Speech-language pathologists are professionals who specialize in understanding the science behind the process of human communication. As a member of the interdisciplinary team in a medical setting, speech-language pathologists diagnose and treat disorders of speech sound production, resonance, voice, fluency, language, cognition, feeding, and swallowing. At times, the therapists encourage development of untapped potential and skill. In working with those with chronic disabilities, the speech-language pathologist may focus on the appreciation and development of the patients’ preserved abilities. Older adults exhibit retrieval difficulties in spelling, suggestive of challenges with word phonology and orthography. In the acute hospital arena, the speech-language pathologist serves to identify cognitive communication or swallowing deficits, educates patients and families regarding areas of concern, and suggests appropriate discharge treatment options aimed to enhance self-sufficiency. The goal of intervention is not geared to “cure” a disability, but rather, to foster an optimal level of independence and function.
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A psychologist must confront many prejudices against older adults that are manifested in most people in non-older adult cohorts. Clinical psychologists specializing in geropsychology work with individual older adults; family members of older adults, including spouses/partners, siblings, and adult children; and caregivers when treating the psychological problems experienced by older adults and dealing with issues of caregiving to older adults experiencing mental illness, dementia, and/or psychological reactions to co-occurring medical illnesses. Unfortunately, despite the fact that older adults are affected by the forces of ageism and stigma, and the fact that community psychologists strive to understand and improve social inequalities and to enable empowerment of marginalized people, there is a significant dearth of research in the field of community psychology. There are four types of ageism: personal, institutional, intentional, and unintentional. The majority of older adults have experienced age discrimination and stigmatization at some time after the age of 65.Source:
Robert Butler coined the term “ageism”. Butler described ageism in three realms: stereotypes and prejudices against older adults, discrimination against individuals, and institutional practices and policy that disadvantage older adults or perpetuate discrimination. He believed that ageism accounts for disregard for older people's rights seen in public policy. He saw it in the failure of institutions to address the needs of older people or protect their rights, citing as evidence government's failure to protect older people against mistreatment or to enforce nursing home regulations. He saw it in the lack of attention to older people in disaster preparedness plans and in the institutional ageism that leaves many older people impoverished and vulnerable. Although Butler and others saw ageism as standing alongside other “isms” other forms of injustice and discrimination it never achieved their traction. This chapter explores why. The chapter discusses elder abuse, ageism in healthcare, workplace, and public policy and politics.
This chapter combines the increasing number of studies that pertain to the stereotype embodiment theory (SET) and reflects upon to represent the current state of this theoretical perspective and how it can help explain age stereotypes’ contributions to health and aging. It describes the history, cultural context, and nature of age stereotypes and age self-stereotypes in a largely ageist society. The chapter presents SET, which provides a framework for explaining how age stereotypes are acquired to subsequently influence health outcomes. It discusses replication studies conducted in different countries, as well as meta-analyses, to demonstrate the validity of this theory as well as to illustrate the meaning and impact of its components. The chapter illustrates how SET may be applied to shape future healthy aging research, policy, and practice. Empirical evidence supports the importance of age stereotype self-relevance among older adults.Source:
The health status of an older person is the result of many factors, including lifelong health habits, genetics, and exposure to occupational and environmental hazards. The quality and availability of health care throughout the life course also plays a significant role in health in later life. These social determinants—the circumstances of our lives, including the neighborhoods in which we live—affect health risks and outcomes over the life course. Individual health behaviors are affected by the practices and habits of the people in one’s immediate social world, but they are also determined by the social circumstances of one’s life. This chapter explores the broad range of individual behaviors and social determinants that shape health in later life. It also examines the policies and practices within the U.S. health care system that shape access to and quality of health care for older adults.
Health professionals are often called upon to intervene in complex ethical dilemmas that involve respecting an older adult's autonomy while also considering protective interventions to ensure safety. This chapter addresses the foundational ethical competencies for psychologists and geropsychologists including the unique challenges associated with surrogate decision making, legal, clinical, and psychosocial interventions specific to working with vulnerable older adults, ethical dilemmas that can emerge within various situations including assessment and integrated care settings, detection and intervention strategies in cases of elder abuse, neglect, and exploitation, and ethical approaches to research with older adults. Finally, the authors discuss the multicultural dimensions that influence how ethical and legal issues are conceptualized and addressed. The micro-and macrosystems in which older adults live and thrive require a level of cultural sensitivity, an understanding of aging processes, and knowledge about professional ethics and legal standards involved in decision making.
This chapter presents a broad and general overview of the structural and physiological changes that occur with aging as well as the underlying pathophysiology of age-related diseases. The body comprises eleven organ systems that include the integumentary, muscular, skeletal, nervous, circulatory, lymphatic, respiratory, endocrine, urinary/excretory, reproductive, and digestive systems. As such, the ensuing sections are arranged by organ system and structured to cover age-related physiological changes and common disorders. Older adults experience a myriad of physiological changes as they age. While some of these physiological changes are benign, other changes increase the risk of age-associated pathophysiological changes, which can result in significant functional impairment or morbidity. These pathophysiological changes are not to be considered part of the normative aging process. Thus, it is essential that providers distinguish between the two states.
This chapter presents specific issues faced by older adults in response to adaptations to chronic illness and disability. Some individuals have congenital disabilities and others acquire a disability early in life and are able to adjust fairly easily, aging with their disability. On the other hand, some individuals acquire a disability later in life and may experience great difficulty making the adjustments to their condition. The chapter presents information on the age-related concerns of older adults, components and perceptions of aging, assessment issues associated with older adults, vocational interests, and death and dying perspectives. It also discusses the implications for service delivery in the context in which older adults are served along with laws and regulations that apply to the population. Aging and geriatric persons often utilize a variety of services from multiple entities (e.g., social, legal, medical, financial, and counseling).
Many older adults are diagnosed with mild cognitive impairment (MCI), a condition that does not meet the criteria for dementia. MCI is considered a risk factor for Alzheimer’s disease-related disorders (ADRD). Although Alzheimer’s disease is a serious problem, this chapter focuses on the five types of dementia commonly seen in practice. These include vascular dementia, dementia with Lewy bodies, Korsakoff syndrome, frontal lobe dementia (including Pick’s disease), and Alzheimer’s disease. Psychoeducational support groups allow the merging of learning about dementia with concomitant psychological support. The breaking of denial enables older adults in these support groups to make better sense of their disease, increasing their abilities to comply with treatments and caretakers. Leisure activities, whether community based or solitary, are shown to be protective against dementia or, at the least, stall the onset of dementia.
Chronic pain is often resistant to traditional medical management and other types of professional intervention. As such, several investigators have conducted studies of pain self-management programs. These self-management programs, however, were often led by therapists and shared much in common with traditional cognitive behavioral therapy (CBT); the efficacy of which, despite some inconsistencies, is largely supported in the literature. Although, like CBT, many therapist led programs involve a component of self-management in the form of “homework assignments,” it is important to evaluate the effectiveness of pain self-management, which is not therapist led. Within the context of controlled investigation, we evaluated a pain self-management program that involved use of a comprehensive self-help pain management book for older adults. Contrary to expectation, we did not identify any differences in the outcomes observed in the self-help patient group as compared to the control group (i.e., participants who did not receive the pain management book until after the study was completed) despite a great deal of satisfaction with the manualized program that was expressed by the participants. The implications of these findings are discussed.