PSYC 322 Final

The withdrawal of an individual from the labour force in later life

Traditional models
Temporal Process Model
Resources-based Dynamic Model

Role Theory
Continuity Theory
Life Course Perspective

Loss of the work role requires adjustment post-retirement to a new main role; emphasis of occupation as large part of identity

Have to shift perspectives, as your identity was stronly linked to your role/job

Retired individuals desire a maintenance of their self-concept and identity into retirement

To smoothen out transition, someone might adopt identity that smoothens transition from working to retirement

Influenced by a person’s entire life history, rather than a single event (macro-level perspective)

Retirement is influenced by/influences family and friends

Availability of pension, government policies

Retirement planning
Retirement decision-making
Retirement transition and adjustment

Leaving the workforce in one clean unreversed move

unclear, gradual transition; reduced work, un-retirement, bridge jobs

paid work after retiring

What (travel)?
Where (do i live?)
etc.

Can I afford
What are my retirement goals
etc.

Putting plans (planning phase) into action

Monthly payment based on your contribution, taxes, etc after retiring

Monthly taxable pension for seniors (65+)

Actual changes in daily activities, well-being

Transition and Adjustment phase of temporal process model

Individual attributes
Job/organizational factors
Family factors
Socioeconomic contexts

Men have more savings, clearer goals, have bridge employment

Younger people less likely to plan, less likely to retire, more likely to bridge employment

Heathly work longer, engage in bridge employment

Less likely to plan, more likely to bridge employment

more stress, work, physical demands predicts early retirementridge employmenT

retirement benefit/plans for insurance and pension help retiring

Spouse impact (on finance)etirement schedule
Care needs(from family)

retirementniversal healthcare support varies (in different countries)

strong economy/low unemployment = more bridge employment

Retirement adjustment is longitudinal process where retirees' levels of adjustment change due to resources/changes in these resources

Physical, cognitive, motivational, financial, social, emotional

Better health associated with later retirement, expected retirement

People who kept working saw health deteriorate, no matter how psychologically stressful their job was

Spouse has pension
Job dissatisfaction

Self employment

Being married
Race (BIPOC - black, indigenous, people of colour)
Pension coverage, household assets
More positive attitude towards retirement

Less/no autonomy over leaving workforce

Has autonomy over leaving work

Reduced risk of neurocognitive disorders (Alzheimers)

Expanding cognitive reserves

Contribute to sense of identity, focus, and meaning in life

Help maintain health and cognitive functioning

Enable social connections to others

Home care

medical/social services avaliable to people living in their own homes

provided by health care professionals, paid caregivers, and trained volunteers

Assessment and case management
Personal care
Physiotherapy
Occupational therapy
Nursing care
Palliative care (tertiary aging - rapidly declining)

Canadian citizen, permanent resident, or temporary resident
BC resident ~ 90 days
Require care for health conditions in order to remain at home

Most home care recipients 75+, but not only seniors/older adults

Maintained sense of identity, control, autonomy
Familiarity of surroundings and community
Prevention/delay of institutionalization
Cost effective*

Government-regulated housing
Supportive environment (hospitality and personal care services)

have physical health challenge
can live independently but not without help
can make decisions

physical space has residential feel (personal space)

individualized attention ("normal lifestyle") - personal preferences, control

Meeting services and special needs

Typically independent with some shared services

Mixed focus on health needs and independenceelieving daily tasks

government regulated medical institution

provides room, meals, nursing, rehabilitation, medical services, protective supervision

Residents have multiple health conditions and/or moderate/severe cognitive impairment (dementias)

Recovering from injuries, illness, surgery

No space in hospital
Temporary transition between hospital and going home

Physical abuse
Sexual abuse
Psychological abuse
Financial exploitation
Neglect
Violation of rights

Identity Theft
Online Scams
Credit Card Fraud
Phone Scams

personal info stolen to impersonate person; steal money, take out loan, credit card, etc

scams through internet (phising email, email from family)

scammer uses someones card to purchase/withdraw money

Scammer impersonates family, institution to get info

Focus on physical needs

Focus on emotional needs

Traditional Medical Model

Needs put first, interviewed for what is needed

irreversible stopping of circulation and respiration, all structures of brain cease function

Stopping of brain function that regulates consciousness, essential functions

Coma
Brain stem reflexes stop (perma)
Breathing perma stops without aid

conceptual form of death related to dying

dying retreat from family, spend final days in hospital

dying treated as non-person or already dead by family/health care workers via social isolation

Male: heart disease, alzheimers/dementia
Female: alzheimers/dementia, heart disease

Sudden death
Terminal illness
Organ failure
Frailty, degeneration

Frailty, degeneration

Sudden death

Terminal illness

Organ failure

Denial
Anger
Bargaining
Depression
Acceptance

Refusal to believe it (death) is happening

Lashing out in response to reality

Changing behaviours to reverse course

Negative emotions in response to reality

Coming to terms with reality

Helps people understand they are not alone (universal stages?)

Helps individuals seek help

Not just one way to face death

Order may not be same as stage of adjustment

No consideration to other emotional states (fear, apathy, etc)

Increase in percentage of positive words as death nears, no change for negative words

Dia de los Meurtos (Day of the Dead) - Celebration of death (visiting loved ones after death)

Traditional Western Funeral - Sad, Somber

Curative/disease focus

Palliative/Hospice care focus

Diagnosing and treating - finding a cure

extending ones life

Focus on patient goals, quality of life, closure

live happier, better (not longer)

Addresses the needs of people with life limiting conditions to improve quality of life

Manage distressing symptoms (pain)
Helps patients live actively
Use team approach to address needs of patients
Offer support system to help family cope
Enhance quality of life

Hospice care (Final stage of care, last few years of life)

reduces mood symptoms compared to standard care

Palliative care prolongs life, changes steepness of survival curve compared to nromal care

Lack of understanding of palliative care
limited resources, funding, training
people do not like discussing dying
inequality (POI, homeless)

no known palliative care activity

No known palliative care

Has capacity (resources/potential) for palliative care, does not have it currently

Isolated programs of palliative care

development has gaps, not well supported

generalized programs of palliative

same issues as 3a, but more widespread

Palliative care services at prelim stage of integration (to mainstream health care)

Palliative care services at advanced stage of integration (to mainstream heath care)

It is what we want, law cannot decide or overwrite what we want to do with our bodies

decisions for end of life treatment discussed, documented, shared between patient, family, care providers well in advance of death

Document that describes your preferences for future care if unable to speak for yourself

IV, ventilators, meds (do not want to extend life)
DNR (do not rescuscitate)
Refusal of food and drink

intentional administration of sedative medication to reduce patients consciousness (alleviate suffering at end of life)

True

Clinician administered MAID
Self administered MAID

Physican/nurse directly administer substance that causes death

physician/nurse give patient substance they can use to kill themselves

2 independent heath care practitioners need to evaluate an individual for them to quality

Have health insurance
18 y/o
Have a grievous and irremediable condition*
Make voluntary request for MAID, no outside pressure/influence
Give informed consent to get MAID after being informed of other ways to relieve their suffering

(must satisfy all requirements)
Have serious and incurable illness, disease, or disability;
In advanced state of irreversible decline in capability;
Experience unbearable physical or mental suffering from illness, disease, disability or state of decline; cannot be relieved in ways deemed acceptable;
Natural death reasonably foreseeable and have signed a waiver approving of MAID (recently amended in 2021)

Mature minors

Advanced requests due to patient's condition limits their decision making ability for future

Those who have mental disorder as only medical condition

Are they in the right mind, are their decisions influenced by medications?

consulting/supporting patients and staff members with requests
assess eligiblity, administerive drugs for MAID
provide support for family (after)

Lack of clear guidelines/protocols
role ambiguity
evaluating capacity to give consent
lack of collaberation between professionals

Cognitive/physical heterogeneity (diversity) within normalsual aging
Normalsual suggests no risk/harmless, and natural aging

Successful aging combines 3 factors (modifiable/proactive)

avoiding disease/disability
high cognitive and physical function
active engagement with life

not inclusive of those who do not meet requirements (too normative - standard)
subjective: may satisfy requirements, not someones personal thoughts on successful aging
missing concepts (no personal, sociocultural factors)
poorly defined, ambiguious

self reports do not line up with Rowe and Kahns criteria of successful aginng, include much more factors than the ones provided

Too much focus on individual behaviours/attitudes

ignores social, economic, historic contexts of people (ignores inequality too - race, gender, class, etc)

successful aging means different things for different groups of people, there is also much more studies on social engagement and attitudes than health

person believes they have not succesfully aged because self perception of being unwell or not aging properly based on social norms

Model to fight against ageism

Resilience aging
harmonious aging
WHO model of aging

embrace loss/decline, integrate spirituality, meaning, identity

focus on positive adaption when facing risk/adversity

Wisdom of handling opportunities/challenges

acknowledging aging body, physical/functional changes

leads to peaceful mind

internalized social steretyped that influence functioning and health

Culture to individual: Top Down

Individual to culture: Bottom Up

Societal stereotypes internalized and then influence individual behaviors and self-perceptions

Changes while you age

society, historical depitions of old people, beliefs of older people

perspective of self matches these beliefs

Positive self perception of aging associatied with slower functional decline

more likely to have cardiovascual event over next 38 years

on average, extra 7.5 years of life

Social indicator model
Paradox of well being
Set point perspective

older adults have less --> should be unhappier

older adults are able to overcome objective circumstances

personality determines happiness levels

stereotypes of age more likely internalized to self stereotype

Priviledged group --> marginalized group (self prophecying; confirm what we already believe)

Lack of egalitarian thinking

old people should be treated same as young