Sunday, April 19, 2015

Introduction

Introduction

 
My interest in Sociology lies in my career choice of Social Work. Sociology helps provide answers and theories to social problems, and provides a great understanding of the social factors that contribute to individual problems and oppression. I had always looked forward to taking Psychology courses and kind of dreaded taking my first Sociology course. After starting it, I fell in love and immediately added it as a minor!
 
I found this course especially interesting. I have always wanted to work with children and youth as a Social Worker and had never considered focusing on gerontology. To my surprise, I was interested in every topic covered during this course, and now feel motivated to help address the social problems I have learned about.
 
(AS Activities)          

I chose this image because I think it represents how interconnected our society is. Most people think of elders as a burden and cast aside reflecting on the issues that they face. I think it is important to identify how big of a role elders play on other generations, and to recognize the relationships and dependency each generation has on each other. We should have more emphasis in our society on understanding gerontology.


Phased Retirement

Retirement

 

During this course, one of my favorite chapters was 'Chapter 10: Economic Well-Being: Retirement, Employment, and Poverty'. I was astonished to learn how many seniors are economically insecure. As I read this chapter, I often thought of my mom; a woman who loves being challenged by her work and can't imagine enjoying a day of retirement until she is at the end of her life, if ever. I asked myself if there were more people like her; people that wanted to continue working not because they were financially dependent on working post-retirement, but because of their love of work. What are their options?

 

The Baby Boom generation is beginning to enter retirement, and just as they have reshaped social conventions in the past, they are now redefining what retirement means. As Hooyman et  al (2015) notes, “… the generation of workers currently in their fifties and sixties would redefine the notion of retirement, moving by choice into new ‘retirement jobs’ or encore or second or third careers to enjoy a sense of productivity, social contacts, and life satisfaction,” (p 285). While this may be the future of retirement, it doesn’t mean it is yet the definition.
(Phased Retirement: Another "Do As We Say, Not As We Do" Moment)
While many of the Baby Boomers that have currently reached retirement age are wanting to stay in the work force to prevent a loss of role and identity, many are forced to remain in the workforce due to financial reasons. In a national survey cited by Hooyman et al (2015), 25% of respondents said they would have to remain in the workforce until at least the age of 80 in order to have enough money to retire comfortably. In fact, in 2010, “the majority of Americans (75 percent) nearing retirement age had less than $30,000 in their retirement accounts,” (Duska, 2013).  Many Americans can simply not afford to retire, and following the greatest recession the generation of Baby Boomers has ever seen, many retirees were forced back into work after years of retirement (Hooyman et al, 2015) (Duska, 2013) (Tacchino, 2013).
According to Rose (2010), only 17 percent of workers 65 and older remain working for financial reasons. The majority of those that continue working purely for financial reasons hold blue collar jobs and are from the lower class (Hooyman et al, 2015). For the majority of those 65 and older that are still in the workforce, satisfaction and a desire for social impact keeps them working. “The main reason they continue to work is to feel useful, to stay active and connected with others…” (Rose, 2010, p 38). Many retirees dread a loss of production and a loss of role, and struggle with the abrupt transitions of working full time to not working at all.

Phased Retirement

(Phased Retirement)
“Common wisdom held that after marching through their formative decades to a different drummer, boomers would approach retirement differently. Rather than slowing down or settling into a life of leisure, they would step with renewed energy into new pursuits,” (Rose, 2010, p 36). Many new retirees chose to pursue the “encore career” which provides them limitless option allowing them control over their work. The encore career allows for “a suite of options, including returning for project-based work, working part time, and finding ways to marry voluntary and corporate social responsibility activities,” (Sargent et al, 2011, p 323).
Encore careers fall into the category of phased retirement in which retirees will finally have a transition between work and retirement; often one that they can set at their own pace. Phased retirement allows retirees to have a healthy combination of productivity and leisure. Many retirees find it difficult to leave their careers, and phased retirement allows them better financial security while allowing them to try out leisure activities, leading to better emotional preparation for retirement (Tacchino, 2013).

"Service is rent you pay for room on this earth"

(Rose, 2010)

Phased retirement can take on many different forms, including formal and informal. Some phased retirement may include encore careers, continuing work for the same company, or starting one’s own business. Some people phase into retirement by working part time, whether lowering their hours every week, or by working a seasonal schedule. What is most clear about the popularity of phased retirement among the newest retirement generation, is that while most retirees no longer want to be shackled to demanding workloads and schedules, they want the continued freedom to have a career in which they can feel productive, engaged, and which brings meaning to their lives. (Duska, 2013) (Tacchino, 2013) (Sargent et al, 2011) (Rose, 2010).

Additional Resources

US Office of Personnel Management: http://1.usa.gov/1JJ59Bq

OPM states that Phased Retirement is not only a benefit to employees, but is also a useful tool for employers. Phased Retirement is a "forward thinking policy" that allows for mentoring opportunities. This website provides information and webcasts about Phased Retirement.

Encore Careers: http://bit.ly/18BgrKu

Encore.org sees the aging society not as a problem, but as a solution. They are creating an encore network, encouraging retirees to seek an encore career. They even provide an 'Encore Handbook'!

 

AARP- Recareering: http://bit.ly/Uzjai4

This website provides links to several articles about what to do if you decide that full retirement is not right for you. These articles cover topics such as part-time work, starting a business, and second careers.

Housing

Housing for Patients With Dementia

I study Interior Design and was naturally drawn to 'Chapter 11- Community Well-being: Living Arrangements and Social Interactions' because it discussed housing options and design. One of my favorite Interior Design courses was Universal Design, and I often referred back to what I learned while I watched my grandparents struggle while living in a condo that was not built with aging in mind. For this post, I decided to explore a topic other than Universal Design. I chose to research Dementia Friendly Design, which combines two of my greatest passions, Sociology and Interior Design! This type of design provides environmental treatments for elders with dementia.


(Salford Institute for Dementia)
 
Just as there is an increasing availability of housing options for seniors, there is also increasing research indicating the importance of design on quality of life. For seniors with dementia living in special care units, a supportive environment can make a difference in a patient’s health and the ability for staff to manage their care (Hunt, 2011).
Over 3 million elders have problems with activities of daily living (ADL’s) due to dementia (Hooyman et al, 2015). While most people relate dementia with loss of memory, it is not the only deficit associated with disease. “Dementia is characterized by an impaired identification of incoming stimuli (perceptual deficits), resulting in distorted perceptions,” (van Hoof et al, 2010, p 1247). These perceptual deficits can lead to anxiety, disorientation, and confusion which is likely to prompt paranoid or aggressive behavior.
Patients with Alzheimer’s disease can be sensitive to environmental frustrations because they are more affected by their environment, especially at the early and middle stages of the disease. Behavioral problems associated with dementia can be treated with environmental techniques especially by creating supportive environments. “The environment should be used to reinforce behavior and to help people follow through actions and decisions,” (Hunt, 2011, p 16).

There is a large body of research that supports creating spaces for seniors with dementia by using a number of design techniques. These techniques include:
(Chmielewski, 2014)

  • Residential scale and features
  • Variety of social spaces and personal places
  • Sensory Comprehensibility
    • Proper daylighting and daylight exposure
    • Air quality
    • Acoustical materials
  • Open floor plans
  • Walking paths and healing gardens
  • Independence

Residential Scale and Features

It is important for care facilities to remain as homey as possible (Barnes, 2006) (van Hoof et al, 2010) (Hunt, 2011) (Schwarz and Brent, 1999). The use of art and design to create a more homely space can create a calming environment for seniors. Seniors should have the option to bring their own personal items, including furniture, into their personal living spaces. Small residential scales will also assist with patient’s wayfinding--ability to navigate the space (Passini et al, 2000). Residential features will also help patients feel a sense of belonging while creating a positive mood in which residents may have access to memories.
(Chmielewski, 2014)
 

Variety of Social Spaces and Personal Places

Findings from Barnes’ (2006) study “highlight the importance for design guidance to emphasize the need for a variety of spaces- some quiet, some stimulating, some that foster small groups- enabling residents to exercise their need for personal space,” (p 600). This is because patients in special care units can easily become overly stimulated due to the impaired identification of incoming stimuli associated with dementia. Because patients in special care units spend so much of their time around other patients, it is important to have at least three common spaces of different scales as well as personal places including private bedrooms and quiet sitting areas where patients can still observe other elders (Schwarz and Brent, 1999).

Sensory Comprehensibility

While it is true that Alzheimer’s patients can easily become overly stimulated from sensory stimulations, it is important that the indoor environment is not bland. There are several design techniques that can create a calming yet quality environment. Lighting and “the supply of fresh air, elimination of bad odors, reduction of background noise and other aspects of the acoustical environment are recognized as being important to behavior and well-being of people with dementia,” (van Hoof et al, 2010, p 1259).
Adequate daylight in dementia care settings is one of the most effective environmental techniques for managing behavior in seniors with dementia. Sundowning, “a confused state when persons with Alzheimer’s disease become fatigued later in the day when natural light levels are lower” (Hooyman et al, 2015, p 125) can be offset by design that allows for adequate daylighting in living spaces. An increased level of light can improve cognition, mood, behavior, and vision (van Hoof et al, 2010). Proper lighting can also limit the number of falls for seniors, especially those with dementia.
 
(Chmielewski, 2014)
Air quality can effect a patient’s senses and should be kept in mind during design. “Unpleasant smells are known to cause overstimulation, and should be removed from the home as much as possible,” (van Hoof et al, 2010, p 1252). Materials such as flooring, should be easy to clean to help eliminate unpleasant smells. While some smells may be over stimulating, there is also research as to the benefits of aromatherapy. When smells are familiar to residents, they enjoy them (Schwarz and Brent, 1999) and in some cases may provide cognition benefits. Smells can assist with wayfinding, i.e. the smells of cooking may help residents navigate towards the kitchen.
Acoustical materials also provide an important aspect of design for dementia facilities. Since quieter environments are more calming and enjoyable for residents, facility design should account for acoustical solutions. Sound absorbing flooring, curtains, and wall coverings can limit reverberation and drop overall noise levels. These materials will also make the care unit feel less institutional and homier.

Open Floor Plans

Open floor plans allow increased daylight while also assisting with wayfinding (van Hoof et al) (Passini et al, 2000). Open floor plans allow residents “who have lost their cognitive mapping abilities [to] obtain the information to make their wayfinding decisions,” (Passini et al, 2000, p 697). Open floor plans allow for reference points to be easily seen, a design technique that is especially important to Alzheimer’s patients who operate on a sequential basis. Design techniques that assist with wayfinding increase the independence for residents and lower anxiety and agitation.

Walking Paths and Healing Gardens

(An inspirational healing garden in Toronto)
Access to outdoor environments can increase the overall health and quality of life for seniors with dementia. For facilities that have access to safe and secure outdoor environments, healing gardens can create a sanctuary for patients that often feel confined by their indoor environment (Schwarz and Brent, 1999). Healing gardens can also create sensory stimulation that may help elders reminisce on old memories. Special architectural arrangements including patios, terraces, and gardens can also increase an elder’s exposure to daylight. Outdoor walking paths can transform wandering, which is commonly associated with dementia, into an activity while allowing seniors the benefits of the outdoor environment.
 

Independence

The most important part of designing for dementia is that residents remain as independent as possible. Accessibility techniques such as slip proof flooring, handrails, ­­and ramps will create a safer environment in which staff members are more likely to allow residents to move about by themselves making independent choices (Schwarz and Brent, 1999). Open floor plans, proper daylighting, outdoor access, and personalization of the space can all lead to independence and a better quality of life for residents.
 
The following video discusses dementia friendly design and shows examples of how to utilize it in everyday environments.
 
 

Additional Resources

For more information on this topic, please visit the following websites.

Excellence in Design: http://bit.ly/1i5tUiA

This is a detailed design report that lists great examples of Alzheimer's Care Facilities and dementia design. There are great examples and images.

Dementia Friendly Environments: http://bit.ly/1Og1dPa

The Department of Health, Victoria, Australia provides great information about designing environments for elders with dementia. This page discusses lighting and how colors effect patients and wayfinding, as well as surface and furniture options.

 Dementia Enabling Environments: http://bit.ly/1bxWJSV

This website introduces an interactive tool that walks the viewer through considerations when designing a care environment garden. Such things as outdoor musical instruments are often overlooked when planning a supportive environment, yet they provide many residents with rich sensory stimulation.



Local Agency and Self-Reflection

Senior Solutions
Boise Senior Center
 
I researched a local agency called Senior Solutions in my hometown of Boise, Idaho. Senior Solutions is a non-profit organization the provides services to seniors in Boise, aiming to assist seniors so that they may remain living independently for as long as possible.
 
While researching Senior Solutions, I learned about the Boise Senior Center, a community center that the agency manages. The center provides activities, such as bowling, dancing, and cards, as well as art and education and health activities. The center offers a daily meal, and once a month, birthdays are celebrated. The center assists with providing volunteer opportunities to seniors in the community and even facilitates overnight trips. The center also has a Craft Store and a Thrift Store.
 
(Boise Senior Center)


Activities:

Billiards

Cards

Bowling

Discussion groups

Games

Gardening Club

Income tax assistance

Line Dancing

Single Seniors Group

Prize Bingo

Travel Groups

Volunteer Opportunities

 

Arts and Education:

Computer classes

Driver refresher course

Legal Counsel

Lending library

Art exhibits

Watercolor classes

(Boise Senior Center)

Health Activities

Blood pressure clinics

Exercise classes

Health fair

Foot clinics

Hearing aid clinic

Yoga

 
 
 
 


During our course, I really enjoyed learning about community centers and even discussed starting a community center as a form of social support during my week 9 Discussion Post. While I was unable to visit the center because of the distance between Boise and Moscow, I plan on visiting it this summer when I am home.
 

For more information on Senior Solutions: http://www.seniorsolutions.bz/home

For more information on Boise Senior Center: http://www.boiseseniorcenter.org

 

Self-Reflection

This course has taught me a lot about the study of gerontology, and I have realized a have a passion for not only understanding, but for helping to provide solutions to the social problems associated with aging. The topics I discussed in my blog, phased retirement and dementia friendly design, are only two of the many topics in this course that I found interesting and am passionate about. 

References

References
 
An inspirational healing garden in Toronto. (n.d.). Retrieved from http://www.finegardening.com/inspirational-healing-garden-toronto
AS Activities. (n.d.). Retrieved April 27, 2015, from http://napierpress.com/as-sociology-student-activities
Barnes, S. (2006). Space, choice and control, and quality of life in care settings for older people. Environment and Behavior, 38(5), 589-604. Retrieved from Sage Journals.
Boise Senior Center. (n.d.). Retrieved April 27, 2015, from http://www.boiseseniorcenter.org
Chmielewski, E. (2014, June 1). Excellence in Design: Optimal Living Space for People with Alzheimer's Disease and Related Dementias. Retrieved from http://www.alzfdn.org/documents/ExcellenceinDesign_Report.pdf

Creating a Care Environment Garden. (2014). Retrieved April 27, 2015, from http://www.enablingenvironments.com.au/GardensandNature/CreatingCareEnvironmentGarden.aspx
Dementia-Friendly Environments. (2104, July 16). Retrieved April 27, 2015, from http://www.health.vic.gov.au/dementia/changes/interior-design.htm
Duska, R. (2013). Baby Boomers, Retirement, and Financial Services. Journal Of Financial Service Professionals, 67(3), 13-16.
Hooyman, N., Kawamoto, K., & Kiyak, H. (2015). Aging matters: An introduction to social gerontology. Boston: Pearson.
Home - Encore.org. (2014). Retrieved from http://encore.org/
Hunt, L. (2011). ENVIRONMENTS DESIGNED TO HEAL. Nursing Older People, 23(1), 14-17.
Passini, R., Pigot, H., Rainville, C., & Tetreault, M. (2000). Wayfinding in a nursing home for advanced dementia of the Alzheimer's type. Environment and Behavior, 32(5), 684-710. Retrieved from Sage Journals.

Phased Retirement: Another "Do As We Say, Not As We Do" Moment. (2014, August 28). Retrieved from http://benefitsbryancave.com/phased-retirement-another-do-as-we-say-not-as-we-do-moment/
Phased Retirement: What You Need to Know. (n.d.). Retrieved, from http://www.nextavenue.org/blog/phased-retirement-what-you-need-know

Recareering - Second Careers, Jobs for Older Workers, Semi-Retirement, Encore Careers for Boomers & Seniors - AARP. (2014). Retrieved April 27, 2015, from http://www.aarp.org/work/working-after-retirement/

Rose, B. (2010). Not done yet. ABA Journal, 96 (4), 36-41.
Salford Institute for Dementia. (n.d.). Retrieved from http://www.salford.ac.uk/salford-institute-for-dementia
Sargent, L., Bataille, C., Vough, H., & Lee, M. (2011). Metaphors for retirement: Unshackled from schedules. Journal of Vocational Behavior, 79(2), 315-324. doi:10.1026/j.jvb.2011.03.002
Schwarz, B., & Brent, R. (1999). Life-Quality Alzheimer Care in Assisted Living. In Aging, Autonomy, and Architecture: Advances in Assisted Living (pp. 110-129). Baltimore: The John Hopkins University Press.
SENIOR SOLUTIONS. (n.d.). Retrieved April 27, 2015, from http://www.seniorsolutions.bz/home
Tacchino, J. I. (2013). Will Baby Boomers Phase into Retirement?. Journal Of Financial Service Professionals, 67(3), 41-48.
 
Van Hoof, J., Kort, H., Duijnstee, M., Rutten, P., & Hensen, J. (2010). The indoor environment and the integrated design of homes for older people with dementia. Building and Environment, 45(5), 1244-1261. Retrieved from Science Direct.