1. Movie and Aging Project by Crystal Ammons, Andrea Isbell, Laura Sullivan, and Regina Wallace.

2.  Touhy, T. (2008). Cognition and caring for persons with cognitive impairment. In C. Jackson & A. Politte (Eds.), Toward healthy aging: Human needs and nursing response (7th ed.). St. Louis, MO: Elsevier.  Touhy, T. (2008). Emotional Health in Late Life. In C. Jackson & A. Politte (Eds.), Toward healthy aging: human needs and nursing response (7th ed., p. 625). St. Louis, MO: Elsevier.  Jett, K. (2008). Loss, death, and dying in late life. In C. Jackson & A. Politte (Eds.), Toward healthy aging: Human needs and nursing response (7th ed., pp. 641-642). St. Louis, MO: Elsevier.  Jett, K. (2008). Physiological changes with aging. In C. Jackson & A. Politte (Eds.), Toward healthy aging: Human needs and nursing response (7 th ed.). St. Louis, MO: Elsevier.

3.  Henry Fonda: Norman Thayer, Jr., a retired professor.  Katharine Hepburn: Ethyl Thayer, Norman’s wife.  Jane Fonda: Chelsea Thayer, Norman and Ethyl’s divorced daughter.  Dabney Coleman: Bill Ray, a dentist and Chelsea’s love interest.  Doug McKeon: Billy Ray, Jr., Bill Ray’s 13 year-old son from a previous marriage.  Directed by Mark Rydell, the film received great acclaim with Fonda and Hepburn both winning Oscars for leading actor and actress.

4.  Norman and Ethyl Thayer visit their Summer cottage on Golden Pond to celebrate Norman’s 80 th birthday.  Joining them is their daughter, Chelsea, her boyfriend Bill, and his son Billy Jr.  Norman is faced with his mortality and changes that often accompany aging. These changes bring about a negative attitude that revolves around limited time and death.  Chelsea and her father have been estranged and her visit brings up old wounds.

5.  Chelsea and Bill leave for Europe for a month, leaving Billy Jr. behind to spend the time with Norman and Ethyl.  Billy’s attitude toward the old couple is one of disdain and he talks of leaving and going back to California.  Norman and Ethyl slowly interest Billy Jr. in life on the pond and soon he begins fishing and doing things around the house with them.  Norman and Billy forge a bond that changes Billy Jr.’s attitude toward the old couple and relationships with elders.  Chelsea returns to see that Norman has a relationship with Billy Jr. that she never had with her father.  Norman and Chelsea work toward healing the rift that has pulled them apart for so many years.

6.  Director Mark Rydell sets the film in an old cottage on Golden Pond that has seen some wear and tear similar to the physical changes that Norman and Ethyl have experienced over the years. The unhinged door is a metaphor for Norman’s aging mind, body, and his attitude. With some care, it may be repaired.  Norman and Billy Jr. search for “Walter”, the elusive trout that is the prize of their fishing trips. The fish symbolizes the peace that Norman is seeking in dealing with his mortality.

7. Central points made by the director include:  Fear of aging and death.  Change in attitudes toward mortality and the strain it puts on relationships.  Anticipatory grief felt by Norman as he experiences physical and mental changes (Jett, 2008a).  Reminiscence of good times on the pond by Ethyl used as a means of therapy (Touhy, 2008b).

8.  Integument changes: gray hair caused by decreased production of melanin in the bulb of hair which is often thin in areas of the head such as the vertex (Jett, 2008b)  Decreased visual acuity and accommodation.95% of older adults over the age of 65 generally wear glasses and often view this normal process as an inconvenience rather than problem (Jett, 2008b).  Auditory changes: Norman had manifestations that leave one to believe he had loss of auditory neurons in spiral ganglia or organ of Corti as evidence by his inability to hear high-frequency sounds that interfered with understanding of speech (i.e. when he talked on telephone).

9.  Memory Retrieval: the ability to retain and regurgitate information as needed (Touhy, 2008a). ◦ Norman exhibits signs and symptoms of mild cognitive impairment in that he has a greater level of memory loss in respect to his peers which in this case refers to his wife (Touhy, 2008a). ◦ Norman exhibits this when his wife sends him out to pick strawberries in a field that he has visited many times and he suddenly becomes stricken with anxiety due to his inability to recall his surroundings. ◦ This type of cognitive impairment leads to dementia which includes memory retrieval deficits as well as aphasia (i.e. inability to speak fluently), apraxia (i.e. inability to create purposeful movements), agnosia (i.e. inability to recognize familiar objects or people), and “disturbances in executive functioning” (i.e. inability to plan or organize) (Touhy, 2008a, p. 560).

10. Defenses used by Norman  Definition of defense mechanism: psychological autonomic reactions that protect one against anxiety, stressors, and dangers (Touhy, 2008b).  Projection: attribution of ones own feelings outwardly onto others (Touhy, 2008b)  Altruism: dedication of ones time and efforts in an attempt to obtain gratification via feelings of appreciation (Touhy, 2008b) Possible Adjustment disorders  Definition of Adjustment disorder: emotional responses to the loss of ones integrity (i.e. creativity, self-worth) that results in despair as evidenced by anger and depression (Touhy, 2008b).  Generalized Anxiety Disorder: unpleasant regards of apprehension commonly related to life events such as illness, social and financial status changes, as well as decreased cognition (Touhy, 2008b).  Excessive suspicion: insecurity resulting in a lack of trust stemming from an attempts to control unsatisfactory situations secondary to social isolation (Touhy, 2008b).

11.  Aging is a consistent battle for integrity vs. despair  Denial of aging results in anger, cynical behavior, and decreased emotional vulnerability  Normalizing external factors to ones inner emotional integrity yield coherent and therapeutic coping mechanisms regarding age  Increasing psychological supports decrease despair in the elder thus creating an accepting, healthy, and anticipatory aging process.

12.  Renewing his relationship with his daughter Chelsea by increasing his social interactions with others.  Expressing more emotional vulnerability and acceptance to aging  Redefining his purpose and meaning in life

13.  Conflicts of aging vs. appreciation of aging process  Disorganized family relationships

14.  Nature and time are symbolized in the film by the Thayer couple retiring to the pond around the time where everything is beginning to bloom and has a new look on life. In essence Norman begins to “bloom” by shedding his old habits and creates a new life for himself. His life now has meaning and purpose.  This purpose is symbolized by the releasing of the old fish, Walter. This catch and release symbolizes the captivity of Norman’s emotional and mental beliefs regarding aging. Norman releases his old thoughts and is given a second lease on life.

15.  Memory Impairment  Impaired Vision  Self care deficit  Ineffective coping with the aging process  Impaired Judgment

16.  Encourage Norman/patient to discuss feelings or concerns while letting them know that you are there for them.  Provide constant supervision of patient. When nurse is not available a family member or hired persons can fill in with watching over patient.  Provide extra lighting in the patient’s house as well as keep a clear pathway free of clutter.