C H A P T E R 8
•Social Gerontological Theory Before 1961
•Role Theory and Activity Theory
•The First Transformation of Theory
•Disengagement Theory
•Gerotranscendence Theory
•Continuity Theory
•Alternative Theoretical Perspectives
•Symbolic Interactionism & Subculture of
Aging, Labeling Theory, Age Stratification
Theory, Social Exchange Theory, Political
Economy of Aging, Life Course Perspective,
Life Course Social Capital
•The Second Transformation of Theory
•Phenomenology and Constructivism, Critical Theory and Feminist Perspectives
•Based on the belief that roles
define us and our self-concept, and
shape our behavior
•Based on the hypothesis that
•1. Active older people are more satisfied and better adjusted than those who are not active,
•2. An older person’s self-concept is validated through participation in roles characteristic of
middle age, and older people should therefore replace lost roles with new ones to maintain
their place in society
•Based on hypothesis that older people, because of inevitable decline with age,
become decreasingly active with the outer world and increasingly preoccupied with
their inner lives; disengagement is useful for society because it fosters an orderly
transfer of power from older to younger people
•Parallels disengagement theory
•Places focus on inner self as positive characteristic
of old age; represents elders’ shift from
materialistic rational view to cosmic transcendent
•Accompanied by increase in life satisfaction
•Values contemplation

•Based on the hypothesis that central
personality characteristics become more
pronounced with age or are retained
through life with little change; people age
successfully if they maintain their preferred
roles and adaptation techniques throughout
•A theoretical perspective based on the argument that the interactions of such factors
as the environment, individuals, and encounters can significantly affect one’s behavior
and thoughts, including the aging process
•A theoretical perspective based on the belief that people maintain their self-
concepts and social identities through their membership in a defined group
•A theoretical perspective derived from symbolic interactionism,
premised on the belief that people derive their self-concepts from
interacting with others in their social milieu; in how others define us
and react to us
•Age Stratification Theory
•Theoretical perspective based on belief that societal age structure affects
roles, self-concept, and life satisfaction
•Social Exchange Theory
•Based on the hypothesis that personal status is defined by the balance
between people’s contributions to society and the costs of supporting them
•A theory based on the hypothesis that social class determines a person’s access
to resources; that dominant groups within society try to sustain their own
interests by perpetuating class inequalities
•Life Course Perspective
•Multidisciplinary view of human development that focuses on changes with age
and life experiences
•Life Course Capital
•Expansion of life course perspective that addresses impact of differential
acquisition of resources among different members of a cohort
•Social Phenomenology/Social Constructionism
•A point of view in studying social life that places an emphasis on the assumptions and
meanings of experience rather than the “objective” facts, with a focus on
understanding rather than explaining
•Perspective that genuine knowledge is based on involvement of the
“objects” of study in its definition and results in a positive vision of how
things might be better rather than an understanding of how things are
•The view that the experiences of women are often ignored in understanding
the human condition together with efforts to attend critically to those
•Emphasizes cultural interactions of the complex aging body and social
context in shaping “lived experience” across the life course
•Addresses biotechnology and reconstruction of aging bodies to reinvent
aging with biomedical/information technology
•Centers on medical and social work “expert gaze” that distances themselves from
elders and treats them as dependent objects
•Relationship of the controller and the controlled in long term care
•Encourages elders to resist practices of professional power and scientific knowledge
to control them
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Caring for Parents with Alzheimer’s
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00:03 (soft music)
00:06 – [Woman] I don’t think I can draw
00:08 with my right hand. – No, okay.
00:10 You could give it a try, give it a try today.
00:13 – With my right hand?
00:15 – With your right or left,
00:16 whichever you prefer. – I don’t wanna draw
00:17 with my right, because I can’t.
00:19 – Alright, I would draw with your left then.
00:22 – [Woman] Aw, look at that.
00:24 – What is this I’m at?
00:28 – It’s called art links.
00:29 They give you a theme and you just paint.
00:33 (heartwarming, upbeat piano music)
00:45 – What we know about people with dementia is that you
00:48 don’t become someone else, you just become more yourself.
00:53 If who you really are is a happy person,
00:56 then you’re going to be happy.
00:57 If you’ve been a somewhat sad or sullen person,
01:00 perhaps you’re gonna be sullen or sad.
01:02 Every person who has dementia has a different experience.
01:05 The best way we can serve people of any age
01:09 is to tailor their care, individualize their service
01:13 to what is truly important for them.
01:16 (heartwarming piano music)
01:20 – Well her mother still insists I’m her father.
01:25 (laughing)
01:27 – [Woman] How do you feel your memory is these days?
01:29 – It has something to be desired. (chuckles)
01:33 I don’t remember what it is. (laughs)
01:35 – Give me five, come on.
01:38 (speaks in foreign language)
01:42 – I cannot take those retirement homes yet,
01:44 I’m not old enough.
01:50 – Well I get ticked off at her at times,
01:54 she gets ticked off at me, but she doesn’t show it,
01:58 and I hope I don’t show it too much. (laughs)
02:03 – Not the mom I remember certainly,
02:05 but I don’t think I have any doubt of her affection.
02:11 – In my later years, my hopes are that I live
02:15 100% completely healthy and get hit by the beer truck.
02:23 – I think what we’re talking about here is quality of life.
02:26 We know that dementia is a terminal disease
02:29 but in experiencing the disease, what do we all long for?
02:32 We long for comfort, we long for solace,
02:35 and we long for peace.
02:37 So even though we can’t change
02:38 the trajectory of this illness,
02:40 we can create the opportunity for quality of life
02:43 and that begins with comfort.
02:53 (birds chirping)
03:04 – [Woman] Oh I’m sorry, I didn’t hear you.
03:05 – You didn’t hear me?
03:07 I just came in and opened your blinds
03:09 so you’d know it was morning.
03:11 Mom has been a very healthy, very active woman
03:16 throughout her life.
03:18 Thirsty? – My mouth is
03:19 still dry. – I know, here.
03:21 In 2010 in February, she was diagnosed with colon cancer and
03:26 besides the cancer she has, Alzheimer’s or dementia
03:29 which she’s on medication for.
03:31 Do you want some lip stuff?
03:34 – [Greta’s Mother] Yeah.
03:39 – I’m gonna have to get you to drink more water
03:41 because your lips are chapped.
03:43 So from now on when I say drink, just drink. (laughs)
03:49 Did you sleep good?
03:53 I hated being in Alaska when I would talk to Mom
03:56 on the phone and she was having a not so good day.
04:02 I planned to be here for Christmas
04:04 and a few days before I got here,
04:05 I got a phone call that she’d fallen and broken her hip,
04:09 so I came home to her being at Life Care
04:13 which is a rehab slash nursing home facility.
04:17 I didn’t want my mom to spend her last days in a facility.
04:21 I wanted her to be home where she had her surroundings,
04:25 where she had her own bed.
04:28 How’s that feel?
04:29 – Feels good. (Greta chuckles)
04:32 – I had discussed it with my brothers,
04:34 I need to be there for my mom and
04:37 I propose a six weeks on and two weeks off schedule
04:40 and we’ll modify that as we go along.
04:43 My brothers were happy with that and so we did it.
04:48 We busted her out of Life Care,
04:49 we brought her home for Christmas
04:50 and it’s worked out every since.
04:55 – Thank you sweetheart.
04:56 – You’re welcome.
04:58 – Well let’s see, I have three children.
05:02 Bud, Kevin, and Greta.
05:08 Yeah, that’s it, the three.
05:12 – [Greta] Are you watching cartoons? (laughs)
05:15 – Where’s my breakfast?
05:19 – When I moved up there as a teenager
05:21 and I was just young and wild and unthinking
05:26 and I didn’t come home as much as I should’ve,
05:28 maybe I could make up for that now.
05:31 I feel like this is the way it needs to be.
05:35 The best way.
05:37 (soft, calming music)
05:45 – When I came here in 1982,
05:49 that’s when my mother decided that her and me will
05:53 live on our own and so we lived together ever since.
06:01 I am a single mother with three boys.
06:05 My oldest one had been out of our house.
06:09 All those years when I got married and then I had my kids,
06:14 she took care of my three boys and everything.
06:17 Things were alright.
06:19 Well her dementia didn’t kick in at an early age.
06:25 It was just lately, maybe around nine years ago.
06:30 (speaks in foreign language)
06:33 At that time, I got a call from the police’s station
06:36 stating that I had to come home.
06:39 (sirens wailing)
06:43 When I got home, the chief of police told me
06:47 that my mother was trying to fry her food
06:51 and that she forgot, the fire started,
06:55 and my next door neighbor came to help her.
06:59 The house was burnt.
07:01 That’s when I realized that I cannot leave mother
07:05 by herself anymore and I ask my friends
07:10 on how to get help for my mother.
07:13 She used to be a seamstress,
07:15 she used to sew my clothes when I was a little girl.
07:21 (soft, calming music)
07:32 – We had a really big building.
07:35 In this town, can you believe,
07:37 we actually live in this building.
07:39 I guess it’s kind of like a play land for adults and kids.
07:44 It’s fun.
07:47 I would love for my mom to be here with us.
07:50 You know, until she decides to move somewhere else.
07:54 It would have to be her decision, not mine.
07:59 I received a phone call from my sister in Alaska
08:04 who said that I needed to contact my mother immediately
08:06 because she had tried to hit and choke my father.
08:14 My sister said that she felt that
08:16 my mother needed to be committed,
08:18 and I said I didn’t think so
08:20 because I was talking to my mom quite frequently but
08:23 it was the stress of my father’s disease, in my opinion.
08:28 – I miss my husband.
08:32 We were going to live in Palmer on this five acre property,
08:36 garden, and plant trees,
08:41 thought we’d live there for the rest of our lives.
08:45 But he had this terminal cancer and they said five years
08:49 and that would be it.
08:52 – My mom was married to my dad for 56 years so we
08:57 got her into some counseling, they felt she was depressed.
09:02 She had dementia or Alzheimer’s.
09:05 One more.
09:08 – I don’t get any more the second time.
09:11 – It was just devastating to me, I don’t understand it.
09:14 All of our lives we work so hard and for what?
09:18 To have to give it all away or get rid of it
09:21 or surrender it to the state in order to keep living?
09:24 You ready, grandma?
09:27 I made a promise to my mother, “I promise you I will not
09:31 “leave you here in Alaska if Daddy’s to pass away.”
09:35 They as a parent deserve that when they become elderly.
09:39 They gave up themselves and it’s a lot to give.
09:42 I want my mother to have that respect that she deserves.
09:48 I have a home, I have a roof over my head,
09:50 I have food that I can put on the table,
09:53 and I have an extra plate to give to my mother
09:55 and I have loving arms to wrap around her 24/7.
10:04 – Favorite number one daughter.
10:05 – Daddy’s little pumpkin pumpkin.
10:09 That’s what he used to call me.
10:12 I remember Dad always working two or three jobs and
10:18 usually it was truck driving and things like that.
10:23 Let’s go out here and have a picnic lunch.
10:30 – This is the finest pioneer home in our country.
10:37 From up here you just have a beautiful view
10:40 of the whole area, all the mountains and all.
10:44 – That’s it, can’t get any better than this.
10:48 I am his primary caregiver outside of
10:50 the pioneer home where he lives.
10:54 He’s my number one Dad.
10:59 He was on a constant high, always,
11:02 always, always, always whistling, always happy.
11:05 – It goes back at least 40 years, I’ve always been happy.
11:10 – It was out of the blue.
11:14 He was doing things at that time like walking out
11:17 right in the middle of a conversation,
11:19 he would leave the room and just walk out.
11:24 There was something happening with Dad
11:28 and I took him in for a diagnosis
11:31 and he was diagnosed with early Alzheimer’s disease.
11:35 We had a little family meeting and decided
11:37 that there needed to be something done.
11:40 Because of Mom’s health, Dad was needed more and more
11:43 to take care of Mom, and Dad was becoming
11:47 less and less able to function,
11:50 especially the way Mom needed and wanted him to.
11:55 That’s when my niece and my sister started paperwork
12:00 to get him into the pioneer home.
12:05 (upbeat piano music)
12:09 (laughing)
12:11 – [Boy] Hi, you want another kiss?
12:12 – Sure. (boy blows raspberry)
12:13 Oh! (laughs)
12:18 – I am the primary caregiver for my mother, Eileen Hall,
12:22 who is 77 and she was diagnosed
12:25 almost three years ago with Alzheimer’s.
12:28 (laughing)
12:31 We have a four year old and I’m about to,
12:33 in a month, to have another baby boy
12:37 who my four year old is insisting on calling Wolverine,
12:40 so we have to refer to him as Wolverine.
12:42 That will not be his name.
12:45 (laughing)
12:47 – Hey, you did it, look at that.
12:49 – She had said she didn’t want to spend another winter alone
12:52 but we hadn’t really set a date and one day,
12:55 oh, it was one of those awful days.
12:58 I ran in and I was like, “Mom I’m gonna drop Aiden off,
13:00 “I gotta meet a repair person.”
13:01 I got back 45 minutes later and she was
13:06 hand on the wall, propping herself up,
13:08 trying to get Aiden to the bathroom.
13:11 – I think I’m, I feel healthy, I don’t feel like,
13:15 I mean I thought by this age,
13:18 you know you’re supposed to be kind of shuffling around.
13:22 – She hadn’t eaten in like two days,
13:24 hadn’t drank anything in two days.
13:26 She was so out of it.
13:29 We couldn’t have ethically left her there.
13:32 She would not have survived.
13:34 That was the point where I said,
13:35 “You know what, you’re moving today.”
13:37 I called all my siblings, everybody dropped work,
13:40 came over, we moved her out of the house that day.
13:43 My mom came alone when she was 21 or 22,
13:47 just got out of nursing school in the 50s.
13:49 Alaska was still a territory, she took a job alone,
13:52 jumped on her very first airplane form Connecticut,
13:55 and took Hoppers up to Sitka, Alaska to be a nurse,
13:57 not knowing what she was getting into to,
13:59 just packed her bag and left.
14:02 – That’s me right here, right on the end here.
14:07 The funny thing is, I was actually left handed
14:11 and forced to change.
14:14 – I love that we’re doing this.
14:17 – I’m Wolverine.
14:18 – I love that Aiden sees her every day,
14:21 that she’s a real part of his life,
14:23 that he will have a solid memory of Nana.
14:26 It’s a real gift to him.
14:32 – You’re going too fast!
14:35 Hey, you’re the winner!
14:44 – She’s mouthy,
14:46 but she’s loving.
14:50 – I think we have a system and then we don’t.
14:52 Like today, when she got up at seven o’ clock this morning.
14:56 That doesn’t usually happen.
14:58 – Why I don’t live alone?
15:01 Aren’t I living alone?
15:03 – [Mona] I’m your number one daughter.
15:05 – Alright, next question.
15:06 – Your favorite number one daughter.
15:09 – Okay.
15:10 – They like cards, they like games, they play Wii,
15:14 they have dancing like teenagers have,
15:16 and I said “I never saw anybody dance like that.”
15:21 – [Violet] It’s your birthday right?
15:22 – [Woman] Uh-huh.
15:24 (laughing)
15:28 (chattering)
15:31 – I shouldn’t put this in here,
15:33 probably she’ll kill me.
15:35 She didn’t finish high school quite,
15:39 she wanted to do it herself.
15:43 – Say goodnight Betty.
15:44 – Goodnight!
15:51 – At Life Care the one thing they were really good about
15:52 was the therapists were excellent working with me.
15:55 The two weeks I went up there,
15:56 I went to physical therapy with her every day
15:58 and they taught me how to transfer her form point to point,
16:01 they taught me how to do exercises with her,
16:04 they taught me how to roll her around in the bed,
16:06 but still, it’s different when you’re the only one
16:09 and it’s your turn and nobody’s here to help.
16:13 The good news is nobody’s here to watch either. (laughs)
16:15 So if you mess up, you mess up.
16:19 When we got home and everybody left, suddenly it was me.
16:24 We’re talking chair, bedpan, bed,
16:28 sometimes trying to get to the potty,
16:30 making sure she sleeps so that I could sleep,
16:34 listening to hear that she would call for me
16:37 and making sure I would hear.
16:39 My worst nightmare was that in her forgetfulness,
16:43 she would forget that she wasn’t supposed
16:45 to put weight on her leg, and try to get out of bed.
16:47 Where do you think I’m going?
16:49 For the first two weeks we had her home,
16:51 she was non weight bearing on one leg,
16:53 so she really had to let me do everything.
16:58 (soft music)
17:02 – Fet-a-peen
17:04 Boy, they didn’t put refills on a lot of these.
17:06 Keeping track of medical bills
17:09 and dealing with the insurance companies and Medicare
17:11 and trying to figure out who owes what and what owes who,
17:15 then you have the medications that are different
17:17 because Medicare only covers certain parts.
17:20 It’s really having to learn what it’s like to be elderly.
17:25 The worst part is, is when you’re older
17:28 and they talk about people with dementia or Alzheimer’s,
17:31 how on earth, as complicated as they make it,
17:36 would these people be able to handle that?
17:38 They wouldn’t.
17:41 My mother is yet to get the social security from my father
17:46 and he passed away in October, we’re already in January.
17:49 That would be those loopholes
17:51 that you have to dive in and out of
17:52 and sometimes they’re a big fiery ring.
17:55 – [Pat] Do you want me to hold on or not?
17:56 – [Nurse] You can hold on.
17:59 – [Janet] In this town, we tried to get in-home healthcare
18:02 because my mom’s insurance covers that.
18:05 – Nothing’s changed on the medicines.
18:07 – None of the organizations are licensed
18:10 to expense medication.
18:13 They can bathe her, they can dress her,
18:16 and they can feed her, but what I need is if I’m not home,
18:20 or my daughter’s at school, I need somebody to push
18:24 the blender on the insulin.
18:31 – The transition was incredibly rough for her
18:33 because I mean she’s going from her own house
18:36 with everything around her.
18:37 The times that we’ve had to kind of tear her out of that
18:40 have just been really, really hard on her.
18:43 Sometimes it’s a little rough here but I
18:45 can think back to when she was living by herself
18:49 and it was a lot more, it was actually a lot more stressful.
18:52 Whereas here, things are normal,
18:54 we make sure she takes her medication,
18:56 we make sure she gets fed.
18:57 You know, and she has companionship.
19:00 – I can’t even count how many pills she was on.
19:03 – It was like 14, 14 different medications.
19:06 – The first thing we did was just slowly back off
19:08 every single pill and say, “Does she really need this?”
19:11 What you see behind you, this is her morning routine.
19:14 That’s a vitamin D and three pills, and the paper.
19:18 I mean this is what orients her today,
19:20 so she knows what day of the week it is.
19:22 Then her pills are there,
19:23 so she still feels like she’s taking them on her own.
19:26 It took probably four months to back off
19:28 down to what we really felt like were the essential pills.
19:32 Sometimes she just enjoys her time on the couch,
19:34 she’s reading the paper all morning
19:37 and she doesn’t wanna go anywhere.
19:44 We can’t get her to walk outside on a sunny day.
19:47 We’re successful some days and not others.
19:51 – Boy, I think I need to go back to bed and get up again.
19:58 – If mother’s condition is really worse,
20:01 then I’ll decide if I will take off, use my sick leave,
20:06 which I don’t have anymore, then I’ll use my annual leave.
20:12 It was so hard to figure it out because as
20:16 a single mother, I don’t have time to
20:20 go to every organization here in town
20:24 to look for the help because I have to work.
20:27 If I don’t work, there goes my two boys too,
20:31 which I need to feed them.
20:34 I only work nine months in a year at the school district,
20:38 and during summer time I don’t get paid,
20:41 so I have to save as much penny as I can.
20:47 My middle son will go to college,
20:50 and he’s the one who’s been helping me here in the house.
20:54 – I actually take care of her on Sundays,
20:57 doing what my mom generally does, feed her.
21:04 One time she thought someone was gonna come and kill her
21:08 and I had to spend around three hours
21:10 at three a.m. to like try and calm her down
21:14 to put her back to bed.
21:17 – You see that my mother’s brain is deteriorating.
21:22 It’s sad to see that the Alzheimer’s
21:24 is really killing her slowly.
21:29 (soft piano music)
21:32 – [Narrator] Alzheimer’s is a slow, fatal disease of
21:35 the brain, affecting one in nine people over the age of 65.
21:39 Unfortunately, no one is immune.
21:43 Alzheimer’s comes on gradually
21:45 as two abnormal protein fragments called plaques and tangles
21:49 accumulate in the brain and kill brain cells.
21:56 They start here in the hippocampus,
21:58 the part of the brain where memories are first formed.
22:04 Over many years time, the plaques and tangles
22:06 slowly destroy the hippocampus
22:09 and it becomes harder and harder to form new memories.
22:12 Simple recollections from a few hours or days ago that
22:17 the rest of us might take for granted are just not there.
22:20 After that, more plaques and tangles
22:23 spread into different areas of the brain,
22:26 killing cells and compromising function wherever they go.
22:30 This spreading around is what causes
22:32 the different stages of Alzheimer’s.
22:35 From the hippocampus, the disease spreads here
22:38 to the area of the brain where language is processed.
22:41 When this happens,
22:42 it gets tougher and tougher to find the right words.
22:48 – The rooms and everything off of this
22:51 are designed for mostly the handicapped people.
22:57 I didn’t come in to that classification.
23:01 – The requirement for that floor is to wear the wander guard
23:06 and they went to put it on and he just told them well,
23:11 no he wasn’t gonna wear it.
23:12 If he had to wear one of those things
23:14 like those old handicapped people wear,
23:17 then he’ll just go kill himself.
23:20 One of the things that he has really gotten active in
23:25 is the hoarding, going through garbage cans.
23:28 Very interesting selection of items.
23:32 Finds lots of tires on the side of the road and hubcaps.
23:37 Three or four bed frames that he had,
23:40 they were actually out in the hall for months.
23:43 Sweaters, baby shoes, always thinking about the families
23:49 that may not have things.
23:55 – [John] I think the lack of privacy
23:56 can be a little bit much.
23:59 – Who are all these people?
24:01 – [John] We have to kind of find our little niches.
24:04 – I used to be nurse and I’ve held lots of babies.
24:08 It better be his. (laughs)
24:12 – Well he kind of looks like me.
24:13 – I think he’s got more hair though.
24:15 – The baby does?
24:17 – Thanks.
24:18 – He’s just part of the family and you know,
24:21 I had four children.
24:23 A baby is a blessing.
24:25 – I know that when she’s in her element,
24:27 it’s just like a car, you fuel it up,
24:29 and you maintain it, and it runs well.
24:31 But man if you don’t take care of it,
24:33 you’re off on the side of the road
24:34 in 10 below with a flat tire and life’s miserable.
24:39 – We’re a cooperative few.
24:42 But we all cooperate with each other and things are fine.
24:46 No complaints.
24:49 – I can see where it could really tear a marriage apart.
24:52 You know if you don’t have the right mindset,
24:55 you can really lose each other.
24:59 – People who are caring for a loved one with dementia
25:02 are twice as likely to develop their own health care issues.
25:06 You’re talking about increased stress,
25:08 potentially increased isolation,
25:10 a lack of getting to the doctor
25:11 for their own health care issues,
25:13 and when you add all of that up,
25:15 they’re not having their own needs met.
25:18 – This is Mom’s favorite place, not in the winter.
25:22 This is where she spends most of her time.
25:25 Here’s the bird lady.
25:28 I am having a hard time keeping my spirits up.
25:32 I’m very homesick and I’m looking forward to getting home.
25:39 The thing we don’t have in Alaska
25:40 are the beautiful red birds.
25:42 I’ve never been gone from Alaska this long.
25:46 I miss my dogs, I miss my husband, I miss my house,
25:50 my friends.
25:51 I’ve been gone too long.
25:55 Life as I know it is left behind.
25:58 I came into this thinking I knew
25:59 all about how to take care of myself
26:01 and I wouldn’t sacrifice not taking care of myself,
26:03 but weeks into it found I would lay in bed at night
26:07 with back pain and it wasn’t a back pain
26:09 that was there from strain, it was there from stress.
26:12 It was from sitting tensed, laying down tensed,
26:15 bending over tensed.
26:18 Cereal your favorite breakfast?
26:21 We have a caregiver, Candy,
26:23 who has been taking care of Mom since last October.
26:26 Mom really likes her,
26:27 they have a great relationship with each other,
26:29 and every day I take off for at least four hours.
26:32 Usually I run errands, there’s always something to pick up,
26:34 something you need, garbage bags, wipes, food, milk,
26:39 prescriptions that are at three different pharmacies
26:42 all over town for one reason or another. (chuckles)
26:45 – Some self care ideas can include
26:47 definitely taking some time for yourself,
26:49 whether it’s a nap, something that you really love to do.
26:53 The other piece of it though is to make sure
26:55 that you’re connecting with your peers or
26:59 with professionals because you wanna have a time
27:01 to be able to let out the feelings and emotions.
27:04 You don’t necessarily need someone to fix it,
27:06 you just need to let it go.
27:10 – This is the best part of the drive, right here.
27:14 Going up, the rest and relaxation ride.
27:20 Here come the horses.
27:22 This is zen time, this is where I go for relaxation.
27:31 It’s kind of the point of sanity because Kat takes,
27:34 helps take care of my parents.
27:47 I’m just slopping in the hay.
27:49 (mumbles) but that’s what makes it all fun.
27:52 – 11, 11:30? Okay, see you then, bye.
27:57 That was Candy.
27:58 – [Candy] Have you looked at your new Reader’s Digest?
28:01 – No I haven’t gone through it yet.
28:05 – She did get up at seven, I heard you asking her.
28:07 But she when back to sleep and didn’t get up ’til about 10.
28:13 Sun’s shining, I’m going for a walk.
28:16 I love you. – I love you too.
28:25 – Sometimes it takes me ’til I get to the stop sign up here
28:28 to feel the relief because I leave
28:29 and feeling guilty and tense about leaving
28:32 and then I get up here to the stop sign
28:34 and I take a breath, and my cell phone works.
28:37 Candy is familiar enough with Mom and what’s going on
28:41 that I don’t feet uncomfortable leaving her there.
28:47 I may think things need to be done in a different way but
28:52 she does things just fine.
29:03 They do a good job here of calling him
29:06 and letting him know that he needs to come back
29:09 at a certain time to get his meds, but he forgets.
29:13 Now he’s getting more forgetful about
29:15 taking his phone with him.
29:17 He forgets that he has to sign in and sign out.
29:21 In the coldest of the winters, every single night,
29:25 every night, he would go out and go downtown.
29:30 What is frightening for us as the family is that
29:36 anything can happen when he’s out.
29:40 I’ve been taking classes and things
29:43 on the various stages of Alzheimer’s
29:45 and the symptoms and what happens
29:47 and I know that he’s not responsible for the change
29:51 in judgment and the inability to connect
29:55 his actions and the consequences.
30:01 The very worst part is there’s no hope
30:06 that it’s going to get better.
30:13 – I don’t know, I can’t draw with my right hand.
30:17 I eventually was forced to learn
30:20 to write with my right hand,
30:23 and I write all the time with my right hand,
30:26 but I cannot draw, I just don’t have it.
30:41 – Thinking back, growing up as a kid,
30:44 during my time in the service.
30:47 – The only one left I have is my sister.
30:51 I kind of remember.
31:01 – [Narrator] The disease creeps towards the front
31:03 of the brain where logical thought takes place.
31:07 Gradually, the person begins to lose the ability
31:09 to solve problems, grasp concepts, and make plans.
31:15 Next, the plaques and tangles invade the part of the brain
31:19 where emotions are regulated.
31:21 When this happens, the person gradually loses control
31:24 over their mood and their feelings.
31:28 After that, the disease moves to the part of the brain
31:31 that makes sense of the things it sees and hears and smells.
31:36 In this stage, Alzheimer’s wreaks havoc
31:39 on the person’s senses and unfortunately,
31:42 it can spark hallucinations.
31:44 Eventually the plaques and tangles
31:46 erase a person’s oldest and most precious memories
31:50 which are stored here in the back of the brain.
31:55 – We had a caretaker come in here,
31:58 what they weer about two weeks maybe at the most?
32:01 Then she finally just started locking them out.
32:03 – She was angry all the time.
32:06 There was no specific incident,
32:07 it was just this ramping up of being really unhappy,
32:10 telling everyone that called how unhappy she was,
32:12 how much she hated it here.
32:14 – She was getting increasingly hostile with Aiden.
32:17 Last weekend, he’d went to do something
32:19 and within the first couple of minutes.
32:22 – 30 seconds.
32:22 – 30 seconds, she was spanking Aiden.
32:24 We say, “Well Nana’s got a disease, it’s her brain,
32:27 “the thing that makes her think.
32:29 “Can you imagine if you had something in there
32:31 “that was eating it away and you couldn’t think straight
32:33 “and you would forget all the time?”
32:35 He’s like, “Oh yeah,”
32:37 but he doesn’t get the emotions behind it.
32:39 – Or the fact that like when Nana repeats something
32:42 for the fourth time, that the appropriate response is,
32:45 “Yes Nana, you’ve told me that four times
32:46 “but I know you’re sick and you’ve got Alzheimer’s.”
32:50 That perhaps you shouldn’t actually say that to Nana.
32:54 He’s five, he doesn’t get that.
32:55 She’s very upset, and three minutes later,
32:57 she’s forgotten it and so we can roll forward.
32:58 I mean it’s not an unforgivable thing, but it’s hard.
33:05 – When mother’s hallucination kicks in,
33:08 she thinks that someone is attacking her.
33:16 She sees so many bugs on the floor too at the same time,
33:21 crawling, and that those bugs are after her.
33:25 She doesn’t go to sleep because it goes on and on and on.
33:30 It’s a nonstop activity for her.
33:34 Her doctor gave me the sleeping pills.
33:36 Once I give her, she sleeps like continuously.
33:41 So if she doesn’t wake up then I’ll end up
33:46 taking care of her and I will take off from work.
33:49 I don’t know where to balance my situation here.
33:54 – [Greta] Mushrooms, potato, broccoli, and a little salad.
33:56 – [Betty] I need a knife.
33:58 – [Greta] You need a knife?
33:59 There you go, what are you gonna do with it?
34:01 – I need some butter.
34:02 I need a fork.
34:04 – You need a fork?
34:06 What happened to your fork?
34:07 Thank you Father for giving us this food
34:10 to nourish our bodies, thank you for us being together
34:14 and being able to support each other.
34:17 In your name, we pray, amen.
34:20 How’d I do?
34:22 (laughs) – I do too.
34:24 – I said how’d I do? (laughs)
34:27 And I love you too.
34:30 You can’t eat?
34:31 – [Betty] No, I don’t want anything to eat.
34:36 – Do you want some ice cream?
34:38 – [Betty] No.
34:39 – Okay, do you wanna go to bed?
34:41 – [Betty] No.
34:42 – Okay well– – I don’t know what I want.
34:48 – I love you too.
34:50 Here, let’s put you up a little bit.
34:56 Goodnight. – Thank you darling.
35:00 – [Greta] I’m gonna close your door a little bit, okay?
35:03 – [Betty] I love you so very much.
35:05 – [Greta] (chuckles) I love you right back.
35:08 – Okay. – Okay.
35:14 She’s so cute, she’s so sweet, you know at night
35:17 and in the mornings sometimes
35:18 she’s just so cute and sweet.
35:20 Then in the middle of the night it’ll be very frustrating,
35:23 there’ll be poop and puke and blowouts and stuff,
35:28 and she won’t be cute and sweet,
35:29 she’ll be like demanding and whatever, but.
35:35 January 10th and January the 11th,
35:37 I had a strange two days with Mom.
35:40 She went into another world on me.
35:42 Most of the day, and wholeheartedly during the night,
35:45 taking things out of her hand
35:47 that weren’t really there and handing them to me,
35:49 talking about all kinds of things that weren’t happening.
35:52 She went to bed around nine
35:53 and I laid on the couch and listened,
35:55 I listened to her talk until midnight.
35:58 It sounded quiet and I went to bed
36:00 and at five a.m., I was jolted awake by a sound.
36:04 I jumped up and went in to her room
36:07 and she was sitting across the room in a chair
36:09 trying to put on her PJ bottoms.
36:11 She didn’t know it was morning, she thought it was night,
36:13 and the shocking part was that
36:15 she’d gotten herself out of bed and across the room.
36:17 My worst fear had come alive.
36:21 The fact is, she was hallucinating and disoriented.
36:24 Another one of the steps of the end.
36:34 – We had hired an outside company to come in
36:39 and it was for four hours per day.
36:41 The lady left early one day without calling me,
36:44 and the next thing I got was a phone call from
36:47 the paramedics saying they were in route to my house
36:50 and my mother had fallen.
36:53 Sure enough, she broke her shoulder
36:56 and she ended up with ten pins.
36:59 The heavy anesthesia they had to use for her arm
37:01 and the painkillers, it was almost like
37:04 that was the turning point for her memory
37:08 and her mental stability, and it was almost like
37:12 she never came fully out of the anesthesia.
37:15 I came to the hospital where she was at and the nurse said,
37:18 “Oh, we had an incident with your mother,”
37:20 and of course I said, “Did she fall out of bed?”
37:22 She said, “No, she used the phone and dialed 911
37:27 “and reported herself as missing.”
37:31 She has enough to know inside that she’s missing things,
37:35 including herself.
37:41 I just sty and stared at my mom and thought well,
37:44 it’s like she’s jailed in her own brain
37:48 that is fighting to keep ahold of reality in the present.
38:01 – I got home late from work one day, I had no idea,
38:05 I mean I walked into a buzzsaw.
38:07 She started swearing, which is not like her at all,
38:11 about a car and getting up to leave and that my husband,
38:16 she started calling him expletives
38:18 and she had called the police to say that
38:21 he had stolen her car.
38:23 Things escalated and we didn’t,
38:25 and what you have to do is engage.
38:27 I had to call my siblings and say,
38:28 “You need to take her for a few days.”
38:31 She was still mad, if you brought up the car,
38:32 she would go right back to that anger
38:34 and then she would get real teary like
38:37 and we’d say, “Well you called the police,
38:39 “you called John these names,” and she was mortified.
38:42 She didn’t remember that she did it
38:43 and by the time she got to my sister’s house
38:45 and out of the way, she didn’t remember.
38:47 That was the end of the car.
38:48 Yeah that disappeared that night.
38:49 She went one way, the car went another.
38:52 (Aiden crying)
38:53 Hey can you tell me what’s upsetting you?
38:55 I’m not doing as well as I did before.
38:57 There’s lots of things that we rolled with.
38:59 Frustration with just not being able to remember things and
39:03 you know, not being oriented in the day.
39:07 I needed him to be the center of attention.
39:10 – [Candy] Give me a hug.
39:13 Did Bud bring this? – Yes.
39:14 – Hey Betty drank every bit of that.
39:17 – I see that. – This is mine.
39:19 – Do you wanna write your hours for the last three days
39:22 since I’m not keeping track for you?
39:26 Write down today anyway and
39:28 I figured that one out but I don’t remember this one.
39:32 – [Candy] Just circle today whenever you got here,
39:35 and then yesterday–
39:36 – Candy, I’m serious as a heart attack about this.
39:39 I cannot keep track of you and me.
39:42 – I understand. – I don’t know what time
39:43 I got here, what time did I get here?
39:45 – I don’t know.
39:46 – See, this is the log where I try to keep track
39:48 of everything that happens during the day
39:50 and not much got written down today
39:52 but other days look like that and that
39:55 and this is where Candy’s supposed to be tracking her time
39:57 because normally, Kevin comes in here
39:59 and reads through the book and writes her a check.
40:01 You know what, if she doesn’t have her time written down,
40:04 she’s not gonna get a check.
40:08 – We’re at our new coffee shop and we started this endeavor
40:12 because my other career would have taken me
40:16 out and away from where my mom is.
40:19 She has a lot of urinary tract infections
40:21 and so those take that Alzheimer’s,
40:24 it gets very severe where she’ll start calling me
40:28 at three and four in the morning and ask me,
40:31 say, “Who’s this?” and I’m like,
40:33 “Well this is Janet and you called me.”
40:36 She goes, “Well why do you sound like you’re sleeping then?”
40:39 And I said, “I am,” and she goes,
40:40 “Well you need to get up, it’s like four in the afternoon.”
40:43 I go, “No that’s four in the morning.”
40:46 Then she won’t remember talking to me.
40:50 It kinda gets you that
40:53 you don’t know who I am but yet you’re conversing with me
40:56 so it takes you down crazy, is what it is.
41:01 – There can unfortunately be some pretty significant
41:03 behavioral changes.
41:05 They may not even recognize their family anymore.
41:07 I know that we see that as a reason why individuals
41:11 look to others to take care, it’s heartbreaking.
41:14 (speaks in foreign language)
41:20 – So when do you make the decision between
41:23 caring for someone at home or moving to an assisted living
41:26 or a skilled nursing facility?
41:27 It’s different for every single family situation.
41:30 It will depend on what stage their loved one is in,
41:33 what resources the family has,
41:35 both formal and informal resources,
41:37 and the needs of the individual.
41:40 – We have just decided to get on the waiting list
41:43 at Horizon House, which is apartments.
41:46 It’s a really good place.
41:47 I don’t know how the transition’s gonna go.
41:53 – We decided that my mom needed to live in assisted living
41:56 and then the home called me and said that
41:58 my mom was in her wheelchair
42:00 and had attended lunch without her pants on.
42:04 I said, “This is not my mother, my mother is very shy,
42:07 “very introverted,” and so it was two days later,
42:11 they called and said that my mother
42:13 had all of her belongings,
42:15 as much as she could pile in her lap in her wheelchair,
42:18 and she proceeded to head to the front door,
42:22 she was leaving and she told the people
42:24 that she needed to be at the bus stop to meet her father
42:28 who was picking her up to take her to college.
42:32 We had gone from being an 82 year old woman
42:35 down to an 18, 19 year old girl waiting for her dad.
42:48 That was very difficult.
42:52 – They decided that his independence
42:55 was more important than his safety.
42:59 I got the call to come get him.
43:05 – Looking better if you’re not looking in a mirror.
43:08 – Yeah.
43:09 (laughing)
43:11 – I did, I got up a minute ago and looked
43:14 and I said, “Gee is that me?”
43:16 – Yep, mm-hmm.
43:18 – Kind of crazy how things happen sometimes.
43:21 All I remember is just walking out across the street there
43:24 and I was right in the middle of some other people around.
43:28 – And then, boom right?
43:32 That is consistent with what I think happened.
43:36 He had never been in so much pain.
43:41 That just choked me up.
43:45 I just thought, oh this is it.
43:47 This is the beginning of the end.
43:50 I felt helpless, just helpless.
43:56 (sad piano music)
44:02 – Until there’s something that we can do about
44:05 the condition medically, then it really falls on us
44:08 to try and develop methods for successful caring
44:12 and service for people who have trouble thinking.
44:15 One of the questions that you should probably be asked is
44:18 if the person with dementia could see themselves now,
44:21 what guidance would they give you?
44:23 What would they say is important?
44:27 – I remember my mother when
44:28 she used to take care of my grandmother.
44:31 I said, “Mom how come you’re taking care of grandma
44:35 “when there’s auntie and uncle too?”
44:38 Then she said, “No, I love to take care of my mother,
44:43 “so you watch me the way I take care of your grandmother,
44:48 “so when I become old like her,
44:51 “you’ll know what to do with me too.
44:55 “I’m pretty sure you will take care of me,”
44:57 that’s what she said.
44:59 I hope my boys will take care of me when I will be old too
45:03 like my mother.
45:05 – I think I said that if that’s the case,
45:09 she’s living with Calvin.
45:41 – We’re going to G. Barrington
45:43 Fort Richardson National Cemetery for DOD, Dear Old Dad’s,
45:48 Happy Harold’s service, funeral, such as it is.
45:59 Lauren’s brother Wayde.
46:06 Medical orders weren’t followed,
46:09 he was given drugs that he didn’t want.
46:12 Other people made decisions for him and it was wrong.
46:17 It was just, it was wrong.
46:22 Family members are either the best supporters
46:27 or the worst supporters,
46:29 the same is true with end of life decisions.
46:32 They’ll either support you
46:34 or they’ll do what they want to have done.
46:38 Unfortunately dying is not simple.
46:40 You just don’t take your last breath and that’s it.
46:44 (military shouting)
46:46 (horn playing “Taps”)
47:12 (military shouting)
47:25 – Oh.
47:26 Men fix, we caregive.
47:33 It’s pouring rain, I don’t want to get everything wet.
47:39 (upbeat music)
47:44 Here I am in the parking lot and she’s calling me.
47:47 – [Pat] It’s Patty and I was wondering where you are,
47:49 it’s 10:30 or more.
47:51 – I have no arms to carry my own purse.
47:54 I kept talking to her before we did this that
47:58 it’s a place to go and start over, to meet friends,
48:02 new friends, and so she was kind of on to that whole idea
48:07 and she thought that was exciting,
48:09 but she also said, “Well I don’t wanna be with old people
48:12 “because they can never remember anything,”
48:14 and I was like wow, okay.
48:15 I was gonna ask you some questions.
48:17 We found this photograph album
48:20 and I don’t recognize a lot of the people
48:24 and I didn’t know if it was yours
48:27 or if that’s Aunt Betty’s.
48:30 How are you gonna steer and wheel?
48:33 – [Pat] One hand.
48:34 – One handed? Aren’t you gonna go in a circle?
48:40 No we had some people coming in at the restaurant,
48:44 the coffee house.
48:46 – One of the things I often tell the family is that
48:48 moving into an environment like this is not only
48:51 going to provide the care that your mom or dad
48:54 or whomever needs, but it’s gonna allow you to go back
48:56 to being the family member.
48:58 Whether they recognize it or not, you do.
49:01 When you come and visit, yeah you may have
49:03 to bring some supplies in or something,
49:04 but you’re not coming to visit to provide the care.
49:07 You’re coming back as the daughter or the son.
49:09 That relationship can flourish
49:11 and be dynamic of a family again, versus a caregiver.
49:15 – I’m embracing it, I have to find the positive in it
49:17 because if you don’t, you’re just gonna be miserable.
49:20 I stopped getting upset, I stopped saying,
49:26 “Are you listening to me? Can’t you retain this?”
49:28 Because the answer is no she can’t.
49:30 And that’s your dad.
49:34 – [Pat] That’s your grandpa.
49:35 – [Janet] I know, Walter.
49:37 – [Pat] This is when we came to Alaska.
49:39 That’s the car we had with all our personal things in it.
49:46 – When people have dementia,
49:47 we know what the outcome is going to be.
49:49 We know that unless some other illness
49:52 takes their life first, that dementia will claim it.
49:55 But that doesn’t mean that you’re dead from the beginning,
49:58 that every moment that you’re living,
50:01 there’s an opportunity to create for you
50:04 that wonderful living experience.
50:08 The fact that you can still know when you’re comfortable
50:10 and when you’re not, those are things that we can utilize
50:13 to create the greatest quality of life possible for you.
50:17 – [Janet] I remember when I was a kid,
50:18 when I was growing up, she loved to garden,
50:20 she loved to watch the birds.
50:23 Those things haven’t changed.
50:26 It’s like she can go back 30 years,
50:28 but yesterday she can’t remember.
50:33 (slow, sad music)
50:55 – I want the roses to show.
51:01 It’s like every day I hear someone else
51:06 talk about their parents and
51:09 what they’re having to do with their parents.
51:12 Probably gonna be everyday for the rest of our lives.
51:26 – The good lesson learned that you’ve said tonight is
51:30 to allow them what they want because
51:35 changing things in that time,
51:39 it’s not going to make it better,
51:41 it’s not going to get better, it’s not going to reverse.
51:44 You can only help them as much as you can,
51:46 and the best way you can help them is to make them happy.
51:50 – Nobody comes with a manual.
51:52 Nobody does.
51:53 The loving care and support that you gave your mom
51:57 by preparing those meals for her is all she needed, truly.
52:02 The best part was, you were there for her,
52:05 you loved her, she loved you, and you took care of her.
52:09 (slow, sad music)
52:15 – [Greta] Do you want a crystal, Kevin?
52:16 – [Kevin] I will take one, yes.
52:21 – You can have the daddy.
52:22 – The daddy?
52:24 One of the last pictures I took of mom,
52:26 she was sitting right there,
52:27 there was a rainbow shooting right on her forehead.
52:30 – [Greta] That’s right, I forgot about that.
52:39 (beep)
52:40 – [Automated Voice] All message, press back.
52:43 – [Eileen] This is your mother, I want out of here.
52:49 – Her mood from day to day, sometimes she loves it there
52:51 and sometimes she hates it.
52:54 You get there slowly, all of a sudden
52:56 you look up and realize where you’ve gone,
52:58 and you’re like we’re hiding in our bathroom
53:00 to have a conversation about our marriage,
53:02 wow that’s probably not healthy.
53:04 I just had to bite the bullet and say she needs to go
53:07 and it’s the best thing for all of us.
53:10 – Hey, pretty neat.
53:12 They threw me out. (laughs)
53:14 – [Marietta] We threw you out.
53:16 – [John] We feel really guilty about it.
53:18 Is it the right thing or the wrong thing?
53:20 I’m not sure that there is such a thing with this.
53:23 – [Marietta] The door is closed, nobody that works here
53:25 is gonna hear anything you say.
53:26 – The place is okay.
53:28 – Sit down next to her. – I’m just not thrilled
53:30 being here. – Nana, remember when it was,
53:33 wasn’t it fun when you made the bubbles
53:36 in the newspaper bags and you’d pop them?
53:38 – Yeah. (laughs) – Yeah that was fun.
53:41 – Sometimes it’s hard to know I’m here
53:44 just thrown in by myself.
53:45 – [Aiden] I wanna play with the newspaper.
53:46 – I mean there’s a lot of people,
53:49 but at the same time, I’m by myself.
53:52 I don’t have my family.
53:54 – [Marietta] I couldn’t be sick and be at home
53:55 because I would constantly have to be
53:57 interacting and caring for and getting food for her
54:00 and explaining things and so I would actually
54:02 go to work sick so that I could take a break.
54:06 I had not realized how depressed I’d gotten.
54:10 Did you show Nana, did you write your name?
54:13 – I don’t even know for sure how long I’ve been here.
54:16 – [Marietta] About two months.
54:18 You got here the beginning of February.
54:21 When she left and she ended up liking it,
54:24 it was such a load off my shoulders.
54:26 – You’re catching me when my mind’s not working.
54:30 On all two cylinders.
54:35 – We have to go back home.
54:37 – I know that it’s gonna happen,
54:38 that I’m gonna walk in and she’s gonna think
54:41 I’m the nursing staff which she doesn’t treat all that well.
54:45 I know that there will come a time when
54:48 she doesn’t recognize my kids,
54:50 and then she won’t recognize my husband,
54:53 and then she won’t recognize me.
54:56 I’m not gonna be the first person.
55:04 It’s as if she’s backing out of time.
55:13 – A very wise person once told my mother
55:15 that there were six people who were doing your job.
55:18 Do the math, it’s difficult for one person
55:21 to do what six people do and to do it every day,
55:26 24 hours a day, every single day of the year.
55:30 (somber piano music)
55:36 – It’s kind of like when your child goes off to school,
55:39 it gets to the point where they don’t wanna hug me,
55:40 don’t kiss me, doesn’t want me to take her any further.
56:00 – Basically everything has gone back to normal
56:03 after Dad’s died to where it was before Dad got sick
56:08 where there’s no family contact
56:12 unless they need me for something.
56:14 Dad’s biggest thing in life was family.
56:18 Everything that he did was for family.
56:20 I have learned a lot through this process.
56:26 – My mom gave me this ornament right here.
56:29 This was the ornament when she was little girl
56:31 that she got to hang on the tree.
56:33 The first whole year was really hard for every occasion.
56:36 I didn’t get a Valentine’s Day card
56:38 from my mom for the first time ever,
56:41 I didn’t have a Christmas box to pack up for her,
56:45 you know it was all the firsts, the first year after.
56:48 Things have gotten much better in that way.
56:53 I think about my mom every day and I miss her very much.
56:58 I really thank my husband for giving me the opportunity
57:01 to be with her and take care of her in her last days.
57:06 To me, that made everything alright.
57:14 – [Marietta] When she comes over now
57:15 it’s like she’s on vacation, and so she’s happy to be there,
57:18 she plays with the kids, and we have a really good time.
57:21 That’s a really good stage.
57:24 I think seeing that she’s happier than she was at my house
57:27 is hard because I know we did the right thing,
57:30 but then you see her there and think,
57:31 well should we have done that to start with?
57:33 Would she have been happier all along?
57:36 She seems content.
58:01 (uplifting music)
A compassionate documentary film telling the stories of five diverse family caregivers over a three year time period who are navigating the labyrinthine and often heartbreaking terrain of caring for their aging and increasingly dependent parents who suffer from Alzheimer’s disease or related dementia (ADRD). ADRD is one of the most rapidly increasing health concerns of our rapidly growing population of older Americans. This website includes cross-cultural perspectives and forward-thinking leaders in the aging field and is designed to complement the story-driven film. The goal of the documentary and dedicated website is to produce resources that provide education, awareness, comfort, information and support for the family caregivers who directly impact the lives of those with ADRD. Because one thing we do know: the cost-savings of keeping a parent at home for as long as possible are astronomical.
BACKING OUT OF TIME balances the serious and heartfelt journeys of the individuals and their families with an upbeat, solutions-oriented, and positive perspective for the film. In each of the five stories, the adult children are trying to do the best for their parents, but stumble repeatedly as they navigate their way through understanding the illness itself, personal expectations, and systemic obstacles for which they were unprepared and lack enough support. This shock, frustration and exhaustion which these families face with such grace are felt by the viewers and can assure those who may be facing similar situations that they are not alone. The significant emotions facing these families no matter what or when the choices are made, is universal. Conflict within a family can be caused by the lack of understanding about the disease progression as it is happening, and before it has progressed when plans could have been made. Bottom line: Have your affairs in order and in writing well before ADRD takes over.
Running Time
59 mins
Mary Rosanne Katzke
Mental Health
Health & Wellness
Those over 85 years old are the fastest growing segment of the U. S. population. Medical advances have enabled an unprecedented number of Americans to live longer, healthier lives. But for millions of elderly, living longer can also mean a debilitating physical decline that often requires an immense amount of care. After reading the theories of aging document and watching the caregiver video address the following questions:
•    Compare and contrast two theories of aging as it relates to the role of the care giver.
•    What is the one thing you learned that you did not previously know?
•    What is the one piece of information that will most likely affect your nursing practice?
Your initial post must be posted before you can view and respond to colleagues, must contain minimum of two (2) references, in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussion board posts.
· Initial Post: Minimum of two (2) total references: one (1) from required course materials and one (1) from peer-reviewed references.
Words Limits
· Initial Post: Minimum 200 words excluding references (approximately one (1) page).
Last updated: 1/31/2020 © 2020 School of Nursing – Ohio University Page 1 of 1
NOTE: No direct quotes are allowed in the discussion board posts.

*Peer-reviewed references include professional journals (i.e. Nursing Education Perspectives, Journal of Professional Nursing, etc. – see library tab on how to access these from
database searches), professional organizations (NLN, CDC, AACN, ADA, etc.) applicable to population and practice area, along with clinical practice guidelines (ECRI Institute –
https://guidelines.ecri.org). All references must be no older than five years (unless making a specific point using a seminal piece of information) References not acceptable (not
inclusive) are UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

**Since it is difficult to edit the APA reference in the Blackboard discussion area, you can copy and paste APA references from your Word document to the Blackboard discussion area
and points will not be deducted because of format changes in spacing.

Levels of Achievement
Meets Expectations Needs Improvement Unsatisfactory
of initial post
10 to 10 Points
• Provided response with rationale.
• The post is substantive and reflects careful
consideration of the literature.
• Examples from the student’s practice/experience are
provided to illustrate the discussion concepts.
• Addressed all required elements of the discussion
• Well organized and easy to read.
3 to 9 Points
• Provided response missing either
substantive rationale, consideration of the
literature, or examples from the student’s
practice/experience to illustrate the
discussion concepts.
• Addresses all or most of required elements.
• Somewhat organized, but may be difficult to
0 to 2 Points
• Provided response with minimal
• Does not demonstrate thought
and provides no supporting
details or examples.
• Provides a general summary of
required elements.
Support for
initial post
5 to 5 Points
• Cited minimum of two references: at least one (1)
from required course materials to support rationale
AND one (1) from peer-reviewed* references from
supplemental materials or independent study on the
topic to support responses.
• The initial post is a minimum of 200 words excluding
2 to 4 Points
• Missing one (1) required course reference
AND/OR one (1) peer-reviewed reference to
validate response.
• Post has at least 200 words.
0 to 1 Points
• Missing 1 or more of the correct
type (course or peer-reviewed)
or number of references to
support response.
• Post is less than 200 words or
there’s no post.
Responses to
10 to 10 Points
• Responses to colleagues demonstrated insight and
critical review of the colleagues’ posts and stimulate
further discussion
• Responded to a minimum of two (2) peers and
included a minimum of one (1) peer-reviewed* or
course materials reference per response.
• Responses are a minimum of 100 words and are
posted on different days of the discussion period by
the due date.
4 to 9 Points
• Responses to colleagues are cursory, do not
stimulate further discussion and paragraph
could have been more substantial.
• Responses missing one of the following:
o insight/critical review of colleague’s
o OR respond to at least two peers,
o OR a peer reviewed*or course materials
reference per response
• Responses are a minimum or less than
100 words and posts were on the same
date as initial post.
0 to 3 Points
• Responses to colleagues lack
critical, in depth thought and
do not add value to the
• Responses are missing two or
more of the following:
o insight/critical review of
colleagues’ post
o AND/OR response to at least
two peers
o AND/OR a peer reviewed*
reference per response.
• Responses are less than 100
words, posted same day as
initial post.
APA format*;
5 to 5 Points
• APA format** is used for in-text citations and
reference list.
• Posts contain grammatically correct sentences
without any spelling errors.
2 to 4 Points
• APA format is missing either in-text or at
end of the reference list.
• Posts contain some grammatically correct
sentences with few spelling errors.
0 to 1 Points
• Not APA formatted OR APA
format of references has errors
both in-text and at end of
reference list.
• Post is grammatically incorrect.

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