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Lifespan Chapters 15 17 Online Stud


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Lifespan Chapters 15 17 Online Stud

  1. 1. Aging Death and Dying Chapters 15-17
  2. 2. Successful Aging <ul><li>Living longer </li></ul><ul><li>Positive Aging </li></ul><ul><li>X Cult </li></ul>
  3. 3. Life Span and Life Expectancy <ul><li>has increased 31 years since 1900 </li></ul><ul><li>average U.S. life expectancy = 77.6 years </li></ul><ul><li>women outlive males an average of 5 years </li></ul>
  4. 4. Successful Aging
  5. 5. Biological Theories of Aging <ul><li>Cellular Clock Theory </li></ul><ul><ul><li>as we age, cells become less capable of dividing </li></ul></ul><ul><ul><li>telomeres -- DNA sequences that cap chromosomes </li></ul></ul><ul><ul><li>as cells divide, telomeres become shorter and eventually cell can no longer divide </li></ul></ul><ul><li>Free Radical Theory -- people age because as cells metabolize energy, the byproducts include unstable oxygen molecules known as free radicals </li></ul><ul><ul><li>damages DNA </li></ul></ul><ul><ul><li>can lead to disorders such as cancer and arthritis </li></ul></ul>
  6. 6. <ul><li>Hormonal Stress Theory -- aging in the body’s hormone system can lower resistance to stress and increase likelihood of disease = risk of chronic disease </li></ul>Biological Theories of Aging
  7. 7. Sensory Developments <ul><li>Inevitable </li></ul><ul><li>Vision </li></ul><ul><ul><li>visual acuity, color vision, and depth perception decline </li></ul></ul><ul><ul><ul><li>cataracts -- thickening of lens </li></ul></ul></ul><ul><ul><ul><li>glaucoma -- optic nerve damaged by pressure from fluid build-up </li></ul></ul></ul><ul><ul><ul><li>macular degeneration -- deterioration of retina </li></ul></ul></ul><ul><li>Hearing </li></ul><ul><ul><li>degeneration of cochlea </li></ul></ul><ul><li>Smell and taste </li></ul><ul><ul><li>most older adults lose some ability to taste and/or smell </li></ul></ul>
  8. 8. Changes in: <ul><li>Sexuality </li></ul><ul><li>Hypertension </li></ul><ul><li>Arthritis </li></ul>
  9. 9. Other Health Issues <ul><li>Major depression </li></ul><ul><ul><li>Increase in the oldest old (85 and older) </li></ul></ul><ul><ul><li>Sometimes associated with drug side effect/interaction! </li></ul></ul><ul><li>Parkinson’s disease -- chronic, progressive. Muscle tremors, slowing of movement, partial facial paralysis </li></ul><ul><ul><li>Degeneration of neurons that produce dopamine </li></ul></ul><ul><li>Dementia -- global term > neurological disorder; deterioration of mental functioning </li></ul>
  10. 10. Causes of Alzheimer’s Disease <ul><li>Alzheimer’s -- progressive, irreversible; gradual deterioration of memory, reasoning, language, physical function </li></ul><ul><li>No certain scientific proof of causes. Associated with: </li></ul><ul><ul><li>Age </li></ul></ul><ul><ul><li>Genetic links seem to exist </li></ul></ul><ul><ul><li>Lack of exercise </li></ul></ul>
  11. 11. Alzheimer’s Disease <ul><li>< 65: less than 2%; ~doubles every 5 years </li></ul><ul><li>Symptoms </li></ul><ul><ul><li>Inattention </li></ul></ul><ul><ul><li>Disoriented </li></ul></ul><ul><ul><li>Altered Py </li></ul></ul><ul><ul><li>Difficulty articulating </li></ul></ul><ul><ul><li>Impaired gait/movement </li></ul></ul><ul><li>Kills ~100,000/yr in U.S. </li></ul>
  12. 12. Leading Causes of Death <ul><li>Heart disease </li></ul><ul><li>Cancer </li></ul><ul><li>Stroke </li></ul><ul><li>Chronic lung diseases </li></ul>
  13. 13. Other issues <ul><li>Arthritis -- inflammation of the joints, accompanied by pain, stiffness, and movement problems </li></ul><ul><li>Osteoporosis -- can reduce/reverse effects </li></ul><ul><li>Sexuality </li></ul><ul><li>Declines in memory </li></ul><ul><li>Exercise > maintain independence, prevents institutionalization, increases longevity </li></ul>
  14. 14. Training Cognitive Skills <ul><li>Training can improve the cognitive skills of many older adults </li></ul><ul><li>There is some loss of plasticity in late adulthood, especially in those older than 85 years </li></ul><ul><li>Cognitive vitality can be improved with training </li></ul><ul><li>Lack of use of working memory may cause neural connections in prefrontal lobes to atrophy </li></ul>
  15. 15. Work <ul><li>Older workers have a lower rate of absenteeism, fewer accidents, and increased job satisfaction </li></ul><ul><li>Best adjustment for those who are </li></ul><ul><ul><li>healthy </li></ul></ul><ul><ul><li>have adequate income </li></ul></ul><ul><ul><li>active </li></ul></ul><ul><ul><li>educated </li></ul></ul><ul><ul><li>have an extended social network </li></ul></ul><ul><ul><li>satisfied with life before retirement </li></ul></ul>
  16. 16. Socioemotional Dev’t <ul><li>Integrity versus despair </li></ul><ul><li>Life review </li></ul><ul><li>Social convoy model -- individuals go through life embedded in a social network of individuals from whom they give and receive social support </li></ul><ul><ul><li>Social support enhances coping skills </li></ul></ul><ul><ul><li>Being lonely and socially isolated is a significant health risk </li></ul></ul>
  17. 17. Living Arrangements <ul><li>Nursing Home </li></ul><ul><li>Hospice care - palliative </li></ul><ul><li>Adult day-care </li></ul><ul><li>Assisted living/retirement hotel </li></ul><ul><li>Continuing-care facility (combination skilled nursing/assisted living/convalescent </li></ul>
  18. 18. Elder Abuse <ul><li>Less healthy </li></ul><ul><li>More isolated </li></ul><ul><li>Those with dementias particularly at risk </li></ul><ul><li>More likely to be living in caregiver’s house </li></ul><ul><li>Types of Abuse (what to look for outside of the obvious) </li></ul><ul><ul><li>$ </li></ul></ul><ul><ul><li>Cuts, scars </li></ul></ul><ul><ul><li>Bedsores </li></ul></ul><ul><ul><li>Food, water </li></ul></ul><ul><ul><li>Underclothes, hygiene (check for odors) </li></ul></ul><ul><ul><li>Physical activity </li></ul></ul><ul><ul><li>Social opportunities </li></ul></ul>
  19. 20. Legal Documents <ul><ul><li>Living will </li></ul></ul><ul><ul><li>Health care proxy OR > </li></ul></ul><ul><ul><li>Medical Power of Attorney allows you to designate someone to make health care decisions for you when you are unable . </li></ul></ul><ul><ul><li>Power of Attorney </li></ul></ul><ul><ul><li>Will </li></ul></ul><ul><ul><li>Living Trust </li></ul></ul>
  20. 21. DNR Medical personnel should not go to extraordinary or extreme efforts to save the terminally ill patient. However… <ul><li>Difficult to define. </li></ul><ul><li>No one likes to make this decision </li></ul>
  21. 22. <ul><li>Sometimes difficult to get medical personnel to follow directives: </li></ul><ul><ul><li>Claim unawareness of wishes. </li></ul></ul><ul><ul><li>Intentionally left off chart by MDs. </li></ul></ul><ul><li>Survey of dying patients: </li></ul><ul><ul><li>1/3 asked not to be resuscitated; only 47% of physicians reported knowing their patient’s wishes. </li></ul></ul><ul><ul><li>Only listed on the charts of 49% of patients. </li></ul></ul>
  22. 23. What constitutes death? <ul><li> </li></ul><ul><li> </li></ul>
  23. 24. Defining Death <ul><li>Thanatology-the study of death and dying </li></ul><ul><li>Complex </li></ul><ul><li>Functional death: the absence of a heartbeat and breathing. </li></ul><ul><li>Medical measure of death > no possibility of restoring brain function </li></ul>
  24. 25. Death Across the Lifespan: Causes & Reactions <ul><li>SIDS </li></ul><ul><li>Prenatal death (Miscarriage) also; often feel isolated </li></ul><ul><li>Children do not have a realistic view of death. </li></ul><ul><li>Before age 5, children see death as temporary, like sleeping. </li></ul><ul><li>~ 5 children have begun to accept death as universal and final </li></ul>
  25. 26. Death in Adolescence <ul><li>Adolescents’ views of death are also unrealistic & often highly romantic. </li></ul><ul><ul><li>Personal Fable: leads to sense of invulnerability </li></ul></ul><ul><li>The most frequent cause of adolescent death is accidents (usually motor vehicle). </li></ul>
  26. 27. Death in Young Adulthood <ul><li>Particularly difficult because it is the time when people feel most ready to begin their own lives. </li></ul><ul><li>Future planning (e.g., marry or not? have children?). </li></ul><ul><li>Like adolescents, young adults are outraged at impending death and may direct anger toward their care providers. </li></ul>
  27. 28. Death in Middle Adulthood <ul><li>Disease is the most common cause of death in middle-aged adults. </li></ul><ul><li>More aware and accepting of death but also have a lot of fears (more than any other time in lifespan). </li></ul><ul><li>Most frequent causes are heart attack or stoke - both of which are sudden. </li></ul>
  28. 29. Death in Late Adulthood <ul><li>The prevalence of death and loss around older adults makes them less anxious about dying than at any other time of life. </li></ul><ul><li>Suicide rate increases with age for men. </li></ul><ul><li>Caucasian men over age 85 have the highest proportion of suicide. </li></ul><ul><li>Major issues for seniors with terminal disease: </li></ul><ul><ul><li>Do lives still have value? </li></ul></ul><ul><ul><li>How much of a burden? </li></ul></ul>
  29. 30. Kubler-Ross <ul><li>Stage theory of death and dying was created from extensive interviews with people that were dying and those that cared for them </li></ul>
  30. 31. <ul><li>Widows outnumber widowers 5 to 1 </li></ul><ul><li>Many widows are lonely </li></ul><ul><li>Bereaved are at higher risk for health problems </li></ul><ul><li>Stories </li></ul><ul><li>Recordings </li></ul>End of Life Issues