PSYC 381 Lecture Notes - Lecture 5: The Green House, Health Promotion, Job Satisfaction
26 May 2018
School
Department
Course
Professor
Chapter 5
1. Describe the concept of person-environment interactions. Describe the competence and
environmental press model. Be sure to include a discussion of adaptation level and the different
zones of performance. How do people respond to changes in press or competence according to
Lawton? (pp. 151-153)
2. What is the congruence model? What needs to be considered when optimizing the fit? What
shortcomings did Langer find regarding nursing homes promoting competence and control in
their residents? (pp. 153-156)
3. Describe the stress and coping model. What is everyday competence and why is it important?
(pp. 156-157)
4. What is ‘aging in place’? What are the key decision points when deciding on the best
environment? Describe the home modifications that can be done and the major issue. (pp. 158-
160)
5. Describe adult day care and the options it provides. What are the major issues in deciding to
use adult day care? What is congregate housing? (pp. 160-162)
6. What are the characteristics of assisted living facilities? (pp. 162-164)
7. What are the different types of nursing homes and who is likely to be living in nursing homes?
What are the important characteristics of nursing home? (pp. 165-169)
Different Types of Nursing Homes:
- Nursing homes contains the highest amount of older residents in long term facilities
- the cost of nursing homes is extremely high and funding for these long term facilities will be a
great political concern in the future
There are two types of nursing homes
a) Skilled nursing care
- includes 24 hour care consisting of skilled medical care and other health services, from nurses
b) Intermediate nursing care
- includes 24 hour nursing supervision but at a less intense level
- the main differences between the two is the number of health care professionals and the type of
health care professionals
Who is likely to live in nursing homes?
The typical characteristics of an individual likely to be in a nursing home are as follows:
a) they are over the age of 85
b) they are female
c) they have been recently admitted to a hospital
find more resources at oneclass.com
find more resources at oneclass.com
d) They live in a retirement home rather than being a homeowner
e) They are unmarried or live by themselves
f) they have no children or siblings living near them
g) they typically have some type of cognitive impairment
h) they have challenges with instrumental activities of daily living
- characteristics of the residents at nursing homes are not similar to the population at large
- ethnic minorities and males are underrepresented in nursing homes
- higher rates among poverty may serve as an explanation as to why minorities tend to be more
impaired than others in nursing homes
- residents tend to have severe mental and physical problems
- they typically have mobility problems, eating problems and incontinence problem
- frail older people typically resort to nursing homes until all other options have been explored
- the older people present as very high stress problems to deal with in the home environment
even with assisted living services and for this reason they move to nursing home
- the decision to move to the nursing home is a fast decision typically made after an individual is
discharged from the hospital
Characteristics of nursing homes:
- the goal is to find the optimal environmental support for people who have low levels of
competence
- there are several characteristics of nursing homes that individuals should consider when
choosing a nursing home:
a) quality of life for the residents
b) quality of care
c) safety
d) and other issues such as outdoor facilities for residents
- Other aspects they should be kept in mind are the following:
1. facilities offer both skilled nursing and custodial care or either or.
2. some nursing homes that take Medicaid residents and will only offer longer term but less
intensive care levels – residents may get kicked out when their Medicare runs out
3. Ensure the staff are qualified and administrators are fully licensed – ensure training has taken
place for employees to allow them to provide optimal care
4. Ensure a solid plan for the residents has been put together.
- the most important approach to have in nursing homes is a “person-centred planning” approach
- this approach emphasizes the importance of promoting the well being of the resident by
increasing their perceived level of control and treating the respectfully
- residents will have the choice the decorate their rooms, choose their food plans, and decide if
they prefer showers or baths
- it focuses on providing each resident with a personal care team that caters to their needs and
works together to provide the best environment for them
- advantages of using this approach are studies have illustrated that nursing homes that use this
approach have less need for certain medications and soft restraints
find more resources at oneclass.com
find more resources at oneclass.com
8. What are special care units and how do they differ from other nursing facilities? What are the
important factors that can make nursing homes feel like real homes? (pp. 169-172)
Special Care Units:
- Special care units are specifically designed to meet the environmental needs of individuals who
have cognitive impairments such as dementia
- these individuals require specialized design and intervention features as they provide a
supportive and therapeutic set of programs that help the person continue to function at the
highest level
- For Ex: some special care units have their patients wear bracelets that set off an alarm when
they go past their permitted boundaries (this can help address wandering)
- the best facilities have allow their residents to bring in some personal objects to remind
themselves of the past and make the environment feel more like home
- Special care units must have the right environmental set up and support and must be prepared
to provide more support to individuals as their competence levels begin to decline
- staff who work at special care units must receive adequate training to meet the needs of their
patients
- training includes learning the following:
a) appropriate and effective communication techniques
b) behavioral management techniques to address aggressive or agitated behavior
c) appropriate techniques for assisting with personal health and hygiene that protect resident’s
dignity
d) appropriate techniques for handling sexuality in persons with dementia
e) effective techniques to address wandering
f) appropriate ways of supervising or assisting with eating
g) appropriate techniques and interventions to address memory failure and disorientation
h) Appropriate techniques for assisting with mobility
Nursing homes vs Special Care Units:
- the increased quality of care residents of special care units receive is more the result of a
difference in philosophy of care between nursing homes with and without special care units than
it is due to the special care unit itself
- nursing homes that include special care units also have different approaches for dealing with
problem behaviors that help avoid the use of physical restraints
- residents of special care units are younger and more behaviorally impaired then general nursing
home residents
Factors that make Nursing homes feels like real homes:
- on the surface nursing homes seem to present various barriers to making residents feel as if
they are at home such as not allowing them to bring their furnishings or any personal effects
- According to researchers residents of nursing homes do feel at home due to the following:
a) having time to think about and participate in placemen decision
b) having prior knowledge of and positive experience with specific faculty
c) defining home predominantly in terms of family and social relationships rather than in tersm
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Chapter 5: describe the concept of person-environment interactions. Be sure to include a discussion of adaptation level and the different zones of performance. How do people respond to changes in press or competence according to. What shortcomings did langer find regarding nursing homes promoting competence and control in their residents? (pp. 153-156: describe the stress and coping model. What is everyday competence and why is it important? (pp. Describe the home modifications that can be done and the major issue. (pp. 158: describe adult day care and the options it provides. 160-162: what are the characteristics of assisted living facilities? (pp. What are the important characteristics of nursing home? (pp. Nursing homes contains the highest amount of older residents in long term facilities. The cost of nursing homes is extremely high and funding for these long term facilities will be a great political concern in the future. There are two types of nursing homes: skilled nursing care.
