Sociology of Aging
Age Related Impairments: A Simulation Exercise
Deppen Wood, MA
Rutgers University - Camden
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.
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.
Wood, MD, "Experiential Learning for Undergraduates: A Simulation
About Functional Change and Aging." In Gerontology & Geriatrics
Education, Vol. 23(2), 02.
- 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.
- Absorbent cotton
- Ear plugs (optional)
- "Ace" bandages
- Glasses or plastic
- Sunflower seeds
or dried split peas
- Petroleum jelly
- Straws (cut into
I. DIVIDE CLASS
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.
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
Put on glasses which
impose either a visual field cut or blurred vision.
- 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
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
- Place ear plugs
or absorbent cotton balls into both ears.
SMELL and TASTE
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
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
Participants who choose
not to "become impaired" will be designated caregivers. They
- 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
The students will leave
the class room in their small assigned groups of two or three "impaired
participants" and their "caregiver". The participants with simulated
impairments will experience their new functional status while attending
to regular activities for about 30 minutes. They will not remove the simulating
devices until the exercise is completed. Make sure one "caregiver" stays
with each group of impaired participants at all times. Suggested 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
- Use the toilet.
IV. REFLECT ON
Allow time for participants
to discuss their experience. The facilitator may ask:
- What happened
while you where out there?
- Did you experience
- 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?
The activity might
be slightly hazardous because as students are experiencing sensory or functional
losses they will lose the ability to perform activities otherwise done
routinely. Even simple tasks like sitting on a chair or walking down the
steps with glasses that simulate vision loss can be a little risky. For
example, one of my students misjudged the location of her chair as she
was attempting to sit down. Consequently she missed the chair and fell
on the floor. Fortunately, she was only a little bit embarrassed, but not
To avoid problems,
make sure you spend a few minutes going over the instructions for this
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.
Baum, B. J. "Alterations
in Oral Function." In Principles of Geriatric Medicine, edited by
R. Andres, E.L. Bierman, and W.R. Hazzard. New York: McGraw-Hill, 1985.
Ellis, Nancy B. "Aging,
Functional Change, and Adaptation." In Occupational Therapy and
the Older Adult, edited by Jean M. Kiernat, Aspen Publishers, 1991.
R.L., and Snow, J.B. "Age-related Alterations in
Olfactory Structure and Function." In Molecular
Neurobiology of the Olfactory System: Molecular Membranous
and Cytological Studies, edited by F.L. Margolis
and T.V. Getchell. New York: Plenum, 1988.
Irene & Susan K Whitbourne, Teaching Undergraduate
Courses in Adult Development and Aging, Mt. Desert,
MN: Beech Hill, 1979.
Grace. "Aging: Try Walking a Mile in Moccasins of
Age." In The Life Course: A Handbook of Syllabi
and Instructional Material,edited by Timothy
J. Owens, Indiana University at Indianapolis, 1993.
Distributed by ASA Teaching Resources Center, 1722
N. Street NW, Washington, DC 20036.
VL, Understanding Older Adults and Experiential
Approach to Learning. Lexington, MA: Lexington
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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