https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.1982.tb02839.x
Supported in part by grant No. 7362 from the Robert Wood Johnson Foundation and by
grant No. MH 32946 from the National Institute of Mental Health.
Abstract
Many performance deficits observed in institutionalized elderly patients may be the
result of social and environmental factors rather than disease or the aging process.
To test this hypothesis, 72 nursing home residents (mean age, 78 years) were randomly
assigned to three groups for training in completion of a simple psychomotor task.
In four training sessions, members of Group I (“helped”) were given extensive assistance
in completing the task; members of Group II (“encouraged only”) were given verbal
encouragement but minimal assistance; members of Group III (“no contact”) received
no training sessions and served as controls. All subjects were tested on proficiency
in completion of the task (a simple jigsaw puzzle) before and after the intervention
period. Completeness of performance by Group II improved during the study, but that
of Group I deteriorated significantly (P = 0.04 between groups) to a level even below that of the control group (P = 0.03). Similar differences were found in speed of performance, with Group II performing
best, Group I performing worst (P = 0.05), and the control group performing intermediately. Perception of task difficulty
was greater (P = 0.02) and self‐confidence was less (P = 0.06) for Group I than for Group II. The psychosocial environment of long‐term
facilities can have important effects on the competence of elderly patients. Excessive
infantilization of residents and overly intrusive help in self‐care beyond clinical
requirements can lead to “learned helplessness,” with further disability.
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