(1a) Explain the three types of values.

(i)

Ultimate values are philosophical or conceptual values that are commonly

accepted by most people. They are derived by refining our goals and
means to the point where they become abstract or conceptual.
(Sociologyguide.com, 2016). Liberty and justice are examples of such
values (Ko, Kalyani & Ko, 2006). For example, for justice, older folks who
are being put up in nursing home may experience injustice as they felt
they are being treated unfairly by their children. They may insist that it is
their childrens responsibilities to take care of them until they die as being
the just and right way in spite of their worsening mental and/or physical
conditions. The concept of justice is one shared by many and abstract in
that everyone has their own perception of it.

(ii)

Instrumental values refer to preferable modes of behaviour. They are not

end goals, rather they provide a method by which end goals are
accomplished. Rokeach (2014) stated that there are 18 instrumental
values namely, ambitious, broadminded, capable, cheerful, clean,
courageous, forgiving, helpful, honest, imaginative, independent,
intellectual, logical, loving, obedient, polite, responsible, self-controlled.
Dahl and Lindblom classified them as instrumental if the values are
thought of as goals. If a value is instrumental, it can be called a mean.
Similarly, an end goal can be seen as a mean when it is used to achieve
another end (Dyke, 1962). For example, the elderly may exhibit a cheerful
self in their lives in order to suppress or not to deal with the hurt and pain
of life, that is to say to sweep it under the carpet. Being cheerful (the

mean) allows him to live his life in a positive and meaningful way (the
goal). Therefore it is the way we want to live our lives and these values
may change depending on circumstances.
(iii)

Proximate values are defined by individual and these values are precise to
each person though each of them may see it differently from the same
dictionary definition. It can include any other explanation and/or related to
individual belief, experiences, thoughts etc. The rights to do something,
the reason for telling white lies are some examples of such values. For
example an elderly who are being abused by their children may cover up
for them because they value loving their children and not wanting them to
be seen in a bad light as compared to the elderly achieving a fair
treatment. Hence it is in the eyes of individuals to determine what is
consider right or wrong even though the values may seem wrong to
others.

(1b) Give an example of each of these three values that you identify yourself
with.
i)

To the elderly in the nursing home, the old folks may see themselves as
the victims of abuse, and abandonment. To me, as a young adult who
supports my elderly mother financially, I see it as a burden if her mental
condition worsens. This may require me to hire a helper to take care of her
physical needs which further increases the financial strain at home. On top
of that, she may compare her standard of living with her friends, and
complains that I am doing injustice to her as she cannot get to enjoy her
old age (such as going on a trip with her friends) due to money constraint.
In this situation, it feels more like an injustice to me. My suggestion is, for
the sake of her health, I think I would do better justice by putting her up in
a nursing home where there are healthcare professional that will take care
of her physical and social needs, and it would also help lessen my burden
physically and financially. Therefore ultimate value such as fairness is
subjective.

ii)

As for instrumental values, I hope to achieve a life lived with honesty and
broadmindedness. It allows me to be real, to say what I mean without
needing to put up a false front, and this enables me to live a life where I
can appreciate myself. These values allow me to be congruent which will
help me to develop a character that can be perceived as being genuine by
the clients thus facilitates the counselling process.

iii)

In area of proximate values, telling white lies or even lies for the sake of
escaping punishment or avoid being blamed is considered dishonest to

me. For example, in order for me to feel I am part of the church I grew up
in, I must agree with their ideas that we should condemn LGBT (Lesbian,
Gay, Bisexual, and Transgender) community. Since I dislike telling white
lies, I tell my leaders that I embrace LGBT people but I do not condone
their behaviour. Having said this, it enables me to counsel people from this
community.

(2a) Describe four physical changes and their limitation that may affect the
counselling process?
Hearing impairment sensory change affects communications (Ko, 2012). Its limitation
may lead to redundant misunderstanding and clashes or social withdrawal. In order
to avoid redundant misunderstanding, it requires the elderly to clarify the
conversation. The action of clarification may give them the feeling of being stupid,
and acknowledging their hearing impairment which they want to avoid such labelling.
If the elderly mistake or mix-up the instructions given to them by the counsellors, it
can create confusion and unexpected arguments among them. The elderly will also
need to raise their voices in order to hear themselves correctly. The raised voice may
give inexperienced counsellors the false impression that they are getting annoyed.
Social withdrawal can occur with elderly that find it embarrassing if they need to
admit they cannot hear properly and require them to ask others to repeat themselves
or speak up louder. The more they withdraw, the more they feel there is a lesser
need to continue counselling as they feel they may be wasting the counselling time
and effort, and this impedes recovery.
Visual impairment sensory change affects the comfort level of the elderly during the
therapy. They experience dry eyes which may results in eye irritation, burning
sensation, and blurring of vision (Ko, 2012). Having such conditions means the
session have to be kept shorter in order not for the elderly to experience discomfort
after having to focus in the session. Therapist that requires client to do homework
will have to take note of the side effect of the mentioned condition. Having eye
irritation will cause frustration and it will affect their mood. Being in bad mood and
unable to concentrate will disrupt the learning experience during the sessions.

Nervous system decreases with aging (Ko, 2012). Elderly may experience difficulty
in sleeping resulting in raised anxiety and frustration. Lack of sleep reduces their
concentration during the counselling sessions. Fatigue makes them unable to retain
the information and advice exchanged during the therapy. Prolonged exposure to
anxiety can make the elderly increase their frequency of negative self-talk, and may
even convinced themselves that something is really wrong with them and counselling
will not help them at all.
Skin becomes thinner and more fragile (Ko, 2012) and will leave the elderly feeling
cold more easily. In an environment where the air conditioner is controlled by a
central system, the coldness will make it uncomfortable for the elderly to concentrate
to retain the information exchanged and/or respond appropriately to the questions
asked by the therapist.

(2b) Discuss three psychological changes and their limitations, which may
affect effective counselling.
The first psychological change is on sustain attention. Attention (Ko, 2012) is the
process where one directs the mind to focus on an object or become aware of the
issue on the topic being discussed. Research shows that the ability to sustain
prolonged attention on multiple tasks or topics is harder for older adults, thus they
will struggle with catching up with the counsellor especially if the counsellor switches
topic or gives extraneous information (Glisky, 2007). Sometimes they can even
struggle to stay on the same topic especially if the counsellor requires the elderly to
perform some task simultaneously. As such the recovery progress will be slower as it
may take more sessions to reiterate what was learned or discussed in the last
session. Counsellor should discuss one topic at a time and he ought to begin with a
summary of what was covered in the last session and also to ask the elderly to jolt
down what was discussed at the current session.
The second change is on Memory and Language.
Language (Ko, 2012) is the way of communication, either spoken or written. As
elderly ages, their comprehension skills with lengthy, complex and/or fast-spoken
messages declines. Thus it is important for inexperienced counsellor to give clear
and concise message spoken at a slower pace, even to the extent of having to
repeat the sentences to make sure the elderly understands well.
Memory (Ko, 2012) declines with age. Research shows that semantic memory
shows little decline in normal aging (Squire, 2009). As such elderly may remember
remote events better especially things that happened during their glory days. In
contrast, short-term memory shows a decline in the speed of processing thus the

working memory abilities affects the performance (Squire, 2009). The elderly may
forget what was discussed or brought to their attention during the last session and
may fail in carrying out the homework or transferring the skills learnt during the
session to their lives. Cohen hypothesized that older adults' decreased performance
on memory and comprehension tasks was due to reduced processing capacity (Light
& Burke, 1988). Often times during the sessions, they may slip their mind and repeat
what was already spoken minutes ago, repeating the whole process thus slowing
down the rate of improvement as compared with younger adults. Inexperienced
counsellor may be led to think that the elderly may not be serious to change thereby
becoming frustrated or less patient with them.
The third change is on the fear of the future (Fritch, 2016). As people aged, the body
is no longer as healthy as before. As standard of living rises, concern of losing ones
own senses, being seen as useless in the work place, unable to take care of oneself,
the need to give up activities that ones enjoy, and the fear of losing a love one
creates much anxiety and fear for the elderly. An inexperienced counsellor may think
that the elderly worries the unnecessary if he were to measure the elderly using his
own yard sticks. When the counsellor gives reassurance at an inappropriate time,
the elderly will feel that he is not being heard, and think that counselling will not help
him.
Total word counts: 1,724 (excluding question titles and references)

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Sociologyguide.com,. (2016). Values, Basic Concepts of Sociology Guide. Retrieved
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