Conclusions from psychology literature form the basis for today’s general awareness of a continuum of relationships beginning with knowledge and extending to attitudes and then to behavior (Ajzen & Fishbein, 1977; Allport, 1954). It is plausible, therefore, that a certain level of knowledge about older adults is important for generating attitudes which can lead to the provision of optimal care for this population. It is also important that a relatively simple tool help to distinguish fact from fiction, and truth from myth about aging and older adults. In this chapter the methods by which the level of knowledge about geriatrics has been assessed and interpreted will be examined. Also, the extent to which the level of knowledge about older adults relates to the level of care for this population will be discussed.
Tests of knowledge about older adults
Several tests have been developed to assess the knowledge of healthcare professionals about older adults (International Academic Nursing Alliance, 2010; Ming et al., 2004; Palmore, 1977; Towner, 2006). Palmore’s Facts on Aging Quiz (FAQ) has been used widely in surveys of dental professionals as well as other health professionals and it is discussed here in some detail (Table 4.1).
Table 4.1 Palmore’s Facts on Aging Quiza
|Directions: Circle “T” for true or “F” for false|
|(NOTE: For odd numbered questions, the answers are FALSE; for even questions, the answers are TRUE)|
|1||The majority of old people (past age 65) are senile (i.e., defective memory, disoriented, or demented)|
|2||All five senses tend to decline in old age|
|3||Most old people have no interest in, or capacity for, sexual relations|
|4||Lung capacity tends to decline in old age|
|5||The majority of old people feel miserable most of the time|
|6||Physical strength tends to decline in old age|
|7||At least one-tenth of the aged are living in long-stay institutions (i.e., nursing homes, mental hospitals, homes for the aged, etc.)|
|8||Aged drivers have fewer accidents per person than drivers under age 65|
|9||Most older workers cannot work as effectively as younger workers|
|10||About 80% of the aged are healthy enough to carry out their normal activities|
|11||Most old people are set in their ways and unable to change|
|12||Old people usually take longer to learn something new|
|13||It is almost impossible for most old people to learn something new|
|14||The reaction time of most old people tends to be slower than reaction time of younger people|
|15||In general, most old people are pretty much alike|
|16||The majority of old people are seldom bored|
|17||The majority of old people are socially isolated and lonely|
|18||Older workers have fewer accidents than younger workers|
|19||Over 15% of the US population are now age 65 or over|
|20||Most medical practitioners tend to give low priority to the aged|
|21||The majority of older people have incomes below the poverty level (as defined by the federal government)|
|22||The majority of old people are working or would like to have some kind of work to do (including housework and volunteer work)|
|23||Older people tend to become more religious as they age|
|24||The majority of old people are seldom irritated or angry|
|25||The health and socioeconomic status of older people (compared to younger people) in the year 2000 (or 2020) will probably be about the same as now|
From Palmore (1977).
After several early efforts to assess knowledge about geriatrics (Golde & Kogan, 1959; Kogan, 1961; Tuckerman & Lorge, 1952), Palmore’s FAQ became the first attempt to incorporate elements that were evidence-based and which sought to avoid responses based on attitudes and suppositions. It is likely the most widely used assessment instrument currently; a literature search by the author utilizing PubMed® and Medline® revealed 207 citations.
In 1980, Palmore himself reviewed findings of 25 studies using the FAQ and reported that training in gerontology usually resulted in higher scores (Palmore, 1980). However, also in 1980, Miller and Dodder suggested, in a critical review, that unintended bias was inherent in the wording of several of the FAQ items used in the instrument that Palmore developed (Miller & Dodder, 1980).
In 1981 Palmore published a revision of the first FAQ (FAQ1), termed FAQ2, which included more content on social aspects of behaviors of the population (Palmore, 1981). Lusk and others, in a detailed analysis of content of both studies, reported that the correlation between the two was low (r = 0.04) and Cronbach’s alpha, which reflects the internal validity of the quiz items, was just 0.45 for FAQ1 and 0.32 for FAQ2 (Lusk et al., 1995) [A good score on the scale for Cronbach’s alpha would be >0.70 (George & Mallory, 2003).]
Although other modifications of FAQ1 have followed, it appears that most applications since have utilized the original. In 2008, Unwin and />