Deck 5: Where People Live: Person-Environment Interactions

Question 1

Special care units provide a supportive environment for people with moderate to severe dementia.

Answer 1

True

Question 2

Support services such as transportation, socialization, and daily checks are characteristics of assisted living facilities.

Answer 2

True

Question 3

Research indicates that residents in assisted living facilities have higher well-being when the decision to live there was made by other family members along with the suggestions of a medical professional.

Answer 3

False

Question 4

Assessing a nursing home resident's ability to make medical treatment decisions can be conceptualized as a problem involving the fit between the original intent of the law and the resident's physical capacity.

Question 5

At any given point in time, less than 5% of adults over 65 live in nursing homes.

Question 6

The person-centered theory suggests that the facilities focus on the individual.

Question 7

Schooler argued that the presence of social support systems can greatly reduce the impact of environmental stressors.

Question 8

Accessory dwelling units (ADUs) provide independence and support for aging in place based on a congregate housing model.

Question 9

Patronizing speech is a way of speaking with older adults that is termed secondary baby talk, and infantilization is a pattern of speaking to older adults based on stereotypes of incompetence and dependence.

Question 10

The main reason for institutionalization of nursing home residents is because of their lack of economic resources.

Question 11

Based on person-environment interactions, adaptation level is the point when competence and environmental press are in balance.

Question 12

According to Langer's social¬psychological perspective approach to the person-environment issue, the key to residents' well-being is the degree to which they have medical attention available.

Question 13

Special care units require special training in dementia.

Question 14

Competence is the theoretical upper limit of a person's capacity to function.

Question 15

The Pioneer Network focuses on changing the culture of aging in America regardless of where older adults live.

Question 16

Special care units having residents with cognitive impairment wear wrist or ankle bands that trigger alarms if they wander beyond a certain point or exit the facility.

Question 17

Less than 28% of adult day care facilities are sponsored by nonprofit organizations.

Question 18

In the preventative model, older adults' adaptation depends on both their perceptions of the environment and their attempts to cope.

Question 19

In the United States, there are more than 30,000 assisted living facilities.

Question 20

Everyday competence is a person's actual ability to perform a wide range of activities considered essential for independent living.

Question 21

A new spin on an old concept to give an older relative both privacy and proximity to family is known as a(an)

A) accessory dwelling unit.
B) cluster housing.
C) adult day care.
D) assisted living.

Question 22

Home modification is an example of

A) increasing one's competence.
B) lowering environmental press.
C) maladaptive coping.
D) decreasing corrective adaptation.

Question 23

One of the consequences of infantilizating speech is

A) residents become resentful.
B) residents become less dependent.
C) resident become more engaged with staff.
D) residents become more satisfied with their care.

Question 24

The person centered planning approach is based on promoting residents' well-being by increasing their perceived level of personal control and treating them with

A) control.
B) respect.
C) support.
D) importance.

Question 25

Environmental press refers to the physical, interpersonal, or ________ demands that environments put on people.

A) cognitive
B) behavioral
C) social
D) intellectual

Question 26

The law that mandates that all facilities provide written information to people about their right to make medical treatment decisions and create advance directives is known as the

A) American with Disabilities Act.
B) Geriatric Ethics Act.
C) Patient Self-Determination Act.
D) Nursing Home Bill of Rights.

Question 27

Willis' model proposes that the primary outcomes of everyday competence are

A) independent living and absence of chronic disease.
B) emotional and cognitive well-being.
C) low environmental press and high competence.
D) psychological and physical well-being.

Question 28

The four types of nursing home care generally recognized include all of the following except

A) informal community care.
B) intensive skilled nursing care.
C) intermediate care.
D) custodial care.

Question 29

Better care for residents, better cooperation between CNAs and nurses, and reduced turnover are some of the results of

A) Schooler's survey of residents living in short-term care facilities for information about the quality of their care.
B) effective resident generated group complaints to long-term care facility leaders.
C) certified nurse aides working in nursing homes being provided with training and empowered as a way to deal with environmental stressors.
D) political action committee leaders lobbying elected representatives to enact increases in federal oversite of nursing homes.

Question 30

The Eden Alternative lists which of the following as accounting for the bulk of suffering among older adults?

A) Boredom
B) Loneliness
C) Helplessness
D) All of these are correct

Question 31

A European American woman, over age 85, was recently admitted to a hospital, has problems with IADLs, and has no siblings or children living nearby. This describes the typical

A) nursing home resident.
B) Alzheimer's patient.
C) adult day care client.
D) elderly person who lives independently.

Question 32

The style of speech most people adopt when speaking to older adults is based on the stereotypes of dependence and incompetence. This in turn conveys to older adults a sense of helplessness and a decline in their abilities. This has often been referred to as

A) secondary baby talk.
B) patronizing speech.
C) a communication predicament.
D) inappropriate speech predicament.

Question 33

The profile of the typical nursing home resident is changing as

A) more older adults of color become residents of long-term care facilities.
B) the average age of long-term care facilities is going down
C) the ratio of women to men has reversed and now more men are in long-term care
D) the costs of long-term care facilities has started to decrease.

Question 34

What is the relationship between nursing home staff satisfaction and resident satisfaction?

A) There is no relationship between these variables.
B) As staff satisfaction increases, resident satisfaction increases.
C) As staff satisfaction increases, resident satisfaction declines.
D) As staff satisfaction decreases, resident satisfaction increases.

Question 35

Figuring out the optimal "fit" where the individual's competence and the environmental press are in the best balance rests on the ability of all concerned to be _______________ about the individual's _____________.

A) objective; emotional needs
B) subjective; competence
C) objective; competence
D) subjective; emotional needs

Question 36

When people encounter changes in their particular combinations of environmental press and competence, they respond with

A) depression or anger.
B) proactivity or anger.
C) proactivity or docility.
D) tend or befriend.

Question 37

The competence and environmental press approach, the preventive and corrective proactivity model (PCP), and the stress and coping framework all agree that

A) the person is the most critical factor.
B) the environment is the most critical factor.
C) one type of environment can serve all older peoples' needs adequately.
D) no one environment meets everyone's needs.

Question 38

The basic assumption of person-environment interactions is that

A) the person is a function of behavior and the environment.
B) behavior is a function of the person and the environment.
C) environment is a function of the person and behavior.
D) the person, behavior, and environment are unrelated.

Question 39

A first step to take when deciding on an optimal environment is to decide whether the individual has significant cognitive or__________impairment requiring intervention.

A) physiology
B) social
C) mental
D) physical

Question 40

Based on the Centers for Medicare and Medicaid Service "Five-Star Quality Rating System," each of the following are key quality factors for choosing a nursing home except

A) quality of life for residents.
B) quality of care.
C) safety.
D) cost.

Question 41

Housing options for older adults that provide a supportive living arrangement for people who need assistance with personal care, but who are not so impaired they need 24-hour care, describes which of the following?

A) Nursing home
B) Assisted living
C) Congregate housing
D) Adult day care

Question 42

Eighty-two-year-old Robert is recovering from an ATV accident from which he now has numerous broken ribs, a broken arm, and a surgically reconstructed ankle. Where is Robert most likely living at the moment?

A) A nursing home
B) An assisted living facility
C) In congregate housing
D) At home by himself

Question 43

Nursing home placement decisions are often made in reaction to

A) opening up of a space at a nursing home.
B) the onset of a slow progressing disease.
C) crisis, such as an impending discharge from a hospital.
D) making a long-term relocation to a planned destination.

Question 44

Lou and NG showed cognitive competence, closeness to family, and relationship-based coping are helping _______________ older adults who live alone to deal effectively with loneliness.

A) Korean
B) Chinese
C) Taiwanese
D) Japanese

Question 45

The Lawton-Nahemow competence-environmental press model accounts for all of the following except

A) why people choose the activities they do.
B) how well people adhere to medication regimens.
C) the stability of relationships between the elderly and their caregivers.
D) how people adapt to changing housing needs over time.

Question 46

The Gerontological Society of America suggests all of the following for making visits to long-term care facility residents more pleasant except

A) facing older adults when you speak to them.
B) asking open-ended questions.
C) that the visitor should control the visit to maximize the amount of conversation.
D) concentrating on the older adult's expertise and wisdom by asking for advice on a life problem he or she knows a lot about.

Question 47

An apartment complex of older individuals that provides some level of services, such as shared meals, to clients is best described as

A) adult day care.
B) congregate housing.
C) auxiliary dwelling units.
D) assisted living.

Question 48

According to Willis' model of everyday competence, one's health and the availability of health insurance would be considered

A) antecedents.
B) mechanisms.
C) components.
D) outcomes.

Question 49

According to your textbook, older adults who age in place form strong emotional and cognitive attachment with their residences that help transform a _________into a ______________.

A) house; home
B) problem; solution
C) residence; status symbol
D) burden; support system

Question 50

Allowing residents to decorate their own rooms, choosing what they want to eat from a buffet, and deciding whether they want to take a shower or a bath, is a description of which of the following?

A) Assisted living
B) Person-environment planning
C) Person-centered planning
D) Staff programs.

Question 51

All of the following are essential in a special care unit except

A) specially designed elements in hallways and rooms.
B) special training for staff to work with residents who have dementia.
C) wrist or ankle bands for residents to allow mobility yet provide safety.
D) special medication and soft restraints for all residents.

Question 52

According to Lawton and Nahemow, the area where press level is average for a given level of competence and where behavior and affect are normal is called

A) adaptation level.
B) psychosocial adjustment.
C) congruence points.
D) balance points.

Question 53

Deciding on the best option for an elderly person entails assessing the ability of family members or friends to provide__________or care.

A) finances
B) support
C) safety
D) love

Question 54

Secondary baby talk, also called ___________, involves the unwarranted use of a person's first name, terms of endearment, simplified expressions, and an assumption that the recipient has no memory.

A) seniorspeak
B) simplespeak
C) patronizing speech
D) elderspeak

Question 55

Special care units in nursing homes have been designed specifically to best suit the needs of clients with

A) agitation and aggression.
B) drug dependency.
C) clinical depression.
D) dementia.

Question 56

Evidence is clear that compared with keeping relatives with cognitive impairment at home, good adult day care programs can do all of the following except

A) reduce problematic behaviors.
B) lower the need for psychotropic medication in clients.
C) result in lower reports of caregiving burden among caregivers.
D) increase family member efforts to clearly seek what is best for their loved one.

Question 57

The circumstances that facilitate feeling at "home" while living in a nursing home include all of the following except

A) participating in the placement decision.
B) having prior knowledge of the facility.
C) focusing on family and social relationships.
D) focusing on autonomy and personal objects.

Question 58

Ryan and her colleagues' Communication Enhancement Model emphasizes communication with older adults must be based in part on

A) recognizing individualized cues.
B) a focus on psychological distress.
C) a relinquishment of power by those needing services in long-term care facilities.
D) the reduction of high-level vocabulary to low-level vocabulary when communicating with older adults in long-term care facilities.

Question 59

Many older adults compensate in their environments in order to effectively cope. Or, they select a different place to live. This description fits with the

A) proactive versus docility theory.
B) congruence-environment model.
C) independent versus dependent living model.
D) competence-environment press model.

Question 60

In Kahana and Kahana's model (2006), helpful factors, such as having friends and having a positive outlook on life, are called

A) Component B.
B) life factors.
C) Component F.
D) buffers.

Question 61

Schooler's stress and coping paradigm is based upon which theory?

A) The life-span perspective
B) The neuroscience approach
C) Programmed cell death theory
D) Lazarus and Folkman's cognitive theory

Question 62

Whether someone believes that he or she is in control of a situation influences how competent that person is. In Willis' model of everyday competence, this is termed

A) an antecedent.
B) a mechanism.
C) a component.
D) an outcome.

Question 63

Nursing home residents who have high perceived personal control show improvements in well-being and activity levels and they

A) sleep more.
B) live longer.
C) return home faster.
D) use more medications.

Question 64

Research-based staff training at the best special care units includes all of the following except

A) appropriate and effective communication techniques.
B) appropriate methods for handling the intensive paperwork associated with caring for older adults with moderate to severe cognitive impairment.
C) appropriate techniques for handling sexuality in persons with dementia.
D) behavior management techniques to address aggressive or agitated behavior.

Question 65

Having a _________ provides a strong source of self-identity.

A) home
B) doctor
C) friend
D) pet

Question 66

Which provides older adults who need skilled nursing care a small, home-like environment that shifts the focus from a large facility to a more home-like setting?

A) Pioneer Network
B) Green House Project
C) Eden Alternative
D) None of these are correct

Question 67

Ecology of aging, or _________, seeks to understand the dynamic relations between older adults and the environments they inhabit.

A) psychology of adaptation
B) aging in place
C) gerontology
D) environmental psychology

Question 68

Willis' model supports the idea that older adults can age in place to the extent

A) their everyday competence permits.
B) cultural stereotypes permit.
C) social policy permits.
D) healthcare policies permit.

Question 69

Residents generally pay the cost of care in assisted-living facilities. This amounts to an average cost of ___________ per year in 2016.

A) $10,000
B) $45,000
C) $75,000
D) $100,000

Question 70

The major reason for placement in a nursing home is

A) lack of other caregivers.
B) financial.
C) health.
D) personal choice.

Question 71

Which well-designed unit cares for people with dementia and provides a supportive and therapeutic set of programs that help the person function at the highest level possible?

A) Special care
B) Nursing home
C) Congruence
D) Traditional

Question 72

Unlike long-term care facilities, cluster housing developments are not

A) covered by Medicaid or other insurance.
B) effective in reducing environmental press.
C) focused on being cost-effective.
D) a research-based way to remain in a familiar environment.

Question 73

In deciding what the optimal housing arrangement might be for an older person (at home, in cluster housing, in assisted living, etc.), one particularly critical component in making this decision is

A) the physician's assessment of what is best.
B) the cost of the various options.
C) the involvement of the person in question, to the extent possible.
D) the range of services provided at each facility.

Question 74

Nursing homes using a person-centered approach note

A) an increase in needed medications
B) an increase in the need for the use of soft restraints
C) a substantial decline in the number of residents who are incontinent.
D) a decrease in the residents' sense of well-being.

Question 75

In Lawton and Nahemow's model, the less competent the person is, the greater the

A) adaptation level.
B) use of preventive adaptations.
C) impact of environmental factors.
D) proactivity.

Question 76

Laura, who turned 85 on her last birthday, lives in an area in which women are frequently victims of violent crimes, but she was the top student in her self-defense for the elderly class. In terms of Lawton and Nahemow's model, she has

A) low environmental press.
B) high alienation.
C) high competence.
D) unrealistic expectations.

Question 77

Most adult day care clients are___________over the age of___________.

A) men; 65
B) women; 65
C) women; 70
D) men; 85

Question 78

Everyday competence is a person's

A) actual ability to perform a wide range of tasks.
B) potential ability to perform a wide range of tasks.
C) ability to get along with others in a community-based setting.
D) ability to satisfactorily perform ADLs.

Question 79

A recent study (Street & Burge, 2012) found that assisted-living residents' well-being was related to whether the decision to live there was under their control and

A) the length of time they had lived in the facility.
B) whether the facility was located within walking distance of businesses and shopping.
C) the quality of relationships they developed with other facility residents.
D) the quality of extracurricular activities offered at the facility.

Question 80

The idea of aging in place reflects a balancing of environmental press and competence through ___________ and ____________.

A) independence; interdependence
B) acceptance; defiance
C) selection; compensation
D) picking; choosing