why are we here? 2017 hallowell... · strengths-based perspectives brooke hallowell hallowell, b....
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Brooke Hallowell April 2017
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Language in the Context of Aging:Strengths-Based Perspectives
Brooke Hallowell
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego,
CA: Plural Publishing. ISBN13: 978-1-59756-477-9
Why are we here?
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego,
CA: Plural Publishing. ISBN13: 978-1-59756-477-9
What are important things to consider when talking and writing about older people and people with disabilities?
Why do words matter?
● Not just a matter of political correctness● Enhance sensitivity and awareness● Advocate for people with disabilities
General terms
● “Disability” generally accepted, but definitely not by all
● “Handicap” generally less accepted● Other options:
● Special needs● Differently abled
Person-first language
● Person-first language: Refer to the person first● Never use a disability label as a noun
An autisticA man with
autism
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The disabled People with disabilities
An aphasic A person with aphasia
A paraplegic A person with paraplegia
REFERRING TO OLDER PEOPLE
� Person-first applies� Not “the aged” or “the elderly”
� What about senior citizen? Or senior?“Admen and Coma (2009): “After all we don’t refer to people under age 50 as ‘junior citizens.’ Instead say ‘man’ and ‘woman, and give their age, if relevant…” (p. 36).
� People under 55, on average, are not bothered by the terms elderly, retiree, and senior citizen; however, those over 55 are.
� What about:� Golden ager, golden years, age of maturity?� Cute, spry, miserly, doughty, or cranky?� 95 years young� Grandfatherly type� Sweet little old lady
WORDS CONSIDERED TO BE “OBVIOUSLY AGEIST” IN THE INTERNATIONAL LONGEVIT Y CENTER-USA AND LEADING AGE
CALIFORNIA ST YLE GUIDE ( A D M E N & C O M A , 2 0 0 9 )
AncientBiddyCodgerCootCroneCrotchety old manDirty old manFogyFossilGeezerHag
Little old ladyMiserly old manOld fartOld fool Old goatOne foot in the graveOver the hillPruneSenile
• Are there some you have used yourself? • Are there some for which you plan to refrain from using ?• What are some constructive ways to counter the use of ageist terms?
HOW WOULD YOU REVISE THESE STATEMENTS?
�Ms. DeRose is a spry 90-year-old paraplegic.� I have three TBIs in my cohort.� It is unclear if the grandmotherly demented woman was
withdrawing socially because of her general crotchetiness or because of clinical depression.
�Subjects in this research were 30 elderly aphasic patients from the community.
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WHAT IS AGING?
�Aging is an ongoing process
�Ways of defining age oChronological ageoBiological ageoCognitive ageoPsychological ageoSocial age
Source: “Project Grandma” by Vinoth Chandar, licensed under CC BY 2.0.
WHAT DOES IT MEAN TO BE “OLD”?
WHAT IS AGING?
� Ways of defining age o Chronological age
� An index of how long a person has lived since birth
o Biological age� An index of the functioning of one’s bodily
organs over time [video exploration] [Do we have to get old and die?]
o Cognitive age� A index of how one’s cognitive abilities
change over time
o Psychological age� An index of how one’s personality changes
over time
o Social age� An index of aging according to one’s social
roles as well as environmental changes Source: “Project Grandma” by Vinoth Chandar, licensed under CC BY 2.0.
US CHRONOLOGICAL DIVISIONS OF OLD AGE
�Oldest-old: 85+�Old-old: 75-84�Young-old: 65-74
WHAT ARE KEY THEORIES ABOUT AGING THAT ARE ESPECIALLY RELEVANT TO COGNITION AND
COMMUNICATION?
WHAT A RE KEY THEORIES A BOUT AGING THAT A RE ESPECIALLY RELEVANT TO COGNITION A ND
COMMUNICATION?
�Biopsychosocial models of aging�The life-span model of postformal
cognitive development (Schaie, 2005; Schaie & Willis, 2002)�Motivational theory of life-span
development (Heckhausen, Wrosch, & Schulz’s, 2010)
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WHAT A RE KEY THEORIES A BOUT AGING THAT A RE ESPECIALLY RELEVANT TO COGNITION A ND
COMMUNICATION?
�Biopsychosocial models of aging�World Health Organization International Classification of Functioning, Disability and Health
WHAT IS THE WHO ICF?
� A conceptual framework (not a model)
� A system for classifying health and health-related domains for clinical and research applications in a consistent way throughout the world to classify health conditions, not people ( T hr e ats , 2010)
� An important approach led by the WHO to classify functional areas of health and disability
Communication
Interpersonal Interactions
Relationships
Domestic Life
Community Life
Social Life
Source: “United Nation” by ClkerFreeVectorImages, licensed CC0 Public Domain.
HOW IS THE WHO ICF RELEVANT TO ETHICS AND HUMAN RIGHTS?
�"Health is a state of complete physical , mental and social well-being and not merely the absence of disease or infirmity“ (WHO, 2006, p.1)
�"The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition" (WHO, 2006, p. 1)
Source: “Right” by geralt, licensed CC0 Public Domain.
WHO 1980 (ICIDH)� Impairment �Disability �HandicapWHO 1999 (ICIDH-2)� Impairment�Activity limitation�Participation restriction
WHO 2001 (ICF)�Part 1: Functioning and
disability� Body structure and function� Anatomical parts� Physiological and psychological
aspects� Activity and participation� Performance � Capacity
�Part 2: Contextual factors� Personal factors� Environmental factors
BOX 5–1. SUMMARY OF WHO MODELS
HOW IS THE WHO ICF SPECIFICALLY RELEVANT TO INTERVENTION AND RESEARCH IN REHABILITATION? � The ICF helps rehabilitation professionals and scholars to
oFocus on health, well-being, and quality of lifeoAcknowledge that every human being can experience a decrement in health and thereby
experience some degree of disabilityoRecognize health and disability as universal human experiencesoTake into account the dynamic interaction among � Life-impacting variables (social support, environment, genetics)� Health r isks in all aspects of assessment, treatment, and clinical research
oConsider disability not as an attribute of any given person but as a construct that can only be considered in an individual's life context, especially his or her social environment
oDeemphasize an individual's health status according to medical diagnostic categories, focusing instead on their holistic functional concerns and what might be done to address them
oAddress intervention through interdisciplinary approaches, combining the best areas of expertise to address an individual's needs
HOW IS THE WHO ICF SPECIFICALLY RELEVANT ADULTS WITH NEUROGENIC CHALLENGES?
� It represents an important departure from the traditional classification of disorders based on neuroanatomical models (impairment-based models)
� The focus is on o Any communication disorder as a contextualized life-affecting condition o Resources and compensatory and adaptive services for full life participationo Working on deficits at the level of body structure and function, but with an
eye toward impacting activity limitations through such work
�Embracing the ICF framework impacts both assessment and treatment o Aphasiologists address all aspects of communication that could affect an
individual’s life and that of others (family members, friends, etc.)
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WHAT A RE KEY THEORIES A BOUT AGING THAT A RE ESPECIALLY RELEVANT TO COGNITION A ND COMMUNICATION?
� The life-span model of postformal cognitive development (Schaie, 2005; Schaie & Willis, 2002)o 7 stageso Adulthood – taking on responsibilitieso Focus on self and family Æ focus on community and societyo Focus on professional development Æ non-professional activitieso Last 2 stages: greater selectivity in activities and emphasis on
legacies
How is this relevant to consideration of age-related changes in communication abilities and needs?
WHAT A RE KEY THEORIES A BOUT AGING THAT A RE ESPECIALLY RELEVANT TO COGNITION A ND COMMUNICATION?
� Motivational theory of life-span development (Heckhausen, Wrosch, & Schulz’s, 2010)o Self-regulatory skills9Anticipate emergent opportunities for goal pursuit9Activate behavioral and motivational strategies of goal
engagement9Disengage from unimportant goals
How is this relevant to consideration of age-related changes in communication abilities and needs?
�Helping a family member consider prognosis for recovery from an acquired language disorder due to stroke or brain injury? �Responding constructively to colleagues who make
misguided statements about the influence of age on an older person’s language abilities? �Working with a social worker on discharge planning at
a subacute rehabilitation facility?
HOW MIGHT MODELS OF AGING THAT PROMOTE CONCEPTUALIZATION OF AGING FROM A LIFE SPAN PERSPECTIVE INFLUENCE YOUR ROLE IN: WHAT ARE SOME IMPORTANT DEMOGRAPHIC SHIFTS IN THE WORLD’S
AGING POPULATION?
�The aging population is rising globally (faster in in developing countries) due to three primary reasons o Decreasing infant
mortalityo Decreasing fertility o Improved longevityo (Also, in the US,
migration)�BBC�Global Aging
Source: “Percentage of the World Population Over 65” by Rcragun, licensed under CC BY 3.0.
US POPULATION OUTLOOK US TRENDS IN PEOPLE AGE 65 AND OVER
U.S. population 65+� 2011: 13.3% (tripled in 100 years)� 2030: 1/5 of the US (doubling in 25 years)� 2050: 83.7 million� Female > male (80% of centenarians)� Increasing racial/ethnic diversity� East Coast > West Coast� Continued chronic conditions� Staying in workforce longer� Increasing educational level� Increasing use of technology
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POPULATION AGINGHOW ARE DEMOGRAPHIC SHIFTS IN AGING POPULATIONS RELEVANT (OR
POTENTIALLY RELEVANT) TO YOUR OWN PERSONAL AND PROFESSIONAL MISSION?
�Why is it so important for us to know about communication disorders among older people?
�What’s so important about communication in the context of aging… in your family, in your community, in your state, in your country, in the world?
HOW ARE THESE TOPICS RELEVANT TO YOU? What are normal changes in the brain as people age?
y General patterns of neuro-structural changes (with great variability) that have effects on cognitiono Neuron shrinkage and reduced dendritic branching
� Leads to decreased brain volumeo Atrophy primarily in the frontal lobes and hippocampus o Reduction in neurotransmitters (e.g., acetylcholine and dopamine)o Decreased white matter, especially on the frontal lobeso Reduced cerebral blood flowo Accumulation of amyloid beta or amyloid plaques without accompanying neurofibrillary
tangles (associated with Alzheimer's disease)
{As we age, our likelihood of acquiring cognitive and language disorders increases.
Neuronal shrinkage and reduced dendritic branching (leading to decreased brain volume)
Macaque study: http://www.nyas.org/publications/ebriefings/Detail.aspx?cid=37cd8b29-2037-4c42-bc96-c2370a7a799e
https://www.google.com/search?q=brain+atrophy+aging&rlz=1C1GPCK_enUS535US536&espv=2&biw=1280&bih=918&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiluvSsh5zPAhUo2IMKHUzQDs4Q_AUIBygC#tbm=isch&q=neuron+dendrite
Atrophy, primarily in the frontal lobes and hippocampus
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego, CA: Plural Publishing. ISBN13: 978-1-59756-477-9
https://www.philrichardsperformance.co.uk/blog/change-your-brain-change-your-thoughts-change-your-life-overcoming-depression-part-1/
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Reduction in neurotransmitters (e.g., acetylcholine and dopamine)
https://www.google.com/search?q=neurotransmitters&biw=1280&bih=918&espv=2&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjKuJDphJzPAhXkzIMKHZW_DmYQ_AUIBigB#imgrc=Hx3TQviKTvB7JM%3A
Decreased white matter, especially on the frontal lobes
/
http://www.wisegeek.com/what-causes-a-loss-of-myelin.htm
Decreased white matter, especially on the frontal lobes
http://neurosciencenews.com/neuroplasticity-aging-learning-1557/
Reduced cerebral blood flow
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego, CA: Plural Publishing. ISBN13: 978-1-59756-477-9
http://www.daviddarling.info/encyclopedia/T/transient_ischemic_attack.html
Accumulation of amyloid beta or amyloid plaques without accompanying neurofibrillary tangles (associated with Alzheimer's disease)
http://www.brightfocus.org/alzheimers/infographic/amyloid-plaques-and-neurofibrillary-tangles
http://thecandidazone.com/candida-and-alzheimers/
Video: Plaques and Tangles in the Alzheimer's Brain
Video: Plaques and Tangles
What are positive aspects of the aging brain?
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego, CA: Plural Publishing. ISBN13: 978-1-59756-477-9
y Memory-related (semantic, procedural, and episodic) changeso Richness of life experience
y Age-related changes in prefrontal and limbic interaction, along with hormonal changes in the braino Balance of basic drives associated with sexual pursuits, career ambition, greed,
and self-centeredness
y Changes to grey and white matter pathways as well as synaptic connections o Wisdom
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Discussion: Positive aspects of the aging brain
y Do you have experience with an older person that reinforces the positive aspects of age-related changes in cognitive-linguistic development? If so, share stories of such experiences, tying them to our focus today.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Distractibility, sometimes considered absent-mindedness
Forgetting essential information related to activities of daily living
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Word-finding problems, especially increasing tip-of-the-tongue experiences (knowing that one knows the word and perhaps knows something about the word but is not able to actually say the word)
Semantic confusion at the discourse level
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Occasional trouble finding proper names
Dysnomia for important names
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Occasional math errors Dyscalculia or problems with basic mathematical functions
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal or near-normal syntactic production (speaking and writing), with greater difficulty in distracting conditions; possible reduced use of complex grammatical forms and reduced length of sentences
Major changes in syntactic structures that were used in younger years
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Brooke Hallowell April 2017
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Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal or near-normal syntactic comprehension (auditory and reading); greater difficulty with longer and more complex stimuli and in dual-task and distracting conditions
Moderately or severely impaired comprehension
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal or mildly impaired working memory; greater difficulty with longer and more complex stimuli and in dual-task and distracting conditions
Moderately or severely impaired working memory
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal or mildly decreased speed of processing during cognitive and motor tasks; greater difficulty with longer and more complex stimuli and in dual-task and distracting conditions
Moderately or severely slowed speed of processing
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal or mildly impaired episodic memory (recall of personal experiences)
Moderately or severely impaired episodic memory
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal procedural memory (recall for how to accomplish specific tasks)
Impaired procedural memory
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal or mildly impaired procedural learning
Impaired procedural learning
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Brooke Hallowell April 2017
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Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal or mildly impaired source memory (memory of where and how one acquired knowledge or where and when a previous event took place)
Impaired source memory
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal short-term memory (recall of recent events)
Impaired short-term memory
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Normal autobiographical memory (memory about important aspects of one’s past)
Impaired autobiographical memory
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
Table 9–1. General Guidelines for Considering Whether Cognitive-Linguistic Characteristics of Older Adults Are Normal
May Be Associated With Normal Aging
Not Characteristic of Normal Aging
Near or near-normal pragmatic and executive function abilities
Impaired pragmatic abilities and executive function deficits
Note that several of the characteristics in the left column may be lifelong characteristics, not necessarily characteristics that have developed in older age. Recall, too, that there is tremendous inter-and intraindividual variability in these characteristics.
What tends to be well preserved in older adulthood?
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego, CA: Plural Publishing. ISBN13: 978-1-59756-477-9
y Memoryo Semantic memoryo Procedural memoryo Autobiographical memory
(Episodic, source, and short-term memory also commonly spared)
y Word findingo Good recognition; not a matter of loss of
vocabulary
y Syntactic processing o Facilitation through slowing and reduced
background noise/clutter
y Reading and writingo Linguistic aspects relatively spared
y Discourseo Good understanding for narratives
(stories)o Production judged to be clearer and
more interesting (Glisky, 2007; Kemper & Kemtes, 2000)
y Pragmaticso Aging in and of itself does not seem to
influence pragmatic abilities in significant ways. (Consider lifespan models and motivational theory of development.)
What are normal changes in cognition and language as people age?
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego, CA: Plural Publishing. ISBN13: 978-1-59756-477-9
y Memoryo Short-term and working memory
y Word findingo More “tip-of-the-tongue” experienceso Slower response times o Less accuracy o Reduced verbal fluency
y Syntactic processing o Comprehensiono Production
y Reading and writingo More likely to be due to sensory and
motor deficits than to linguistic factors per se
y Discourseo Three influencing factors (Shadden, 2011)
� Emotional regulation� Personal discourse goals� The nature of specific discourse tasks
y Pragmaticso Aging in and of itself does not seem to
influence pragmatic abilities in significant ways
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What theories have been proposed to account for cognitive-linguistic changes with aging?
y Resource capacity theories (Burke & Shafto, 2008)
o A reduction in overall cognitive capacity� Working memory� Context processing deficiency� Signal degradation� Transmission deficit
y Speed of processing theorieso Our cognitive processing at all levels slows as we age (the general slowing
hypothesis (Salthouse, 1996)
y Inhibition theorieso Difficulty with inhibiting attention to irrelevant information externally and
internally (Butler & Zacks, 2006; Hasher & Zacks, 1988; Zacks & Hasher, 1993)
Queries for group processing
y What is reserve capacity (or cognitive reserve)? Why is it important for people to know about it?
y What is age-related identity threat? Why is it important to take it into account when assessing communicative abilities of older people?
y Why is it that physical changes that might be detected in the brains of older people do not necessarily correspond to problems in their functional cognitive and linguistic abilities?
y What can be done to ensure the best preservation of language abilities as people age?
Box 9–1. Factors That Promote Brain Health Through the Life Span How are you doing?
1. Active intellectual engagement on a daily basis2. Regular active and pleasurable social engagement and support3. Limitation of time spent in passive activities, such as watching television4. Constructive and proactive management of low mood, stress, and anger 5. Cardiovascular fitness, including well-regulated blood pressure6. Maintenance of low body fat7. Sufficient rest8. A well-balanced diet with well-controlled glucose regulation9. Alcohol consumption only in moderation if at all10. When possible, avoidance of drug effects and pharmacological interactions
that negatively affect brain and language functions
Language in the Context of Aging:Clinical Advocacy for Older Adults
Brooke Hallowell
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego,
CA: Plural Publishing. ISBN13: 978-1-59756-477-9
Assumptions, stereotypes, and attitudes that affect services for older people
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego,
CA: Plural Publishing. ISBN13: 978-1-59756-477-9
Challenging research on the ravages of agingWhy is it important to scrutinize carefully and not necessarily accept as fact the results of research studies that demonstrate declines in cognitive and linguistic abilities as people age?
Brooke Hallowell April 2017
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Challenging research on the ravages of agingConsider these influences on research: • Heterogeneity of the “older” population• Demographic aspects of the samples studied• Control for potentially confounding factors• Longitudinal research challenges• Cohort/cross-sectional research challenges
• conditions related to a group of people having lived through similar circumstances or points in time
What is elderspeak?
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego,
CA: Plural Publishing. ISBN13: 978-1-59756-477-9
• Is elderspeak helpful or is it discriminatory? • Group role play
• What are some positive modifications that can be used instead of elderspeak?
Discussion
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego,
CA: Plural Publishing. ISBN13: 978-1-59756-477-9
• Symptoms of dementia have been assumed by many to be patterns of normal aging. What examples of such assumptions have you heard about or witnessed? How can such assumptions lead to negative consequences for older people?
• What are specific ways in which negative attitudes toward aging may affect health care for older people?
• What may be your role in:• Helping a family member consider prognosis for recovery from an acquired language
disorder due to stroke or brain injury?• Responding constructively to colleagues who make misguided statements about the
influence of age on an older person’s language abilities?• Working with a social worker on discharge planning at a subacute rehabilitation facility?
• How will you continue to challenge your own stereotypes about aging that may negatively affect your role in supporting older adults?
Countering impairment foci and medicalization
Hallowell, B. (2017). Aphasia and other acquired neurogenic language disorders: A guide for clinical excellence. San Diego,
CA: Plural Publishing. ISBN13: 978-1-59756-477-9
Green house project
• http://www.thegreenhouseproject.org/
• Check out news stories:• http://www.thegreenhouseproject.org/news/Media-Coverage
Person-Centered Care
• Person-centered care matters, Center for Positive Aging
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Program for positive aging
• http://www.programforpositiveaging.org/
Center for positive aging
• https://www.centerforpositiveaging.org/
Center for the future of aging
• Milken Institute: http://www.milkeninstitute.org/centers/the-center-for-the-future-of-aging/
Second acts for the greater good
• http://encore.org/
The National Center for Creative Aging is dedicated to fostering
an understanding of the vital relationship between creative
expression and healthy aging and to developing programs that
build upon this understanding.
Envision a world where all individuals flourish across their lifespan through creative expression…
CreativeAging.orgWinners of the 2014 Beautiful Minds Campaign presented by NCCA and DSM Nutritional Products
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Positive EmotionPositive EngagementPositive RelationshipsMaking of MeaningMastery
Gene Cohen, The Creative Age
Martin Seligman, Flourish
Longevity, Creativity, Flourishing Evidence-Based Impact� Vital evidence-based efficacy and positive impact of creative arts and
humanities interventions with aging populations
� Improved health, higher quality of care, resilience,
and quality of life across the spectrum of aging
� Effective for aging adults AND their caregivers by
mitigating long-term depression and anxiety related to
chronic conditions, and enhancing quality of life
� Reducing social and healthcare costs, enhancing
professional provider resilience, and
strengthening networks of care.
The Heart of the Matter� Creating Quality days
for both caregiver and care partner� Living at home for as
long as possible� Strengthening family
relationships� Creating meaning,
memory, and legacy