Overview of the Opportunities and Challenges of Aging

Course Description

This course addresses the special challenges and opportunities associated with aging with a special focus on growing old in small towns and rural communities. In addition, it centers on the assessment, treatment, and service delivery implications of gerontological practice for a range of health and human service practitioners. The experience of aging, gerontological theories of aging, and current health and human service policies and programs which impact older adults and their families will be considered. The role and status of older adults as a population group and a potential patient/client group will be considered recognizing that elders bring both needs and resources to families, communities, and the professional helping relationship. This course partially satisfies the requirements for obtaining the University of Maine’s Interprofessional Graduate Certificate in Gerontology as well as the University of Maine School of Social Work’s Program in Leadership in Rural Gerontological Practice.

Course Objectives

In this course, students will:

• Demonstrate self-awareness and understand the concept of interdisciplinary professional practice in addressing the needs and resources of older adults and their informal
• Integrate concepts of demography, migration, culture, tradition, and family structure in interpreting the aging experience generally and the rural aging experience in
• Assess similarities and differences in social and health services provision and the organization of health and human services for older
• Analyze the status of health and social policies, programs, entitlements, and benefits for older adults generally, and rural-residing older adults in particular, in terms of their adequacy and
• Assess the impact of cultural, racial, ethnic, and other forms of diversity and difference on the aging
• Interpret rural versus non-rural older adult issues in the context of the potential needs and assets that such individuals bring to family and community interactions and the client/patient-professional work
• Demonstrate an understanding of the range of interdisciplinary health professional roles and functions performed when these health professionals deliver gerontological
• Recognize and analyze the ethical challenges that may surface during the course of planning and delivering gerontological and geriatrics service generally, and delivering those services in rural settings in

Course Outline

Week (1) 9/1/14          Introduction and Overview: The Phenomenon of Growing Old in America

Review of course expectations and requirements. The demographics of aging.

Assignment #1: Take the “Facts on Aging Quiz” (Parts 1 and 2) located on the front page of the First Class Conference and in the Week01 folder of your GRN500 2014 SWK584 (Kaye) First Class conference by Friday, 9/5/14 at 12 midnight.

Readings:

Administration on Aging. A Profile of Older Americans – 2013 (Retrieved from:

http://www.aoa.gov/Aging_Statistics/Profile/Index.aspx on August 28, 2014)

Kaye, L.W. “Rurality, aging and social work: Setting the context” (pp. 3-18, Chapter 1). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

Kirschner, A., Berry, E.H., and Glasgow, N. (January, 2009). The Changing Demographic Profile of Rural Areas. Rural New York Minute, pg. 1.

National Rural Health Association. (February, 2013). Elder Health in Rural America, pp. 1-8.

Week (2) 9/8/14          The Aging Experience: Family, Gender, Cultural, Racial, and Ethnic Traditions and Values

Elder tradition, values, and customs. The importance of history in understanding the aging experience. Gender, cultural, racial, and ethnic differences in help seeking behavior.

Readings:

Goins, R.T. (September-October 2012). “Eldercare in Indian Country: in the long term, on their own (pg.13). Aging Today.

Kaye, L.W., Crittenden, J.A., and Charland, J. (Spring, 2008). “Invisible older men: What we know about older men’s use of healthcare and social services,” Generations, XXXII (1), pp. 9-14.

Week (3) 9/15/14        Delivering Team-Based, Integrated Care for Older Adults

The role and function of an interdisciplinary team in the delivery of geriatric care. Geriatric care coordination and management.

Service integration.

Guest Speaker: Jaime L. Boyington, MSW, LCSW, The Acadia Hospital and Eastern Maine Medical Center

Readings:

Ferretti, L.A., McCallion, P., Paeglow, R., and Kintner, E., “Interdisciplinary community practice: Patient activation in a community context,” In Wykle, M.L. & Gueldner, S.H. (Eds.), (2011). Aging Well: Gerontological Education for Nurses and Other Health Care Professionals. Sudbury, MA: Jones & Bartlett Learning, pp. 63-74.

Kaye, L.W. (Ed.). (Winter, 2002). “Geriatric care management with the rural elderly,” A special issue of the Geriatric Care Management Journal, 12 (1), Winter, 2002.

Quinn, M.E., Kolomer, S. and Burden, J., “Place, reminiscence, and interdisciplinary gerontological practice,” In Wykle, M.L. & Gueldner, S.H. (Eds.), (2011). Aging Well: Gerontological Education for Nurses and Other Health Care Professionals. Sudbury, MA: Jones & Bartlett Learning, pp. 439-455.

Week (4) 9/22/14        Rural Practice with Older Adults and Special Elder Subgroups: Theory, Models, and Special Populations

Theoretical perspectives of aging and relationships in rural communities. Concepts of social exchange, family systems and roles, continuity, and activity. Native American, African American, Latino, and disabled rural elders.

Readings

Applewhite, S.L. and Torres, C. “Rural Latino elders” (pp. 151-174, Chapter 9). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

Barusch, A. and TenBarge, C. “Indigenous elders in rural America” (pp. 121-136, Chapter 7). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

DePoy, E. and Gilson, S.F. “Rural disabled elders” (pp. 175-190, Chapter 10). In Butler,

• and Kaye, W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

Gueldner, S.H., Britton, G.R., and Terwilliger, S. “Giving Voice to Vulnerable Populations: Rogerian Theory,” In Wykle, M.L. & Gueldner, S.H. (Eds.), (2011). Aging Well: Gerontological Education for Nurses and Other Health Care Professionals. Sudbury, MA: Jones & Bartlett Learning, pp. 199-207.

Rasheed, M.N. and Rasheed, J.M. “Rural African American older adults and the black helping tradition” (pp. 137-150, Chapter 8). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

Week (5) 9/29/14        Older Adult Vulnerability and the Potential for Abuse

Issues of elder neglect, abuse, and exploitation. The stigma and lack of reporting of elder abuse. Recognizing the symptoms.

Assessment and intervention approaches.

Guest Speaker: Rick Mooers, Former Director, Maine Adult Protective Services

Readings:

Bergeron, L.R. and Gray, B. (January, 2003). “Ethical dilemmas of reporting suspected elder abuse,” Social Work, 48 (1), pp. 96-105.

Nerenberg, L. (2001). “Developing a service response to elder abuse,” Generations, XXIV, pp. 86-92.

Week (6) 10/6/14        Elder Caregiving

The impact of rural living on the elder caregiving experience. Gender differences and similarities in family caregiving style. Clinical issues in working with family caregivers. Grandparents as caregivers. The special case of men who help.

Readings:

Butler, S.S., Turner, W., Kaye, L.W., Ruffin, L., and Downey, R. (2005). “Depression and caregiver burden among rural elder caregivers,” Journal of Gerontological Social Work, 46 (1), pp. 47-63.

Crittenden, J., Adle, M., Kaye, L.W., and Kates, B. (2009). “Substance abuse exposure among youth being raised by grandparents in rural communities: Findings from a Three- Year Evaluation,” Journal of Intergenerational Relationships, 7 (2-3), pp. 291-305.

Kaye, L.W. (2002). “Service utilization and support provision of caregiving men” (pp. 359-378, Chapter 16). In Kramer, B.J. and Thompson, E.H., Men as Caregivers: Theory, Research, and Service Implications. New York, NY: Springer Publishing Company.

Montgomery, R.J.V. and Kosloski, K. (Spring, 2009). “Caregiving as a process of changing identity: Implications for caregiver support,” Generations, 33 (1), pp. 47-52.

Week (7) 10/13/14      Death, Dying, Bereavement and Hospice Care

The dying experience. Clinical issues surrounding death, dying and bereavement. Hospice services for terminal ill patients and their relatives.

Guest Speaker: Anne Donovan-Fortier, MS, MSW, LCSW, Hospice Counselor, Beacon Hospice.

Readings:

Jones, S.H. (September-October 2008). “Managing difficult behaviors in hospice patients,” Social Work Today, 8 (5), p 28.

Lopez, (November-December 2007). “Honoring cultural diversity at the end of life,” Social Work Today, 7 (6) p. 36.

Week (8) 10/20/14      The Current Service Network for Elders and their Families

                     The health and social entitlements and benefits available to elders. Service usage patterns among older adults in rural America.

Guest Speaker: Dyan Walsh, MSW, Director of Family and Community Services, Eastern Area Agency on Aging

Readings:

Butler, S.S. and Webster, N.M. “Advocacy techniques with older adults in rural environments,” (pp. 59-74, Chapter 4). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

Cordisco, S. and Berry, M.M. “The changing face of aging: New challenges, new opportunities,” In Wykle, M.L. & Gueldner, S.H. (Eds.), (2011). Aging Well: Gerontological Education for Nurses and Other Health Care Professionals. Sudbury, MA: Jones & Bartlett Learning, pp. 75-96.

Week (9) 10/27/14      Living with Alzheimer’s Disease and Related-Disorders

Guest Speaker: Amy E. Cotton MSN, FNP-BC, FNGNA, FGNLA, Director of Operations, Rosscare, Eastern Maine Health Systems

Readings:

Podgorski, C. and King, D.A. (Spring, 2009). “Losing function, staying connected: Family dynamics in provision of care for people with dementia,” Generations, 33 (1), pp. 24-29.

Week (10) 11/3/14      The Health and Mental Health of Older Adults: Implications for Multidisciplinary Practice

Alcohol and substance use, misuse, and abuse. Loneliness and aloneness. Depression and anxiety. The capacity for love and intimacy. The issue of isolation in rural America.

Guest Speaker: Clifford M. Singer, MD, Medical Director, Geriatric Mental Health and Neuropsychiatry Program, Acadia Hospital and Eastern Maine Medical Center

Assignment #2 Due the Week of 11/3/14 (Week 10) by Friday, 11/7/14 at 12 midnight.

Readings:

Rathbone-McCuan, E. and Bane, S. Rural mental health: A discussion of service capacity building for rural elders” (pp. 301-312, Chapter 17). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities.

New York, NY: Haworth Social Work Practice Press.

Week (11) 11/10/14    Interdisciplinary Perspectives in Gerontological and Geriatrics Practice

The view from nursing, social work, nutrition, and speech and language pathology and audiology. The special cases of geriatric care management, bereavement, hospice and palliative care, adult day care, home-based care.

Readings:

American Speech-Language-Hearing Association. (2011). Communication disorders in older Americans. File:///C:/DOCUME~1/LENARD~1/LOCALS~1/Temp/fcctemp/Communication%20Dis roders%20in%20Older%20Americans%202.webarchive

Canadian Association of Speech-Language Pathologists and Audiologists. (2005). Communication Disorders and Aging: Fact Sheet. CASLPA-ACOA.

Cassity-Caywood, W. and Huber, R. “Rural older adults at home” (pp. 229-246, Chapter 13). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

Coleman, E.A. (2011). “There remains no ‘I’ in team.” Nursing Outlook, 59, pp. 250- 251.

Young, H.M., Seigel, E.O., McCormick, W.C., Fulmer, T., Harootyan, L., and Dorr, D.A. (2011). “Interdisciplinary collaboration in geriatrics: Advancing health for older adults.” Nursing Outlook, 59, pp. 243-251.

Week (12) 11/17/14    Ethical Issues in Work with Rural Elders

The ethical complexities of multiple relationships in rural communities. Multi-level, contextual, ethical analysis. Older adults as service consumers.

Readings:

Binstock, R.H. “Ethical, moral, and policy challenges in our aging society,” In Wykle, M.L. & Gueldner, S.H. (Eds.), (2011). Aging Well: Gerontological Education for Nurses and Other Health Care Professionals. Sudbury, MA: Jones & Bartlett Learning, pp. 3-16.

Bushy, A. “Ethics: What geriatric care managers in rural practice should know.” In Kaye, L.W. (Ed.), (Winter, 2002). Geriatric Care Management with the Rural Elderly, A special issue of the Geriatric Care Management Journal, 12 (1), pp. 7-10.

Healy, T.C. “Ethical practice issues in rural perspective” (pp. 265-286, Chapter 15). In Butler, S.S. and Kaye, L.W. (Eds.). (2003). Gerontological Social Work in Small Towns and Rural Communities. New York, NY: Haworth Social Work Practice Press.

“Controversy 4: Should we ration health care for older people?” In Moody, H.R. (2010). Aging: Concepts and Controversies (6^th edition).Thousand Oaks, CA: Pine Forge Press, pp. 163-194.

“Controversy 5: Should families provide for their own?” In Moody, H.R. (2010). Aging: Concepts and Controversies (6^th edition).Thousand Oaks, CA: Pine Forge Press, pp. 195- 228.

“Controversy 6: Should older people be protected from bad choices?” In Moody, H.R. (2010). Aging: Concepts and Controversies (6^th edition).Thousand Oaks, CA: Pine Forge Press, pp. 229-256.

“Controversy 7: Should people have the choice to end their lives?” In Moody, H.R. (2010). Aging: Concepts and Controversies (6^th edition).Thousand Oaks, CA: Pine Forge Press, pp. 257-286.

Week of 11/24/14       Thanksgiving Recess (no classes)

Week (13) 12/1/14      Health Promotion and Productive Aging: Civic Engagement and Voluntarism

Resource, capacity, and assets in old age. An alternative frame of reference for examining the aging experience and growing old in rural communities. Challenges to productive aging. What is successful aging? The multiple dimensions of productive aging. Productive aging professional skill sets.

Readings:

Davidhizar, R., Eshleman, J., and Moddy, M. (2003). “Health promotion for aging adults.” Geriatric Nursing. 23 (1), pp. 28-34.

Glass, T.A. (2003). “Assessing the success of successful aging.” Annals of Internal Medicine. 139 (5), pp. 382-383.

Kaye, L.W. “The emergence of the new aged and a productive aging perspective” (pp. 3- 17, Chapter 1). In Kaye, L.W. (Ed.). (2005). Perspectives on Productive Aging.

Washington, DC: NASW Press.

Mezey, M. and Fulmer, T. (2002). “Successful aging: Preserving function and choice.” American Journal of Nursing. 02 (8), p. 11.

Morrow-Howell, N., Carden, M., and Sherraden, M. “Productive engagement of older adults: Volunteerism and service” (pp. 83-105, Chapter 5). In Kaye, L.W. (Ed.). (2005). Perspectives on Productive Aging. Washington, DC: NASW Press.

Pierce, C & Seibold-Simpson, S. “Promoting healthy aging with attention to social capital,” In Wykle, M.L. & Gueldner, S.H. (Eds.), (2011). Aging Well: Gerontological Education for Nurses and Other Health Care Professionals. Sudbury, MA: Jones & Bartlett Learning, pp.

181-190.

Resnick, B. (2008). “Resilience in aging: The real experts.” Geriatric Nursing. 29 (2), pp. 85-86.

Week (14) 12/8/14                  Summary and Wrap-up

Assignment #3 Due the Week of 12/8/14 by Friday, 12/12/14 at 12 midnight.

Course Requirements

The requirements of the course are:

1. Completion of assigned readings during the period

2. Participation in on-line class discussion of the readings, lectures, and assignments in the period assigned that reflect thoughtful and respectful contributions both in the form of questions and responses including one (1) extensive post each week subject to instructor assessment using the provided grading rubric. (If there are occasions when the student will not be able to participate in on-line discussion because of illness or other personal demands, the student is to notify the instructor).

3. Completion of written assignments in the period assigned and deposit of student assignments in the drop box for the week in which that assignment is Written assignments will show evidence of:

• Systematic analysis (applying and integrating theoretical perspectives into the assessment of geriatric practice).
• Being well organized with proper adherence to the rules of grammar, spelling, and
• The use of double spacing using APA Unless otherwise noted, assignments require a reference list and citations in APA format. A full copy of the APA style manual is in the Folger Library. Summaries of APA style are also available on the internet. Students may also consult professional and scholarly journals that adhere to APA style requirements.
• The use of inclusive and person-first language and adherence to other rules related to
• The use of word processing programs for written
• Delivery on the assigned date in the designated drop Students who have serious personal circumstances that affect their ability to meet the assigned date may request an extension.

*Assignment dates and the schedule for required readings as detailed in this syllabus are subject to change at the discretion of the instructor. Any changes will be based on the instructor’s judgment of how best to insure the progress of the class in meeting the course objectives.

Grading and Course Assignments

Assignments                                                                                         Due Date                  % of Grade

Submission of one (1) extensive post each week to the                      Weekly                             30%

Discussion Forum in response to lectures, readings, other                throughout

student posts, and aging-related news reports in the media (by              the

Friday at midnight of the week it is due) in addition to less               semester

extensive posts on course related topics and in response to

other students comments (see the grading rubric for the

extensive weekly post in the First Class conference)

#1  Complete Facts on Aging Quiz (Parts 1 & 2)                                Weeks 9/1/14                   10%

the week of 9/1/14 and share your impressions                              and 9/8/14

in posts during the week of 9/8/14

#2  Older adult interviews paper                                                          Week of 11/3/14              30%

#3  Controversy position paper                                                            Week of 12/8/14              30%

Total                                                                                                                                           100%

Plus/Minus grading may be used in issuing assignment and final grades. Papers should be deposited in the assignment drop box by Friday midnight of the week they are due.

Request for Incomplete

A request for an incomplete grade will be considered if the student is experiencing serious illness or other life stresses that interfere significantly with meeting course requirements and he or she has completed at least two thirds of the course work satisfactorily. Written request for an incomplete is required.

Academic Integrity

Academic dishonesty includes cheating, plagiarism and all forms of misrepresentation in academic work, and is unacceptable at The University of Maine. As indicated in the University of Maine’s on-line “Student Handbook,” plagiarism (the submission of another’s work without appropriate attribution) and cheating are violations of The University of Maine Student Conduct Code. An instructor who has probable cause or reason to believe a student has cheated may act upon such evidence, and should report the case to the supervising faculty member or the Department Chair for appropriate action.

Disabilities (ADA) Statement

Students with disabilities who may need services or accommodations to fully participate in this class should contact Ann Smith, Director of Disability Services in 121 East Annex, (voice) 581-2319, (TTY) 581-2325 as early as possible in the semester.

Class Disruption

In the event of an extended disruption of normal course activities, the format for this course may be modified to enable its completion within its programmed time frame. In that event, you will be provided an addendum to the syllabus that will supersede this version.