University College, Health Studies Program

UNI308H1F

AGING ANDHEALTH

University of Toronto, St. George

University College, Health Studies Program

Fall 2014

Instructor: Lynn McDonaldPhD, Director Institute for Life Course and Aging

Office: 263 McCaul Street, Room 328,

Office Hours: Thursdays, 12:30 – 1:30pm or by appointment

Teaching Team:Dr. S. L. Hitzig,

Dr. R. Mirza, ;

Classes: Thursdays, 10:00am – 12:00pm, Sept. 11, 2014 toNov. 27, 2014

Location: UC/244

COURSE DESCRIPTION

This course provides undergraduate students with an interdisciplinary introduction to issues associated with health and aging in Canada. The course will focus on the physical, psychological, social andeconomicfactors that affect health and aging at the individual and population levels. Students will be introduced to a range of health issues that older persons, their health providers, and society face in the next decade. These include the demographics, biology and psychology of aging, an understanding of basic health and mental health issues, and policy decisions that provinces and the federal government will need to considerin light of these issues.

The purpose of this course is to enable students to develop a critical understanding of the bio-psychosocial, economic, and political forces that shape how the health issues of older adults are perceived in Canada.

COURSE OBJECTIVES

The central objective of the course is to provide an opportunity for students to think critically aboutaging and health in Canada and to demonstrate this knowledge analytically through testsand assignments. By the end of the course students will be able to:

1. Understand the demographic shifts that have led to population aging
2. Understand myths about aging and identify alternatives to ageism
3. Understand the physical and psychological changes that occur with age
4. Understand the major theories and concepts key to the study of aging
5. Understand basic health policy as it applies to population aging
6. Understand the determinants of healthy aging
7. Understand the challenges facing older people and their caregivers

REQUIRED TEXTBOOK

Novak, M. and Campbell, L. and Herbert C. Northcott (2013).Aging & Society: A Canadian Perspective (7th edition). Toronto: Nelson Education Ltd.

The book may be rented at the following address:

READINGS

All course readings will be available in electronic format through the course website.

FORMAT

This course is organized as a series of lectures. Attendance is mandatory. It is your responsibility to find out about missed instructions/assignments/announcements. All relevant information is on the course Blackboard site, which will be updated regularly. Students are expected to do the readings prior to each class and to be respectful of others during lectures/films/discussions.

COURSE ASSIGNMENTS

Course Assignments: / Due Date: / Percentage of Course Grade:
A. SITE TOUR AND REFLECTION PAPER / October 16th / 25%
B. SYNOPISIS OF HEALTH ISSUE (PAPER) / November 27th / 35%
CLASS PARTICIPATION / All classes / 10%
EXAMINATION / Scheduled by Registrar / 30%

GENERAL GUIDELINES FORSUBMITTING ASSIGNMENTS

Please respect the word limits as set out in each assignment.

Please submit an electronic version of your assignment through Blackboard (see the note about Turnitin plagiarism detection software in the “Course and Academic Policies” section).

Please use one and a half spacing forall assignments.

Please include a cover page clearly indicating your name and student number.

Please use APA format for referencing in your assignments.

Please ensure assignments are submitted on time (see the penalties for

 submissions below).

Please get help if you need it

ASSIGNMENTS

A. Site Tour and Reflection Paper – 25% October 16th

i)You will be randomly partnered with a member of your class and will conduct a tour of any health or social service facility serving older adults. These facilities include geriatric wards in hospitals, nursing homes, day hospitals, retirement homes, specialized health clinics for older adults, community outreach teams, art and dementia centres, mental health services, ethnic services, drug addiction services, police services, nutritional services (meals on wheels) etc. Partners will be randomly chosen in class and students will make an appointment for a tour with the designated contact TBA. The tour is as long as the contact person decides (usually not more than two hours).

ii)You are asked to write a 10 page reflection paper plus citations about your experience and because it represents your views, it will be different from your partner’s views.

iii)Some suggestions/guidelines for the structure and content of your reflections:

Ultimately you are addressing three simple questions: What?/ So What?/ Now What?

What ?

A brief descriptive account

Facts, what happened, with whom, where

Substance of interaction/activity

So What ?

Interpretive from your perspective

Meaning of experience for you

Feelings involved, what was new

Understanding why of the experience and activity?

Link to course materials

Now what?

Contextual - what does this activity, experience/situation mean in the broader context of health and aging?

Applying lessons learned / insights gained to new situations

Setting future goals ( e.g. learning goals or plan of action).

Reference:Reed, J. & C.Koliba (1995) Facilitating Reflection: A Manual for Higher Education.

B. Mini Synopsis Paper - 35% November 27th 2014

i)You will complete a mini synopsis review paper using no less then 8 and up totenstudies in an area of interest to you in health and aging. For this assignment the definition of a scoping review from the Canadian Institutes for Health Research (CIHR) will be followed. According to the CIHR, ’Scoping reviews are exploratory projects that systematicallymap the literature available on a topic, identifying the keyconcepts, theories, sources of evidence, and gaps in theresearch.’ (CIHR, 2010:2).

ii)You will follow the five steps (not the 6th) required for the scoping review as outlined by Arksey and O’ Malley (2005):

1. Identifying the research question,
2. Searching for relevant studies,
3. Selecting studies,
4. Charting the data, collating, summarizing,
5. Reporting the results

iii)The final report will be no more then 15 pages plus bibliography. Two instructive papers on scoping reviews will be found on the course website on Blackboard:Arksey and O’Malley (2005) and Levac et al. (2010). There will be an informal tutorial to help you understand the scoping review process.

C. Class Participation – 10% Ten classes - September 18th to November 27th

i)In 10 classes you will be given a sticky note when you arrive upon which you are to provide your name and student number and a question based on the assigned readingsor chapter for that week. These sticky notes will be green.

ii)At the break you will stick your question on the board and the instructor will initiate discussion later in the class with two or three of the questions. Be prepared to participate and lead discussion if asked. You must submit your question on the sticky note by break in order to receive a mark. The instructor willcollect your questions and you will receive one mark for the question and up to 10 marks for the term.

D. Final Examination 30% December 2014

i)You will complete a final examination (multiple choice, short-answer and essay format), based on lectures, films and readings. This exam will be scheduled by the registrar.

LEARNING ENVIRONMENT

A. Use of Electronic Devices in the Classroom

In consideration of your classmates and your own learning please turn off all cell phones and pagers during class. If you must be on call for an emergency, please let your home or office know that you are only available for emergencies that no one else can handle. If you must carry a pager/phone, please set it to vibrate only. Please do not use laptops for anything other than note taking.

B. Grading Criteria, Plagiarism & Late Papers

The University Grading Practices are available at:

Written assignments will be graded on their clarity, comprehensiveness, originality, appropriate use of reference materials and technical adequacy. Papers are expected to be of sufficient quality as to represent your growing knowledge and competence in health and aging. All written work must use an APA reference format.

C. Plagiarism

Students are expected to commit to the highest standards of integrity, and to understand the importance of protecting and acknowledging intellectual property. It is assumed that they bring to their graduate studies a clear understanding of how to cite references appropriately, thereby avoiding plagiarism. The student’s thinking must be understood as distinct from the sources to which the student is referring. Two excellent documents entitled: How Not to Plagiarize and the Code on Behavior and Academic Matters is available for you to review at council.utoronto.ca.

D. Late Assignments

The teaching team for this course has agreed that any paper handed in late will lose 5% per day. Any paper more than one week late will not be accepted without clear documentation of illness or family crisis. Students should make every effort to discuss anticipated late papers with instructors in advance of due dates. Make a copyof everything you submit for course assignments.

E. Accommodations for Students with Disabilities or Medical Conditions

If you need or desire an accommodation for a disability or medical condition, please contact Accessibility Services to develop an academic plan. It is up to you to inform the instructor/s that you need support so we are able to modify the way the course is taught to facilitate participation and/or use resources available to us.We will treat all information as private and confidential.

F. Religious Observances

Please notify the instructors if religious observances conflict with class attendance or due dates for assignments so we can make appropriate arrangements for alternate scheduling of evaluations or make up of missed work.

G. Absence Due to Illness or Injury

If illness or injury is likely to interfere with your meeting a due date for an assignment or other requirements, you must obtain a “Verification of Student Illness or Injury Form” at the time of your illness and submit it to the instructor.

You must inform the instructors of the illness on or before the deadline date.

For more information please refer to the University of Toronto’s “Verification of Student Illness or Injury” website:

COURSE SCHEDULE FALL TERM

Class / Topic / Required Reading
Sept. 11th / Introduction to the course Population aging
Ethnicity and aging / Textbook Chapter 3 and 4
Only recommended:
United Nations (2013). World Population: Ageing 2013. Dept. Of Economic and Social Affairs, Population Div. New York.
National Institute on Aging (n.d.) Why population Aging Matters: A Global Perspective.
Sept. 18th / Aging and health in Canada
Health models and aging
Health Policy ON
The cost of aging / Textbook Chapter 7;
One of the following:
M. J. McGregor, et al. (2014). Nursing Home Characteristics Associated with Resident Transfers to Emergency Department. Canadian Journal on Aging / La Revue canadienne du vieillissement, 33, pp 38-48.
Dr. Samir K. Sinha (2013). Living Longer, Living Well. Highlights and Key Recommendations From the Report Submitted to the Minister of Health and Long Term Care and the Ministry responsible for Strategy for Ontario.
CIHI (2013).National Health Expenditure Trends, 1975 to 2013. Canadian Institute for Health Information, Spending and Health Workforce.
Fast, J. et al. (2013). The economic Costs of Care to Family friend Caregivers: A Synthesis. University of Alberta: Edmonton.
C. Estabrooks et al. (2013). A Profile of Residents in Prairie Nursing Homes. Canadian Journal on Aging / La Revue canadienne du vieillissement 32 (3): 223 – 231.
Pamela L. Ramage-Morin et al. (2010). Health-promoting factors and good health among Canadians in mid- to late life. Statistics Canada, Catalogue no. 82-003-XPE, Health Reports, Vol. 21, no. 3, September
Sept. 25th / Ageism and health
Ageism, health professionals
Your attitude / Textbook Chapter 1;
One of the following:
H. SkirbekkNortvedt, P. (2014). Inadequate Treatment for Elderly Patients: Professional Norms and Tight Budgets Could Cause ‘‘Ageism’’ in Hospitals. Health Care Anal 22:192–201.
B.Ng et al., (2014). Relationship betweendisclosure of same-sex sexual activity to providers, HIV diagnosis and sexual health services for men who have sex with men in Vancouver, Canada. Can J Public Health. 105(3):e186-e191.
C. Hwang (2013). Undergraduate Students’Knowledge about Aging and Attitudes toward Older Adults in East and West: A socio-economic and cultural exploration. Int’l. J. Aging & Human Development, Vol. 77(1) 59-76.
Robin T. Higashi et al., (2012). Elder care as “frustrating” and “boring”: Understanding the persistence of negative attitudes toward older patients among physicians-in-training. Journal of Aging Studies. 26: 476–483.
Oct. 2nd / Biological theories of aging
Wear-and-tear
Autoimmune
Cross-linkage
Free Radicals
The longevity dividend / Textbook Chapter 5;
One of the Following:
H. Kendig et al., (2014). Health, lifestyle, and gender influences on aging well: an Australian longitudinal analysis to guide health promotion.Frontiers in Public Health. 2:70
M.E. Levine, E.M. Crimmins(2014). Evidence of accelerated aging among African Americans and its implications for mortality. Social Science & Medicine. (1982) 07/2014.
Flatt, M.A. et al., (2013). Are “anti-aging medicine” and “successful aging” two sides of the same coin? Views of anti-aging practitioners. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 68(6), 944–955.
Dragojlovic, N. (2013). Canadians' support for radical life extension resulting from advances in regenerative medicine. Journal of Aging Studies 27, 151–158.
Oct. 9th / Psychological Theories in Aging
Neuropsychological (normal and degenerative)
Life span development, SOC, socio-emotional theory
Cognition and aging
Personality and aging, developmental and trait. / Textbook Chapter 6;
One of the Following:
Martin, P. et al., (2014). Defining Successful Aging: A Tangible or Elusive Concept?The Gerontologist, 2014, Vol. 00, No. 00, 1–12.
K. Walhovd, et al., (2014) Cognitive decline and brain pathology in aging – need for a dimensional, lifespan and systems vulnerabilityview. Scandinavian Journal of Psychology, 2014, 55, 244–254
José Marmeleira (2013). An examination of the mechanisms underlying the effects of physical activity on brain and cognition. Eur Rev Aging Phys Act, 10:83–94.
George, D. R. & Peter J. Whitehouse (2011).Marketplace of Memory: What the Brain Fitness Technology Industry Says About Us and How We Can Do Better. The Gerontologist . Vol. 51, No. 5, 590–596.
McCleary, L. et al., (2012) Pathways to Dementia diagnosis among South Asian Canadians. Dementia
12(6) 769–789.
Oct 16th / Disability
*SITE TOUR AND REFLECTION PAPER DUE* / Two of the following:
Molton et al. (2014). Modeling Secondary Health Conditions in Adults Aging with Physical Disability. Journal of Aging and Health. Vol. 26(3) 335–359.
E. Raymond & Amanda Grenier (2013). Participation in Policy Discourse: New Form of Exclusion for Seniors with Disabilities?. Canadian Journal on Aging / La Revue canadienne du vieillissement, 32, pp 117-129.
Rosso et al. (2013). Mobility, Disability and Social Engagement in Older adults. Journal of Aging and Health. 25(4) 617–637.
Hitzig, SL., et al., (2011). An evidence-based review of aging of the body systems following spinal cord injury. Spinal Cord (2011) 49, 684–701.
Oct. 23rd / Chronic Illness
Injury / Two of the Following:
David Armstrong (2014) Chronic illness: a revisionist account January, Sociology of Health & Illness, Vol. 36 No. 1,pp. 15–27
L. Hurd Clark (2014). Negotiating Vulnerabilities: How Older Adults with Multiple Chronic Conditions Interact with Physicians. Canadian Journal on Aging / La Revue canadienne du vieillissement / Volume 33 / Issue 01 / March, pp 26 – 37.
A. Paganini-Hill (2013).J Aging in Place in a Retirement
Community: 90+ Year Olds.Journal of Housing for the Elderly, 27:191–205.
M. G. Ory et al., (2013). National Study of Chronic Disease Self-Management: Six-Month Outcome Findings. Journal of Aging and Health. 25(7) 1258–1274.
Public Health Agency of Canada (2014). Seniors’ Falls in Canada, Second Report. Ottawa.
CIHI (2011). Seniors and the Health Care System: What Is the Impact of Multiple Chronic Conditions? Analysis in Brief.
Oct. 30th / Mental illness and Dementia / Two of the following:
E. L. Mortensen et al. (2014). Personality in Late
Midlife: Associations With Demographic Factors and Cognitive Ability. Journal of Aging and Health.
Vol. 26(1) 21–36.
C. M. Ogle et al., (2014) Cumulative exposure to traumatic events in older adults. Aging & Mental Health, Vol. 18, No. 3, 316–325.
K. Jacklin et al., (2014). The Emergence of Dementia as a Health Concern Among First Nations Populations in Alberta, Canada. Can J Public Health, 104(1):e39-e44.
Larson et al. (2013). New Insights into the Dementia Epidemic. New England Journal of Medicine PerspectivesDec. 12th.
Y. Tieu & K. Konnert (2014). Mental health help-seeking attitudes, utilization, and intentions among older Chinese immigrants in Canada. Aging & Mental Health, 2014
Vol. 18, No. 2, 140–14.
Alzheimer’s Society (2010). The Rising Tide: The Impact of Dementia on Canadian Society. Canadian Alzheimer’s Society.
Nov. 6th / Income
Women’s poverty
Effects on housing, transportation / Textbook Chapter 8 and 11;
Recommended:
Shaw et al., (2014). Socioeconomic inequalities in
Health after 50: are health risk behaviours to blame
SocSciMed. 2014 Jan;101:52-60.
Tochukwu C. Iloabuchi (2014). Risk Factors for Early Hospital Readmission in Low-Income Elderly Adults. J Am GeriatrSoc 62:489–494.
VahidRavaghi, (2014).Comparing Inequalities in Oral and General Health: Findings of the Canadian Health Measures Survey. Canadian Journal of Public Health. Vol. 104, No. 7.
M. Turcotte (2012). Profile of seniors’transportation habits. Canadian Social Trends. StatisticsCanada, Catalogue no. 11-008.
McDonald, L. & L. Robb (2011). The Economic Legacy of Divorce and Separation for Women in
Old Age. Canadian Journal on Aging / La Revue canadienne du vieillissement, Volume 23 Supplement/Supplément, pp. S83-S97
Nov. 13th / Pharmacology / CIHI (2013).Adverse Drug Reaction–Related Hospitalizations Among Seniors, 2006 to 2011. Analysis in Brief. March.
Votova, K. et al., (2013). Polypharmacy Meets Polyherbacy: Pharmaceutical, Over-the-counter,and Natural Health Product Use Among Canadian Adults. Can J Public Health 2013;104(3):e222-e228.
Ballantyne, P J, Mirza, RM., Austin, Z, Boon, H., Fisher, J., Cohen-Kohler, JC. (2011). “Becoming Old as a “Pharmaceutical Person’: Negotiation of Health and Medicines Among Ethno-Culturally Diverse Older Adults”. Canadian Journal on Aging 30 (2):169– 184.
Nov. 20th / Social Isolation
Loneliness / Textbook Chapter 12;
One of the following:
C. Stephens & J. Noone (2014). Upstream andDownstream Correlates of Older People’s
Engagement in Social Networks: What are their effects on Health Over time? Int’l. J. Aging& Human Development, Vol. 78(2) 149-169.
Pettigrew et al. (2014). Older people’s perceivedcauses of and strategies for dealing with social isolation. Aging & Mental Health, Vol. 18, No. 7, 914–920,
Coyle, K. & Dugan, E. (2012). J Social Isolation,