This document summarizes physical, cognitive, social, and personality development in late adulthood as well as processes of death and dying. Key points include: physical and cognitive changes that occur with aging, such as declines in brain, heart, and immune system function; memory loss being more common, though not universal; Erikson's theory of integrity versus despair applying to this stage; and reactions to death varying depending on factors like age and beliefs. The document also discusses leading causes of death in older adults and considerations for counseling clients as they age.

1. Physical, Cognitive, Social, and Personality Development of Late Adulthood and Processes of Death and Dying CNSL/504 Edna M. Rodríguez, Ed.D

2. Physical Development in Late Adulthood

3. External : Hair color turns gray to white and may thin out. Skin wrinkles as it loses elasticity and collagen. Height will shorten from one to four inches as posture changes and disk cartilage of the backbone thins.

4. Internal: The brain becomes smaller and lighter, but retains structure and function in the absence of disease. Blood flow to the brain decreases and neurons may decline in some parts of the brain. The heart’s capacity to pump blood declines; the blood vessels harden and shrink. The digestive and respiratory systems become less efficient. Muscle fibers decrease in size and amount, and become less efficient at utilizing oxygen, and some hormones are produced at lower levels.

5. Reaction time decreases. Peripheral slowing hypothesis suggests that overall processing declines in the peripheral nervous system. Generalized slowing hypothesis proposes that processing in all parts of the nervous system become less efficient.

6. Perception of time increases. - Sensitivity of the senses decrease. - Malnutrition becomes a threat perhaps in part because the taste of food is less appealing.

7. Heart disease, cancer, and stroke become the leading cause of death. People become more susceptible to disease as the immune system weakens. Most older people have at least one chronic, long-term condition, such as arthritis or hypertension.

8. Cognitive Development Dementia, a category covering several diseases involving serious memory loss and declines in other areas of mental functioning, is the most common mental disorder. There is no uniform pattern of intellectual decline. Memory decline is not universal, and seems to occur less in societies where the aged are held in high esteem.

9. Memory Episodic memories, relating specific life experiences, seem to be the most vulnerable to loss. Semantic memories (general knowledge and facts) and implicit memories (unconsciously held) tend to be largely unaffected by age. Short-term memory declines gradually until age 70, when the decline becomes more pronounced.

10. Memory Autobiographical memory retention patterns follow that of younger ages: pleasant memories are more likely to be recalled than unpleasant memories (the Pollyanna principle). Older memories tend to be the most easily recalled.

11. Social and Personality Development

12. Erikson’s Ego Integrity versus Despair . Review of one’s life is the common theme between Erikson and other personality theorists for this stage of life.

13. Four different personality types of coping with aging (Bernice Neugarten) Disintegrated and disorganized personalities : Unable to accept aging, these people experience despair as they age. Passive-dependent personalities : Driven by pervasive fear, these people tend to frequently seek help. Defended personalities : The people attempt to ward off aging, engaging in youthful activities such as vigorous exercise. Integrated personalities : These people cope comfortably with aging. Neugarten found most people fell into this category.

14. Death The definitions include functional death where there is the absence of a heartbeat and breathing, and brain death where there is a cessation of all signs of brain electrical activity. Death can occur across the lifespan. The United States has a relatively high infant mortality rate, ranking behind 22 other industrialized countries which includes late-term miscarriage or pre-term birth, accidents, and sudden infant death syndrome.

15. Reaction to death May vary depending on age and beliefs. Before age 5, children most likely will think of it as a temporary state that involves a reduction in living, rather than the cessation of life; they may tend to think of death in terms of sleep. They may erroneously think that their behavior may have been the cause of death.

16. Reaction to death After age 5, the finality and irreversibility of death become better understood, though children may tend to personify death as a ghostlike or devilish figure, and that it is not universal, but happens to some people.

17. Adolescents and Death While adolescents understand the finality and irreversibility of death, their own sense of invulnerability and uniqueness typically includes the idea that bad things happen to other people. As a result, they are more apt to engage in risky, life threatening behavior.

18. Young Adulthood and Death Adolescent attitudes tend to persist, though risk-taking behavior typically decreases. Being people in the prime of vitality and opportunity, young adults who face death may do so with anger and resentment at the unfairness of the world.

19. Middle Adulthood and Death One’s fear of death tends to be highest in middle adulthood. They have a more realistic understanding of death than they did when they were younger.

20. Late Adulthood and Death By late adulthood, people develop a level of certainty that they will someday die, and face an increasing number of deaths of people in their lives. Sometimes impending death is preceded by terminal decline, a significant drop in performance on cognitive tasks. Often a consequence of severe depression, dementia, or loss of a spouse, men over 85 have the highest suicide rate.

21. Electronic Text Readings Preparation for Retirement” presents a study on the needs of older people. “Psychological Time” explores the phenomenon of how time seems to move more rapidly as we age, and considers implications for counseling.

22. Critical Thinking What is it like to grow old today? What sorts of cognitive and social changes occur? What are the ways you can take developmental phase into account in considering how best to work with a counseling client? How would the degree to which you have successfully resolved losses in your life affect your ability in helping a counseling client deal with a loss?

23. SUMMARY The developmental competencies, challenges, and appropriate interventions for late adulthood, in addition to the topics of death and dying are covered this week. The topics of this course have covered the theoretical frameworks to foster an understanding of the various dimensions of human development from pre-birth to death. Biological, cognitive, and psychosocial development within the context of gender, family systems, social roles, and culture have been emphasized in this course.