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Chapter 14. Life’s Transitions: The Aging Process. LIFE’S TRANSITIONS. Old People Are Useless !. AGING: The process of growing old – IT WILL HAPPEN to YOU !!!!. In 1975 Þ 350 million people over 60 years In 2050 Þ 1.1 billion over 60 years PERCEPTION: HOW YOU VIEW PEOPLE OLDER

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Chapter 14

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Chapter 14

Life’s Transitions: The Aging Process


LIFE’S TRANSITIONS


Old People Are Useless!


AGING: The process of growing old – IT WILL HAPPEN to YOU !!!!

  • In 1975 Þ 350 million people over 60 years

  • In 2050 Þ 1.1 billion over 60 years

    PERCEPTION:

    HOW YOU VIEW

    PEOPLE OLDER

    THAN YOU


Studying Aging

Connotations:

  • A negative psychological shift. Western cultural views are different from others

  • GERONTOLOGY:

    The study of aging.

  • GERONTOLOGIST:

    One who studies aging.


Old People Should Retire So That Younger People Can Work?


Why study the effects of aging? (5 reasons):

  • biology of aging (genetic and environmental factors associated with aging)

  • shift in survival and life expectancy has itself driven the inquiry about the social implications

  • medical science documents the diseases of old age and attempts to moderate their effects


Aging

  • health care costs of an older society

  • psychologists attempting to understand the negative attitudes toward the elderly


Old People Are Slow And Get In My Way!


Old People Aren’t Beautiful!


The Changing Face of the Nation

  • Baby Boomers approaching retirement.

  • Elderly are living longer - combination of modern medicine and lifestyle related factors = age 115 years


Changing Face of the Nation

  • higher quality of life - therefore older people are a major social, political and economic factor in society.

  • Changing demographics also reflected in fact that not as many children are being born in first world countries.


I Will Never Get That Old!


TYPES OF AGING:

BIOLOGICAL:

  • physical changes with time

  • relative age – condition of organs / body systems

  • arthritis / osteoporosis / accelerate aging process


PSYCHOLOGICAL

adaptive capacity =

  • coping abilities intelligence

  • individual capabilities

  • self-efficacy

  • biological

  • social changes


SOCIAL

  • habits and roles relative to society’s expectations

  • people sharing common interests

  • changes in person's familial, occupational and social roles (retirement, loss of income, etc.)


GETTING OLDER


Legal

chronological age

driving

drinking ( not together !)

voting

old age security

Canada Pension Plan


Functional:

  • how people compare at similar ages……..

  • health

  • capacity

  • activity

  • interests

  • mobility


THE AGING PROCESS: a function of three factors:

True aging (also called primary

aging):

  • unavoidable result of chronology that affects all species sooner or later

    Disease processes (secondary aging)

  • aging due to diseases, such as trauma, illness, stress, etc.; lifestyle can be classified in this factor (smoking)


THE AGING PROCESS: a function of three factors:

Disuse phenomena

(secondary aging)

  • aging due to the lack of activity (Sedentary Lifestyle)


THEORIES ON AGING

Biological:

  • the wear and tear theory– “ It’s Not the Years.., It’s the Mileage”

  • the human body simply wears out

  • some activities may predispose this condition (running)


THEORIES ON AGING

  • the cellular theory – limited number of cells / capacity to reproduce / once exhausted body begins to deteriorate / varies from individual to individual

  • the autoimmune theory– declining immune system / loses control attacking body


THEORIES ON AGING

  • the genetic mutation theory –the older you are the more mutant cells develop/ function differently than intended / dysfunction of body organs + systems


Physical Changes

The Skin:

  • (30’s)thinner + loses elasticity /(40’s) lines on the face /

  • (50’s) crow’s feet /(60’s) loses colour + sags / (70’s) age spots etc.

    Bones and Joints:

  • constantly changing accumulating and losing minerals (modeling)

  • 30’ and 40’s – net loss of minerals – could lead to osteoporosis


Physical Changes

OSTEOPOROSIS:

  • loss of bone material / bone mass

  • post-menopausal women

  • fractures common

  • very debilitating

  • risk factors: calcium, lack of exercise, lack of estrogen therapy post-menopause


Physical Changes

The Head:

  • features of the head enlarge ( nose, ears, head - skull thickens)

    Brain shrinks

    The Urinary Tract:

  • urinary incontinence

  • individual

  • treatable - drug therapy


Physical Changes

Heart and Lungs:

  • Resting Heart Rate stays about the same throughout life

  • stroke volume decreases

  • heart muscle deterioration

  • Vital Capacity decreases

    (max. inhalation + exhalation)

  • exercise slows these changes


Eyesight:

  • 30 years of age – lens harden

  • 40 years of age – lens: yellow and looses transparency

  • Cataracts – (clouding of the lens) / focus on retina / blurred vision / blindness possible

  • glaucoma – ( increased pressure within the eyeball)

  • hardening of the eyeball , impaired vision, eventual blindness


Hearing and Taste

Hearing:

  • range diminishes / normal and conversational retained

    Taste:

  • age 30 – each papilla has 245 taste buds - # diminishes over time

  • age 70 – 88 remaining

  • Smell and Touch:

  • pain and tactile sensors decline

  • sense of smell also declines / may lead to malnutrition ( food lacks appeal)


Getting Around and body Comfort

Mobility:

  • 50% of older Canadians Report some disability related to mobility or agility

    Body Comfort:

  • loss of body fat / thinning of epithelium / diminished glandular function

  • body temperature

  • hypothermia / heat stroke / heat exhaustion


Mental Changes:

Intelligence:

  • unchanged - except for illness

  • continue to learn and develop (time?)

  • compensate with practical knowledge

    Memory:

  • short-term can be memory - affected

  • long-term unchanged


Coping with Change

Flexibility vs. Rigidity:

  • LIFE = diverse joys, sorrows, and obstacles –developed coping methods

    Depression:

  • most adults continue to lead healthy, fulfilling lives

  • however, depression is the most common


Confusion and Frustration

Senility:

  • over-generalization

  • misinterpreted as senility = memory failure / judgment error / disorientation / erratic behaviours…….. (any age!)


Alzheimer’s Disease and other Dementias

Dementias – progressive

brain impairments that

interfere with memory

and intellectual

functioning


ALZHEIMER'S DISEASE

The disease most dreaded by the elderly is

dementia; loss of mental functions in an alert

individual, characterized by group of symptoms :

  • memory loss

  • loss of language functions

  • inability to think abstractly

  • inability to care for oneself

  • personality change

  • emotional instability

  • loss of sense of time


ALZHEIMER'S DISEASE

  • three quarters (75%) dementia’s caused by Alzheimer's disease - chronic, degenerative dementing illness / cause unknown

  • no known cure to stop the progression

  • 6% of people over 65 years have Alzheimer's disease

  • Alzheimer's disease 4th leading cause of death - older adults

  • < seventy conditions can cause dementia


Types of Dementia:

  • Degenerative = Alzheimer's, Parkinson's, Huntington's.

  • Vascular dementia: cerebral embolisms, blood clots, and infarctions.

  • Traumatic dementia: head injuries.

  • Lesions: tumors, hematomas, and cancers.

  • Toxic dementia: alcohol, poisons.

  • Others: epilepsy, post-traumatic stress disorders, and heat stroke.


THEORIES OF AGING:

  • Brain size & longevity

  • Biological clock determines how long we live.

  • Disposable soma: Allocation of resources - optimal is as little as possible to body repair, and more to other functions.

  • Wear and tear: Accumulated damage leads to breakdown - like a machine!


Genes and Aging

  • Genetic theories: Loss of genetic info. over time = loss of protein to rebuild.

  • Immunological: Breakdown of immune system.

  • Others: Error accumulation, cell loss, nutritive, environment, and brain chemistry.


AGEISM

  • discrimination

  • stereotyping - generalization of characteristics - + / - without knowing the individual

  • concept of young or old

  • healthy or unhealthy

  • value youth, devalue old age

  • western culture vs. other cultures respectwisdom of elderly


DEATH AND DYING

  • THANATOLOGY: the study of death and dying.

  • PSYCHOLOGY: fascination yet denial in western society.

  • people not prepared!

  • DEATH - a process, not a point in time


KUBLER ROSS: STAGES OF DYING (5):

  • Dying person may experience several intense emotions.

    DENIAL:

  • "No, not me!"

  • patient rejects the news

  • initial positive defense mechanism but can become a problem if reinforced by family and friends, leading to poor coping.


ANGER

ANGER:

  • "Why me?"

  • resentment and rage over impending death;

  • may be directed outwards at loved ones.


BARGAINING

acknowledgement but……...

try to bargain with

GOD

in this stage e.g

Exchange recovery

promise to be a better

person


DEPRESSION:

  • gradual realization of

    consequences

  • difficult time - persons needs to be watched and supported

  • a period of grieving

    must be allowed to work through this stage

  • trying to cheer up isn’t an asset now!


ACCEPTANCE

  • “I’m scared but, I'm ready."

  • These stages may overlap and repeat.


DEFINITION OF DEATH:

Spiritual death:

  • death of meaningful life

  • including responsiveness to others, with activity of the brain and consciousness

    ALSO: Unreceptive and unresponsive to painful stimuli - CPR

  • No movement for an hour

  • No breathing for 3 minutes

  • No reflexes

  • Pupils fixed and dilated - flat EEG

  • LIFE SIGNS………………..


DEFINITION OF DEATH:

Traditional legal definition:

  • failure of heart and lungs = functional death.

    Modern medicine:

  • brain death = absence of electrical impulse activity in the brain (EEG).

    Cellular death:

  • Cells die- e.g., heart, brain, muscle


CIRCUMSTANCES OF DEATH

  • Death at/or before 50 years of age or younger emotional trauma – unexpected

  • Religious belief = less fear

  • Pain and physical distress.

  • Immediately prior to death there is often an increased in vitality

  • People often "hold on" for a specific life event or person


EUTHANASIA: Mercy killing.

INDIRECT INVOLUNTARY

(PASSIVE) -

remove life support

DIRECT VOLUNTARY

administer fatal drug as condition

worsens

DIRECT INVOLUNTARY-

drug once a patient is in a coma.

ILLEGAL / ETHICAL ISSUES


LIVING WILL

  • A statement requesting removal from life support systems……. if the chance for survival is limited….

  • Not accepted in all provinces, e.g. Saskatchewan


DEATH OF A LOVED ONE:

STAGES OF GRIEF:

  • Bereavement: the experience of loss

  • Grief: intense emotional suffering

  • Mourning: social response e.g.

    wearing black, funerals, etc.


Stages and Experienceswhen coping with loss….

  • Physical: Exhaustion, feeling weighed down - stress. - nutrition, rest, exercise crying very important

  • Emotional: ask or accept help

  • Ask for what you need! Being alone or with friends and family

  • Talk to others with similar experiences - take the time

  • Sadness and crying natural - share feelings.


Stages and Experienceswhen coping with loss….

  • Intellectual: Avoid making major life decisions at this time.

  • Process includes anger, resentment, and negative emotions.

  • Work through the feelings - don't avoid or deny them

  • Spiritual: surviving loss and finding meaning to continue, look inside yourself, your faith, and your life!


FUNERALS:

  • A number of considerations: cost, embalming, burial, and cremation.

  • Rites of passage - A process - saying goodbye very important for closure - found in most cultures


SOME IMPORTANT TERMS

  • 1.SIDS: Sudden infant death syndrome - babies 1 to 3 months.

    2.STILLBIRTH: Infant is born dead.

    3.PERINATAL DEATH: Death occurs within hours or days of birth.


HELPING SOMEONE FACE DEATH:

Hospices:

  • concept rather than a place

  • provides health care

  • support

  • free of pain

  • death with dignity


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