chapter 14 life’s transitions: the aging process
TRANSCRIPT
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Chapter 14Chapter 14
Life’s Transitions: The Aging ProcessLife’s Transitions: The Aging Process
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LIFE’S TRANSITIONS
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Old People Are UselessUseless!
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AGING: The process of growing old – IT WILL HAPPEN to
YOU !!!!• In 1975 In 1975 350 million 350 million
people over 60 yearspeople over 60 years
• In 2050 In 2050 1.1 billion 1.1 billion over 60 yearsover 60 years
PERCEPTION: PERCEPTION:
HOW YOU VIEWHOW YOU VIEW
PEOPLE OLDERPEOPLE OLDER
THAN YOUTHAN YOU
•
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Studying AgingStudying Aging
Connotations:• A negative A negative
psychological shift. psychological shift. Western cultural Western cultural views are different views are different from othersfrom others
• GERONTOLOGY:
The study of aging.
• GERONTOLOGIST:
One who studies aging.
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Old People Should RetireRetire So That YoungerYounger People Can
Work?
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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
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Aging
• health care costs of an older society
• psychologists attempting to understand the negative attitudes toward the elderly
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Old People Are SlowSlow And Get In My Way!
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Old People Aren’t BeautifulBeautiful!
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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
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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.
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I Will NeverNever Get That Old!
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TYPES OF AGING:
BIOLOGICAL:BIOLOGICAL:
• physical changes with physical changes with timetime
• relative age – condition of relative age – condition of organs / body systems organs / body systems
• arthritis / osteoporosis / arthritis / osteoporosis / accelerate aging processaccelerate aging process
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PSYCHOLOGICAL
adaptive capacity =adaptive capacity =• coping abilities coping abilities
intelligence intelligence
• individual capabilitiesindividual capabilities
• self-efficacy self-efficacy
• biological biological
• social changessocial changes
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SOCIALSOCIAL
• habits and roles habits and roles relative to society’s relative to society’s expectationsexpectations
• people sharing people sharing common interests common interests
• changes in person's changes in person's familial, occupational familial, occupational and social roles and social roles (retirement, loss of (retirement, loss of income, etc.)income, etc.)
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GETTING OLDERGETTING OLDER
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Legal
chronological age chronological age
driving driving
drinking ( not together !) drinking ( not together !)
votingvoting
old age securityold age security
Canada Pension PlanCanada Pension Plan
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Functional:
• how people compare how people compare at similar ages……..at similar ages……..
• health health
• capacitycapacity
• activity activity
• interestsinterests
• mobilitymobility
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THE AGING PROCESS: a function of three factors:
True aging (also called primaryTrue aging (also called primary
aging):aging):
• unavoidable result of chronology that unavoidable result of chronology that affects all species sooner or lateraffects all species sooner or later
Disease processes (secondary aging)Disease processes (secondary aging)
• aging due to diseases, such as trauma, aging due to diseases, such as trauma, illness, stress, etc.; lifestyle can be illness, stress, etc.; lifestyle can be classified in this factor (smoking)classified in this factor (smoking)
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THE AGING PROCESS: a function of three factors:
Disuse phenomena Disuse phenomena
((secondary aging)secondary aging)
• aging due to the lack aging due to the lack of activity (Sedentary of activity (Sedentary Lifestyle)Lifestyle)
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THEORIES ON AGING
Biological:
• the wear and tear theory – “ It’s Not the Years.., – “ It’s Not the Years.., It’s the Mileage”It’s the Mileage”
• the human body simply the human body simply wears outwears out
• some activities may some activities may predispose this condition predispose this condition (running)(running)
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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
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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
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Physical Changes
The Skin: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 constantly changing
accumulating and losing minerals accumulating and losing minerals (modeling)(modeling)
• 30’ and 40’s – net loss of minerals 30’ and 40’s – net loss of minerals – could lead to osteoporosis– could lead to osteoporosis
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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
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Physical Changes
The Head:The Head: • features of the head
enlarge ( nose, ears, head - skull thickens)
Brain shrinksBrain shrinks
The Urinary Tract:The Urinary Tract:• urinary incontinence • individual • treatable - drug therapy
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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
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Eyesight: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
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Hearing and Taste
Hearing:Hearing: • range diminishes / normal and range diminishes / normal and
conversational retainedconversational retained
Taste:Taste:• age 30 – each papilla has 245 taste buds age 30 – each papilla has 245 taste buds
- # diminishes over time- # diminishes over time• age 70 – 88 remainingage 70 – 88 remaining• Smell and Touch:Smell and Touch:• pain and tactile sensors declinepain and tactile sensors decline• sense of smell also declines / may lead sense of smell also declines / may lead
to malnutrition ( food lacks appeal)to malnutrition ( food lacks appeal)
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Getting Around and body Comfort
Mobility:Mobility:• 50% of older Canadians Report some
disability related to mobility or agility
Body Comfort:Body Comfort:• loss of body fat / thinning of epithelium /
diminished glandular function • body temperature• hypothermia / heat stroke / heat
exhaustion
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Mental Changes:
Intelligence:Intelligence: • unchanged - except for
illness• continue to learn and
develop (time?)• compensate with practical
knowledge
Memory:Memory:• short-term can be memory
- affected • long-term unchanged
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Coping with ChangeCoping with Change
Flexibility vs. Rigidity:Flexibility vs. Rigidity:• LIFE = diverse joys, sorrows, and
obstacles –developed coping methods
Depression:Depression: • most adults continue to lead
healthy, fulfilling lives• however, depression is the most
common
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Confusion and Frustration
Senility:Senility:• over-generalizationover-generalization• misinterpreted as senility = misinterpreted as senility =
memory failure / judgment memory failure / judgment error / disorientation / error / disorientation / erratic behaviours…….. erratic behaviours…….. (any age!)(any age!)
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Alzheimer’s Disease and other Dementias
Dementias – progressiveDementias – progressive
brain impairments thatbrain impairments that
interfere with memoryinterfere with memory
and intellectualand intellectual
functioningfunctioning
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ALZHEIMER'S DISEASE
The disease most dreaded by the elderly isThe disease most dreaded by the elderly is
dementia; loss of mental functions in an alertdementia; loss of mental functions in an alert
individual, characterized by group of symptoms :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
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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
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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.
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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!
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Genes and AgingGenes 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.
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AGEISM• discriminationdiscrimination• stereotyping - generalization of stereotyping - generalization of
characteristics - characteristics - + / -+ / - without without knowing the individualknowing the individual
• concept of young or oldconcept of young or old• healthy or unhealthyhealthy or unhealthy• value youth, devalue old age value youth, devalue old age • western culture vs. other western culture vs. other
cultures respectcultures respect wisdom of wisdom of elderlyelderly
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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
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KUBLER ROSS: STAGES OF DYING (5):
• Dying person may experience several intense emotions.
DENIAL: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.
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ANGERANGER
ANGER:ANGER:
• "Why me?"• resentment and rage
over impending death;• may be directed
outwards at loved ones.
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BARGAINING
acknowledgement acknowledgement but……...but……...
try to bargain withtry to bargain with
GODGOD
in this stage e.gin this stage e.g
Exchange recoveryExchange recovery
promise to be a betterpromise to be a better
personperson
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DEPRESSION:
• gradual realization ofgradual realization of
consequencesconsequences• difficult time - persons needs difficult time - persons needs
to be watched and supportedto be watched and supported• a period of grievinga period of grieving
must be allowed to work must be allowed to work through this stagethrough this stage
• trying to cheer up isn’t an trying to cheer up isn’t an asset now!asset now!
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ACCEPTANCE
• ““I’m scared but, I’m scared but, I'm ready."I'm ready."
• These stages may These stages may overlap and overlap and repeat.repeat.
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DEFINITION OF DEATH:Spiritual death:Spiritual death:• death of meaningful lifedeath of meaningful life
• including responsiveness to others, with activity of the brain including responsiveness to others, with activity of the brain and consciousness and consciousness
ALSO: Unreceptive and unresponsive to ALSO: Unreceptive and unresponsive to painful stimuli - CPR painful stimuli - CPR
• No movement for an hourNo movement for an hour
• No breathing for 3 minutesNo breathing for 3 minutes
• No reflexesNo reflexes
• Pupils fixed and dilated - flat EEGPupils fixed and dilated - flat EEG
• LIFE SIGNS………………..LIFE SIGNS………………..
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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
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CIRCUMSTANCES OF DEATH
• Death at/or before 50 years of age Death at/or before 50 years of age or younger emotional trauma – or younger emotional trauma – unexpectedunexpected
• Religious belief = less fearReligious belief = less fear
• Pain and physical distress.Pain and physical distress.
• Immediately prior to death there Immediately prior to death there is often an increased in vitalityis often an increased in vitality
• People often "hold on" for a People often "hold on" for a specific life event or personspecific life event or person
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EUTHANASIA: Mercy killing.
INDIRECT INVOLUNTARYINDIRECT INVOLUNTARY
(PASSIVE) -(PASSIVE) -
remove life supportremove life support
DIRECT VOLUNTARYDIRECT VOLUNTARY
administer fatal drug as conditionadminister fatal drug as condition
worsens worsens
DIRECT INVOLUNTARY-DIRECT INVOLUNTARY-
drug once a patient is in a coma.drug once a patient is in a coma.
ILLEGAL / ETHICAL ISSUESILLEGAL / ETHICAL ISSUES
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LIVING WILL
• A statement requesting A statement requesting removal from life support removal from life support systems……. if the chance systems……. if the chance for survival is limited….for survival is limited….
• Not accepted in all Not accepted in all provinces, e.g. provinces, e.g. SaskatchewanSaskatchewan
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DEATH OF A LOVED ONE:
STAGES OF GRIEF:STAGES OF GRIEF:
• Bereavement: the experience of Bereavement: the experience of lossloss
• Grief: intense emotional Grief: intense emotional sufferingsuffering
• Mourning: social response e.g.Mourning: social response e.g.
wearing black, funerals, etcwearing black, funerals, etc.
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Stages and ExperiencesStages and Experiences when coping with loss….when coping with loss….
• Physical: Exhaustion, feeling weighed down Physical: Exhaustion, feeling weighed down - stress. - nutrition, rest, exercise crying - stress. - nutrition, rest, exercise crying very importantvery important
• Emotional: ask or accept helpEmotional: ask or accept help
• Ask for what you need! Being alone or with Ask for what you need! Being alone or with friends and familyfriends and family
• Talk to others with similar experiences - Talk to others with similar experiences - take the time take the time
• Sadness and crying natural - share feelings. Sadness and crying natural - share feelings.
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Stages and ExperiencesStages and Experiences when coping with loss….when 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!
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FUNERALS:FUNERALS:
• A number of A number of considerations: cost, considerations: cost, embalming, burial, and embalming, burial, and cremation.cremation.
• Rites of passage - A Rites of passage - A process - saying process - saying goodbye very important goodbye very important for closure - found in for closure - found in most culturesmost cultures
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SOME IMPORTANT TERMSSOME IMPORTANT TERMS
• 1.1. SIDS: Sudden infant SIDS: Sudden infant death syndrome - babies 1 to 3 death syndrome - babies 1 to 3 months.months.
2.2. STILLBIRTH: Infant is born STILLBIRTH: Infant is born dead.dead.
3.3. PERINATAL DEATH: Death PERINATAL DEATH: Death occurs within hours or days of occurs within hours or days of birth.birth.
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HELPING SOMEONE FACE HELPING SOMEONE FACE DEATHDEATH:
Hospices:Hospices:
• concept rather than concept rather than a placea place
• provides health careprovides health care
• supportsupport
• free of painfree of pain
• death with dignitydeath with dignity