Tag Archives: Aging

5 Steps to Jumpstart Your Career in Aging

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By Hardeep Omhi, MA (Gerontology and Human Development and Family Studies Doctoral Student, Iowa State University) 

Did you know that older adults (individuals 65 years of age and older) are the fastest growing segment of the U.S. population?

Did you know that in 2035, older adults are projected to outnumber kids for the first time in U.S. history?

Did you know that the Bureau of Labor Statistics just reported that the majority of the jobs that will have the most growth in the next 10 years are related to aging services?

There is a broad range of exciting and fulfilling personally fulfilling career opportunities to work with this rapidly growing segment of the population. However, students seldom consider pursuing a specialization and career focused on adult development and aging.

There are a variety of factors that come into play when we explore the major subject and career trajectory we would like to pursue. Many of us tend to major in psychology because it offers a variety of avenues to explore and allows us to help others. Within psychology, students tend to pick niches and frequently veer towards specializations of clinical psychology, cognitive psychology, social psychology, and developmental psychology with an emphasis on early life. Those who may consider pursuing a career focused on the later part of the lifespan often find it difficult to discover information about exploring such a career path.

If you or someone you know is interested in exploring careers in aging, here are five steps to take:

1. Gain practical experiences.

Become a research assistant, a volunteer in a setting where older adults are (e.g., senior centers, senior residences, recreation department classes, long-term care facilities), and partake in internships and practicum experiences with older adults. For example, you can capitalize on summers by engaging in paid internships while being a research assistant during the academic year. In these practical experiences, you can ask your supervisors about their career trajectory to explore if it’s something you might be interested in pursuing.

2. Find mentors –  both faculty and graduate students.

Mentors who are supportive and have a personality that meshes with yours are very helpful. It is understandable that your research interests will change over time. Your research interests do not have to exactly match those of your mentors, but it is important that they are parallel to some extent. It’s also helpful to get to know graduate students and potentially have them as mentors because they know what it’s like to be an undergrad and they may be able to relate to you more effectively than a faculty member.

3. Build strong and effective communication skills.

Regardless of whether you’re interested in going into a research or practice-oriented career, it is essential for you to effectively communicate — in both a verbal and written manner. Encourage your mentor or instructor to give feedback on your written work and on your oral presentations.

4. Get to know statistics and how to critically read research articles.

Whether you’re interested in pursuing a research-oriented career or a practice-focused one, it would behoove you to understand statistics and know how to critically disentangle research articles. For example, if you are a manager of a long-term care facility who is interested in decreasing levels of employee burnout, you may look towards research to explore empirically-based programs/interventions to help with this. As such, a strong foundation in statistical and research methodology will help you get through the literature and critically assess how well research findings apply to your employees. In doing so, you’ll encounter issues of reliability, validity, and have the ability to understand what the statistics noted in the research article actually mean.

5. Lastly, take a look at American Psychological Association’s new resource: Exploring Careers in Aging.

These step-by-step educational roadmaps (one for undergraduates and one for graduate students) will help you learn more about career opportunities in aging and ways to prepare for your career trajectory. They also include questions to consider and actions to take at each educational level, examples of adult development and aging-focused careers, and lots of resources.

Figuring out what you should major in and what sort of career path you want to take can be a challenging and exciting process. Gerontology – the study of aging – is a unique field that capitalizes on interdisciplinary work. Students who major in disciplines beyond psychology can also intersect with aging. For example, you can be an engineer who designs technology for older adults or major in business and specialize in later life financial issues. There are endless aging-related career possibilities for you to explore. Using this spiffy and informative APA resource will help you navigate every step of the way.

Biography:

Hardeep Obhi, MA, is currently a doctoral candidate studying Gerontology and Human Development and Family Studies at Iowa State University (ISU). She earned her undergraduate degree in Psychology and possesses a master’s degree in Research and Experimental Psychology from San Jose State University. Ms. Obhi was recently awarded an F31 Ruth L. Kirschstein National Research Service Award Individual Predoctoral Fellowship from the National Institute on Aging within the National Institutes of Health (NIH) for her proposal Biopsychosocial Reserves and Dementia: Identifying Life-span Protective Factors, which  will help contribute to the understanding of life-span biopsychosocial reserves to promote cognitive health in later life as well as have implications for developing public health interventions, preventions, and policies for cognitive decline. In addition to her research endeavors, Ms. Obhi has also been an Interdisciplinary Writing Consultant for the Center for Communication Excellence housed within the Graduate College at ISU for three years; in this mentorship role, she helps graduate students and post-doctoral fellows from all disciplines with professional communication in individualized consultations, develops and presents writing seminars and workshops on a variety of topics (e.g., research and grant writing). In Summer 2017, As a graduate intern, Ms. Obhi provided significant support to the APA Office on Aging and the APA Committee on Aging in developing the Exploring Careers in Aging Roadmaps resource.

What is the Recipe for Success? 5 Ways Cooking Can Keep You Young

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By Erin Cochrane, Sam Gilchrist, and Anna Linden (Department of Psychology, Saint Olaf College, Northfield, MN)

Aging gracefully isn’t always a sweet process. The World Health Organization warns that malnutrition is a looming issue for our aging population1, but sensory losses can make food less appealing and increase risk for undereating and weight loss2. However, eating a variety of foods can boost consumption of micronutrients and help to prevent age-related diseases like osteoporosis and diabetes2. The recent uptick in subscription cooking services like Plated and Hello Fresh, which deliver fresh ingredients to customers’ homes, suggests that Americans are beginning to take charge of their own nutritional needs. Taking an active role in preparing our own food has been shown to benefit physical, cognitive, and emotional wellbeing as we get older. It seems as though healthy aging could boil down to spending more time in the kitchen, so here are five ways cooking can spice up your daily routine!

 

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1. Increases physicality

The health benefits start even before any cooking happens! Before you can cook, you need to get ingredients; getting out to shop for your ingredients is a great way to add some exercise into a daily routine. Food preparation has repeatedly been associated with increased levels of physical activity and self-reported health-status4. The physical advantages of cooking don’t stop there, as research found that those who cook for themselves at least five times a week also had the highest rates of survivorship in a group of individuals over the age of 653. This was consistent even accounting for physical health and nutrition knowledge awareness, showing that anyone can benefit from cooking more of their own meals!

If possible, try to buy ingredients on a day-to-day basis. This will increase your daily exercise as well as ensuring you get the freshest ingredients.

 

2. Helps social and emotional health

Cooking classes can keep kitchen skills from getting stale: they not only improve nutritional habits in older adults, but psychological wellbeing as well5. According to The Guardian, these community classes are increasingly important in the face of budget cuts to programs like Meals on Wheels, and they provide an added bonus of increased independence6. Studies have also shown a relationship between home-based food activities and a strong sense of self, especially when connecting older adults to aspects of their heritage. Cooking traditional dishes and sharing them with a community can promote feelings of belonging and self-efficacy, in addition to joy at mastering new skills7,8.

Look into volunteering for community meals at local charity organizations, or invite friends and family over for a dinner party!

 

3. Improves diet quality

Cooking classes are beneficial for mental health and can also improve the quality of your meals! Researchers have found that older adults enrolled in cooking classes include more vegetables and fiber within their diets, which are associated with a decreased risk of cardiovascular disease5. The same study also showed that 98% of participants improved their overall nutritional knowledge, which is crucial to combatting the malnutrition of aging and controlling what one eats. It is also important to note that when you cook for yourself, you control what you eat. To boot, having higher control over caloric consumption is associated with improved quality of health throughout life9.

Eating healthier means knowing the nutritional value of the ingredients in your meals!

 

4. Maintains mental fitness

Cooking can also preserve your cognitive functioning with age. Research indicates that cognitive abilities generally decrease throughout the lifetime, with some individuals experiencing considerable losses in executive functioning10. These are the skills needed for planning, multitasking, and setting goals – the very abilities that keep you independent!

Don’t stew over that, though, because cooking may be able to offset these declines in cognition. Studies show:

  • Monitoring cooking times, prioritizing certain dishes, and setting a table forces cooks to use their prospective memories
  • The attentional demands of cooking have also been shown to transfer to similar tasks requiring constant updating or shifting attention

You can toast to that!

Try cooking a new recipe that involves many steps and challenges you to plan ahead.

 

5. Adapts to your unique situation

If you are no longer living independently, certain cooking modifications may serve up similar benefits. For those with Alzheimer’s disease and mild cognitive impairment, virtual cooking games like ‘kitchen and cooking’ have increased both speed and accuracy of executive functioning11. Updating your kitchen technology may also offset physical limitations and other age-associated hazards. For example, while elderly individuals are at increased risk for burns and fire, implementing oven sensors and cooking-safe systems can shut off power when needed12.

Third, meal delivery programs can replace traditional shopping for homebound adults. Companies like Blue Apron and Chef’d deliver pre-portioned ingredients and recipes to your home, so there is no need to drive. These modifications can keep you self-sufficient and safe in the kitchen.

If you feel you can no longer cook, look into virtual apps or meal delivery services to help support you!

Cooking for yourself provides more than just delicious, nutritious food; it is a cognitively demanding task that builds up physical health and social connections, helping to combat the specific deficits of aging. Dare we say it is a secret ingredient to aging successfully?

What benefits has cooking given to you? Share your thoughts, stories, and favorite recipes with us in the comments below!

 

For further reading:

1World Health Organization (2018). Nutrition for older persons. Retrieved from http://www.who.int/nutrition/topics/ageing/en/index2.html

2Boyce, J. M., & Shone, G. R. (2006). Effects of ageing on smell and taste. Postgraduate Medical Journal, 82, 239-241. http://dx.doi.org/10.1136/pgmj.2005.039453

3Chen, R. C., Lee, M.-S., Chang, Y.-H., & Wahlqvist, M. L. (2011). Cooking frequency may enhance survival in Taiwanese elderly. Public Health Nutrition, 15, 1142-1149. http://dx.doi.org/10.1017/S136898001200136X

4Thompson, J. L., Bentley, G., Davis, M., Coulson, J., Stathi, A., & Fox, K. R. (2011). Food shopping habits, physical activity and health-related indicators among adults aged ≥70 years. Public Health Nutrition, 14, 1640-1649. http://dx.doi.org/10.1017/s1368980011000747

5Jyväkorpi, S. K., Pitkälä, K. H., Kautiainen, H., Puranen, T. M., Laakkonen, M. L., & Suominen, M. H. (2014). Nutrition education and cooking classes improve diet quality, nutrient intake, and psychological well-being of home-dwelling older people – a pilot study. Journal of Aging Research and Clinical Practice, 1, 4-8. http://dx.doi.org/10.14283/jarcp.2014.22

6Bernhardt, C. (2012). One foot in the gravy: the rise of cookery classes for older men. The Guardian. Retrieved from https://www.theguardian.com/society/2012/apr/10/cookery-classesolder-men

7Plastow, N. A., Atwal, A., & Gilhooly, M. (2014). Food activities and identity maintenance in old age: A systematic review and meta-synthesis. Aging & Mental Health, 19, 667-678. http://dx.doi.org/10.1080/13607863.2014.971707

8Kullberg, K., Björklund, A., Sidenvall, B., & Åberg, A. C. (2011). ‘I start my day by thinking about what we’re going to have for dinner’ – A qualitative study on approaches to food-related activities among elderly men with somatic diseases. Scandinavian Journal of Caring Sciences, 25, 227-234. http://dx.doi.org/10.1111/j.1471-6712.2010.00813.x

9Willcox, B. J., Willcox, D. C., Todoriki, H., Fujiyoshi, A., Yano, K., He, Q., Curb, J. D. and Suzuki, M. (2007), Caloric restriction, the traditional Okinawan diet, and healthy aging. Annals of the New York Academy of Sciences, 1114, 434–455. http://dx.doi.org/10.1196/annals.1396.037

10Braver, T. S., & West, R. (2008). Working memory, executive control, and aging. In F. I. M. Craik & T. A. Salthouse (Eds.), The handbook of aging and cognition (3rd ed., pp. 311–372). New York, NY: Psychology Press.

11Manera, V., Petit, P.-D., Derreumaux, A., Orvieto, I., Romagnoli, M., Lyttle, G., … Robert, P. H. (2015). “Kitchen and cooking,” a serious game for mild cognitive impairment and Alzheimer’s disease: A pilot study. Frontiers in Aging Neuroscience, 7. http://dx.doi.org/10.3389/fnagi.2015.00024

12Yared, R., & Abdulrazak, B. (2018). Risk analysis and assessment to enhance safety in a smart kitchen. Fire Technology, 1-23. http://dx.doi.org/10.1007/s10694-017-0696-5

 

Author Biographies:

Erin Cochrane is a senior at St. Olaf College, currently pursuing a bachelor’s degree in Biology and Neuroscience. She is interested in exploring the relationship between genetics and health, and in the future hopes to pursue graduate studies in either genetic counseling or medicine.

Anna Linden is a senior Psychology major at St. Olaf College, concentrating in Statistics. Her interests lie in the field of Human Factors and data analytics, and she’s looking forward to graduate school in the near future.

Samuel Gilchrist is a senior Psychology major at St. Olaf College. He is interested in the field of Behavioral Economics and studying the psychology behind personal financial decisions. In the future, he hopes to find a job in the field of advertising.

Let’s Talk About Sex — After 60

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By Christina Pierpaoli Parker, MA (Geropsychology Doctoral Student, University of Alabama)

 

 

Science has started to pay attention to what happens between the sheets after 60, especially as medical advances permit us to live longer and healthier lives. Emerging research shows that older adults get busier than we think, finding that many adults remain sexual well into their 90s. As with other periods of development, sex in later life improves quality of life, mood, and health.

 

The Problem

But sex after 60 still has its consequences. Spikes in sexually transmitted disease (STDs) among older adults illustrate that. Compared to younger folks, older adults know less about STDs, underestimate their risk of infection, and practice safe sex less often. Data from the Centers for Disease Control and Prevention (CDC) reflect this, reporting that adults over 50 represent 15% of new HIV infections. By 2020, upwards of 70% of persons living with HIV will be 50 or older. Other STDs including chlamydia, gonorrhea, primary and secondary syphilis, show similar increases in older groups.

 

What’s going on?

Experts offer two explanations: (1) Treatment advances, such as antiretroviral therapy, have enabled already infected adults to live longer, inflating prevalence; and (2) the number of new infections (incidence) among older adults is increasing.

 

Fine, but why are adults becoming infected at all?

Growth in new infections altogether means recognizing that sex doesn’t retire after 60. Complex interactions of biopsychosocial factors underlie the incidence of STDs among older adults.

 

Biological factors. With normal aging, older adults experience changes in immune function, increasing their vulnerability to sexually transmitted diseases. For example, the number and maturity of their T- cells—white blood cells that help fight infection—decrease, depressing immune responsiveness and aiding transmission.  Systemic reductions in testosterone and estrogen can thin the vaginal and anal mucosae and reduce vaginal lubrication, leaving many older men and women susceptible to tears during sex that can facilitate viral entry.

 

Psychological & behavioral factors. Older adults underestimate their risk for contacting sexually transmitted diseases. A recent study comparing actual and perceived sexual risk found that older adults with the greatest risk of contracting STDs were also the group least aware of their vulnerability. Cohort differences surrounding the 1960s rise of penicillin to treat STDs like syphilis may skew older adults’ identification with risky sexual behavior, explaining low rates of condom use among boomers especially. The widespread availability of erectile dysfunction medications in a climate of shifting divorce and dating patterns in later life— when menopause hits and pregnancy ends— have intersected to create more opportunities for sex and infection.

 

Sociocultural factors. Of course, older adults aren’t entirely to blame. Stereotypes, taboos, and biases about aging and sexuality perpetuate misconceptions surrounding late life sex, trickling down into clinical practice. For example, physician-initiated sexual history taking remains suboptimal among older adults, despite CDC recommendations requiring patients of all ages to receive comprehensive STI/STD education and evaluation. A powerful study revealed that few men (38%) and even fewer women (22%) had discussed sex with a physician since age 50, consistent with findings describing the inverse relationship of age and frequency of sexual health discussions. Other studies simply find that practitioners feel uncomfortable initiating sexual health discussions with older adults.  Prevailing interpretations of these findings conclude that practitioners’ attitudes and beliefs about sex in later life may stem from stereotypes of aging and sexuality, rather than experiences with, or explicit education about, late life sexuality.

 

Where do we begin? A call to action

Sex researchers and educators alike have long pointed to the positive contributions of sex education to healthy sexual attitudes and behavior, but adult-specific models remain breathtakingly scarce. Psychologists must therefore work to develop, implement, and evaluate adult sex education protocols for practitioners and older adults on:

  • Increasing knowledge about sexual health and functioning, as well as their changes, in later life;
  • Growing understanding of the biopsychosocial contributions to sexual risk in older adulthood; and
  • Promoting growth in physician and patient comfort to discuss sexual concerns

 

Recent precedent supports this as a good starting point: internal medicine residents who received three brief 30-minute tutorials on sexual history taking demonstrated improved documentation of older adults’ sexual histories than those who did not.

 

Steps you can take right now

We’ve got a long way to go before the paradigm shifts. Here’s what you can do to nudge it:

  1. Pause to assess, recognize, and reflect on your biases. What attitudes and beliefs do you have about late life sexuality? Where do they come from and how do they serve you? How and why should you challenge them?
  2. Practice the kind of sex you’d encourage your child or loved one to have. Sex that’s safe, consensual, and well lubricated.
  3. Have the knowledge and courage to ask questions. If you’re a health care provider working with older folks, ask about their sexual concerns; research says adults appreciate it. If you’re an older adult, share your sexual concerns with your health care provider—a competent professional will work with you or direct you to someone who can.
  4. Learn more. Explore the references included throughout this piece to get more (scientifically sound) information.
  5. Embrace sexuality as a lifelong, developmental process that improves with age. Isn’t that more fun, anyway?

 

 

 

Biography:

Christina Pierpaoli Parker, MA, is a fourth-year graduate student in the Clinical Geropsychology doctoral program at the University of Alabama under the co-mentorship of Drs. Forrest Scogin and Martha R. Crowther. Her research and clinical work explore the intersection of older adults’ physical and psychological health, focusing on the adjustment to and behavioral management of chronic health conditions (e.g., HIV, metabolic syndrome, osteoarthritis). Current interests include developing psychoeducational interventions for understanding, treating, and improving sexual dysfunction in later life. Christina’s work has been published in the Journals of Aging & Health, Sex & Marital Therapy, and The Clinical Gerontologist and presented at international conferences. She translates her academic research for Eng(aging), her widely acclaimed blog on Psychology Today, which has landed her interviews as aging expert on The Psychology Podcast with Dr. Scott Barry Kaufman and The Aging Literacy Podcast with Dr. Bill Thomas. Her forthcoming book, Trixxx Aren’t Just For Kids, written with Dr. Elizabeth DiNapoli, explores the science and stories of sex in later life.

 

What High School Psychology Students Told Us About the Future of Healthy Aging

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By Maggie Syme, PhD, MPH (Member, APA Committee on Aging & Assistant Professor of Gerontology, Kansas State University)

 

In the past year, high school psychology students embarked upon an essay to describe an “Aging World,” the theme of this year’s Teachers of Psychology in Secondary Schools (TOPSS) annual essay competition for high school psychology students. Ultimately, four students from high schools around the world were named winners, but the broader impact was that a bevy of young people learned about how to age well and how to support this goal for our current aging population. The potential contribution of younger to older generations is enormous, and it has been truly inspiring to see the passion and ingenuity with which these high school students approach an aging world.

It was so inspiring that the APA Committee on Aging, which provided input to this year’s TOPPS competition, interviewed the essay winners. The winners provided insight into their experience and the implications for the psychology of aging.

Three thousand words on aging—this is no easy task. Just ask our winners. Each winning student (see below for names and affiliations) commented on the magnitude of the project, and some reflected on how their peers shied away from the task. Yet, each one appreciated the challenge and found clear benefits to participating.

 

Poorvi Dua, now at University of California – Berkeley, indicated that the size did not intimidate her, but instead the challenge was intriguing.

“The second [my teacher] mentioned it I got really excited, and knew if I put work into this it would be the coolest thing.”

 

Wendi Ji, a senior at Shen Zhen College of International Education, also saw the importance of the topic:

“I usually don’t want to participate in essay contests…but the topic really grabbed my attention.”

 

Grace Rhine, now a freshman at Millersville University, stated that the challenge was part of her motivation for doing the essay:

“I really wanted to prepare myself for the writings in college that I would do…It was really helpful for me.”

 

Similarly, Sophia Song, a senior at Seoul International School, indicated that the contest was a “golden opportunity” and further stated,

“I learned a lot about how to format a research paper, which will help me a lot later on.”

 

The winners were especially thankful for their high school psychology teachers in providing the opportunity. Several mentioned their teachers as an integral source of support in the process, and were appreciative of the formatting guidance, as this was the first APA research paper most had written. When asked about other sources of inspiration and guidance, several mentioned their grandparents or other key figures in their lives who had illustrated the importance of healthy aging.

“I thought often about them [grandparents] in my essay, and I asked them a lot about the concepts I explored to see if it was applicable to them.” Grace also pointed to the influence of her grandparents stating, “I’m really close with all my grandparents, and I thought about how their life will be in the future as they age and want them to have a good life.”

 

Wendi spoke about her grandparents as “fighters,” stating,

“They had to fight off against all the negative images they had seen in the media and stereotyping comments about them. [A family member] used the ‘Because you are old…’ a lot. But the truth is, my grandparents never listen when the sentence starts with those words.”

 

In contrast, Poorvi mentioned that she was highly influenced by her English teacher (and mentor), whose wife developed Alzheimer’s disease during Poorvi’s high school career.

“I saw the process he was going through and the mental toll it took on him. And, just how big it became…That really inspired me to write this essay, to see how we can improve the aging process.”

 

In fact, Poorvi is now studying molecular biology and psychology in college with hopes to go to medical school and do research on neurobiology, the brain, and Alzheimer’s. She reported that she has joined a local club at UC-Berkeley, Action for Alzheimer’s, and will be volunteering in a care center as part of the club activities.

 

The other winners also mentioned an intention to “follow up” on aging in some way. Grace, who is studying to be an art therapist, wants to be able to help people across the lifespan through her work. Sophia aims to take a few aging-related courses in psychology when she goes to college. Wendi also indicated her intent for continuing to study aging.

“After researching the aging topic, I find it very hard to just forget about it and go on studying other subjects, just because aging is such an important issue. I want to dedicate myself to helping elderly citizens fight off the negative mass media images and stereotypes.”

 

When talking about the aging-specific aspects of the essay, each winner felt they grasped key points about healthy aging as a result.

For example, Poorvi was captivated by the life course perspective and the real-life impact of psychological and social concepts on biological aging.

“One thing that really surprised me was how much of your early life can play a role in the process of aging. I knew you should exercise and eat healthy, but these studies actually show a direct correlation between things like stress and the length of telomeres in your DNA.”

 

Grace commented,

“I never really thought about it [aging] before, more than just the biological standpoint. Here, I thought about the different experiences people have in retirement, moving into a nursing home, and the impact on that person.”

 

Sophia also commented on broadening her understanding of aging.

“One thing that stood out to me was subjective happiness. We can help older adults have this through gaining independence, autonomy, and from the simplest things like having transportation.”

 

Wendi focused on the psychological impact on healthy aging, stating,

“The overall take-away message was most of the time people had choices, they had choices to lead a healthy and positive life in their 60s and 70s. But the choices originate from their psychology, their attitude and ways of interpreting life events. If we can help them realize the choices and encourage them to make the ones beneficial to their physical and mental health, the word ‘aging’ may finally be free of associated negative emotions fear and worry.”

 

The winners were asked to consider why people their age (or younger) should be interested in aging. What’s the need, if it is decades away?

“It’s going to happen to all of us, sooner or later,” stated Grace.

 

Similarly, Poorvi asserted,

“Every single day, every single second that you are alive, you are aging. You have to be conscious of the choices you are making now because they will play a role down the line. Very small things you wouldn’t think play a role, the effects are amplified as you go along.”

 

Sophia agreed, stating,

“Aging research is an investment for us as we grow up. It’s crucial to understand where we will be in a few decades.”

 

Wendi emphasized that our actions as younger people make an impact on today’s older adults.

“Young people’s attitude and actions towards elderly citizens impose a significant influence upon the expectations and attitudes of elderly people towards aging.” She further stated that, “as responsible citizens, young people should care and help improve the welfare of this very important group who have contributed so much to our society.”

 

Each winner also specified what people in younger generations could (and should) be doing to get involved with aging issues. All of them suggested methods on a larger scale (e.g., volunteering, getting involved in research), but they also mentioned person-level interventions.

“The easiest way is to get a more personal connection with your grandparents, and ask them about aging in general and how each of these things apply to them,” suggested Sophia.

 

The “gap” between older and younger generations was mentioned by Poorvi, stating,

“There’s very young people, and there’s the very old and it feels marginalized. It is a good idea to get them more involved, and there are studies about this. It is better for people in older care homes if they’re surrounded by young/lively people; it boosts their psychological health.”

 

Grace also emphasized the role of personal, intergenerational connections by stating,

“Getting younger people involved in different community programs can integrate the different generations. I’m really involved in my church, and there is a large older population there. I like to get to know them and spend time with them.”

 

Wendi adds,

“They can start by not stereotyping the elderly as ‘lonely, grumpy, and socially withdrawn,’ and hopefully convince others to do the same.” She also suggested the importance of family support for our older relatives. “Consider spending more family time with elderly members in the family. They have the most wisdom and life experience, not to mention the importance of family support for elderly people.”

 

Overall, the essay impacted each of these students in unique ways. Some gained much-needed college preparation, and gained self-efficacy after tackling that ever-challenging APA formatting. Some solidified a previous interest into a potential career pathway. But each one came away with a more profound understanding of healthy aging and the immediate impacts on society. This is summed up in the following from Poorvi:

“Writing this essay made me realize how important this field of study is…All the research in this field is incredibly important because every study is going to be the scientific background for which more programs and laws are created that are geared toward helping older people. It’s underappreciated, but it’s incredibly important in our society because it is so fundamental.”

 

The four winning essays are available to download and read here: http://www.apa.org/ed/precollege/topss/student-competition.aspx. We encourage you to take a look at how these high schools students have captured the challenges and solutions to aging well in our current world.

 

Of note, TOPSS provides students with a writing contest opportunity annually. See this link for guidelines and previous award winners. They also have an award for high school psychology teachers that have innovative lesson plans in psychology. See http://www.apa.org/about/awards/teaching-excellence.aspx for more information and how to nominate your teacher and/or colleague for this award.

 

2017 Essay Winners

Poorvi Dua (Xavier College Preparatory; Phoenix, AZ)

Grace Rhine (Penn Manor High School; Millersville, PA)

Sophia Song (Seoul International School; Seoul, South Korea)

Wendi Ji (Shen Zhen College of International Education, Guandong, China)

 

Biography:

Maggie Syme, PhD, is an assistant professor in gerontology in the Center on Aging and serves as a faculty member in the School of Family Studies and Human Ecology at Kansas State University. Her background is in counseling psychology and public health, with a doctoral degree from the University of Kansas and MPH from San Diego State University. Her clinical postdoctoral training was concentrated in geropsychology and neuropsychology as well as a research postdoc in cancer health disparities and aging. Prior to coming to K-State, Dr. Syme was a Research Assistant Professor at San Diego State University working on grant-funded research from the Alzheimer’s Association on sexual decision-making among cognitively compromised older adults. Her research interests are centered on sexual health in later life and across the lifespan, sexual decision-making in long-term care residents, and person-centered long-term care.

 


Filed under: Aging Tagged: healthy aging, high school psychology, TOPSS essay contest

Give the Gift of Kindness to Your Elders this Holiday Season

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By Sheri R. Levy, PhD, MaryBeth Apriceno, Ashley Lytle, PhD , and Jamie L. Macdonald 

 

The holiday season has a way of encouraging acts of kindness toward family, friends, and even strangers. As the holiday spirit inspires us to treat others with kindness and respect, let us not overlook older adults who tend not to receive everyday acts of kindness, gratitude, and respect.

Ageism (negative attitudes, stereotypes, and behaviors toward older adults) is a significant social problem that impacts their health and well-being.

As the World Health Organization points out:

“Ageism is everywhere, yet it is the most socially ‘normalized’ of any prejudice, and is not widely challenged – like racism or sexism.”

Older adults face disrespectful, avoidant, and patronizing behavior as well as discrimination and even abuse in the workforce, health care, and housing. Challenging ageist stereotypes and treating older adults with respect and kindness can help confront the detrimental effects of ageism.

 

Some figures that should give us pause:

  • Nearly all depictions of older adults in publicly available Facebook groups (including more than 25,489 members) involved the use of negative ageist stereotypes5.
  • There were 20,857 age discrimination claims in employment in 2016 alone, accounting for 22.8% of all discrimination claims in employment2.
  • Ageism was the most frequently reported type of discrimination by a nationally representative sample of 6,000 American adults ages 50 and over when asked whether they experienced discrimination by doctors or hospitals11.
  • The World Health Organization estimates that 1 in 6 older adults have experienced some form of elder abuse in the past year. This abuse includes neglect as well as physical, emotional, financial, and sexual abuse.

 

What you can do to reduce ageism:

 

1. Get the facts on aging:

2. Explore tips from the World Health Organization and the United Nations 

3. Steer clear of birthday cards that poke fun of older adults, which can lead to the internalization of negative age stereotypes, and further perpetuate myths about aging.

 

Celebrate older adults throughout the year:

 

 

If you would like to learn more about this topic, the following resources might be of interest to you:

 

1Abrams, D., Swift, H.J., and Drury, L. (2016). Old and unemployable? How age-based stereotypes affect willingness to hire job candidates. Journal of Social Issues, 72(1), 105-121. doi 10.1111/josi.12158

2Equal Employment Opportunity Commission (January, 2017). EEOC Releases Fiscal Year 2016 Enforcement and Litigation Data. Retrieved from: https://www.eeoc.gov/eeoc/newsroom/release/1-18-17a.cfm

3Erber, J.T., & Szuchman, L.T. (2015). Great myths of aging. Wiley-Blackwell: Malden, MA

4Levy, B. R. (2009). Stereotype embodiment: A psychosocial approach to aging. Current Directions in Psychological Science, 18(6): 332-336.

5Levy, B.R., Chung, P.H., Bedford, T., & Navrazhina, K. (2014). Facebook as a site for negative age stereotypes. The Gerontologist, 54(2), 172–176. doi:10.1093/geront/gns194

6Levy, S.R. (2016). Toward reducing ageism: PEACE (Positive Education about Aging and Contact Experiences) Model. The Gerontologist. 10 AUG 2016, doi: 10.1093/geront/gnw116

7Levy, S.R., & Macdonald, J.L. (2016). Progress on Understanding Ageism. Journal of Social Issues, 72(1), 5-25. doi: 10.1111/josi.12153

8Lytle, A., & Levy, S.R. (2017). Reducing Ageism: Education about Aging and Extended Contact with Older Adults. The Gerontologist. Article first published online: 19 NOV 2017, https://doi.org/10.1093/geront/gnx177

9Palmore, E. B., Branch, L., & Harris, D. K. (Eds. 2005). Encyclopedia of ageism. Binghamton, NY, US: Haworth Pastoral Press.

10Pillemer, K,, Burnes, D, Riffin, C., Lachs, M.S., (2016). Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies, The Gerontologist, 56, 194–205. https://doi.org/10.1093/geront/gnw004

11Rogers, S. E., Thrasher, A. D., Miao, Y., Boscardin, W. J., & Smith, A. K. (2015). Discrimination in healthcare settings is associated with disability in older adults: Health and retirement study, 2008–2012. Journal Of General Internal Medicine, 30(10), 1413-1420. doi:10.1007/s11606-015-3233-6

12United Nations (2014). Retrieved from http://www.un.org/en/globalissues/ageing/

13World Health Organization (September, 2015). Ageing and Health. Retrieved from http://www.who.int/mediacentre/factsheets/fs404/en/

14World Health Organization (June, 2017). Elder abuse: Fact sheet. Retrieved from: http://www.who.int/mediacentre/factsheets/fs357/en/

 

Biographies:

 

Sheri R. Levy is a Professor in the Department of Psychology at Stony Brook University, USA. She earned her PhD at Columbia University in New York City, USA. Levy studies factors that cause and maintain prejudice, stigmatization, and negative intergroup relations and that can be harnessed to reduce bias, marginalization, and discrimination. Her research focuses on bias based on age, ethnicity, gender, nationality, race, sexual orientation, and social class.  With Jamie L. Macdonald and Todd D. Nelson, Levy co-Edited a special issue of Journal of Social Issues on “Ageism: Health and Employment Contexts” (Levy, Macdonald, & Nelson, 2016). Levy was Editor-in-Chief of Journal of Social Issues from 2010-2013 and is a Fellow of the Society for the Psychological Study of Social Issues (Division 9 of American Psychological Association).

 

MaryBeth Apriceno is a graduate student at Stony Brook University. She received her BA in Forensic Psychology from John Jay College of Criminal Justice. Her research investigates factors that affect ageist attitudes, aging anxiety, and self-stereotyping.

 

Jamie L. Macdonald is a doctoral candidate at Stony Brook University working with Sheri R. Levy. Jamie received her BA and MA in Psychology from Stony Brook University, New York, USA. Her research investigates prejudice, stereotyping, and discrimination with a focus on ageism in different contexts, like the workplace. She was a Co-Editor, with Sheri R. Levy and Todd D. Nelson, on a special issue of Journal of Social Issues on “Ageism: Health and Employment Contexts” (Levy, Macdonald, & Nelson, 2016).

 

Ashley Lytle is an Assistant Professor of Psychology at Stevens Institute of Technology in Hoboken, New Jersey, USA. Lytle earned her PhD at Stony Brook University, New York, USA.  Her research explores how prejudice, discrimination, and stereotyping impact academic, social, and health outcomes among marginalized groups. Much of Lytle’s research has focused on better understanding prejudice toward older adults, sexual minorities, and women, with the ultimate goal of creating simple, yet effective, interventions to reduce prejudice.

 

Image source: iStockPhoto


Filed under: Aging, Health and Wellness Tagged: age discrimination, ageism, discrimination, holiday season, prejudice

Finding Meaning in Life and in Death: A Call to Culturally Competent Action

jake-thacker-113197 (1)

This is the second of three blog posts on grappling with end-of-life issues. Posts will go up for the next two Fridays. Subscribe to our Psychology Benefits Society blog to stay updated.

By Keisha Carden, MA (Doctoral Clinical Geropsychology Student, University of Alabama)

“Technically, I am still alive, but I’ve been dead for a long time. What was the meaning of it all?”

Elaina, seemed to be elsewhere as she shared this, her face void of affect. She was my 68-year-old in-home hospice patient suffering from a myriad of chronic health conditions with little time left to live. While I had used meaning-centered interventions with other clients, none had lived a life quite like this—a life peppered with physical, sexual, and emotional abuse, substantial self-harm, onerous failed attempts at healthy relationships and adaptive coping strategies, and an intimate familiarity with discrimination and prejudice. How could I help her make meaning of the senseless trauma, violence, and hate to which she had been subjected for so long? As a well-intentioned psychology scientist-practitioner, I looked to the evidence.

Like Elaina, many of our dying patients express the need for meaning—in life and in death. In palliative care, our primary goal is to facilitate comfort and maximize quality of life. We often employ interventions that emphasize the importance of meaning-making.

Unfortunately, these interventions seem to be overly individualistic and westernized, overlooking important aspects of intersectionality and cultural variations (e.g., Carden, Murry, Matthews, & Allen, in press). For example, Allen and colleagues (2016) reviewed the existing community-based interventions aimed at reducing the burden of palliative caregiving. Ten of the 17 interventions they identified were investigated among primarily (78% – 100%) non-Hispanic White participants and five studies did not report race. It is therefore conceivable that many palliative interventions fail to effectively assess and address the needs of many cultural groups.

So how do we move forward?

 

Back to the Basics

Meaning-based interventions are rooted in the teaching and writings of Viktor Frankl, founder of logotherapy and holocaust survivor. At their core, they assume:

  1. human beings consist of body, mind, and spirit
  2. life has meaning under all circumstances, even the most miserable
  3. people have a will to meaning
  4. people have freedom under all circumstances to activate the will to find meaning
  5. life has a demanding quality to which people must respond if decisions are to be meaningful
  6. the individual is unique

 

The individual is unique…

Have we lost sight of the individual in our efforts to be prescriptive and standardized in treatment development and delivery? It may be time to go back the basics and infuse our practice with more person-centeredness.

 

Promising beginnings

The scientific community seems to agree and is beginning to investigate innovative and creative solutions. These endeavors include utilizing culturally competent hospice educational materials (Enguidanos, Kogan, Lorenz, & Taylor, 2011), videos aimed at improving disparities in knowledge (Volandes, Ariza, Abbo, & Paasche-Orlow, 2008), employment of patient navigators (Fischer, Sauaia, & Kutner, 2007), and other peer support programs (Hanson et al., 2013).

 

What can you do?

It is time for researchers and providers to tackle this issue together. Research is needed that:

  1. explores factors contributing to differences and disparities in end-of-life and palliative care
  2. evaluates the effectiveness of current end-of-life interventions among diverse groups
  3. considers appropriate and ethical modifications to said interventions to enhance quality end-of-life care for all.

In the meantime, providers must go back to the basics and rely on ethical standards to facilitate quality care to diverse patients and their families.

 

References:

Allen, R. S., Noh, H., Beck, L.N., Smith L. J. (2016). Caring for individuals near the end of life. In L.D. Burgio, J.E. Gaugler, & M.M. Hilgeman (Eds.), The spectrum of family caregiving for adults and elders with chronic illness (pp. 142-172). New York, NY: Oxford University Press.

Enguidanos, S., Kogan, A. C., Lorenz, K., & Taylor, G. (2011). Use of role model stories to overcome barriers to hospice among African Americans. Journal of Palliative Medicine, 14(2), 161-168. doi:10.1089/jpm.2010.0380.

Fischer, S. M., Sauaia, A., & Kutner, J. S. (2007). Patient navigation: A culturally competent strategy to address disparities in palliative care. Journal of Palliative Medicine, 10(5), 1023-1028. doi:10.1089/jpm.2007.0070.

Hanson, L. C., Armstrong, T. D., Green, M. A., Hayes, M., Peacock, S., Elliot-Bynum, S., Goldmon, M. V., Corbie-Smith, G., & Earp, J. A. (2013). Circles of care: Development and initial evaluation of a peer support model for African Americans with advanced cancer. Health Education & Behavior, 40(5), 536-543. doi:10.1177/1090198112461252.

Volandes, A. E., Ariza, M., Abbo, E. D., & Paasche-Orlow, M. (2008). Overcoming educational barriers for advance care planning in Latinos with video images. Journal of Palliative Medicine, 11(5), 700-706.

 

Biography:

Keisha Carden is a fourth year graduate student in Clinical Geropsychology at The University of Alabama working under the mentorship of Dr. Rebecca S. Allen. Her primary clinical and research interests include: family caregiving for older adults (with and without cognitive impairment/Alzheimer’s disease and dementia); resilience; existential/death anxiety; childhood trauma; intergenerational relationships; and outcomes and treatment mechanisms of non-pharmacological interventions that incorporate aspects of positive psychology and meaning-making.

Image source: Photo by Jake Thacker on Unsplash


Filed under: Aging Tagged: end of life, existential, gender, intersectionality, meaning, minority, palliative care, sexuality

A Good Death is an Important Part of a Good Life

assisted-dying2

This is the first of three blog posts on grappling with end-of-life issues. Posts will go up for the next three Fridays. Subscribe to our Psychology Benefits Society blog to stay updated.

By Amy Albright (Clinical Geropsychology Doctoral Student, University of Alabama)

We spend a lot of time talking about quality of life, but, increasingly, people around the world are talking about quality of death. Facing the end of life is hard for everyone involved, and many worry about the pain and loss of dignity associated with dying.1 In some areas of the world, individuals may choose legalized medical aid in dying, allowing them to control the time and place of their own death. This assistance allows patients to peacefully and painlessly end their lives through prescribed medication, which is often referred to as “assisted dying” or “death with dignity.” The majority of patients who choose these options are receiving hospice care,2 and many choose to die peacefully at home.3

Within the United States, residents of California, Colorado, Montana, Oregon, Vermont, Washington, and Washington D.C. may seek assisted dying.4 Currently, all U.S. states that allow assisted dying require that the patient is at least 18 years old, has a terminal illness, and has the legal capacity to make medical decisions.5 Psychologists don’t take a stand on this issue one way or the other; instead, they work with individuals to identify their own values and make their own decisions during this difficult time.6 There is a great deal of controversy surrounding  assisted dying, as the idea of ending one’s own life may be uncomfortable within certain cultures and religions.7 This is a choice that must be made at an individual level, and many who explore this option do not choose to hasten their own death. As of 2015, approximately 64% of medications prescribed under Oregon’s Death with Dignity Act were used.3

There is a great deal of variation in assisted dying laws,5 which may be due to how these laws develop. Brittany Maynard, a resident of California, was 29 when she was diagnosed with terminal cancer.8 While she wanted to choose death with dignity, this was not an option in California at the time, and she and her husband moved to Oregon so she could choose a peaceful death on her own terms. Ms. Maynard and her family advocated for California to pass a death with dignity law, and the California End of Life Option Act took effect in June of 2016.9 Due in large part to Ms. Maynard’s efforts, the idea of choosing assisted dying at the end of life is something that many Americans are now aware of. While hastening death is not something that most people will choose, having these tough conversations helps patients and their families become more aware of the services and options available to them at the end of life, allowing them to make the best decision possible.10

Choosing to pursue assisted dying is an incredibly difficult decision for all involved, and judging quality of death is very personal.11 While losing a loved one is never easy, family members of those who seek assisted dying have noted that their relative appeared prepared for death, allowing goodbyes to be said.1 Death is an inevitable part of life, and death with assisted dying  laws allow patients and their families some measure of control over the time and manner of death. Simply having the option to influence quality of death may be enough for some patients, and not all who consider assisted dying laws will choose to hasten death. Ultimately, there are no universal standards about the decision to pursue assisted dying, and this should always remain a matter of personal choice.6

 

References

  1. Smith, K. A., Goy, E. R., Harvath, T. A., & Ganzini, L. (2011). Quality of death and dying in patients who request physician-assisted death. Journal of Palliative Medicine, 14(4), 445-450.
  2. Campbell, C. S., & Black, M. A. (2014). Dignity, death, and dilemmas: A study of Washington hospices and physician-assisted death. Journal of Pain and Symptom Management, 47(1), 137-153.
  3. Oregon Public Health Division. (2016). Oregon Death with Dignity Act: 2015 Data Summary. Retrieved from http://www.worldrtd.net/sites/default/files/newsfiles/Oregon%20report%202015.pdf.
  4.  Death with Dignity National Center. (2017). Death with Dignity Legislation. Retrieved from https://www.deathwithdignity.org/faqs/#laws.
  5. Emanuel, E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., & Cohen, J. (2016). Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. JAMA, 316(1), 79-90.
  6. American Psychological Association. (2017). Resolution on Assisted Dying and Justification. Retrieved from http://www.apa.org/about/policy/assisted-dying-resolution.aspx.
  7. Hendry, M., Pasterfield, D., Lewis, R., Carter, B., Hodgson, D., & Wilkinson, C. (2013). Why do we want the right to die? A systematic review of the international literature on the views of patients, carers, and the public on assisted dying. Palliative Medicine, 27(1), 13-26.
  8. Maynard, B. (2014, November 2). My right to death with dignity at 29. CNN. Retrieved from http://www.cnn.com/2014/10/07/opinion/maynard-assisted-suicide-cancer-dignity/index.html.
  9. Coalition for Compassionate Care in California. (2017). End of Life Option Act. Retrieved from http://coalitionccc.org/tools-resources/end-of-life-option-act/.
  10. Balaban, R. B (2000). A physician’s guide to talking about end-of-life care. Journal of General Internal Medicine, 15(3), 195-200.
  11. Meier, E. A., Gallegos, J. V., Thomas, L. P., Depp, C. A., Irwin, S. A., & Jeste, D. V. (2016). Defining a good death (successful dying): Literature review and a call for research and public dialogue. The American Journal of Geriatric Psychiatry, 24(4), 261-271.

 

Biography:

Amy Albright is a doctoral student in the Clinical Geropsychology program at the University of Alabama. Her research focuses on health literacy and the end of life, and she has a particular interest in factors that influence seeking medical assistance in dying. This includes both patient and provider attitudes towards physician-assisted death, as well as health and palliative care literacy.


Filed under: Aging Tagged: aging, assisted dying, death with dignity, end of life, hospice care, palliative care

Is Poking Fun at Birthdays a Harmless Way to Celebrate Them?

blog-ageism-birthday

By Sheri R. Levy, PhD, & MaryBeth Apriceno (Stony Brook University)

 

Have you ever noticed that the tone of birthday cards for children is upbeat with messages like, “way to go, you’re another year older”? Whereas that is rarely the theme in cards for adults older than 21, at least in the United States.

 

Next time you find yourself in a card store, read through a few birthday cards for adults. You might find one or two cards with an upbeat and pro-age sentiment like “Fifty and fabulous.”  More likely you’ll encounter a lot that reiterate false and negative stereotypes of aging and older adults — cards that exaggerate the incidence of Alzheimer’s disease, depict dramatic age-related physical changes, portray older adults as very unattractive and cranky, as well as cards that suggest older adults lack sexual interest or have inappropriate sexual interest.  Nothing appears to be off limits.

 

Likewise, the aisles for adults at party supply stores are often devoted to party supplies and gifts poking fun of older adulthood. Here you’ll encounter a lot of “over the hill” themed party supplies such as balloons and serveware. You’ll also likely see favors and gifts that refer to ageist stereotypes, like signs that say “CAUTION, slow senior zone,” over the hill potty night lights, over the hill emergency diaper kits, and over the hill canes equipped with a horn, plastic chattering teeth, and a mini fine-extinguisher.

 

Funny or foul?

 

Birthday cards and gifts that poke fun of older adulthood are communicating negative ageist stereotypes found in society, including negative depictions of older adults in books, movies, and television. Together, these negative stereotypes and images take a toll on older adults.  Negative ageist messages may be internalized over the course of a lifetime and cause older adults to adopt an older self-image.  Older adults may then tailor their behaviors to these learned stereotypes, resulting in more sedentary lifestyles, decreases in cognitive functioning, decline in overall health, and a shorter lifespan (see Levy, 2009). Such effects may be amplified in women who face ageism as well as sexism (see Chrisler, Barney, & Palatino, 2016).

 

Widespread sale of birthday cards and supplies poking fun of older adulthood indicates the accepted nature of the stereotypes they communicate and the pressing problem of ageism. In fact, the World Health Organization (2015) has noted, “Ageism may now be more pervasive than sexism or racism.”

 

Ageism affects society. It can limit intergenerational contact and undermine intergenerational harmony. It contributes to age discrimination in the workplace, worse health care and poorer health for older adults, as well as financial and physical abuse of older adults.

 

“The world is in the midst of a unique and irreversible process of demographic transition that will result in older populations everywhere” (United Nations, 2014).

It is more important than ever to take steps to reduce ageism, and this includes no longer tolerating cards and gifts that poke fun of aging and older adults.

 

If you would like to learn more about this topic, the following might be of interest to you:

 

Chrisler, J., Barney, A., & Palatino, B. (2016). Ageism can be hazardous to women’s health: Ageism, sexism, and stereotypes of older women in the health care system. Journal of Social Issues, 72(1), 86-104. doi: 10.1111/josi.12157

Demos, V., & Jache, A. (1981). When you care enough: An analysis of attitudes toward ageing in humorous birthday cards. The Gerontologist, 21, 209-215.

Levy, B. R. (2009). Stereotype embodiment: A psychosocial approach to aging. Current Directions in Psychological Science, 18(6): 332-336.

Levy, S.R. (2016). Toward reducing ageism: PEACE (Positive Education about Aging and Contact Experiences) Model. The Gerontologist. 10 AUG 2016, doi: 10.1093/geront/gnw116

Levy, S.R., & Macdonald, J.L. (2016). Progress on Understanding Ageism. Journal of Social Issues, 72(1), 5-25. doi: 10.1111/josi.12153

United Nations (2014). Retrieved from http://www.un.org/en/globalissues/ageing/

World Health Organization (WHO; September, 2015). Ageing and Health. Retrieved from http://www.who.int/mediacentre/factsheets/fs404/en/

 

Biographies:

 

Sheri R. Levy, PhD, is a Professor in the Department of Psychology at Stony Brook University, USA. She earned her PhD at Columbia University in New York City, USA. Levy studies factors that cause and maintain prejudice, stigmatization, and negative intergroup relations and that can be harnessed to reduce bias, marginalization, and discrimination. Her research focuses on bias based on age, ethnicity, gender, nationality, race, sexual orientation, and social class.  With Jamie L. Macdonald and Todd D. Nelson, Levy co-Edited a special issue of Journal of Social Issues on “Ageism: Health and Employment Contexts” (Levy, Macdonald, & Nelson, 2016). Levy’s research has been funded by the National Science Foundation, and Levy publishes her research in journals such as Basic and Applied Social Psychology, Child Development, Cultural Diversity and Ethnic Minority Psychology, Group Processes and Intergroup Relations, Journal of Personality and Social Psychology, Personality and Social Psychology Bulletin, and Social Issues and Policy Review. Levy was Editor-in-Chief of Journal of Social Issues from 2010-2013 and is a Fellow of the Society for the Psychological Study of Social Issues (Division 9 of American Psychological Association).

 

MaryBeth Apriceno is a graduate student and teaching assistant at Stony Brook University. She received her BA in Forensic Psychology from John Jay College of Criminal Justice. Her research investigates factors that affect ageist attitudes, aging anxiety, and self-stereotyping.

 

Image source: Flickr user tawest64 via Creative Commons

 

 


Filed under: Aging, Health Disparities Tagged: age discrimination, ageism, aging, stereotypes, stereotyping

A Fate Worse than Death? Being Transgender in Long-term Care

Serious transgender couple standing together

 

By Mark Brennan-Ing, PhD (Senior Research Scientist, Brookdale Center for Healthy Aging)

 

“I would kill myself.” This is what a 70 year-old transgender woman told me recently when I asked what she would do if she needed long-term care. While this sounds dramatic, it is a common sentiment among older transgender and gender nonconforming (TGNC) adults (Witten, 2014). Many TGNC older adults do not have family caregivers available to meet their needs for assistance in later life, having been rejected and ostracized by their families of origin according to a study by Grant and colleagues (2011), and long-term care services may be their only option.

 

Plans for concealing gender identities, suicide and euthanasia are one way for older TGNC adults to cope with the fears of entering long-term care (Bockting & Coleman, 2007; Ippolito & Witten, 2014). The National Senior Citizens Law Center (2011) reports that TGNC older adults, regardless of the degree of gender transitioning, are at risk for abuse, mistreatment, or violence in institutionalized settings, especially those needing assistance with activities of daily living such as showering, dressing, and toileting.

 

Accessing medically competent care may also be a problem for older TGNC adults in long-term care. Geriatric care for TGNC older adults requires special considerations. Due to potential drug interactions, contraindications, and polypharmacy, TGNC older adults using hormone therapy concurrent with other medications may require close monitoring (Grant et al., 2011; SAGE & NCTE, 2012; Witten & Eyler, 2015). Sometimes these problems may require stopping hormone therapy, which may be especially traumatic for those who have transitioned later in life and not yet achieved their goals for masculinizing or feminizing their appearance.

 

Since private rooms in long-term care facilities are not covered by insurance, older TGNC adults may be assigned shared rooms based on their birth sex instead of their gender identities, which is problematic for the TGNC person as well as their roommate. The Department of Veterans Affairs (2013) has issued a directive that rooms for TGNC veterans are assigned based upon self-identified gender without regard to physical presentation or surgical history. This policy should be a requirement in all long-term care facilities.

 

The Nursing Home Reform Act and the Fair Housing Act prohibit TGNC discrimination and mistreatment in long-term care. The Affordable Care Act (ACA) also prohibits discrimination on the basis of gender identity by health care organizations (NCTE, 2015), but this legal protection is at risk following the 2016 election with promises by those in power to repeal the ACA. If ACA repeal is successful, older TGNC people will lose safeguards around denial of services, access to facilities like restrooms that conform to their gender identities, isolation, deprivation, and harassment by staff.

 

For long-term care providers, there are a number of resources available for continuing education to better serve their TGNC clients. These include the National Resource Center on LGBT Aging, which offers a variety of in-person and on-line training options (http://www.lgbtagingcenter.org/training/index.cfm). Providers working with veterans can review training and education options in the VA system at http://www.patientcare.va.gov/LGBT/index.asp . And TRANSLINE provides on-line consultation for medical providers (http://project-health.org/transline/ ).

 

Sadly, we may soon witness a rollback of protections for TGNC individuals in long-term care. Therefore it is imperative that the TGNC community and their allies work harder than ever to insure that policies, legislation, and training programs are in place to guarantee that older TGNC people are treated with the dignity and respect they deserve in long-term care and other clinical settings.

 

Portions of this blog were drawn from “Providing competent and affirming services for transgender and gender nonconforming older adults” (Porter, Brennan-Ing et al., 2016), and “Guidelines for psychological practice with transgender and gender nonconforming people (American Psychological Association, 2015).

 

References:

American Psychological Association (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832-864. http://dx.doi.org/10.1037/a0039906 .

Bockting, W. O., & Coleman, E. (2007). Developmental stages of the transgender coming‐out process. In R. Ettner, S. Monstrey, & A. Eyler (Eds.), Principles of transgender medicine and surgery (pp. 185‐208). New York, NY: Haworth.

Department of Veterans Affairs (VA; 2013). Providing health care for transgender and intersex veterans (VHA Directive 2013–003). Retrieved from http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2863

Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Kiesling, M. (2011). Injustice at every turn: A report of the national transgender discrimination survey. Washington, DC: National Center for Transgender Equality & National Gay and Lesbian Task Force. Retrieved from http://endtransdiscrimination.org/PDFs/NTDS_Report.pdf

Ippolito, J., & Witten, T. M. (2014). Aging. In L. Erickson-Schroth (Ed.), Trans bodies, trans selves: A resource for the transgender community (pp. 476-497). New York, NY: Oxford University Press.

National Center for Transgender Equality (2015). Know your rights: Healthcare. Retrieved from http://www.transequality.org/know-your-rights/healthcare

National Senior Citizens Law Center (2011). LGBT Older Adults in Long-Term Care Facilities: Stories from the Field.  Washington, DC: National Senior Citizens Law Center.

Porter, K. E., Brennan-Ing, M., Chang, S. C., dickey, l. m., Singh, A. A., Bower, K. L., & Witten, T. M. (2016). Providing competent and affirming services for transgender and gender nonconforming older adults. Clinical Gerontologist. http://dx.doi.org/10.1080/07317115.2016.1203383

Services and Advocacy for GLBT Elders (SAGE) & National Center for Transgender Equality (NCTE; 2012). Improving the lives of transgender older adults. New York, NY: Authors. Retrieved from http://transequality.org/Resources/TransAgingPolicyReportFull.pdf

Witten, T.M. (2014). End of life, chronic illness and trans-identities. J. Social Work in End-of-Life and Palliative Care, 10(1), 1-26. doi:10.1080/15524256.2013.988864

Witten, T.M. & Eyler, A.E. (2015). Care of aging transgender and gender non-conforming patients. In. R. Ettner, S. Monstrey and A.E. Eyler (Eds.), Principles of transgender medicine and surgery. New York, NY: Routledge Press.

 

Biography:

Mark Brennan-Ing, PhD is the Senior Research Scientist, Brookdale Center for Healthy Aging at Hunter College, City University of New York. He was the 2016 Chair of the APA Committee on Sexual Orientation and Gender Diversity.

 


Filed under: Aging, Health Disparities, LGBT Issues Tagged: health disparities, health equity, LGBT, long-term care, older adults, transgender

The Hidden Population of Caregiving Youth in Our Schools

 

blog-young-caregivers

It’s that time of year again – back to school! Follow along with our newest blog series on prepping your young ones for the new school year. Most posts will focus on issues affecting children (K-12) and eventually college-age youth.

By Ann Farone, EdD; Connie Siskowski, RN, PhD; & Carol D. Goodheart, EdD

 

As students around the country are excitedly gathering their backpacks and school supplies in anticipation of the new school year, there is another group of students who are more worried than excited…worried about the family member(s) they are caring for…”What if something happens when I am at school?”  “What if people at school find out what I do…will they take me away from my family?”

 

These are not carefree days for caregiving youth.

 

The National Alliance for Caregiving research (2005) on this population estimated there are over 1.3 million youth, ages 8-18 years, who are sacrificing their education, health, well-being and childhood by providing care for an ill, injured, elderly or disabled family member. It might be a parent, sibling, grandparent or even great-grandparent or other relative in today’s extended families.  Frequently these students are assisting more than one person.  Their responsibilities include administration of medications, transferring, bathing, toileting, cooking, translating at doctor’s visits, and anything else that an adult caregiver might do.

 

Yet, they are still children – developing, maturing and trying to figure out life and their futures.

 

“Why me?” some ask. Most do not identify themselves as “caregivers.”

 

A child’s job is to learn. With the challenges of academic success compounded by adult-sized caregiving tasks, how do these youth manage and cope?

 

They often feel isolated and alone. “Who else does this?” they wonder.  Feelings of anger, sadness, anxiety and depression are typical and normal responses to tough circumstances.

 

What can be done?

 

A Model Program

 

In the U.S. the first comprehensive program to address the challenges faced by these children began in Palm Beach County, FL in 2006. At the time, many were skeptical. However, in partnership with schools, the Caregiving Youth Project (CYP) of the American Association of Caregiving Youth (AACY) began.  Youth caregivers and their families were no longer alone – others understood and would help to support their challenges.

 

School staff began to look at the back stories of children who had frequent absences or acted out in school. They learned that before school one student made sure her mom got off to dialysis safely.  A boy was having trouble staying awake in class. Why? He was up during the night settling down his mentally ill mother.  Furthermore, financially insecure families often do not have computers or internet access for homework help.  If the sole parent is ill, who helps with school projects, buys the supplies or advocates on their child’s behalf?  Lack of participation in school meetings may be misinterpreted as disinterest in the child’s well-being.

 

Interventions – The CYP has developed specific prioritized support services for student-caregivers:

  • They are identified through a screening process in grade six.
  • The CYP professional team provides Skills Building groups from 6th grade through high school.
  • Lunch and Learn sessions educate about illnesses common to care receivers such as heart disease, diabetes, Alzheimer’s and autism.
  • CYP staff participates in School Based Team meetings, working with school counselors to identify student issues and collectively strategize solutions.
  • The home visit results in linkages to resources to strengthen families and reduce stress on youth.
  • Sponsored activities, including an overnight camp, provide caregiving youth time to bond with each other and experience childhood fun.

 

Our Changing Society

Not everyone agrees that a child should be in the role of a family caregiver. However, changes in family composition and healthcare delivery impacts children:

  • There are more single parent as well as multi-generation households.
  • Complex care, formerly delivered in medical facilities, is now done at home.
  • Managed care programs have decreased home care support.
  • More grandparents are raising grandchildren with little consideration for illness or disability affecting that family unit.

 

Particular Risks for Caregiving Youth

We must face the realities of youth caregivers’ lives, recognize their valiant work, and strive to reduce their worries so they can focus on learning.

 

Risk of invisibility – Few people are aware that the numbers of youth caregivers far exceeds those in the foster care system. They face the risks for school drop-out, depression, anxiety, physical injury, trauma, abuse, grief, loss of normal developmental and social activities.

 

Risk of not meeting school expectations – signs of caregiving may include tardiness, absences, incomplete assignments, non-participation in school events, distraction or inability to focus, lethargy, unkempt appearance, and being isolated, anxious or bullied.

 

Risk of school dropout – the Civic Enterprises Silent Epidemic (2006) reported that among young adults who had dropped out of school, 22% said it was to care for a family member.  Others reported dropping out for financial reasons.  Did these young people have to go to work because mom or dad was no longer able to work?

 

Risk of exposure – Families may fear that if others knew their child was providing significant care, the child would be removed from the home. They do not know about possible resources to support their family.

 

Risk of role “blindness” – Parents may not be aware of the anxiety that family illness creates. The child, realizing how overwhelmed the family already is, may not share his/her own feelings or concerns.  Also, when an adult in the home is employed, the adult may not fully appreciate all the caregiving the child is doing when the parent is not home.  “But, I’m the caregiver” a parent said until asked if her son gave medications or assisted with feedings; then the mom realized that he too was providing care.

 

All caregivers within a family deserve recognition and support!

 

Educators, counselors, school nurses, psychologists and others can help by identifying and then supporting a caregiving student.

 

Resources

 

American Psychological Association, Connecting with Caregivers:  http://www.apa.org/pi/about/publications/caregivers/consumers/index.aspx

American Association of Caregiving Youth: www.aacy.org or call 800-508-9618 or 561-391-7401 for direct assistance. The AACY website has suggestions and links that can help families, professionals and school-based staff to assist these vulnerable students.

View short videos of real caregiving youth as broadcast on national TV via the home page of www.aacy.org

 

Help caregiving youth to gain recognition and support by sharing this blog post.

 

Biographies:

 

Ann Farone, EdD, is the Director of Education Services at the American Association of Caregiving Youth (AACY). With over four decades of experience in the field of education, Dr. Farone began her career as a teacher in NYC. She has also been the Program Director for the NYS Department of Education, Assistant Dean of the Graduate School of Education & Human Services at St. John’s University, and as a Principal in NY & FL.

Connie Siskowski, RN, PhD, is founder of the American Association of Caregiving Youth (AACY). She was named as a Purpose Prize winner in 2009 and a top 10 CNN Hero in 2012. She went to nursing school at Johns Hopkins University and holds a PhD in Public Administration from Lynn University. She founded AACY in 2006.

Carole Goodheart, EdD, earned her doctorate in Counseling Psychology at Rutgers University and is a licensed psychologist practicing in Princeton, New Jersey. She was the 2010 President of the American Psychological Association. She is also a Fellow of the American Psychological Association, a Distinguished Practitioner in the National Academy of Psychology, a Registrant in the National Register of Health Service Providers in Psychology, and the recipient of national and state Psychologist of the Year Awards from Psychologists in Independent Practice and from the New Jersey Psychological Association, as well as the recipient of the Gold Medal Award for Life Achievement in the Practice of Psychology.

 

Image source: iStockPhoto.com

 


Filed under: Aging, Children and Youth Tagged: academic problems, caregiving, caregiving youth, Education, school absences, stress