Insel10ebrup Ppt Ch14

1,224 views

Published on

Published in: Education, Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,224
On SlideShare
0
From Embeds
0
Number of Embeds
16
Actions
Shares
0
Downloads
13
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Insel10ebrup Ppt Ch14

  1. 1. The Challenge of Aging Chapter 14
  2. 2. Life is Like a River <ul><li>“The flow is continuous, and you never step in the same place twice.” </li></ul><ul><li>There is no precise age when a person becomes “old.” </li></ul>
  3. 3. Generating Vitality As You Age <ul><li>What happens As You Age? </li></ul><ul><ul><li>Characteristics associated with aging are not due to aging but to abuse and neglect. </li></ul></ul><ul><li>Life-Enhancing Measures: Age-Proofing </li></ul><ul><ul><li>Challenge Your Mind. </li></ul></ul><ul><ul><ul><li>Stay mentally active </li></ul></ul></ul><ul><ul><li>Develop Physical Fitness. </li></ul></ul><ul><ul><li>Eat Wisely. </li></ul></ul><ul><ul><li>Maintain a Healthy weight. </li></ul></ul><ul><ul><li>Control Drinking and Overdependence on Medications. </li></ul></ul><ul><ul><li>Don’t Smoke. </li></ul></ul><ul><ul><li>Schedule Physical Examinations to Detect Treatable Disease. </li></ul></ul><ul><ul><li>Recognize and Reduce Stress. </li></ul></ul>
  4. 5. Confronting the Changes Of Aging <ul><li>Planning for Social Changes. </li></ul><ul><ul><li>Changing Roles and Relationships. </li></ul></ul><ul><ul><li>Increased Leisure Time. </li></ul></ul><ul><ul><li>The Economics of Retirement. </li></ul></ul>
  5. 6. Adapting to Physical Changes <ul><li>Some physical changes are inevitable </li></ul><ul><li>Hearing Loss </li></ul><ul><li>Vision Changes </li></ul><ul><ul><li>Age-related macular degeneration (AMD) </li></ul></ul><ul><ul><li>Presbyopia </li></ul></ul><ul><ul><li>Cataracts </li></ul></ul><ul><li>Arthritis </li></ul><ul><ul><li>Osteoarthritis (OA) </li></ul></ul><ul><ul><li>Rheumatoid arthritis </li></ul></ul><ul><ul><li>Lupus </li></ul></ul>
  6. 8. Adapting to Physical Changes <ul><li>Menopause </li></ul><ul><li>Osteoporosis </li></ul><ul><ul><li>Build bone throughout your life </li></ul></ul><ul><ul><li>Diet and exercise </li></ul></ul><ul><ul><li>Avoid tobacco </li></ul></ul><ul><ul><li>Manage depression and stress </li></ul></ul>
  7. 9. Handling Psychological and mental Changes <ul><li>Dementia </li></ul><ul><ul><li>Severe and significant brain deterioration </li></ul></ul><ul><ul><li>Two most common forms </li></ul></ul><ul><ul><ul><li>Alzheimer’s disease </li></ul></ul></ul><ul><ul><ul><li>Multi-infarct dementia </li></ul></ul></ul><ul><li>Grief </li></ul><ul><li>Depression </li></ul><ul><ul><li>Unresolved grief can lead to depression </li></ul></ul><ul><ul><li>Suicide </li></ul></ul>
  8. 10. Life In An Aging America <ul><li>America’s Aging Minority </li></ul><ul><ul><li>65 or Older. </li></ul></ul><ul><ul><ul><li>35 million people, about 13% of the total American population in 2000. </li></ul></ul></ul><ul><ul><ul><li>Affecting the stereotypes. </li></ul></ul></ul><ul><ul><ul><li>Political attention to the growing population. </li></ul></ul></ul><ul><ul><ul><li>The Aging population is increasing proportionately. </li></ul></ul></ul>
  9. 12. Family and Community Resources for Older Adults <ul><li>Family Involvement in care giving. </li></ul><ul><li>Other Living and Care Options. </li></ul><ul><li>Community Resources. </li></ul><ul><ul><li>Senior citizens’ centers </li></ul></ul><ul><ul><li>Homemaker services </li></ul></ul><ul><ul><li>Visiting nurses </li></ul></ul><ul><ul><li>Household services </li></ul></ul><ul><ul><li>Friendly visitor </li></ul></ul><ul><ul><li>Home food delivery </li></ul></ul><ul><ul><li>Adult day hospital care </li></ul></ul><ul><ul><li>Low-cost legal aid </li></ul></ul><ul><ul><li>Transportation. </li></ul></ul>
  10. 13. Government Aid and Policies <ul><li>Food stamps </li></ul><ul><li>Housing subsidies </li></ul><ul><li>Social Security </li></ul><ul><li>Medicare and Medicaid </li></ul><ul><li>Life insurance and old-age pension plan </li></ul>
  11. 14. What is Death? <ul><li>Defining death. </li></ul><ul><ul><li>Defined as cessation of the flow of bodily fluids. </li></ul></ul><ul><ul><li>Life-support systems. </li></ul></ul><ul><ul><li>1968 Harvard Medical School Committee, Brain death involves: </li></ul></ul><ul><ul><ul><li>Lack of receptivity and response to external stimuli. </li></ul></ul></ul><ul><ul><ul><li>Absence of spontaneous muscular movement and breathing. </li></ul></ul></ul><ul><ul><ul><li>Absence of observable reflexes. </li></ul></ul></ul><ul><ul><ul><li>Absence of brain activity. </li></ul></ul></ul><ul><ul><ul><ul><li>Electroencephalogram (EEG). </li></ul></ul></ul></ul><ul><ul><ul><li>Second set of tests after 24 hours </li></ul></ul></ul><ul><ul><ul><ul><li>Hypothermia (Below 90 degrees F) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Central nervous system depressants </li></ul></ul></ul></ul><ul><ul><li>Clinical death </li></ul></ul><ul><ul><li>Cellular death </li></ul></ul>
  12. 15. Dying Versus Welcoming Death <ul><li>Anxiety associated with death. </li></ul><ul><li>Many seek to avoid any thought or mention of death. </li></ul><ul><ul><li>“Out of sight, out or mind” </li></ul></ul><ul><li>United states attitude is to “death denying”. </li></ul>
  13. 16. Planning for Death <ul><li>Making a will. </li></ul><ul><ul><li>Legal instrument expressing a person’s intentions and wishes for the disposition of his or her property after death. </li></ul></ul><ul><ul><li>Estate. </li></ul></ul><ul><ul><ul><li>Money, property, and other possessions </li></ul></ul></ul><ul><ul><li>Testator. </li></ul></ul><ul><ul><ul><li>The person making the will </li></ul></ul></ul><ul><ul><li>Interstate. </li></ul></ul><ul><ul><ul><li>Without having left a valid will </li></ul></ul></ul>
  14. 18. Considering Options for End-of Life Care <ul><li>Spending your last days at home, cared for by relatives and friends? </li></ul><ul><li>-OR- </li></ul><ul><li>Access to the sophisticated medical technologies in the hospitals. </li></ul><ul><li>Home care. </li></ul><ul><li>Hospital-based palliative care. </li></ul><ul><li>Hospice programs. </li></ul>
  15. 19. Deciding to Prolong Life or Hasten Death <ul><li>Would you want aggressive treatment to keep you alive, even if it meant that your were put on life-support? </li></ul><ul><li>Modern medicine. </li></ul><ul><ul><li>Persistent vegetative state. </li></ul></ul><ul><ul><li>Ethical questions about the “right to die”. </li></ul></ul><ul><li>U.S. Supreme Court </li></ul><ul><ul><li>1990. Cruzan case </li></ul></ul><ul><ul><li>2003. Schiavo case </li></ul></ul><ul><ul><li>The right to refuse life sustaining treatment is constitutionally protected. </li></ul></ul><ul><ul><li>The importance of expressing one’s wishes about life-sustaining treatment </li></ul></ul>
  16. 20. Deciding to Prolong Life or Hasten Death <ul><li>Withholding or Withdrawing Treatment. </li></ul><ul><ul><li>The right of a competent patient to refuse unwanted treatment. </li></ul></ul><ul><ul><li>Passive euthanasia. </li></ul></ul><ul><li>Assisted Suicide and Active Euthanasia. </li></ul><ul><ul><li>Physician-assisted suicide (PAS). </li></ul></ul><ul><ul><ul><li>1997. Supreme Court cases </li></ul></ul></ul><ul><ul><ul><ul><li>Washington v. Glucksberg </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Vacco v. Quill </li></ul></ul></ul></ul><ul><ul><ul><li>Oregon is the only state permitting PAS </li></ul></ul></ul><ul><ul><ul><ul><li>The Death with Dignity Act (1994) </li></ul></ul></ul></ul><ul><ul><li>Active euthanasia. </li></ul></ul>
  17. 21. Completing an Advance Directive <ul><li>Living will. </li></ul><ul><ul><li>Enables individuals to provide instructions about the kind of medical care they wish to receive. </li></ul></ul><ul><li>Health care proxy. </li></ul><ul><ul><li>Durable power of attorney for health care </li></ul></ul><ul><ul><li>Appoint another person to make decisions about medical treatment </li></ul></ul><ul><ul><li>Surrogate. </li></ul></ul>
  18. 22. Becoming an Organ Donor <ul><li>Human body is a valuable resource. </li></ul><ul><li>Each day 60 people receive an organ transplant. </li></ul><ul><li>Each day 18 people on the waiting list die because not enough organs to assist. </li></ul><ul><li>Uniform Donor Card. </li></ul>
  19. 24. Planning a Funeral or Memorial Service <ul><li>Disposition of the body. </li></ul><ul><ul><li>Considerations: </li></ul></ul><ul><ul><ul><li>Social </li></ul></ul></ul><ul><ul><ul><li>Cultural </li></ul></ul></ul><ul><ul><ul><li>Religious </li></ul></ul></ul><ul><ul><ul><li>Psychological </li></ul></ul></ul><ul><ul><ul><li>Interpersonal </li></ul></ul></ul><ul><li>Arranging a Service. </li></ul><ul><ul><li>Choice of last rites </li></ul></ul><ul><ul><ul><li>Traditional funeral ceremony </li></ul></ul></ul><ul><ul><ul><li>Simple memorial service </li></ul></ul></ul><ul><ul><ul><li>Costs between $5,000-$7,000 </li></ul></ul></ul><ul><ul><li>Non-profit memorial society. </li></ul></ul>
  20. 25. Coping With Dying <ul><li>No one right way to live or die of a life-threatening illness. </li></ul><ul><ul><li>Doctors treat diseases; people suffer from illness. </li></ul></ul><ul><ul><li>Concerns with: </li></ul></ul><ul><ul><ul><li>Costly medical care. </li></ul></ul></ul><ul><ul><ul><li>Loss of income. </li></ul></ul></ul><ul><ul><ul><li>Repeated and lengthy hospitalization. </li></ul></ul></ul><ul><ul><ul><li>Physical pain. </li></ul></ul></ul>
  21. 26. The Tasks of Coping <ul><li>On Death and Dying (Elisabeth Kubler-Ross). </li></ul><ul><ul><li>5 Psychological stages: </li></ul></ul><ul><ul><ul><li>Denial. </li></ul></ul></ul><ul><ul><ul><li>Anger. </li></ul></ul></ul><ul><ul><ul><li>Bargaining. </li></ul></ul></ul><ul><ul><ul><li>Depression. </li></ul></ul></ul><ul><ul><ul><li>Acceptance. </li></ul></ul></ul><ul><li>Charles Corr’s primary dimensions in coping with dying. </li></ul><ul><ul><li>Four primary dimensions in coping with dying </li></ul></ul><ul><ul><ul><li>Physical. </li></ul></ul></ul><ul><ul><ul><li>Psychological. </li></ul></ul></ul><ul><ul><ul><li>Social. </li></ul></ul></ul><ul><ul><ul><li>Spiritual. </li></ul></ul></ul>
  22. 27. Coping With Loss <ul><li>Experiencing Grief. </li></ul><ul><ul><li>Reaction to loss </li></ul></ul><ul><ul><ul><li>Thoughts, feelings, physical and mental responses. </li></ul></ul></ul><ul><ul><li>Bereavement. </li></ul></ul><ul><ul><li>Mourning. </li></ul></ul><ul><li>Tasks of Mourning. </li></ul><ul><ul><ul><li>Accepting the reality of the loss. </li></ul></ul></ul><ul><ul><ul><li>Working through the pain and grief. </li></ul></ul></ul><ul><ul><ul><li>Adjusting to a changed environment. </li></ul></ul></ul><ul><ul><ul><li>Emotionally relocating the deceased and moving on. </li></ul></ul></ul>
  23. 28. Coping With Loss <ul><li>The Course of Grief. </li></ul><ul><ul><li>Early phase </li></ul></ul><ul><ul><li>Middle phase </li></ul></ul><ul><ul><li>Last phase </li></ul></ul>
  24. 29. Supporting a Grieving Person <ul><li>Give kind and loving support. </li></ul><ul><li>Be a good listener. </li></ul><ul><li>Refrain from making judgments about the survivor’s feelings are “good” or “bad”. </li></ul><ul><li>Social support is critical. </li></ul>
  25. 30. Coming To Terms With Death <ul><li>Confronted with emotions and thoughts that relate to the immediate loss but also to our own mortality. </li></ul><ul><li>Teaches us that relationships are more important than things </li></ul><ul><li>Allow ourselves to make room for death </li></ul><ul><li>Denying death, it turns out, results in denying life. </li></ul>
  26. 31. Aging: A Vital Process Chapter 14

×