Academic literature on the topic 'Autonomy (Psychology) in old age Australia'

ABSTRACTAutonomy is a pervasive concept in Western lifestyles today. However, people in the fourth age are assumed not to be autonomous but dependent on other people. The data of this study consisted of interviews with Finnish community-dwelling 90–91-year-old people. The study aim was to examine how these people see their own autonomy in their everyday lives. The analysis was based on membership categorisation analysis. Our respondents considered their autonomy through three distinct themes. Functional ability was considered in terms of being physically capable of managing daily tasks. Independence in decision making was based on material and financial self-sufficiency and on the respondents' supposition that they were capable of making decisions due to an absence of memory disorders. Additionally, autonomy was considered as contesting norms of age-appropriateness. Among respondents, chronological age seemed to have been replaced by functional and cognitive ability as a definer of categorisations; age-others became ability-others. Our study revealed that the perceptions of autonomy also included gendered features as they were linked with differing gendered ideals, roles and life domains of women and men. The results highlight the internal diversity among the oldest old and challenge the third/fourth age division. Instead, they suggest the existence of a certain ‘grey area’ within old age, and urge an analysis on the subtle meaning making involved in older people's constructions of age-categorisations.

ABSTRACTBackground: Few studies have specifically examined mental health service delivery to persons aged over 84 years, often described as the “old” old. Our aim was to compare mental health service provision in Australia to persons aged 85 years and over with the “young” old and other age groups. We hypothesized that the “old” old would differ from the “young” old (65–84 years) by diagnostic category, rates of specialist psychiatric hospital admission, and use of Medicare funded psychiatric consultations in the community.Methods: Mental health service delivery data for 2001–02 to 2005–06 was obtained from Medicare Australia on consultant psychiatrist office-based, home visit and private hospital services subsidized by the national healthcare program and the National Hospital Morbidity database for separations (admitted episodes of patient care) from all public and most private hospitals in Australia on measures of age, gender, psychiatric diagnosis, location and type of psychiatric care.Results: Use of specialist psychiatric services in the community per annum per 1000 persons declined with age in men and women from 137.28 and 191.87 respectively in those aged 20–64 years to 11.84 and 14.76 respectively in those over 84 years. However, men and women over 84 years received psychiatric home visits at 377% and 472% respectively of the rates of persons under 65. The annual hospital separation rate per 1000 persons for specialist psychiatric care was lowest in those aged over 84 (3.98) but for inpatient non-specialized psychiatric care was highest in those over 84 (21.20). Depression was the most common diagnosis in specialized psychiatric hospitalization in those aged over 84 while organic disorders predominated in non-specialized care in each age group over 64 years with the highest rates in those aged over 84.Conclusion: Mental health service delivery to persons aged over 84 is distinctly different to that provided to other aged groups being largely provided in non-specialist hospital and residential settings.

ABSTRACTThe study investigated housing tenure as a factor moderating the effects of loneliness and socio-economic status (SES) on quality of life (control and autonomy, pleasure, and self-realisation) over a two-year period for older adults. Data from the 2010 and 2012 waves of the New Zealand Health, Work, and Retirement Study were analysed. Using case-control matching, for each tenant (N = 332) we selected a home-owner (N = 332) of the same age, gender, ethnicity, SES, working status and urban/rural residence. Structural equation modelling was employed to examine the impact of SES, housing tenure and loneliness on quality of life over time. Emotional loneliness exerted a significant negative main effect on control and autonomy and pleasure. Tenure and SES influenced control and autonomy, but not pleasure or self-realisation. Tenure moderated the effect of emotional loneliness on control and autonomy, with the negative effect of emotional loneliness weaker for home-owners compared to renters. Tenure moderated the effect of SES on control and autonomy, with the positive impact of SES stronger for home-owners. Findings suggest that owners capitalise on their material and financial resources more than tenants in terms of their quality of life. In addition, home-ownership can act as a protective factor against the harmful effects of emotional loneliness in old age.

Abstract. Health Psychology at the Freie Universität Berlin is devoted to research and teaching in the entire field of health psychology, including stress, coping, social support, self-efficacy, personality, quality of life, and health behavior change. In this article, we briefly describe one theory that represents our line of thinking (the Health Action Process Approach), followed by examples of longitudinal and experimental studies on health behavior change. A major finding is that interventions to improve physical activity, healthy nutrition, and dental hygiene are most effective when matched to three stages of change. Moreover, we address the field of health self-regulation across the life span: We are involved in the consortium Autonomy Despite Multimorbidity in Old Age (AMA), co-investigating the project Health Behaviors and Multiple Illnesses in Old Age (PREFER), and we are the home institution of the project Fostering Lifelong Autonomy and Resources in Europe: Behaviour and Successful Aging (FLARE-BSA).

This study investigates whether attachment quality at ages 1, 6 and 16 is related to autonomy and relatedness behavior in adolescence. In a follow-up of the Regensburg Longitudinal Study, forty-three 16-year-old adolescents and their mothers were assessed in a revealed differences task and a planning a vacation task. Attachment was assessed during infancy using the Ainsworth Strange Situation and at age six with the reunion procedure. Adolescent attachment representation was assessed using the Adult Attachment Interview. Results provided no evidence for significant continuity between infant or childhood attachment behavior and adolescent attachment representation. Instability of attachment organization, however, was linked to a higher number of experienced risk factors. Substantial relations between adolescent attachment representation and adolescent autonomy and relatedness behavior were found in both interaction tasks with their mothers. Further, significant relations between attachment qualities at ages 1 and 6 and adolescent interaction behavior during the planning a vacation task at age 16 were found. Thus, independent of attachment stability or instability, both early attachment in infancy and childhood and concurrent attachment representation were significantly related to autonomy and relatedness behavior in adolescence.

ABSTRACTSecond couplehood in old age is a growing phenomenon alongside increases in life expectancy. Lately, a shift has occurred in that individual diversity of ageing is perceived to depend on the physical and social contexts in which older persons experience change. Thus, the purpose of the study on which this paper reports was to examine second couplehood in the context of old age and old age in the context of second couplehood using an existential-phenomenological theoretical orientation. Twenty couples were recruited using criterion-sampling: men aged 65+ and women aged 60+, with children and grandchildren from a lifelong marriage that had ended in widowhood or divorce, living in second couplehood – married or not – in separate houses or co-habitating. Forty individual semi-structured interviews were tape-recorded, transcribed verbatim and analysed according to phenomenological tradition. Five sub-themes emerged, demonstrating couplehood and old age intertwining: (a) enjoying life while still possible; (b) living with health-related issues; (c) relationships with adult children: autonomy versus dependency; (d) loneliness: living as a couple is better than living alone; (e) self-image: feeling young–feeling old. Findings support the existence of positive and negative aspects of old age. Our discussion suggests the need to replace perceptions of old age as either a negative burden or a positive asset towards a period of balancing between gains and losses. Furthermore, we acknowledge the role of second couplehood in older peoples’ wellbeing on the personal–micro level through love, the familial–mezzo level through care-giving and the social–macro level by reducing prejudice.

Gender stereotypes of typical and optimal, mentally healthy aging were examined with sixty-year-old and seventy-five-year-old women, men and gender-unspecified older people as target persons. Respondents were young adult individuals ( N = 232) and their older adult relatives/acquaintances ( N = 233). Perceptions of typical aging varied depending on the age of the respondent, the target gender and the target age. Gender stereotypes were more pronounced than age stereotypes: respondents described same-gender targets more similarly than same-age targets. Older women were rated higher on dimensions related to nurturance while older men were rated higher on intellectual competence and autonomy. Perceptions of optimal aging were not found to be affected by the gender of the respondent or target. Views of optimal aging, however, were influenced by respondent and target age. These findings suggest a double standard of aging for typical but not for optimal aging.

With a sentence completion technique, 708 elderly participants (64 to 90 years of age) expressed 15,020 personal aspirations. These goals were classified according to their motivational content in ten major categories and their relationships with different sociodemographic variables were studied. Two goal profiles emerge from this analysis. Aspirations centered on self-preservation are associated with very old age, functional impairment, lower S.E.S. and education, being alone or institutionalized. Aspirations of self-development and interpersonal relationships are associated with younger age, physical autonomy, higher S.E.S. and education, being married or living at home. Development of meaningful personal goals are discussed as a mean of intervention with elderly individuals.

Subjective health is known to predict later outcomes, including survival. However, less is known about subjective health changes across adulthood, how personality moderates those changes, and whether such associations differ with age. We applied growth models to 10 waves of data from the Household, Income and Labour Dynamics in Australia Survey (HILDA, N = 7,172; median ages 20–93) to examine age-related differences in trajectories of subjective physical and mental health. On average, perceptions of physical health declined with increasing steepness in old age, whereas self-rated mental health remained relatively stable across all ages. Higher neuroticism and lower extraversion and conscientiousness were each related to less successful aging. The health implications of personality did not differ by age for physical health, but were weaker for mental health in old age. We discuss implications of our results for accelerated longitudinal designs and consider avenues for future more mechanism-oriented research.

Australia has an increasingly aging population with increasing levels of physical inactivity. The potential detrimental effects of these two factors on the health of the community highlight the need to investigate methods to increase physical activity in older Australian adults. The study reported in this thesis formed part of the PATH (Physical Activity Time for Health) Project, a community-based research trial that compared two strategies to increase physical activity in underactive, 60-80 year old men (n = 66) and women (n = 188). Twelve recreation centres were randomised to either a supervised group based walking intervention with behavioural change components, or a self-managed/usual care intervention. Participants in behavioural intervention centres were asked to complete 150mins/week of moderate intensity physical activity as a supervised walking program, organised as 3 sessions/week for the first 3-months and then 1 supervised and 2 unsupervised walk sessions/week for the second 3-months. Participants in self-managed centres were asked to complete 3 sessions of moderate intensity physical activity (150mins/week) for 6 months. In this thesis I have investigated the efficacy of Self-Determination Theory (SDT; Deci, 1980) to explain motivation of older adults to adopt physical activity. There were three sub-purposes. First, to determine the effect of the behavioural intervention compared with the self-managed approach on psychosocial, physiological, and physical activity outcomes. Second, to investigate the contributions of psychosocial predictors to adherence and physical activity level across the self-managed and behavioural intervention strategies. Third, to estimate the directional relationships between self-determination constructs and adherence using path analysis. The physical activity outcomes measured in this study were retention, adherence and total physical activity level. Retention was defined as the number of participants in the study after 6 months. Adherence was defined as the number of exercise sessions completed over the 6 months. Total physical activity level was measured using the Physical Activity Scale for the Elderly (PASE; Washburn, Smith Jette, & Janney, 1993). At baseline the behavioural intervention program had 138 participants, compared to 116 participants in the self-managed condition. After 6 months the behavioural intervention program had retained 84% of these participants, compared to 67% in the self-managed condition. With respect to adherence there was no significant difference between participants in the behavioural intervention compared to those in the self-managed condition (67.7% and 59% of sessions, respectively). The total physical activity level (related closely to the adherence score) also did not differ between conditions (114.69 and 115.87 for the behavioural intervention and self-managed groups, respectively). The major and novel finding of this study was that social connectedness was a significant factor in the engagement of older adults in physical activity. This was evidenced by the increases in social connectedness in the behavioural intervention group, compared to decreases in social connectedness reported in the self-managed group. Furthermore, structural equation modelling demonstrated that social connectedness, compared to physical self-perceptions and autonomy, was the only significant predictor of adherence. This study also found that self-perceptions outside the physical domain can have as important a role in exercise behaviour as physical self-perceptions. Structural equation modelling provided further support for this proposition showing adherence was more strongly related to social self-perceptions than physical or cognitive selfperceptions after the intervention. Also, lower perceptions of physical appearance and higher perceptions of nurturance were associated with higher total physical activity levels at 6-months This study confirms previous research and contributes novel findings demonstrating the importance of social connectedness in physical activity behaviour in older adults. Further it provides strong evidence for the ability of physical activity to influence multiple aspects of the lives of older adults. These findings have implications for health practitioners and development of policy and programs to increase physical activity. Employing Self-Determination Theory has further elucidated motivation for exercise in older adults and provided novel findings to support inclusion of socially based components into physical activity promotion campaigns for older adults.

Why is independence a central theme for proponents of assisted living facilities? How do assisted living providers respond to this theme? These questions are pursued in an ethnographic study centered on Oregon's assisted living program. Assisted living facilities (ALF), defined and monitored by Oregon's Senior and Disabled Services Division (SDSD), are a type of housing for disabled, primarily elderly, persons. Oregon Administrative Rules (OAR-411-56) define independence, requiring ALF providers to support resident independence. Using social worlds theory as a sensitizing concept, assisted living is treated as a distinct social world. The activities of key groups, including SDSD staff, an ALF professional group, and assisted living managers, are described. These members commit to a “social model” approach to long-term care for which independence is the unifying construct. This approach offers a value-practice “package” that explains how to implement the value of independence (Fujimura, 1997). Three arenas where this package is apparent are described: marketing, manager training, and daily operations. Content analysis of marketing brochures from 63 assisted living facilities shows that independence is a dominant theme, promoted like any other product. These materials indicate that assisted living operators promote resident independence by providing a barrier-free environment, helping residents with daily tasks, and allowing residents control over their decisions. Manager training programs are another arena where the policy value of independence is evident. Here, new managers learn “who we are” and “what we do” in this social world. They learn a new vocabulary and are introduced to tools for daily practice. They learn the boundaries of this social world, and above all, how to behave differently from nursing facilities that they associate with the “medical model.” In daily practice, managers use institutional conventions, including the “negotiated service agreement” and "managed risk agreement." These tools are designed to respond to the tension between supporting independence and providing care to chronically ill, disabled individuals. Observations of marketing, management training, and resident assessments indicate that the social world of assisted living is in a formative stage, as members attempt to define and legitimate who they are and what they do.

As the number of elderly individuals in the population continues to increase, the demand for alternatives to group care settings will also increase. Homes for adults represent an example of the diversification of long term care options by providing care to elderly individuals in a setting that is more home-like and less institutionalized than traditional nursing homes. Since previous research is often limited to nursing home residents, the study of home for adult residents offers a fresh approach to sample selection, and provides reassurance that the needs of elderly residents are indeed being met not only in terms of custodial care but also in a therapeutic sense that enhances life satisfaction. In this study, the relationship of integrity/despair, locus of control, and life satisfaction was examined in a sample of elderly persons who reside in homes for adults. The participants were 17 males and 83 females, ranging in age from 60 to 95 and reporting fair to good health. It was hypothesized that elderly individuals who felt in control of their lives would also be more satisfied with life, Additionally, it was proposed that elderly individuals who looked back on their lives and were not satisfied would be afraid to die and would feel little or no control over their lives. Death anxiety, as measured by the Death Anxiety scale (Templer, 1970) was used to define integrity/despair. The indicator of locus of control was the Mastery Scale (Pearlin & Schooler, 1978), and life satisfaction was assessed with the Philadelphia Geriatric Center Morale Scale (Lawton, 1975). Correlation analysis yielded the following results: (a) the more internal an individual’s locus of control score, the lower the death anxiety score, (b) the more internal the locus of control, the higher the life satisfaction score, and (c) the higher the life satisfaction, the lower the death anxiety score. These findings supported the hypotheses and indicate that elderly individuals who feel in control are also satisfied with their lives and are not afraid to die.
Master of Science

This thesis will investigate the significance of the Eastern Orthodox perspective of theosis, for the bioethical principle of autonomy, specifically with regard to its respect for the elderly. Theosis is a central doctrine of the Orthodox Church which pertains to the salvation of human persons and their free and cooperative response to God's grace, and as such, has an intimate relationship with the Eastern Orthodox understanding of personhood.
On the one hand there are a number of areas of mutual concern or overlap between the concept of respect for autonomy and the Orthodox understanding of personhood and the goal of theosis. There are, however, significant differences which prevent them from being viewed as synonymous or even as totally compatible.
There are complementary aspects, some of which will be identified in this initial study. It is hoped that such an investigation can help to further develop Eastern Orthodox thinking with regard to bioethical issues and be of value when dealing with the complex issues related to the elderly. This topic will also be of interest to a wider audience involved in bioethical reflection from both Christian and secular perspectives.

Intercountry adoption is a globally politicised institution that triggers strong discourses about whether transplantation to a markedly different country and culture, often into families with racially different parents, negatively affects the children ' s well-being and identity. Although empirical intercountry adoption research has increased elsewhere, Australian-based research has lagged behind. This thesis presents a body of evidence about the well-being and identity of over half the population of 14- to 26-year-old intercountry adoptees in Western Australia, how their well-being changed from 1994 to 2004, how they compare with non-adopted migrant peers and the influence of risk and threat factors. In 2004, participants consisted of 110 intercountry adoptees, three partners, 120 adoptive parents of 160 adoptees, 80 migrant peers and 44 parents of 56 peers. Data were collected by mail survey. From theoretical perspectives in subjective well-being, identity processes and transracial adoption, well-being was examined in terms of physical health, happiness, satisfaction with life and adoption/migration, self-esteem, self-efficacy, competence and adaptive and problem behaviours. Identity was examined in terms of adoptive/migrant status, heritage, community membership, ethnicity, culture, race and place.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
The Radio Program has followed the lives of all the people in our country for decades. Especially in places where, at present, digital technologies take place gradually in the daily lives of the elderly, radio continues to be the way people get information, have their entertainment in it, occupy their ears at last, while they are busy with other activities. At this threshold of the 21st century, with the elderly segment experiencing the privilege of longevity, and aspiring to a more active participation in society, a question arises: Will a radio program manage to move the elderly to a more active participation by interacting with your presenter / speaker? Or: Would the elderly participate in a collaborative way with a radio-media directly addressed to those of their age group? It is a qualitative, descriptive-explanatory study, whose answers to the open questions made to the elderly were analyzed according to the interactionist-gerontological approach. The general objective is to describe and evaluate the subjective / social effects / resonances, a proposal involving the production, and the weekly broadcast of a radio program for the elderly, where they have the opportunity to speak out, raising questions and receiving the answers, through their direct participation, in real time. Specific objectives: (i) Introduce the conceptual discussion of media education for aging through radio; (ii) To verify, in the programming offered by the radio, how the production of the most critical and / or more participative content (polemics) is produced, precisely to recover those who say the most about the needs of the elderly; (iii) Explain how programming can promote the participation of the elderly, leading them to be co-producers of the radio program; (iv) To make it more objectively possible for elderly radio listeners to receive answers to their questions about the problematic they are experiencing, including by intensifying intergenerational dialogue in their homes. It was concluded that the elderly, when given the opportunity to present themselves live on a radio program: (i) they receive answers to their questions about the problematic they experience, increasing sociability, intergenerational dialogue; (ii) they began to collaborate pari passu for the construction of specific radio programming, becoming as co-producers in providing ideas for topics to be discussed, gaining, and enthusiasm for the new practice practiced voluntarily; (iii) by this way, these elderly reinforce their socialization, their social emancipation by empowering their autonomy, promoting, in short, the citizenship of these elderly, through these socio-cultural practices of media interaction
O Programa de Rádio acompanhou a vida de todas as pessoas em nosso país, durante décadas. Especialmente em lugares onde, no presente, as tecnologias digitais acontecem de forma gradativa no cotidiano dos idosos, o rádio continua a ser a forma de as pessoas receberem, prontamente, informações, terem nele seu entretenimento, ocuparem seus ouvidos enfim, enquanto continuam ocupados com outras atividades. Neste limiar do século XXI, com o segmento idoso vivenciando o privilégio da longevidade, e aspirando a uma participação mais ativa na sociedade, uma pergunta se coloca: Será que um programa de rádio conseguiria mover os idosos para uma participação mais ativa, ao interagirem com seu apresentador/locutor? Ou: Participariam os idosos de forma colaborativa com uma mídia-rádio diretamente dirigida àqueles de sua faixa etária? Trata-se de um estudo qualitativo, descritivo-explicativo, cujas respostas às questões abertas feitas aos idosos foram analisadas segundo a abordagem interacionista-gerontológica. São Objetivos Gerais: (i) Descrever e avaliar os efeitos/ressonâncias, de ordem subjetivo-social, obtidos por meio da idealização de uma proposta de produção e veiculação semanal de um programa de rádio, destinado ao segmento idoso; (ii) Possibilitar a participação do ouvinte-idoso de modo direto e em tempo real, a fim de interagir com o programa radiofônico e receber resposta às suas dúvidas. São Objetivos Específicos: (i) Introduzir a discussão conceitual da educação midiática para o envelhecimento, por meio de rádio, discutindo seus efeitos em uma comunidade; (ii) Explicitar como a programação radiofônica pode promover a discussão e participação dos ouvintes idosos, conduzindo-os a serem como co-produtores de um programa de rádio; (iii)Propiciar que os ouvintes idosos da rádio possam receber respostas às suas indagações sobre as problemáticas que vivenciam, recrudescendo o diálogo intergeracional. Concluiu-se que os idosos, ao terem a oportunidade de se manifestarem ao vivo em um programa de rádio: (i) recebem respostas às suas indagações sobre a problemática que vivenciam, incrementando a sociabilidade, o diálogo intergeracional; (ii) eles passaram a colaborar pari passu para a construção da programação da rádio específica, tornando-se como que co-produtores ao fornecerem ideias para tópicos a serem discutidos, ganhando, entusiasmo pela nova prática exercida voluntariamente; (iii) por essa via, esses idosos reforçam sua socialização, sua emancipação social ao potencializar sua autonomia, promovendo-se, em suma, a cidadania desses idosos, por meio destas práticas socioculturais de interação midiática

The purpose of this exploratory study was to develop an instrument to measure perceived food autonomy (PFA) among cognitively alert residents in state licensed Assisted Living (AL) facilities, and to investigate the influence of PFA on food satisfaction, while controlling for functional (physical, social, and psychological) status, general health, and demographic characteristics. The study was designed to achieve four objectives: 1) to define a theoretical framework for food autonomy among residents in AL settings and to develop an instrument accordingly; 2) to evaluate the content and construct validity of the PFA scale; 3) to evaluate the reliability of the PFA scale; and 4) to investigate the effect of perceived food autonomy, functional (physical, social and psychological) status, and general health on food satisfaction in AL settings. Definitions for food autonomy and three underlying dimensions were developed based on conceptualizations of personal autonomy for older adults in long-term care settings, which provided a theoretical framework for the PFA scale development. Content validity was established by expert panel evaluation and a pilot study. Construct validity was achieved from factor analysis procedures with a sample of 120 residents from eleven AL facilities. Cronbach's alpha measure of internal consistency showed the 11-item PFA scale to be reliable (alpha = .71). Multiple linear regression analysis examined the effect of residents' PFA, health and functional status, and demographic characteristics on food satisfaction. Food satisfaction was measured by a highly reliable (alpha = .87) scale that was compiled for this study. Perceived food autonomy was the most significant predictor of food satisfaction, explaining 37% of its variance. Residents' perceptions of daily pain along with the joint effect of ADL needs and dentures use made a lesser but significant contribution. Altogether, the above variables explained 48% of the variance in residents' food satisfaction. Application of reliable%instruments such as the PFA and FS scales can be used by AL provider to guide food service quality improvement efforts. Residents' PFA and food satisfaction should be periodically measured due to the typical decline in overall health and functional status of AL residents.
Graduation date: 2004

"February 20, 2003"
Includes bibliographical references (leaves 586-603)
xvii, 603 leaves : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Investigates the level of resident participation in decision-making in aged care hostels in South Australia.
Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 2003