THE UNIVERSITY OF NORTH CAROLINA at CHAPEL HILL SCHOOL OF SOCIAL WORK COURSE NUMBER: SOWO 803 COURSE TITLE: Human Behavior of Aging SEMESTER/YEAR: Fall 2008 INSTRUCTOR: Kerri Patrick, MSW Email: kpatrick@unc.edu Phone: 419-1390 TEACHING ASSISTANT: Yeong Yeo, MSW, Doctoral student Email: yyeo@email.unc.edu OFFICE HOURS: By appointment COURSE DESCRIPTION: This course includes a presentation of major biological, psychological, and sociological theories used to understand the normal aging process. The course also surveys pathologies and functional disorders associated with aging. Special emphasis is placed on disadvantaged populations. OBJECTIVES: Upon completion of the course, the students will be able to demonstrate knowledge of: 1. Ethical values and the major biological, psychological, and sociological theories used to understand the aging process; 2. Major clinical diseases or pathologies and functional disorders of the aged; 3. Cultural and societal forces influencing the aging process, and the development of social interventions designed to strengthen multi-generational families; 4. Key diagnostic, treatment, and prevention issues associated with the health care problems of the aged; 5. The effects of race, gender, poverty, and rural residence on aging and the special needs of gay, lesbian, bi-sexual, transgender persons and other special and oppressed elder populations; 6. A strengths-based conceptual framework viewing older people as adaptive resources and contributing members of society. 1 COURSE INSTRUCTIONAL MATERIALS Required Text: Hooyman, N.R. & Kiyak, A.H.(2008). Social gerontology: A multidisciplinary Perspective (8th Ed.). Boston, MA: Allyn & Bacon. Required Readings: Required readings are designated by an R on the attached syllabus Supplementary: Supplementary readings or research materials are designated by an S on the attached syllabus. These readings are not required, but will add to the student’s knowledge of a give area and are suggested for students who wish to examine certain topics or issues at greater depth. COURSE OVERVIEW AND INSTRUCTIONAL METHODS This course consists of a series of weekly seminars. Each week both the instructor and students are expected to come to class prepared to discuss and evaluate materials in the required readings. In order to meet this expectation, both the instructor and students have a responsibility to complete reading assignments prior to each class. Optimal learning takes place when students are active participants and, indeed, may teach both other students and the instructor. Further, as this course material incorporates gerontological as well as social work research along with theoretical and empirical knowledge, prior preparation is essential to contributing to class as well as understanding materials presented. The development of a supportive learning environment, reflecting the values of the social work profession, is essential for the success of the class. A supportive learning environment is fostered by respectful listening to the ideas and views of others, being able to understand and appreciate the ideas of others, articulating your own point of view, and translating class discussions to reading and written assignments as well as practice. It is important to remember that all human beings (including graduate students and instructors) are entitled to unconditional, positive personal regard. The classroom presents an opportunity to practice this important value and create a safe and respectful environment for growth. POLICIES ON LATE OR INCOMPLETE ASSIGNMENTS Professional practice and administration require attention to detail as well as timely completion of assignments. The classroom serves as an environment in which to develop professional practices such as meeting deadlines and producing high quality work. As such, class assignments are expected to be completed on time and to represent the student’s highest level of effort. If there are circumstances which prohibit the student’s completion of an assignment, it is the responsibility of the student to contact the instructor prior to the assignment due date. The instructor may grant an extension under certain extenuating circumstances; however, the instructor may choose not to grant an extension. Five points will be deducted for each day an assignment is late. POLICY ON ACADEMIC DISHONESTY It is the responsibility of every student to obey and support the enforcement of the UNC Honor Code, which prohibits lying, cheating, or stealing in actions involving academic processes of this 2 class. All written work should contain a signed pledge stating: “I have neither given nor received unauthorized aid in preparing this work.” In keeping with the UNC Honor Code, if reason exists to believer that academic dishonesty has occurred, a referral will be made to the Office of the Student Attorney General for investigation and determination if further action is required. It is the responsibility of students to properly cite sources used in preparing written work. To avoid difficulties with plagiarism, remember to credit ideas that are not your own, whether or not those ideas have appeared in print. If you use an example from someone else in your paper, you must cite that person in your references. EXPECTATIONS FOR WRITTEN ASSIGNMENTS Students are expected to use good academic English; grades will be lowered for poor grammar, syntax, or spelling. Those who have difficulty writing are STRONGLY encouraged to use online resources of the campus Writing Center (http://www.unc.edu/depts/wcweb/) and/or seek assistance from Diane Wyant or Susan White in the School of Social Work. The School of Social Work faculty has adopted APA style as the preferred format for papers and publications. All written assignments for this course should be submitted in APA format. A summary was distributed at orientation. The web sites listed below provide additional information, though students are strongly encouraged to purchase the following text: American Psychological Association. (2001). Publication manual of the American Psychological Association, 5th Edition. Washington, D.C.: American Psychological Association. http://www.apastyle.org/elecref.html (APA Style for material in electronic formats) http://owl.english.purdue.edu/handouts/research/r_apa.html (general information about documentation using APA style) http://www.bartleby.com/141/ (electronic version of Strunk's The Elements of Style which was originally published in 1918) http://www.fas.harvard.edu/~wricntr/resources.html (The Writing Center, links to on-line reference material and many other useful sites for authors) http://www.unc.edu/depts/wcweb/ (The UNC writing center—on-line and tutorial help at Phillips Annex 962-7710) POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES: Students with disabilities that affect their participation in the course and who wish to have special accommodations should contact the University’s Disabilities Services (http://disabilityservices.unc.edu) and provide documentation of their disability. Disabilities Services will notify the instructor that the student has a documented disability and may require accommodations. Students should discuss the specific accommodations they require (e.g. changes in instructional format, examination format) directly with the instructor. POLICIES ON THE USE OF ELECTRONIC DEVICES IN THE CLASSROOM Use of electronic devices for non-class related activities (e.g. checking email, surfing, IMing, blogging, playing games) is prohibited. Use of laptops is permitted as a tool for small group activities and in-class assignments or as an approved accommodation for students with disabilities (see above). 3 CLASS ASSIGNMENTS Following is a brief description of assignments required for successful completion of this class. Additional information will be provided throughout the semester. Please contact the instructor in the event clarification is needed. Class Participation (10%) Attendance, punctuality, constructive contributions to discussions, role in small group tasks and responsiveness to others comments in class determine this grade. In-class presentation (25%) Each student workgroup is required to prepare and present a 60 minute, in-depth presentation on a special, oppressed, or vulnerable segment of the aging population. The instructor will provide a sign up sheet at the second class meeting indicating suggested topics and due dates. The presentation should include a characterization of the population as well as special individual (e.g., social, psychological, physical) needs. The presentation should also include and environmental specialization and interventions (proposed and/or existing) that support these older adults. Class handouts are required; power point is optional. Presentations will take place over the course of the semester. Mid-term exam (25%) Questions for this exam will be drawn from the required readings on the syllabus and class lectures. The format of the exam will include multiple choice, short answer and essay questions. The purpose of the examination is to evaluate the student’s knowledge of course content and progress in integrating that content effectively. Students may use their own notes; however, they may not refer to books or journal articles during the exam. The midterm will take place during the Week 7 (10/13) class period. In the past, most students have taken from 1-2 hours to complete the exam. There will be no time limit for completion. The full length of the class will be provided to complete the exam if needed. Life Grid Paper (25%) The final paper will include two parts. The first part will involve completing life grids for yourself and two other adults. One adult should be of your parents’ age (and indeed could be your parent). The other adult could be someone your grandparents’ age or someone younger than yourself. (At least 18 years or older, please). You will complete a life grid based on his/her prior years and projections his/her life based on expectations of the future. The second part of the paper involves describing the differences and similarities of the three life grids using information from the course. You will integrate social theories (at least one theoretical perspective is required), life course perspective, the biopsychosocial contexts, and demographic trends. An outline for this assignment will be provided on the fourth week of class. The final paper, in hard copy, is due on Friday, December 5th by 5:00 p.m. An electronic copy of the paper will be accepted but the student must take complete responsibility for the paper arriving at the assigned time or the paper will be considered late. Final Exam (25%) This exam will follow the same format as your Mid-Term. The questions from the exam will be drawn from the required readings on the syllabus and from class lectures. You may use your own notes. The Final Exam will be held on December 1st, 2008 during the final class meeting. EVALUATION OF WORK: Class Attendance and Participation Class presentation (TBA) 10% 25% 4 Mid-term Exam Final Paper Final Exam Total (10/13) (12/05) (12/01) 20% 20% 25% 100% The School of Social Work operates on an evaluation system of: Honors (H), Pass (P), Low Pass (L), and Fail (F). For this class, the numerical range of H is 94-100; P is 80-93; L is 70-79. WEEK & DATE Week 1 8/25 TOPICS READINGS AND ASSIGNMENTS An Overview: The Aging Population R Sasson, S. (2000). Beneficence versus respect for autonomy: An ethical dilemma in social work practice. Journal of Gerontological Social Work, 33(1), 5-16.1 Autonomy vs. Beneficence R (for SW students) Reamer, F.G. (1995). Ethics and values. In R. L. Edwards (Ed.), Encyclopedia of social work (pp. 893-902). New York: National Association of Social Workers. 1 R Rosowsky, E. (2005). Ageism and professional training in aging: who will be there to help? Generations, 24(3), 55-58. 1 S United States Census Bureau (n.d). Older Americans Update 2008: Key indicators of well-being. Available online at: http://www.agingstats.gov/update2008/default.htm S US Department of Health and Human Services. (2004). Health, United States, 2003: Special excerpt: Trend tables on 65 and older population. (DHHS Pub No. 2004-0152). Hyattsville, MD: Author. S Administration of Aging (2008). A Profile of Older Americans: 2008. Available online at: http://www.aoa.dhhs.gov/PRESS/prodsmat/fact/pdf/ss_stat_profile.pdf S Morgan, D.L. (1998). Facts and figures about the baby boom. Generations, 22(1), 10-16.3 Week 2 9/8* Psychological Context of Aging Reminder: No class next week – Monday Sept. 1! Use this week to read first three articles. R Text: Chapter 6: Personality and Mental Health in Old Age R Riley, M.R. (1987). On the significance of age in sociology. American Sociological Review, 52, 1-14. 2 S Flynn, K. E. & Smith, M.A. (2007). Personality and health care decisionmaking style. Journal of Gerontology: Psychological Sciences, 62B (5), 5 WEEK & DATE TOPICS READINGS AND ASSIGNMENTS 261-267. 3 S Mui, A. & Kang, S.Y. (2006). Acculturation stress and depression among asian immigrant elders. Social Work, 51(3), 243-255. 3 Week 3 9/15 Psychological Context of Aging R Text: Chapter 5: Cognitive Changes with Aging R Alzheimer’s Association. (2007). Alzheimer’s Disease Facts and Figures: 2007. Available on-line at: http://www.alz.org/national/documents/report_alzfactsfigures2007.pdf Video: The Aging Brain: R Ardelt, M. (2000). Intellectual versus wisdom-related knowledge: The case for a different kind of learning in the later years. Educational Through Many Gerontology, 26(6). AN4140568 2 Lives S Froehlich, T. (2001). Dementia and race: are there differences between African-Americans and Caucasians? Journal of the American Geriatrics Society, 49, 477-484 3 S Dufouil, C., Fuhrer, R., & Alperovitch, A. (2005). Subjective cognitive complaints and cognitive decline: Consequence or predictor? The epidemiology of vascular aging study. Journal of the American Geriatrics Society, 53(4), 616-621. 3 S Forno, G.D., Palermo, M.T., Donohue, J.E., Karagiozis, H., Zonderman, A.B., & Kawas, C.H. (2005). Depressive symptoms, sex, and Alzheimer’s disease. Annals of Neurology, 57(3), 381-389. 3 S Memory Bridge: Validation breakthrough video clip. (2007). Available on-line at: www.memorybridge.org/video.php S Kemperman G, Wiskott, L, & Gage, F. (2004) Functional significance of adult neurogenesis. Current Opinion in Neurobiology 14(2) 186-191 3 Week 4 9/22 R Text: Chapter 4: Managing Chronic Diseases and Promoting Well-Being The Biological and Physiological in Old Age Context of Aging R Text: Chapter 3: The Social Consequences of Physical Aging . R Yang, Y. & George, L. (2005). Functional disability, disability transitions, and depressive symptoms in late life. Journal of Aging and Health, 17(3), 263-292. 2 R Achenbaum, W.A. (2006). Living with chronic illness: chronically me. Generations 30 (3), 93-95. 3 6 WEEK & DATE TOPICS READINGS AND ASSIGNMENTS S Cuijpers, P. & Lammeren, P. (1999). Depressive symptoms in chronically ill elderly people in residential homes. Aging & Mental Health, 3(3), 221. AN3954758. 2 S Marek, K.D., et al. (2005). Clinical outcomes of aging in place. Nursing Research, 54(3), 202-211. 3 S Center for Disease Control (2007). State of Aging and Health in America: 2007. Available online at: http://www.cdc.gov/aging/pdf/saha_2007 Week 5 9/29 Social Context of Aging R Text: Chapter 8: Social Theories of Aging R (for SW students) Turner, F. J. (1995). Social work practice: Theoretical base. In R. L. Edwards (Ed.), Encyclopedia of Social Work (pp. 22582265). New York: National Association of Social Workers. 2 R Hendricks, J. (1992). Generations and the generation theory in social gerontology. International Journal of Aging and Human Development, 35(1), 31-47. 2 R Haber, C. (2006). Old age through the lens of family history. In Binstock, R.H. & George, L.K. (Eds). Handbook of Aging and the Social Sciences (pp. 59- 75). New York: Academic Press. 2 R Angel, R. & Angel, J. (2006). Diversity and aging in the united states. In Binstock, R.H. & George, L.K. (Eds). Handbook of Aging and the Social Sciences (pp. 94-110). New York: Academic Press. 2 S Hoover, K., & Donovan, T. (2001). The elements of social science thinking. New York: Bedford/St. Mary's.2 S O’Rand, A.M. & Krecker, M.L. (1990). Concepts of the life cycle: Their history, meanings, and uses in the social sciences. Annual Review of Sociology, 16, 241-262. 2 S Riley, M.R. (1971). Social gerontology and the age stratification of society. The Gerontologist, 11, 79-87. 3 Week 6 10/06 Social Context of Aging: Productive Aging R Text: Chapter 12: Paid and Nonpaid Roles and Activities R Schulz, R. & Heckhausen, J. (1996). A life span model of successful aging. American Psychologist, 51(7), 702-714. 2 R Kahn, RL. (2002). On “successful aging and well-being”: Self-rated compared with Rowe and Kahn. The Gerontologist, 42 (6), 725-726. 2 7 WEEK & DATE TOPICS Life grid activity and final paper outline provided READINGS AND ASSIGNMENTS R Rowe, JW. & Kahn, RL. (1997). Successful aging. Gerontologist, 37 (4), 433-440. 3 R Hinterlong, J.E. & Williamson, A. (2006). The effects of civic engagement of current and future cohorts of older adults. Generations, 30(4), 1017.3 S George, L.K. (2006). Perceived quality of life. In Binstock, R.H. George, L.K. (Eds). Handbook of Aging and Social Sciences (pp 320-336). New York: Academic Press. S Carlton-Laney, I. (2006/07). ‘Doing the lord’s work’: African-American elders’ civic engagement. Generations, 30(4),47-50.3 S Cohen, G. (2006). Research on creativity and aging: the positive impact of the arts on health and illness. Generations, 30(1), 7-15.3 S Schmidt, P.B. (2006). Creativity and coping in later life. Generations, 30(1),27-31.3 Week 7 10/13 Week 8 10/20 MID TERM EXAM Social Context of Aging: R Text: Chapter 9: The Importance of Social Supports: Family, Friends, Neighbors, and Communities Social Supports and Caregiving Issues R Text: Chapter 10: Opportunities and Challenges of Informal Caregiving R Cantor, M.H. (1992). Families and caregiving in an aging society. Generations, 16(3), 67-71. 2 R Carter, B. & McGoldrick, M (1989). Overview: The changing family life cycle. In The changing family life cycle: A framework of family therapy (2nd Ed.). Boston: Allyn and Bacon. 2 R Hashimoto, A. (1993). Family relations in later life: A cross-cultural perspective. Generations, 17(4), 24-27. 2 S Chadiha, L., Adams, P., Phorano, O., Ong, S.L. & Byer, L. (2002). Stories told and lessons learned from African- American caregivers: vignettes for empowerment practice. Journal of Gerontological Social Work. 40 (1/2), 135-144. 3 S Gold, D.T. (1989) Sibling relationships in old age: A typology. International Journal of Aging and Human Development, 28(1), 37-51. 3 S Moyer, M.S. (1993). Sibling relationships among older adults. Generations, 8 WEEK & DATE TOPICS READINGS AND ASSIGNMENTS 16(3), 55-59. 3 S White, L.K. & Riedmann, A. (1992). When the Brady bunch grows up: Step/Half-and Full sibling relationships in adulthood. Journal of Marriage and the Family, 54(1), 197-208. 3 Week 9 10/27 The Social Context of Aging: R Chapter 15: The Resilience of Older Women R Roe, K.M. & Minkler, M. (1999). Grandparents raising grandchildren: Challenges and responses. Generations, 22(4), 25-33. 2 Aging and R Burton, L. & Devries, C. (1992). Challenges and rewards: African Gender and American grandparents as surrogate parents. Generations, 16(3), 51-55. Intergenerational 2 Families S Pillemer, K. & Suitor, J. J. (1991). Will I ever escape my child’s problems? Effects of adult children’s problems on elderly parents. Journal of Marriage and the Family, 53(3), 585-594. 2 Week 10 11/03 The Social Context of Aging: Ethnicity and Older Adults R Text: Chapter 14, The Resilience of Elders of Color R Kasper, J.D., Ensminger, M.E., Green, K.M., Fothergill, K.E., et al. (2008). Effects of poverty and family stress over three decades on the functional status of older African-American women. Journal of Geronotology: Social Sciences, 63B, (4), 201-210. 3 R Olson, L.K. (2001). Multiculturalism and long-term care: The aged and their caregivers. In Olson, L. (Ed.) Age through Ethnic Lenses (pp. 116). New York: Rowan & Littlefield Publishers. 2 R Dilworth-Anderson, P. & Gibson, B.E. (1999). Ethnic minority perspectives on dementia, family caregiving, and interventions. Generations, 23(3), 40-45. 2 S Harel, Z. (2001). Jewish aged: Diversity in need and care solutions. In Olson, L. (Ed.) Age through Ethnic Lenses (pp. 143-159). New York: Rowan & Littlefield Publishers. 2 S Feld, S., Dunkle, R.E. & Schroepfer, T. (2004). Race/ethnicity and marital status in IADL caregiver networks. Research on Aging, 26(5), 531-558. 3 For statistics related to minorities and aging: S aarp.org/research/reference/minorities/areasearch-import-5 S www.aoa.gov/prof/statististics/minority-aging/facts 9 WEEK & DATE Week 11 11/10 TOPICS READINGS AND ASSIGNMENTS Living Arrangements and Social Interactions R Text: Chapter 11: Living Arrangements and Social Interactions Video: Almost Home R Rahman, A.N. & Schnelle, J.F. (2008). The nursing home culture-change movement: recent past, present, and future directions for research. Gerontologist, 48(2), 142-148.3 R Decker, F.H. (2005.) Nursing homes, 1977-1999: What has changed, what has not? Online available at: http://www.cdc.gov/nchs/data/nnhsd/NursingHomes1977_99.pdf. R (for social work students) Zimmerman, S.I., Munn, J., & Koenig, T. (2006). Social work practice in assisted living settings. In B.Berkman & S. D'Ambruso (Eds.), Handbook of Social Work in Health and Aging. New York: Oxford University Press. 3 S Zimmerman, S.I., et al., (2005). How good is assisted living? Findings and implications from an outcomes study. Journal of Gerontology: Social Sciences, 60B (4), S195-S204. 3 S Jones, A. (2002). The National Nursing Home Survey: 1999 summary. National Center for Health Statistics. Vital Health Statistics 13(152). Retrieved July 10, 2005 from http://www.cdc.gov/nchs/about/major/nnhsd/nnhsd.htm. S Bowers, B., Fibich, B. & Jacobson, N. (2001). Care-as-service, care-asrelating, care-as-comfort: Understanding nursing home residents’ definitions of quality. The Gerontologist, 42(4), 539-545. 3 S DeVries, B. (2006). Home at the end of the rainbow: Supportive housing for LGBT elders. Generations, 29(4), 64-69. 3 S Blank, T. (2004). Sunset Pink Villa: a home for gay and lesbian elders. The Gerontologist, 44 (6), 856-857.3 Week 12 11/17 The Psychological Context of Aging: R Text: Chapter 7: Love, Intimacy, and Sexuality in Old Age Personal Relationships & Spirituality R Eckert, J.K, Zimmerman, S.I., & Morgan, L.A. (2001). Connectedness in residential care: A qualitative perspective. In Zimmerman, S., Sloane, P., & Eckert, K. (Eds.) Assisted living: Needs, practices and policies in residential care for the elderly. (pp 292-317). Baltimore and London: Johns Hopkins Press. 2 R Skultety, K. (2007). Addressing issues of sexuality with older couples. Generations, 31(3), 31-37. 3 R Blazer, D. (1991). Spirituality and aging well. Generations, 15(1), 61-66. 2 10 WEEK & DATE TOPICS READINGS AND ASSIGNMENTS R Fry, P. (2000). Religious involvement, spirituality and personal meaning for life: Existential predictors of psychological well-being in community residing and institutional care elders. Aging and Mental Health, 4(4), 375.AN4176430 2 S de Vries, B. (2007). LBGT couples in later life: a study in diversity. Generations, 31(3), 18-23. 3 S Bitzan, J.E. & Kruzich, J.M. (1990). Interpersonal relationships of nursing home residents. Gerontologist. 30(3): 385-390. 2 S Miles, S. & Parker, K. (1999). Sexuality in the nursing home: Iatrogenic loneliness. Generations, 23(1), 36-43.2 S Parker, M. et al. (2002). A multi-disciplinary model of health promotion incorporating spirituality in a successful aging intervention with African American and white elderly groups. The Gerontologist, 42(3), 406.AN6815503 3 S Johnson, C.L. & Barer, B.M. (1997). Life Beyond 85 Years: The Aura of Survivorship. New York: Springer. Week 13 11/24 End of Life R Text: Chapter 13: Death, Dying, Bereavement, and Widowhood. R Hansson, R.O. & Stroebe, M. (2007). Coping with bereavement. Video Clip: Generations 31(3), 63-65. 3 From On Our Own Terms: A Different Kind of R Steinhauser, K. E., Christakis, N. A., Clipp, E. C., McNeilly, M., McIntyre, L., & Tulsky, J. A. (2000). Factors considered important at end of life by Care. patients, family physicians, and other care providers. JAMA, 284(19), 2476-2482. 2 R Kwak, J., Haley, W., Chiriboga, D. (2008). Racial differences in hospice use and in-hospital death among medicare and medicaid dual-eligible nursing home residents. Gerontologist, 48 (1), 32-41.3 S D’Epinay, L., Cavalli, S., & Spini, D. (2003). The death of a loved one: impact on health and relationships in very old age. Omega: Journal of Death and Dying 47 ( ), 265-284 3 S Mezey, M., Dubler, N.N., Mitty, E., & Brodya, A.A. (2002). What impact do setting and transitions have on the quality of life at the end of life and the quality of the dying process? The Gerontologist, 42(SI III), 54-67. 3 Week 14 12/1 Evaluation of Learning Final Exam and Course Evaluation 11 1 Instructor will provide during the first class meeting. Available online via Blackboard (http://blackboard.unc.edu) under “Assignments” and “Readings”. 3 Can be found online through UNC Libraries – electronic journals. * Note: No class on Labor Day 9/1/08. 2 12