theme of the chapter, as this is a major issue in the adult personality field. Furthermore, the midlife crisis theory and criticisms are presented, a topic that is essentially unique to the field of adult development and aging. The material in this chapter lends itself to two to three lectures, divided roughly between the pychodynamic-trait section and the cognitive perspectivemidlife crisis section.

There is a heavy research emphasis in this chapter, reflecting the fact that there is a considerable body of work accumulating on the topic of personality in midlife and particularly the relationship between personality and health-related behaviors. Although students will probably be eager to learn about "personality" in the popular sense, they may be surprised to find that the material is at this more advanced level of theory and research. However, the instructor can get students on board with examining the empirical findings on adult personality by relating the theme of personality stability vs. change to their own lives. Each of the theorists and researchers discussed in this chapter is dealing with concrete and important issues, and the question of maturity becomes an intriguing one to explore here.

Many of the studies point to the development of greater insight, perspective, and a general "mellowing out" of personality. However, it is just as important for students to recognize that middle age and beyond do not involve a simple settling in or settling for what life has dealt. Therefore, the chapter also emphasizes the ways that adults can find new sources of growth and creativity (much as in the section on wisdom) as they reach their later years. Erikson's concept of "vital involvement" serves as an important contrast to the notion that people simply adapt to life's vicissitudes as they get older.

Videos and Films There are many popular movies that can be shown depicting personality changes in middle and later adulthood but relatively few documentaries or professional videotapes. The movie “Up” can be used to show personality change in later adulthood (as the protagonist seems to be transformed through his relationship to the young boy). “The Bucket List” could also be shown here to illustrate ego integrity.

Several popular "midlife crisis" movies are available to choose from, including the classic "American Beauty."

Discussion questions The psychodynamic perspective Do you agree with Freud that personality is fixed by the age of 5?

What do you think of Freud's statement that the goal of development "to love and to work"? What does that mean in today's terms?

Why is Erikson's theory in the category of "ego psychology" theories?

Do you agree with Loevinger's conclusion that the majority of adults are at the ConscientiousConformist stage?

Can you think of a time you used a mature defense mechanism? Can you think of a time you used an immature defense mechanism?

Do you think people's personalities become more "mature" as they get older?

Do the Mills and Radcliffe studies (like the Rochester Study) focus on too narrow of a sample? Would you expect these results to appear in a more representative sample of adults?

Do the studies of defense mechanisms and coping portray middle-aged and older adults as too passive and willing to "go with the flow"? Would you look forward to becoming this way as you got older?

What type of attachment style do you think you have?

The trait perspective How would you describe your best friend? How would your best friend describe you?

Why do you think people use trait terms when defining the personality of people they know?

Can you think of traits other than the five in the Five Factor Model that should be included?

As high as the numbers are in favor of the stability position, are you convinced that personality does not change after the age of 30? Can you think of cases where people changed their personalities?

Is it depressing to think that personality might be fixed so early in adulthood? What would you like to change about yourself and do you think you'll be able to do so?

Social cognitive perspective In your opinion, does socioemotional selectivity theory predict that older adults have fewer close relationships or that the nature of their relationships changes? Defend your answer.

The cognitive perspective and coping Do you agree that views of the self are important in understanding personality? Why or why not?

How might views of the self change as people develop through adulthood?

How might people's ideas about what they will be like in the future influence their present behavior?

What are your possible selves? How do they influence the decisions you make now?

Which method of reacting to obstacles characterizes your approach to life- do you try to change the environment or do you change your goals?

How do these theories relate to the identity process model and Kelly's personal construct theory?

What do these theories imply about change in motivation in later adulthood?

What are the advantages of identity assimilation? What are the advantages of identity accommodation?

Can you provide examples of people who illustrate each identity process?

Why might people who use identity assimilation have higher self-esteem than those who use identity accommodation?

Why might women be more likely to use identity accommodation than are men?

Midlife crisis theories and findings Do you agree that there is a midlife crisis? Have you observed it in people you know?

Why do you think the concept of a midlife crisis was proposed? How does it fit with other theories of personality development in adulthood?

Why is the concept of midlife crisis still so popular despite lack of evidence to support it?

Who is most likely to experience a midlife crisis?

Do you agree that the concept is popular because it makes a "good story"?

Could a midlife crisis be used as an excuse by someone seeking a way out of an unhappy life situation?

Do you think the midlife crisis concept would have originated if Levinson had used a more diverse sample in his study?

CHAPTER 9 Relationships Lecture guidelines The topic of marriage and family constitutes an entire course in itself, so it is somewhat of a challenge to condense it into one or two lectures. Reflecting the extensive information in this area, the chapter is one of the longer ones in the book. Lecture time must be used carefully and students should be encouraged to complete their reading prior to class (as always but especially in this case). The first section within each of the topics covers current statistics. These could be skipped in lecture in favor of more theoretical material, or the statistics could be presented in terms of highlights. These highlights would include the decline in marriage rates since 1970, the rising age of first marriage, and changes in the divorce rate. Variations in marriage and divorce rates by age, sex, and race should also be included in a discussion of statistics. The theoretical perspectives provided by socioemotional selectivity theory, attachment theory, and theories of marital satisfaction in adulthood help to bring depth to these discussions of marital patterns in adulthood. This section also includes sexual patterns in marriage over adulthood, a topic that is obviously of great interest to many people. The second unit of information in this chapter concerns family relationships, and here there are also a wealth of data, concepts, and theories. Summarizing statistics on childbirth, family size, and grandparenting helps to provide background to more theoretically oriented discussions regarding the transition to parenthood, extended family relationships, and changes in the family from a sociocultural perspective. Many of these topics can be given specific focus, particularly the relatively new phenomenon of grandparents raising grandchildren. However, other relatively neglected areas such as sibling and friendship relationships also provide very interesting personal and theoretical insights for students. Variations among people in so-called "nontraditional" situations (becoming more traditional), such as blended families and lesbian and gay relationships, are discussed throughout the chapter but can form a theme of a particular lecture or part of a lecture according to the instructor's expertise and interest in the area.

Videos and Films There are virtually an infinite number of popular movies to choose from to illustrate almost any point on the topic of marriage and family relationships. The guiding principle here should be recency (i.e. only show "Love Story" if it is to illustrate a point about relationships in the 1960s) and perhaps the culture of the campus in terms of what might be considered too explicit in a film about adult relationships. Within those very broad guidelines, there are literally hundreds of films showing couples, parents, grandparents and grandchildren, extended family networks, and so on. In terms of documentaries, there has been recent publicity given to the topic of improving sexuality in long-term relationships through pharmaceutical techniques such as Viagra or hormone replacement therapy.

Examples of movies showing late-life relationships include “It’s Complicated” (which also discusses divorce and remarriage), and “Something’s Gotta Give.” The movie “Failure to Launch” depicts children who refuse to leave the home in a humorous (if not tasteful) way.

Network news shows often produce short pieces on the family. These can be inserted for up-to-date information on the latest statistical trends on such topics as marriage, childbirth, and divorce rates.

Discussion Questions

Marriage and intimate relationships Do you think it is necessary to be married to have an intimate relationship? Why or why not?

What is the social significance of marriage? Why do people invest so much energy and expense into their own weddings?

Why are men more likely than women to marry late in life?

What sociocultural factors are responsible for differences in marriage rates between whites and blacks?

Do you agree with some experts who believe that many current problems can be attributed to a decline in the traditional family structure?

Why might adults decide to cohabit rather than get married?

What are some of the problems involved in calculating the probability that a marriage will end in divorce?

Do you know (or are you one) people who have been divorced? How were their lives affected?

Do you know (or are you one) children of divorced parents? What has their experience been like?

Has anyone in your family lost a spouse? How did he or she react to the loss?

What are the problems faced in our society by people who become widows?

Do you feel that "opposites attract," or does "like attract like"?

Parenthood What are the problems with the family life cycle model?

Do you think people go through an empty nest when their children leave home? Do you think it has happened or will happen with your parents?

Is it inevitable that older people lose their sexuality?

Were you surprised by the findings on sexual preferences of older adults?

What are the interactions of identity with changes in sexuality in adulthood? (if any parents are in the class) How did you feel when you became a parent? How did it change your life? (for non-parents) How do you think your life will change when you become a parent?

Why is the transition to parenthood important from a theoretical point of view?

What might some of the dynamics be in blended families?

Do you know people in blended families? How do they compare with families that are not blended?

Is there a difference between "blended" and "reconstituted"?

What understanding can we gain from examining same sex couples who become parents?

What are the roles of household tasks (such as taking out the garbage) vs. child care duties as influences on the transition to parenthood?

How does your family fit into the intergenerational solidarity model?

Have you experienced the concepts of developmental stake and developmental schism? How have these affected you?

Does your cultural background emphasize filial obligation? How does this affect the dynamics in your family?

Siblings Do you get along well with your sibling(s)?

Is sibling rivalry still an issue in your family?

How did you rate on the sibling relationship questionnaire?

Grandparents What are some of the issues faced by grandparents who have responsibility for raising their grandchildren?

What types of grandparents do you have? How would you rate them on the grandparent style types?

Friendships Do you think you will stay in touch with your college friends throughout the rest of your life? Why or why not? What could you do to ensure that your close friendships do not dissolve after college?

CHAPTER 10 Work, Retirement, and Leisure Patterns Lecture guidelines The broad coverage of this chapter includes portions of the field of occupational sociology, vocational psychology, industrial-organizational psychology, retirement, and leisure. There are potentially two lectures worth of material, depending on how in-depth the instructor wishes to go with any particular area. Statistics on the labor force, occupational level, income, and education by age, sex, and race provide an excellent opportunity for discussions of diversity. Specifically, students are presented with some of the grim facts of life regarding how resources are obtained and distributed throughout the U.S. In addition to pointing out these issues with regard to diversity, there is also opportunity for the instructor to illustrate several significant points within the biopsychosocial perspective. For example, occupational level and income interact significantly with health to influence mortality in middle and later adulthood. Therefore, it is important, when reviewing these statistics, to point out their "human" meaning. The area of vocational development is potentially of great interest to students, who are heavily involved in the process of finding their own vocational identity. Holland's model and the accompanying O*NET system can be helpful in encouraging them to think about where they are heading in life. Presenting questions from vocational inventories, such as the Self-Directed Search (as suggested below) can also encourage active learning by students on this topic.

The areas of vocational satisfaction and performance, similarly, lend themselves to considerable discussion and self-scrutiny among students. They will be spending the majority of their waking lives for the next forty to fifty years involved in work. Posing the question of what they will find satisfactory from this activity can get them involved in thinking about how older workers feel and perform. It is also important to educate students about age discrimination, as most of them will not have heard of the Age Discrimination in Employment Act (ADEA) until taking this class.

The area of retirement seems distant indeed to an average-age college student. Although some forward-thinking individuals may be planning how they will start their IRA's, retirement seems as real a possibility to most students as a trip to the moon. However, by presenting retirement as a current social issue involving huge implications for the economy, students can be encouraged to think about the phenomenon in a more concrete fashion. Real-life examples of retired people talking about their experiences (in videotape or in person) would also help bring the points home. Furthermore, the issue of women and retirement should appeal to the females in the class, and as data on this topic are relatively recent, this material also has great current relevance to understanding retirement as a whole.

Finally, given the burgeoning leisure industry, it is becoming increasingly important for students to be knowledgeable about this aspect of the retirement experience. Students can certainly appreciate the importance and value of leisure, based on its role in their own lives. By examining aging and leisure patterns, students can therefore gain practical knowledge of potential use in their own careers as well as a basis for relating to older adults in this common area of importance in life.

Videos and films

There are a number of news programs that regularly cover issues related to retirement, and these can be interspersed with the latter portion of the lecture.

Feelings that adults have about work can be depicted through showing any one of many popular movies or television shows in which characters are disaffected with their jobs. A humorous movie that is a classic among many undergraduates is "Office Space" (starring Jennifer Aniston and Ron Livingstone). A scene from “The Office” demonstrates age discrimination when Michael Scott provides a very poor model of how to deal with age (“Dunder Mifflin Infinity”). Difficulties in the early stages of career development are demonstrated in “The Devil Wears Prada.”

Discussion questions Work patterns in adulthood Why have labor force participation rates by age changed over the past 40 years?

In your opinion, why are women entering the labor force in greater numbers than in the past, particularly those who are married with young children?

Where do you think the term "pink collar" comes from?

Why do people over 55 move into service and sales jobs?

Why do women earn less than men even at the highest occupational levels?

Why do people earn the most when they are 45-54? Do you think the peak earning age will rise as the Baby Boomers grow older?

Does knowing that your college degree will lead to a higher salary have motivating value for you?

Why is a college education and beyond related to higher earnings in adulthood?

Why is there a glass ceiling for college educated black men?

What might the impact be on health and lifestyle of lower education among minority adults over 65?

How have older minority adults been limited in their educational and occupational attainments by discrimination when they were younger? Has the situation improved in recent decades? Why or why not?

Vocational development How is a vocation different from or the same as an occupation?

What is an "R," "I," "A," etc. type of job? (Have students name jobs within the different types). What type of job is a carpenter, artist, etc. (Ask students to categorize jobs from different types.)

Do you think there are advantages to the federal government of the U.S. having a standard job classification system? What are these?

How would you use the O*NET to find the right job for you?

What are the limitations of the RIASEC model?

Are people free to choose their own vocations or are they limited? What might these limiting factors be?

If you were putting together a team of workers, would you combine people with similar profiles or people who had opposite profiles from each other?

Do you think people choose their leisure activities on the basis of the same or the opposite type that they express in the workplace?

Does Super's theory make sense in contemporary Western society in which people do not experience a static set of stages throughout their careers? Or does the theory have universal applicability? Justify your answer.

How does Super's theory differ from Holland's? What are the implications of Super's theory for vocational satisfaction in adulthood?

Vocational satisfaction How important is it to you that you find satisfaction in your job?

What factors might predict vocational satisfaction in adulthood?

Can you identify the intrinsic and extrinsic factors in a job that you held or are currently holding? Which are or were more important to you?

Why might extrinsic rewards lower intrinsic satisfaction with work?

Can you describe the ORP of a job you have held?

Do you know people who seem happy all the time and therefore would probably like any job?

Why would a personality variable like attachment style be related to vocational satisfaction?

Can work and family life relate positively to each other or are they always in conflict?

What are the implications of studies showing negative relationships between work and family life?

How can workers maintain a positive attitude toward their jobs even when they have held them for many years?

Suggest some possible relationships between identity and vocational satisfaction in adulthood. For instance, if a firm is being downsized, might a worker reduce job commitment as a way of protecting the self in the event that he or she is laid off?

Age and vocational performance Is it inevitable that performance should decline in older workers? Why or why not?

Why was there a need for the ADEA? Why do gerontologists prefer to view retirement as a process rather than an event?

Would you prefer to retire all at once or would you rather do so in stages?

What will be the future of the Social Security system? What are the projections for its "security" in the next 20 to 30 years?

Retirement Why was mandatory retirement abolished in most occupations? Should it be reinstated to allow younger workers to have more jobs?

Which theory of retirement and the individual fits most closely with your own views on the subject? Will you look forward to or dread retirement?

How can social scientists test the validity of the three theories of retirement and the individual?

Why do certain people suffer more ill effects of retirement than do others?

Which factor seems most important to retirement adjustment in your experience?

How does retirement self-efficacy relate to other forms of self-efficacy discussed in earlier chapters?

How might this personality factor influence the way people adapt to the retirement process?

Do you think that women have an easier or more difficult time in retirement than do men? Why or why not?

Will the retirement experience of women differ in the future from what it is today?

How do your leisure activities fit into your identity?

Do you think that, over time, your leisure interests will change? If so, how might they change?

Will the leisure interests of the older generation change as the Baby Boomers move into later adulthood? What might these changes be?

How might leisure interests vary as a function of socioeconomic status and income?

CHAPTER 11 Mental Health Issues and Treatment Lecture guidelines There is extensive material in this chapter; virtually a short form of a course in abnormal psychology.

Therefore, the instructor must proceed with the assumption that students have done their background reading and the lectures will present highlights. Even with this understanding, there is sufficient lecture material for two to three lectures. The main point of this chapter is to orient students to the need to think about psychopathology in later adulthood as a real concern that affects the lives of many people in the U.SA second major point is that the majority of older adults do not psychological disorders and, contrary to what students might expect, there are fewer rather than more older adults with diagnosed depression. However, a caveat to this statement is the fact that many older adults under-report their symptoms, and the actual prevalence figures may not represent accurately the extent of psychological problems in this age group. These and related diagnostic issues are interesting and worthwhile to present and discuss to the class. Similarly, there are many inherently fascinating and important issues involved in the psychological treatment of older adults. This field is relatively new within psychology, but it is growing very quickly. Instructors who learned about the field of psychopathology in later life some years ago will be encouraged by the burgeoning of new methods and research in this area.

Fortunately, students are inherently interested in the topic of abnormal psychology, so there is a good chance that they will be motivated to do the reading on their own and to come to class prepared to discuss both theoretical and clinical issues.

Videos and films The specific area of mental health and aging is not one that is well represented in either documentaries or popular media. There are a few documentaries produced by television news magazines that focus on certain issues (e.g. alcohol use in later life), but other than that, the choices are limited. One example is the A&E series called “Hoarders” which included several episodes focusing on older adults. A second is a segment in the PBS special “Depression: Out of the Shadows” http://www.pbs.org/wgbh/takeonestep/depression/ which demonstrated ECT in an older adult.

Discussion Questions Psychological disorders in adulthood Do you agree with the text definition of psychological disorder? Why or why not?

What alternatives might you suggest to the current definition of psychological disorder?

Why does the diagnostic system of the DSM-IV use a multidimensional rating scheme? What are the advantages and disadvantages of such a system?

Do you think that people should receive diagnoses for psychological disorders? Why or why not?

Why is it important to distinguish prevalence from incidence?

Why do clinicians have difficulty diagnosing mood disorders in older adults?

How can mental health professionals be better trained to diagnose anxiety disorders in older adults?

What do you think life is like for an older adult who has had schizophrenia for most of his or her adult years?

What happens to an older person with delirium or amnesia who is misdiagnosed with Alzheimer's disease?

How can clinicians avoid making errors in diagnosing disorders that look like dementia?

Why do you think that substance use rates are so high in the U.S.?

What factors might account for changes in substance use in people over the age of 35?

Do you think that rates of substance abuse and dependence will increase or decrease as current cohorts of young people move through adulthood?

What are some possible explanations for the maturation hypothesis?

Elder abuse Why does elder abuse occur? How is it related to other problems in social treatment of older adults?

Thinking of issues discussed in Chapter 9 (adult child-parent relationships), what factors might account for the high frequency of children as abusers of their aging parents?

Suicide What are the possible reasons that people who survive to advanced old age would wish to end their lives?

Why is it that health care providers often miss the diagnosis of suicidality in older adults?

Treatment issues in mental health care Why should clinicians consider differentiating their treatment approaches to older adults from those used for younger adults?

What sorts of training would seem necessary to become a geropsychologist?

Which type of assessment measures would you use if you were a clinician? Why? What types of research are needed to refine and improve assessment procedures for diagnosing psychological disorders in older adults?

If you were a clinician, would you recommend somatic treatments for older adults? Which ones would you recommend and why?

What might be the justification for giving ECT to an older adult?

How can clinicians be better trained to provide therapy to older adults?

Why might the current generation of older adults be reluctant to become involved in therapy?

CHAPTER 12 Long-Term Care Lecture guidelines The material in this chapter on institutionalization and financing of mental health and medical services provides important up-to-date information on one of the major issues facing the world today. The topic of institutional adaptation is one of the oldest areas within gerontology and ties together many relevant issues that fit within a biopsychosocial perspective. Furthermore, as many students taking the course will be (or maybe are) working within these settings, there is a great deal of value in exploring these topics in depth. Technical issues involved in the financing of health care are important to cover, as students who complete this course should be familiar with the structure of Medicare and Medicaid.

Although not "psychological" in the narrow sense, these health care financing systems contribute in important ways to the well-being of older adults.

Videos and films There is an extensive amount of material that can be used to illustrate institutionalization and financing of long-term care. In addition to news reports on Medicare funding, which has been given a great deal of attention with the healthcare reform debate in the U.S., there are many movies that depict institutionalization, for better or worse. Some movies from the 1970s portray the "bad old days" prior to the Nursing Home Reform Act and are interesting to show as contrast to what we think of now as improved nursing home care. These old movies include "Where's Poppa?," "I Never Sang for my Father," and "Do You Remember Love?" More recent movies, which still emphasize negative aspects of institutionalization include "Happy Gilmore." The Simpson’s episode, “The Old Man and the C Student” shows a humorous depiction of children visiting a nursing home (and trying to change it).

There is an excellent documentary entitled “Sunset Story” that provides a poignant and extremely wellcrafted portrayal of a group of aging “radicals” (http://www.sunsetstory.com/).

Discussion questions

Institutional facilities for long-term care How is a nursing home different from a hospital?

Would you consider placing a chronically ill relative in a nursing home? Why or why not? What would you look for in a nursing home?

What are some of the advantages of residential care facilities compared to nursing homes?

How do assisted living facilities fall short of their goal of "aging in place"?

Community-based services and facilities What are some of the advantages of home health services compared to a nursing home or residential care facility?

Why don't nursing homes take advantage of behavioral methods of reducing incontinence in residents?

If you were a consultant to a nursing home, how would you recommend that such training be instituted?

The financing of long-term care Why is there so much concern in the U.S. about Medicare funding?

What do you think about the need for nursing home residents to "spend down" so that they qualify for Medicaid?

What steps could states take to cut down on Medicaid costs, or should no limits be set on Medicaid?

Legislative issues in care of older adults Why was the Nursing Home Reform Act needed? Do you think it went far enough or should there be more regulation of nursing homes?

If you were a nursing home administrator, how would you enforce the rights of residents as mandated by the Nursing Home Reform Act? Characteristics of nursing homes and their residents Visit a local nursing home and see if you can spot any of the deficiencies found in the 2007 GAO report.

Why is food sanitation such an important issue for nursing homes?

Psychological issues in long-term care How would the competence-press model apply to the dormitory that you live in?

Why is it difficult for institutions to meet the needs of the average resident?

Can changes in nursing homes to personalize the living areas significantly improve the extent to which residents adjust to life in an institution?

CHAPTER 13 Death and Dying Lecture guidelines This is a fascinating topic highly relevant to the goals of the course. Without becoming morbid, the instructor can generate considerable excitement about a topic that naturally draws student interest.

Although the opening of the chapter is somewhat technical, the instructor can emphasize the importance of knowing the facts and figures on mortality as consisting of useful data about a society's overall health. Furthermore, variations in mortality rates across age, sex, and race groups provide important diagnostic information about the social problems existing within a country or culture. Here, as in previous chapters with extensive presentations of population figures, it is important for the instructor to point out the "human" side of the numbers.

Cultural variations in attitudes toward death and death rituals provide another rich source of information to enhance the lecture. Instructors can draw from their own cultural background, travels, and opportunities to learn about death in ancient or non-Western civilizations. Students can also share their own perspectives and backgrounds in class discussions. Through videos (see below), instructors can also poke fun (without getting too morbid) at some of Western society's discomfort with death and dying.

The topic of end-of-life care is very new within medicine and even newer within psychology. SUPPORT provided a rich source of data on the actual experiences of dying patients, and the AMA and Institute of Medicine have developed extensive documents regarding how dying patients are best treated. The well-publicized actions of Dr. Jack Kevorkian have prompted a wealth of alternative proposals and viewpoints regarding the humane treatment of dying individuals.

Finally, the area of bereavement is being revisited within psychology as it is recognized that continued attachment to a lost family member or friend has beneficial aspects. Grief counselors are recognizing that it is not necessarily best to rid oneself of memories and emotional ties to the dead person. In this lecture, these issues can be raised with students, particularly those who have experienced the loss of someone close to them.

This is not the last chapter of the book-- on purpose. Although death is the natural ending of a course on adult development and aging, the last chapter will look at the productivity and creativity of older people in the context of successful aging. At the same time, it is worth recognizing that the ability to move beyond the inevitable losses that older adults experience is part of the process of successful aging (as has eloquently been stated by Robert Kastenbaum).

Videos and Films There are many resources available for instructors to supplement the material in this lecture- so many that it would be possible to spend the entire class time viewing relevant videos. Therefore, the instructor must choose judiciously among the many available options and rather than show one film in its entirety, select the best portions of two or three. The options include documentary materials on PBS

and various cable networks in which the topic of death has been treated, either from a psychological or sociocultural perspective. Sensationalistic attitudes toward death can also be illustrated by excerpts from news stories describing deaths of famous people (such as Michael Jackson) or stories covering disasters (such as earthquakes, tsunamis, hurricanes, to name a few).

The History Channel documentary, “Cities of the Underworld” included an excellent segment on the Egyptian mummies—ordinary citizens—who were not buried in tombs as elaborate as the Pharaohs but with similar embalming processes. The TV show “Gray’s Anatomy” did an excellent job illustrating physician-assisted suicide in the episode which aired in Spring 2010 entitled “Suicide is Painless.”

Discussion questions Technical perspectives on death When is a person considered legally dead?

Have you ever been with a dying person? What types of symptoms did that person exhibit?

Why is it necessary to perform autopsies?

Do you think the results of autopsies are always accurate? When might they be wrong?

What is the difference between an age-specific and an age-adjusted death rate? Why are both needed?

What can we learn about a population from knowing its mortality rate?

Why has the mortality rate decreased over the past 100 years? How much more do you think it will decrease in the next century?

What do death rates by age, sex, and race, indicate about a group in the population?

Why is it that people with a college education have lower mortality rates?

What factors lead some poor countries to have lower death rates than other poor countries? What does the mortality rate of a country say about the health and living conditions of its people?

What can be applied from studying mortality rates in other countries to understanding health status in our own country?

Cultural perspectives What would it be like to live in a culture in which death was not feared?

How does belief in the afterlife relate to a culture's views of death?

How did medical advances in the 20th century change contemporary society's views of death?

What does the Death with Dignity movement signify about current attitudes toward death and dying?

The dying process Which dying trajectory would you prefer to have happen to you and your loved ones? Why? What does the concept of the dying trajectory add to our understanding of the dying process?

Do you think the five stages of dying provide a useful perspective for understanding the dying process?

Why or why not?

What alternatives would you propose as a way of thinking about the dying process?

Do these social-psychological processes such as legitimization of biography provide a more useful perspective than the stages of dying proposed by Kubler-Ross? Why or why not?

Have you ever heard a person engage in the legitimization of biography? What was that like? How do these processes relate to Erikson's concept of ego integrity?

What changes in medical care of the dying necessitated the PSDA? Will you or have you written an AD? What will or did it include?

What are the implications of SUPPORT for current care of the dying?

How can the experience of dying patients be improved?

Do you agree with the policies and practices of Kevorkian? Why or why Not? What are the concerns of physicians and others who disagree with Kevorkian's treatment of terminally ill patients?

How does the notion of hospice care differ from the view of death promoted by Kevorkian?

Bereavement Do you agree with the recommendation that assistance with mundane tasks such as help around the home and buying groceries can help ease the psychological burdens on the dying and their families?

Why are bereaved persons at risk for physical disease?

Have you witnessed the symptoms of bereavement in yourself or others? Did they correspond to the description provided here? How were they different?

How do you think it feels for a person married 40 to 50 years or more to experience the death of a spouse? Have you witnessed this process in a relative or friend?

Why might it be more difficult for younger widows to adjust to a spouse's loss? Why might it be more difficult for older widows to make the adjustment?

How are men and women differentially affected by the loss of a spouse?

Which of the types of loss do you think is hardest for an individual to experience? Why? What is the role of religion in the bereavement process? Why is this not discussed by current theories of bereavement?

Why did traditional theories of bereavement regard the working through of a death as a necessary part of adaptation to loss? What has caused that view to change?

CHAPTER 14 Successful Aging and Creativity Lecture guidelines As mentioned in the last chapter, the end of the course covers successful aging rather than death and dying. This allows the instructor to send the students out of the course with an upbeat feeling about what they have to look forward to in the rest of their lives. The topic of successful aging has existed for some years within gerontology, but it has been given recent impetus by the "Positive Psychology" movement and the emphasis on optimism that is beginning to pervade the field. The job of ending the course on this topic has been made much easier by this recent shift in emphasis, as in the past there was not much data from which to draw. However, as is evident from the chapter, the research on subjective well-being, successful aging (the MacArthur studies), and productivity in later life (Simonton's work) provides a wealth of riches in this area. Moreover, the instructor can delve as much as desired into the material on creativity in later life by incorporating the works of great artists, musicians, and literary geniuses who continued to produce well into their eighties.

Videos and films Instructors will find many possible sources for this lecture, including documentaries on amazing older adults as well as movies that provide a positive image of old age. There are also any number of "Today Show", documentaries, and evening news stories about remarkable older adults. In terms of movies, there are again ample choices available. One particularly good movie that is available on video is “Young at Heart” http://www.youngatheartchorus.com/.

There are videos available on Rembrandt’s self-portraits on YouTube (http://www.youtube.com/watch?v=V_H71aiz290) Also a biography of Picasso that includes his later years http://www.youtube.com/watch?v=3k1lUBoBBIc A multimedia piece that can be designed specifically for this lecture works very well in the class in the section on achievements by older adults. A collection of slides showing the “Age Busters” described in the text can be played along with a musical selection (such as "My Way"). This can have a very emotional impact on the class, when they see the compilation of people they have heard about (and those they have not) who have continued to accomplish beyond the point that would be predicted on the basis of their age. The "swan song" can also be illustrated by playing examples of music composed at the end of life-- the best example is Lacrymosa from Mozart's Requiem in D minor (thanks for Dean Simonton for this suggestion!). Slides from Rembrandt's self-portraits (ages 23 to 63) can be shown to illustrate the "old age style," as can paintings and sculptures from the artists mentioned in the text. To summarize, the instructor can use this lecture to end the course with a grand fireworks finale- a wonderful ending to what students will certainly have found to be a fascinating and worthwhile course.

Discussion questions

Theoretical perspectives on successful aging What do you think is involved in successful aging?

Subjective well-being How would you rate your subjective well-being? Do you think it varies from day to day? What factors cause it to vary?

Do you think that people can actively construe their lives in a positive way even if their objective circumstances are negative? How? Productivity and creativity What is the meaning of the compositional fallacy?

What examples can you think of that fit with the idea of “Old Age Style”? How about the “Swan Song”?

How does the idea of the Age Busters fit with the overall predictions based on Lehman's views of aging and productivity?

Successful aging: Final perspectives How is productivity measured in "ordinary" people at the end of life?

What can we learn from successful agers?