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Transcript of The Elderly
2 Different areas of the unit
1one area less severe dimensia
second area more severe dimentia
residents will not leave their room for fear of forgetting where it is and having to ask furthering their confirmation of having dimentia
12 rooms in second clinic
1 nurse 5 CNA’s work 6-6
I activity director
2 separate activities for each unit
one is more sensory and more childlike the other is more hands on and building
Lots of activities
Elemenatry kids singing
Music is big for them
“Music will be the big difference between this generation and the next” Activities dirlkfa;s
Marilyn Luptak gave great insight concerning historical culutral approaches to the elderly, in her periodical titled "Social Work and The End-Of-Life Care For Older People: A Historical Perspective":
Non verbal communication differs among cultures around the world. After visiting with the elderly at Kolob, we found that the individuals living there use facial expressions as a form of nonverbal communication. A lot of the residents are sassy, cranky, and senile, and we would often see them rolling their eyes at other residents. This was one of the more common forms of nonverbal communication we saw. In addition, most of the residents also maintained eye contact during conversation and
some used their hands
Said the little boy, "Sometimes I drop my spoon."
Said the little old man, "I do that too."
The little boy whispered, "I wet my pants."
"I do that too," laughed the little old man.
Said the little boy, "I often cry."
The old man nodded, So do I."
"But worst of all," said the boy, "it seems grown-ups don't pay attention to me."
And he felt the warmth of the wrinkled old hand. "I know what you mean,"said the little old man.
Silverstein, 1981, "The Little Boy and the Old Man"
Because residents of retirement homes have limitations on who they can see, they are somewhat restricted on having current intercultural relationships. To gather a more in depth analysis of the elderly and their intercultural relationships, we relied on interviews. In these interviews, we asked a series of questions pertaining to the participants' past and present:
We see conflict all the time in our own culture. However, it may be hard to see conflict when you are not in the culture. For us to get an in-depth idea of the conflict we conducted a few interviews where we asked questions about conflict with in or around the elderly culture.
Not until the 16th and 17th hundreds did the struggle against death emerge, before it was always about making sure one passed comfortably from this life to the next with friends and family around (8). It wasn't until the 20th century that America really started to focus on the end-of-life care. During the early part of the century, "being old in America was emerging as a social position equated with need" (As cited in Luptak, pg. 8, 2004)
Economic needs of the elderly were more important early in the century over their other needs until the Social Security Act of 1935
In the first 50 Years of the century the older population quadrupled in number
In 1940 older people were seen normal if they received dependency, disability and isolation
More tha 3/4s of all the people facing death died in a hospital or nurisng home, making death invisible
1964 Medicare health insurance program
1990 Supreme court recognized the ability for the elderly to refuse services
(Luptak, pg 7-10, 2004)
Medical ailments in older populations often are misdiagnosed or completely overlooked by physicians
. Mental health professionals frequently fail to notice depression in older patients
(Lasser, Siegel, Dukoff, & Sunderland, 1998)
. Perhaps the most insidious type of neglect of older patients has to do with physicians-atient communication. For example, physicians avoid discussing end-of-life issues with older patients, presumably because of their own discomfort
(Resnick, Cowart, & Kubrin, 1998)
. In an analysis of blind-coded, taped medical interviews, researchers found that when talking to patients over age 65, physicians were less engaged, less respectful, less supportive, and less egalitarian than when talking to younger patients. Most startlingly, physicians provided less-detailed medical information to older patients
(Greene, Adelman, Charon, & Friedmann, 1989)
. Sadly,this is only a sampling of the findings that reveal the neglect suffered by elderly people in medical settings.
(As cited in Cuddy, Norton & Fiske, pg. 279, 2005)
1. Growing up, did you have many relationships with individuals from other cultures?
2. If so, did those relationships differ from those that were a part of the same culture as you?
3. If not, why didn’t you form relationships with those from other cultures?
4. Now, do you have relationships with individuals from other cultures?
5. If so, do those relationships differ from those that are a part of the same culture as you?
6. If not, why don’t you form relationships with those from other cultures?
The first set of questions pertained to the participants' childhood. When we asked if the participant had intercultural relationships growing up, we found that most did not. Their reasoning was simply because the opportunity never presented itself. This is definitely a limitation in our research, but it should be noted that location plays a huge role in the forming of intercultural relationships. One participant said that she grew up with mostly Caucasians. There was one Hispanic family in the town she lived in, but the language barrier made it difficult for her to form any sort of relationship with that family. This participant also mentioned the first time she ever remembers seeing an African-American,
"I distinctly remember the first time I saw a black person - I was 17!! I was working as a cashier in a grocery store and he came in as a customer. I remember thinking, 'I hope I am not acting funny.' His appearance at my check out stand was certainly a surprise."
"Americans stereotype elderly people as warm and incompetent, following from perceptions of them as noncompetitive and low status, respectively."
Cuddy, 2005, p. 267
When we asked about the current relationships of which our elderly interviewee's now have, all of them said they do have them. Work has provided several opportunities to engage in intercultural interaction. Upon asking if her relationship with those of a different culture was different than those of her same culture, one interviewee said, 'The cultures are different, but my relationship with them is not.'
Notable Achievements of the Elderly
She went on to say that she is able to relate to most cultures and that she even married a Jewish man. The only difference is the passion she has for certain controversial topics compared to the passions of those she shares intercultural relationships with. She believes these relationships are so easy to have and maintain because she is familiar with diversity and other cultures. She has researched many cultures, so new things do not give her the normal 'culture shock' others may receive upon meeting someone from a different culture than their own.
Based off our analysis, we found that the elderly are able to have intercultural relationships if they are open-minded. It is important to recognize that all cultures have different beliefs and different priorities, and no specific group is right or wrong.
65 years old
Volunteer at the Texas Department of Aging and Disability Services
Discovered most of her patients were unable to fight for their own rights and needs
2009 volunteered for a program to "resolve nursing-home residents' complaints"
Visits for facilities in her hometown weekly
Wants to protect elerly from being taken advantage of specifically financially
"Pet Cause: Explaining to families the need for a financial power of attorney"
Many elderly people suffer from hearing loss. Listed below are some of the nonverbal ques that suggest an elderly person is losing their hearing.
Do you feel that there is another group (culture) that has some kind of conflict with the elderly culture?
When answering this question we received two very different answers and one that said there is no conflict. When looking at interviewee 1 noticed a conflict with the middle aged generation because they don’t seem as fearless and less open to change and the conflict lies with the middle age culture not the younger culture. However, interviewee 3 states that there is an conflict with the younger generation because of how different they are from each other. In figure 1 we see the connection between the different generations and where the conflict is with the middle age generation, also the younger and older generation seem to see eye to eye. In figure 2 we can see the common idea of generational conflict, and everyone has conflict.
- Does not understand when spoken to from behind
- Pretends to understand
- Closely watches face of speaker
- Leans forward or turns ear toward speaker
- Appears confused during conversation
- Lacks awareness of environmental sounds
- Listens to radio or television at high sound level
- Avoids social interaction
middle aged generation
- Tires during social interactions
middle aged generation
(Erber, N 2002)
From our observation, we found that the elderly in the media are under represented, meaning you won't see near as much of the older generation on
television and other media outlets compared to other cultures. In particular, television appears to not have much advertising directed towards the elderly. This is interesting because studies have found that young children and the elderly are the the ones that actually watch television the most(Kubey, 1977).
We think the lack of representation may be partly because media has put such an emphasis on being youthful, healthy, and beautiful. We often see advertising for products that
prevent people from getting and looking older. Some products advertised might include: anti-aging cream, medication, or even hair dye.
Media generally portrays getting old as a very negative thing, and they tell people they should avoid it at all costs.
While sometimes media portrays elderly people positively, most of the time they are portrayed in a negative way. The media seems to reaffirm both negative and positive elderly stereotypes. These stereotypes include:
- Bad Health
Reliable on Other/Immobile
- No Sex Drive
- Sight & Hearing Impaired
- Always Tired
- Bad Memory
- Can't Drive
- Can Bake/Cook
- Humorous/Air headed
- Great Grandparents
Social Security act of 1935
1965 Medicare Health Insurance
The Patient Self-Discrimination Act of 1990
Though the recognized achievements of the elderly are big steps they continue to be recognized as individuals who need help and are still people not objects to be waited out until they die.
"How do you deal with this conflict?"
Outside Suggestions to Enhance Communication
-Allow them to Reminisce
-Speak Clearly, Straight to their Face
-Sympathy with limits/sickness
-Adapt to unexpected problems
Understanding and accepting diverse communication approaches and styles is an important concept in communicating across cultures and we found it to be particularly applicable when communicating with the
Appendix B Continued
We think the lack of representation and negative representation may be partly because media has put such an emphasis on being youthful, healthy, and beautiful which overtime has been deemed as more and more important. This has changed the representation of the elderly.
Growing up, did you have many relationships with individuals from other cultures?
- Growing up I had few/little relationships with other cultures.
- No, I didn’t have very many relationships with individuals from other cultures. I grew up in a very small town in rural North Dakota, with most families of Swedish, Norwegian, and Polish nationalities. During my senior year, we had a foreign exchange student from Finland. She fell in love with one of my classmates, married, and remains in America to this day.
If not, why didn’t you form relationships with those from other cultures?
– I think this is because I grew up in a small town in ND. The population there, at that time, was 100% white/Caucasian. At least that is what I was aware of. Looking back I can recall that we had a Mexican migrant worker population that would arrive in the summer to work the fields with the farmers. I was not in a relationship with these people, as I had no way to meet them. The migrant kids went to summer school and I did not. That is probably where I would have met those kids. There was also the language barrier. I spoke only English and they spoke only Spanish. As a kid, I also mainly stayed home. There were too many of us to really go anywhere and do anything. I think if perhaps we would have had a Mexican family living near us, it would have been different. When you grow up in a small town in ND in the 50s and 60s, you are pretty isolated, culturally. I distinctly remember the first time I saw a black person, I was 17!! I was working as a cashier in a grocery store and he came in as a customer. I remember thinking I hope I am not acting funny. His appearance at my check out stand was certainly a surprise.
– The opportunity did not present itself.
Now, do you have relationships with individuals from other cultures?
– Now, I do have relationships with other cultures.
– As an educator for over 3 decades, I have had several Hispanic students. Their parents, migrants, would arrive in the Valley in early April to work in the Agricultural sector of the community. Late October, when harvest was complete, and before the harsh winter would fall upon us, they would leave for their homes in the south. It was a teacher/student/parent relationship.
If so, do those relationships differ from those that are a part of the same culture as you?
– The cultures are different, but my relationship with them is not. Or, at least, it is very subtle. Moving to AZ introduced me to the culture of Mexico. I became very familiar and had many relationships through my years of teaching. with Mexican families and teachers. I do not feel that I have a different relationship with them as with my culture. I also became part of the Jewish culture when I married Alan. I relate to them in the same way as my culture, except in one area. That area would be the issue of peace in the Middle East and how to achieve it. To put it simply, I am not a pissed at the Arabs as they are. I have done lots of reading of the Jewish history to understand their viewpoints, and I do understand their view. I just don't feel as strongly about it as the Jewish people do. To me this is understandable, as my ancestors/previous generations were not lost in the Holocaust. I relate to them differently in this way, Many times I will not state my opinion as I would with my culture, because the Jewish history is so complicated and goes back a long time. I don't think I fully grasp the history they have, yet, I do feel compassion and great sorrow for what their grandparents endured in WWII and with Hitler. I am also good friends with African Americans. I relate to them the same as I relate to my culture. I think this is because the African Americans I know do not seem to hold any animosity to white people. I have met black people who appear to hold a grudge/blame white people for their situation. Those folks have not become close friends, but rather acquaintances. In some odd way I feel that I was prepared in some way to have a relationship with Jews and African Americans. As a Jr High kid I read every book on the Holocaust and every book on the Civil Rights movement that was in the small town library. It gave me a view I would not have had if I had not read them.
– My relationships with students and parents were on a professional level.
If not, why don’t you form relationships with those from other cultures?
– We don’t have many opportunities to form relationships with other cultures in our community. The Norwegian/Polish/Swedish heritage is so entwined it is practically seamless. We have some Hispanic members of our community that have decided to make our community their home, rather than travel. While, it appears they have immersed themselves in our “cultural community”, they honor traditions of their culture and families. There are opportunities to experience and learn about other cultures within 60 miles of our community. The University of North Dakota hosts a POW WOW. Many area communities host Norwegian Days, and a rural community parish has a group of Polish Dancers that perform at special events. These experiences are community people re-creating cultural experiences from their heritage.
To research the elderly culture, our group used the dialectic research approach. We participated in a variety of research methods. Before conducting our main research, we gathered date and statistics to become more familiar with the culture we were studying. Our main research site was Kolob retirement home. While volunteering there, we had the opportunity to play bingo with the residents, take residents to lunch, and to reminisce with them. We were able to gather a fair amount of research at Kolob, but because retirement homes are a subculture of the elderly culture, we reached out to other sources as well. We observed the elderly at church, at the dog park, and at the hospital. We were able to see how the elderly interact with one another, as well as how they interact with younger generations. It was interesting to see the difference between the elderly living in a retirement home and the elderly living outside of a retirement home. In total, we spent 14 hours simply observing the elderly culture. In addition to observing, we also interviewed several elderly people. We interviewed elderly people throughout the community and we reached out to elderly relatives in hopes of attaining more diverse research. Between the five of us, we each did four hours (give or take) of observing and/or interviewing. By doing this, we were able to ensure we spent a total of 20 hours researching the elderly.
Do you feel that there is another group (culture) that has some kind of conflict with the older generations?
– Is there another culture that has some kind of conflict with the older generations? I think we have
Why is there conflict?
– There is a conflict because many American older folks just cannot seem to accept that things have changed since they were younger.
How would you deal with this conflict?
– How would I deal with this conflict? I would support the young people in their actions. I am pretty liberal as a 60-year-old woman.
Do you feel this conflict is productive or destructive?
– This conflict is productive and will bring about social change.
How do you think the media portrays older generations?
– I think the media portrays the older generation fairly.
– I consider myself middle aged, and have never felt defensive or angry towards the media in their portrayal of my age group.
How do you feel about social media?
– I like it. However, I do worry that our younger generation will miss out on the face-to-face personal relationships. You all will get so used to having everyone right at your fingertips, whenever you want or need them, it seems to me that it would be hard to build a solid relationship that way. on the other hand you may have a stronger relationship because of the constant communication and sharing. Who knows. I don't think we will know if this texting/Facebook/Instagram is a good thing or a bad thing until some time has passed. I hope it turns out as a positive for all involved. The other thing about social media is that I think we are losing our privacy. Because of the advance of technology I fear that we lose much privacy before we realize that it is gone. And yet, because of social media, I have been able to be in contact with friends and family in a way that I could not be if there were no social media.
– I appreciate social media. I enjoy the interaction and the ability to connect with a global community even though I am in a very rural area. I am connected through: Facebook, Twitter, Pinterest &Google Hangouts.
a group of young people who are much more accepting of people's differences. For example, I would suggest that young folks aged 20-30 are more apt to share their
feelings/thoughts when it comes to prejudice and discrimination. Young people today would probably tell the KKK to shove it. Those a little older have a bit more fear.
Maybe because they have witnessed some of the atrocities? I don't know. But you young folks seem to have less fear and will correct the older generation. I see this in relation to minorities and the gay and lesbian community.
You are more apt to step up and ask why not equality? Yea, you guys!!
– Ummmm, conflict with the older generation? Perhaps, the younger generation. I can’t necessarily say for sure but it sometimes seems we are pinned against each other.
Allow them to reminisce
Another factor that stood out within our research was the inherent need for the elderly to reminisce
Symbolic exchange is another suggestion that was implied by those we talked to. Sometimes the elderly have a hard time hearing and the use of nonverbal symbols and gestures can help enhance their understanding within a particular context.
Taking time to understand the physical context of the situation is something that can make a difference in the effectiveness in the communication between our culture and the culture of the elderly. A great point that they brought to our attention was the presence of loud objects or people. We had not considered this an issue, but once again, the elderly have trouble hearing sometimes and being close to loud machinery or a loud television can have disastrous effects on communication. In this situation, minimizing the noise or completely removing it would be the most effective way of handling it. If that is not possible, try to speak clearly, slowly, and a little bit louder.
communication strategies continued
elderly. In several situations involving our culture and the culture of the elderly, being able to adapt and accept different communication styles is imperative. In a nursing home community the likelihood of running into unexpected limitations is very high. The diseases and disabilities that affect the elderly can show in their communication methods. In order to communicate with them effectively across cultures we learned that we must adapt quickly and modify our communication
Flexible communication is a very important concept that can help encourage the bond between our culture and that of the elderly. Knowledge, Attitude, and the Skills to integrate this knowledge and attitude can have great effects when communicating outside of our own cultures. Those we talked to within the elderly community also implied that the three criteria for flexible intercultural communication was important. Appropriateness, Effectiveness, and Adaptability were all on the list of qualities that they suggested would help enhance the communication between our two cultures.
The most important concept we found with our research was having an ethnorelative mindset. It is important to be able to understand the communication behavior from the other person's cultural frame or reference.
strategy to compliment theirs. In most cases, we found that the elderly were not willing to modify their own strategies; we were the ones who needed to adapt for effective communication to continue.
about past memories. It makes sense, with them being older and having so many life experiences. In several of
our communication experiences we were told about things of the past, memories, and lessons learned by the elderly. This was a point that was not brought up directly by the elderly
themselves, but showed very clearly in their communication. In return, we could share our own memories of the past, but the memories of the elderly were the more impressive ones and more or less the highlight
of the conversation. This point was suggested by several articles that help enhance communication with the elderly, especially in a situation such as a nursing home or hospital where they are very limited, sick, and possibly dying.
Interviewer 1 "How would I deal with this conflict? I would support the young people in their actions. I am pretty liberal as a 60-year-old woman"
Interviewer 2 "Hmmm how would I deal with the younger generation, I would try to understand more."
Within the interviews
we see compromising and integrating as the two main styles of conflict. However, we see all 5 conflict styles in the elderly culture it depends on who, when, why, and what is going on.
- Differences, I can’t understand
what is going on in your world and the younger generation can’t see how things use to be. So we butt heads when we can’t connect.
Interviewee 2 -
Hmmm how would I deal with the younger generation, I would try to understand
- It is both.
The elderly have been a part of humanity since the beginning of time. Throughout the ages elderly members of society at times have been regarded as the most wise and, at other times, have been seen as the hardest to be around. In this portfolio, researchers attempt to not only understand the
elderly but to help others understand how to help and engage the elderly in their end-of-life experience. To fully understand the elderly, one must first understand the history. Once this is understood, the stereotypes that surround the elderly and the communication that can be seen
between them must also be recognized. A recognition of the conflict that the elderly go through and ultimately how to reach out to the elderly will thoroughly help readers to be involved with the elderly around them. Upon reading and enjoying this portfolio, it is the researchers hope that one will become involved in their surrounding communities.
Lots of busy activities
Memory games or Sensory games
Elementary Kids Singing
Almost anything Involving music
The elderly tend to get used to routines
An interview performed with the Director of Activities revealed different stereotypes that the elderly deal with.
Do not like to be touched
"The stink isn't as bad as people think and the big one is that death is taboo. It's really not we can talk about it all the time. Also they are not grouchy like people think, you get a few but not all of them."
Director of activities on What stereotypes she felt were not true
"They love music. An interesting fact is that they will recognize music more than anything. Memories will be brought back by music."
Example common & uncommon stereotypes of the elderly culture in the media
How do you feel media portrays the older generation?
Have a wonderful day!
“Out of touch, old fashion, and outdated! People think we’re intolerant just because moral standards have changed, and values are different than they used to be.”
How do you feel about social media? Do you use social media?
“Social media is out of control. Back in my day we used to talk to our dates than text them. Now kids are more interactive with things than people. We understood that people matter more than things. I do have things like Facebook, email, a smart phone, and I do watch the news but I don’t live for it. I use it for convenience but I could do without it unlike people nowadays. Social media is as addicting as alcohol and it can be an utter waste of time.”
What kinds of media do you use/like the most?
“I like to watch the news each night, and often will email friends”
How do you feel media portrays the older generation?
“It treats them too well, most old people are
republicans and they should get rid of those. Overall it’s okay, but old people get away with things like not paying taxes. They don’t want to lose their Medicaid and social security and the republicans are trying to get rid of it.” [Had to try to get him back on track] “Media doesn’t target them by themselves, but certain channels might. Old people get a lot of respect.”
How do you feel about social media? Do you use social media?
“It’s an intrusive thing in our life today. I don’t like the idea of people knowing about all the personal things put on social media. I refuse to turn a computer on. I don’t want to lose all the numbers in my head and I would hate to get all that information about people. It causes major problems that are there forever.”
What kinds of media do you use the most/like the most?
“The telephone. If you want to talk to someone you call them. Emails are the easy way out. I will never get social media because it spreads gossip. I always watch television mostly and it keeps me updated pretty well.”
How do you feel media portrays the older generation?
“Wearing depends, frail, weak, dependent. If they fall they need buttons to push. They need those bathtubs that have doors cause they can’t climb in.” [Referring to Television commercials]
How do you feel about social media? Do you use social media?
“There are negatives and positives of social media.
The negatives are that there’s lots of trash on there, and its effecting kids. There are also child predators out there that can get information easily. It’s good cuz it can keep people connected. I’m just not sure if it’s worth it. I have the internet and just got a phone that I’m learning to use. It’s necessary for me to keep in tough, but it’s taking me a while to learn to use texting. It bugs me that Facebook is used to complain and tell people your problems. I don’t care what your husband did and I don’t care what you’re doing tonight.”
What kinds of media do you use the most/like the most?
“I mostly use the internet and will sometimes read books and watch TV.”