Sociology of Aging
Age Related Impairments: A Simulation Exercise

Monika Deppen Wood, MA
Rutgers University - Camden

Undergraduates often have difficulty understanding what the normal sensory losses and changes in functional status mean to older adults. To overcome this experiential problem, a classroom assignment, the aging simulation exercise, was developed to engage students as active participants in their learning. Students are obliged to "experience" first-hand some of the many aches and pains as well as sensory losses commonly associated with the aging process.

The aging simulation exercise individualizes the effects of physiological aging by forcing students to experience functional losses. By doing so, it brings home the meaning of functional impairments to healthy, young undergraduate students in a much more effective way than even the best written chapter in a text or the most brilliant lecture could hope to achieve.

From:
Wood, MD, "Experiential Learning for Undergraduates: A Simulation About Functional Change and Aging." In Gerontology & Geriatrics Education, Vol. 23(2), 02.

TEACHING OBJECTIVES

• To develop an appreciation of the effects age related changes in sensory-motor function have on daily living activities.
• To increase knowledge of the physical requirements for accomplishing tasks basic to community living.
• To increase sensitivity to the feelings engendered when functional skills are impaired and independence is compromised.

Supplies needed:

• Absorbent cotton balls
• Ear plugs (optional)
• "Ace" bandages
• Glasses or plastic safety goggles
• Sunflower seeds or dried split peas
• Petroleum jelly
• Transparent tape
• Straws (cut into 1/2)

I. DIVIDE CLASS INTO GROUPS

Break up class into groups of three or four students who do not know each other very well.

II. ASSUME IMPAIRMENTS

Two or three members of the group will volunteer to modify their ability to perform activities in ways that simulate motor and/or sensory changes which frequently accompany old age. Participants may choose to have both a hearing and mobility impairment or any other combination of impairments. Students must undertake everyday tasks in their impaired state and should not remove simulating devices until the exercise is completed. In each group there will be one participant with no impairment. This person is responsible for maintaining the safety of the other group members both indoors and outdoors.

Age-related changes in vision usually begin in midlife, then tend to stabilize until around age 70 or 80, when further visual changes occur. About 95% of individuals over 70 years of age develop cateracts or some other form of vision loss. Although older individuals can compensate environmentally for many of these changes by increasing illumination, reducing glare, using large, clear visual images, and using higher contrasts between foreground and background materials (Ellis, 1991), they are more likely to experience problems with daily tasks.

To simulate vision impairments:

• Coat lenses with petroleum jelly to simulate cataracts.
• Cover the temple area and outer edges of eyeglass lenses with construction paper and transparent tape to simulate loss of peripheral vision caused by glaucoma.

Changes in acoustic acuity begin at midlife. They usually are very mild until individuals reach 60 or 70 years of age, when reduced ability to hear low intensity and high frequency sounds pose significant problems for over a third of older individuals. Presbycusis, or high-frequency loss, makes it difficult to distinguish consonants and understand verbal messages. "That's the wrong way" may be interpreted as "That's the long way."
To improve communication, raising your voice does not help. Instead use a low-pitched voice, speak slowly. Rephrase your sentence, if the hearing impaired person does not understand you. Avoid background noise and make sure that your face is in clear view of the listener (to enable lip reading).

To simulate hearing loss:

• Place ear plugs or absorbent cotton balls into both ears.

Many older people complain that food no longer tastes as good as it did when they were younger. This may have less to do with the food or the cook than with other sensory, age-related changes. The ability to derive pleasure from eating is mediated, to a large degree, by the sense of smell. Odor detection and appreciation diminishes with age. Researchers found that 50% of those 65-80 years old showed evidence of impairment in odor identification (Doty & Snow, 1988). Reduced olfactory function puts older individuals at risk for succumbing to noxious substances in their environment such as leaking gas or spoiled food as well as poor nutrition.
Taste sensation shows only minor changes in late adulthood. The ability to taste salt appears to be moderately diminished, while detection of sweet, sour, and bitter flavors remains relatively unimpaired. It is worth noting, however, that dental disease, poor oral hygiene, and some medicines can alter the ability to taste (Baum, 1985).

To simulate a diminished sense of smell and taste:

• Divide a cotton ball and insert into one nostril.

The ability to be mobile and to remain active depends upon the combined functions of the cardiovascular, respiratory, and musculoskeletal systems. Age-related changes in these three systems are well documented in the literature; however the inevitability of some of these changes is currently in question (Ellis, 1991). Major threats to mobility and other activities of daily living (ADLs) are caused by illnesses, such as arthritis, strokes, or pulmonary disease.

To simulate impairments in joint mobility, balance and respiratory function:

• Use transparent tape to restrict the movement of thumb, index and middle finger joints of the dominant hand (to simulate stiffness due to arthritis)
• Place several dried split peas or sunflower seeds in the sole of each shoe (to simulate pain and loss of balance associated with bunions, corns)
• Use an ace bandage to restrict the movement of one knee joint (to simulate restricted movement due to arthritis).
• Take the straw and breathe through it while walking up stairs (to simulate respiratory problems).

• are responsible for maintaining the safety of their group both indoors and outdoors.
• will assist group members who may require help in getting around. Be particularly watchful on stairs!
• will observe the responses of the "impaired participants" regarding their impairments and the reaction of others to them.

III. CARRY OUT SOME OF THE FOLLOWING ACTIVITIES

• Move about campus, indoors and outdoors - negotiating stairs, hallways and elevators, ramps and curbs;
• Go to the library, use the computer, check out a book;
• Purchase a snack (and eat and/or drink it);
• Go to the Campus Center, use a vending machine, play a computer game;
• Make a telephone call;
• Use the toilet.

IV. REFLECT ON THE EXPERIENCE

• What happened while you where out there?
• Did you experience any difficulties?
• Describe your feelings about this experience.
• What changes did you observe? - about yourself? - about other participants? - about other people responding to you?
• Does the experience stimulate thoughts about the reactions and behaviors of older individuals who have some form of impairment?
• Does the experience suggest changes in your feelings or behavior towards aged individuals?

POSSIBLE PITFALLS:

Emphasize safety issues and always designate an "unimpaired person" to each group. "Caregivers" are needed to assist "impaired participants" in navigating the stairs, hallways, class rooms, and campus grounds. If there are not enough volunteer "caregivers", make sure you assign students to that role.

REFERENCES:

Remnet, VL, Understanding Older Adults and Experiential Approach to Learning. Lexington, MA: Lexington Books, 1989.

Wood, Monika Deppen, "Experiential Learning for Undergraduates: A Simulation About Functional Change and Aging." In Gerontology & Geriatrics Education, Vol. 23(2), 2002.

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