From Psychological Theory to Practice: Improving Frail Elders' Quality of Life Through Control-Enhancing Interventions

Abstract

We explore ways in which psychological control theory can be applied with frail elders in long-term care, particularly those in institutional settings. We review the importance of perceived control in the maintenance of physical and psychological well-being, with particular emphasis on the frail elderly population. Several recommendations for enhancing clients' perceptions of control in long-term care service provision settings are discussed: (1) promoting choice and predictability, (2) eliminating helplessness-engendering stereotypes, (3) promoting positive attributions and a sense of responsibility, (4) providing early success experiences, (5) modifying unrealistic goals, and (6) using control-enhancing communication skills. We also address considerations and caveats for implementing control-enhancing interventions in the long-term care facility, as identified by prior research.

Deference as a Form of Reciprocity Among Residents in Assisted Living

“…Although Blau's proposition points to the possible role of deference in social exchanges, our work clarifies the meaning of deference for older care recipients by identifying several distinct kinds of deference. The resulting typology includes two forms of deference (i.e., cooperation and pleasantness) described by others (Baltes et al 1991;Shield 1988;Teitelman and Priddy 1988). However, two other forms that emerged from this research (i.e., participation and gratitude) represent additions to the literature on deference.…”

“…However, benefits may also accrue from deference to staff. Specifically, deference may result in more interaction with and approval from staff, reduced isolation, and increased feelings of control (Baltes et al 1991;Teitelman and Priddy 1988). Taken together, these benefits may result in increased feelings of stability and security among older care recipients (Nelson 2000).…”

“…One nursing home ethnographer observed that residents purposely limited their requests for assistance from staff and refrained from arguing and complaining in an attempt to redress their inequitable relationships with staff (Shield 1988). Other researchers have noted residents yielding to the staff's desire for passive, easygoing, dependent behavior (Baltes, Wahl, and Reichert 1991;Shield 1988;Teitelman and Priddy 1988). This form of deference has been referred to as "learned compliance" and may be expressed in a number of ways, including pretending to be confused, helpless, or indecisive (Nelson 2000).…”

Upswing: Development of a Workshop for Long‐term‐care Staff Responsible for Residents’ Councils

“…Seligman (1975) is known for the concept of learned helplessness, the kind of premature dependency engendered when people perceive that they cannot control their physical and social environments. This, according to Seligman, results in "diminished motivation to initiate actions or respond to the environment, decrements in cognitive functioning, and negative affect, characterized by listlessness, apathy, and withdrawal" (Teitelman & Priddy, 1988). Schulz (1976) discussed the large number of observational accounts documenting the link between lack of personal autonomy and certain negative effects observed among the institutionalized aged.…”

A “last rights” group for people with AIDS

“…Several researchers (Cunningham, Lockwood, & Cunningham, 1991;Korda & Pancrazio, 1991;Pearlman & Uhlmann, 1988;Teitelman & Priddy, 1988) have given suggestions on how to increase a terminally ill person's sense of purpose. Pearlman and Uhlmann (1 988) have offered the valuable guideline of viewing purpose from a multidimensional perspective, seeing purpose as more than a traditional role or job.…”