Chapter FourteenChapter Fourteen

The Challenge of AgingThe Challenge of Aging

What Happens as You What Happens as You Age?Age?

• Even with the healthiest behaviors, Even with the healthiest behaviors, aging still occursaging still occurs

• It results from biochemical processes It results from biochemical processes still not fully understoodstill not fully understood

• The functioning of the human body is The functioning of the human body is not affected until after the age of 70not affected until after the age of 70

• The changes that do occur are due to The changes that do occur are due to gradual aging and impairment from gradual aging and impairment from diseasedisease

How to Delay the Aging How to Delay the Aging Process?Process?

• Challenge the Challenge the MindMind

• Develop Physical Develop Physical FitnessFitness

• Eat WiselyEat Wisely• Maintain a Healthy Maintain a Healthy

WeightWeight• Recognize and Recognize and

Reduce StressReduce Stress

• Control Drinking Control Drinking and and Overdependence Overdependence on Medicationson Medications

• Don’t SmokeDon’t Smoke• Schedule Physical Schedule Physical

Exams to Detect Exams to Detect Treatable DiseasesTreatable Diseases

How to Delay the Aging How to Delay the Aging Process?Process?

• Challenge the Challenge the MindMind

• Develop Physical Develop Physical FitnessFitness

• Eat WiselyEat Wisely• Maintain a Healthy Maintain a Healthy

WeightWeight• Recognize and Recognize and

Reduce StressReduce Stress

• Control Drinking Control Drinking and and Overdependence Overdependence on Medicationson Medications

• Don’t SmokeDon’t Smoke• Schedule Physical Schedule Physical

Exams to Detect Exams to Detect Treatable DiseasesTreatable Diseases

Types of Changes That Types of Changes That Occur With AgingOccur With Aging

• Social ChangesSocial Changes• Roles and Relationship ChangesRoles and Relationship Changes• Increased Leisure TimeIncreased Leisure Time• New Economic SituationNew Economic Situation

Adapting to Physical Adapting to Physical ChangesChanges

• There are some physical There are some physical changes that will be inevitable changes that will be inevitable such as:such as:

• Hearing LossHearing Loss• Vision ChangesVision Changes• ArthritisArthritis• MenopauseMenopause• OsteoporosisOsteoporosis

Psychological and Mental Psychological and Mental ChangesChanges

• As one ages, the following conditions As one ages, the following conditions could affect one’s mental statuscould affect one’s mental status

• Dementia/Alzheimer’s DiseaseDementia/Alzheimer’s Disease• Grief and MourningGrief and Mourning• DepressionDepression

Life ExpectancyLife Expectancy

• This is the average length of time we can This is the average length of time we can expect to liveexpect to live

• Current life expectancy for someone born in Current life expectancy for someone born in 2002 is 77.3 years2002 is 77.3 years

• Women have a longer life expectancy than menWomen have a longer life expectancy than men• Life expectancy also varies among the Life expectancy also varies among the

following:following:• Ethnic groupsEthnic groups• Socioeconomic levelsSocioeconomic levels• GeneticsGenetics• Lifestyle factorsLifestyle factors

Theories on AgingTheories on Aging

• The following theories are possible reasons The following theories are possible reasons why we agewhy we age– Cellular Theory based on genetic makeup of cells Cellular Theory based on genetic makeup of cells

containing ‘aging’ genes that can duplicate so containing ‘aging’ genes that can duplicate so many timesmany times

– Cellular Theory based on ‘free radicals’ that would Cellular Theory based on ‘free radicals’ that would undermine the integrity of cell membranesundermine the integrity of cell membranes

– Immune system failure to provide adequate Immune system failure to provide adequate protein synthesis causing an auto-immune protein synthesis causing an auto-immune disorderdisorder

– Metabolic function which causes collagen to Metabolic function which causes collagen to stiffen over time, creating immobilitystiffen over time, creating immobility

Older Americans as a Older Americans as a MinorityMinority

• People over the age of 65 (35 million) are People over the age of 65 (35 million) are considered a minority population in the considered a minority population in the United StatesUnited States

• The status of older Americans are improving The status of older Americans are improving from past years i.e. health care, economics, from past years i.e. health care, economics, etc.etc.

• However, there still are a percentage of However, there still are a percentage of elderly who are ill and dependent upon otherselderly who are ill and dependent upon others

• Many Americans still rely on Social Security, Many Americans still rely on Social Security, which still does not provide the essential to which still does not provide the essential to have an adequate retirement lifestylehave an adequate retirement lifestyle

How to Change the Public’s How to Change the Public’s Perception on Aging?Perception on Aging?

• Examine our own perceptions of what Examine our own perceptions of what ‘aging’ actually means‘aging’ actually means

• Make available arrangements for full Make available arrangements for full and part time volunteersand part time volunteers

• Provide re-training programs or new Provide re-training programs or new educational programseducational programs

Defining DeathDefining Death

• Death has been defined as cessation of Death has been defined as cessation of the flow of vital bodily fluidsthe flow of vital bodily fluids

• This occurs when the heart stops beating This occurs when the heart stops beating and breathing ceasesand breathing ceases

• The concept of cellular ‘brain death’ The concept of cellular ‘brain death’ involves the following:involves the following:

– Lack of receptivity and response to external stimuliLack of receptivity and response to external stimuli– Absence of spontaneous muscular movement and Absence of spontaneous muscular movement and

spontaneous breathingspontaneous breathing– Absence of observable reflexesAbsence of observable reflexes– Absence of brain activity (EEG)Absence of brain activity (EEG)

Denying vs. Welcoming Denying vs. Welcoming DeathDeath

• Many people seek to avoid any mention of Many people seek to avoid any mention of deathdeath

• The saying, “out of sight, out of mind” The saying, “out of sight, out of mind” appears to be the rule compared to facing appears to be the rule compared to facing death directlydeath directly

• Cartoons and video games give death a Cartoons and video games give death a ‘two-dimensional’ concept which distorts ‘two-dimensional’ concept which distorts realityreality

• Problems can arise when the avoidance or Problems can arise when the avoidance or denial that death can happen to youdenial that death can happen to you

Planning For DeathPlanning For Death

• Accepting that death will occur Accepting that death will occur allows the ability to plan for this allows the ability to plan for this eventevent

• Basic tasks may include:Basic tasks may include:• Making a WillMaking a Will• Considering options for ‘End-of-Life’ careConsidering options for ‘End-of-Life’ care• Home CareHome Care• Hospital based Care (palliative care)Hospital based Care (palliative care)• Hospice ProgramsHospice Programs

Deciding to Prolong Life or Deciding to Prolong Life or Hasten DeathHasten Death

• Once someone is given the prognosis Once someone is given the prognosis that life would end soon, the following that life would end soon, the following decisions would have to be considereddecisions would have to be considered

• Withholding or Withdrawing Treatment Withholding or Withdrawing Treatment (passive euthanasia)(passive euthanasia)

• Assisted Suicide (active euthanasia or Assisted Suicide (active euthanasia or physician assisted)physician assisted)

• Advanced Directive (document regarding Advanced Directive (document regarding treatment if you become unable to make them)treatment if you become unable to make them)

• Living WillLiving Will• Health Care ProxyHealth Care Proxy

• Organ DonationOrgan Donation

Planning a FuneralPlanning a Funeral

• A funeral are rites of passage that A funeral are rites of passage that commemorate a person’s life and commemorate a person’s life and acknowledge their existenceacknowledge their existence

• Funerals provide a framework that Funerals provide a framework that allows survivors to support one another allows survivors to support one another as they cope with the loss and express as they cope with the loss and express griefgrief

• The following need to be addressed The following need to be addressed when planning a funeralwhen planning a funeral

• Disposition of the bodyDisposition of the body• Service ArrangementService Arrangement

Coping With DyingCoping With Dying

• Charles Corr distinguishes 4 primary Charles Corr distinguishes 4 primary dimensions in coping with dyingdimensions in coping with dying

• Physical (satisfying bodily needs0Physical (satisfying bodily needs0• Psychological (maximizing sense of security)Psychological (maximizing sense of security)• Social (sustaining significant relationships)Social (sustaining significant relationships)• Spiritual (reaffirming sources of meaning)Spiritual (reaffirming sources of meaning)

• Contemplating these dimensions gives Contemplating these dimensions gives us a framework for considering us a framework for considering specific tasks that need to be specific tasks that need to be addressedaddressed

Coping With DyingCoping With Dying

• Charles Corr distinguishes 4 primary Charles Corr distinguishes 4 primary dimensions in coping with dyingdimensions in coping with dying

• Physical (satisfying bodily needs0Physical (satisfying bodily needs0• Psychological (maximizing sense of security)Psychological (maximizing sense of security)• Social (sustaining significant relationships)Social (sustaining significant relationships)• Spiritual (reaffirming sources of meaning)Spiritual (reaffirming sources of meaning)

• Contemplating these dimensions gives Contemplating these dimensions gives us a framework for considering us a framework for considering specific tasks that need to be specific tasks that need to be addressedaddressed

Coping With LossCoping With Loss

• Grief Grief is the reaction to loss and encompasses is the reaction to loss and encompasses thoughts and feelings, as well as physical and thoughts and feelings, as well as physical and behavioral responsesbehavioral responses

• MourningMourning is closely related to grief and refers is closely related to grief and refers to the process by which a person adjusts to to the process by which a person adjusts to loss and incorporates this into their lifeloss and incorporates this into their life

• William Worden has identified 4 tasks when William Worden has identified 4 tasks when mourningmourning

• Accepting the reality of lossAccepting the reality of loss• Working through the painWorking through the pain• Adjusting to a change environmentAdjusting to a change environment• Emotionally relocating the deceased and moving onEmotionally relocating the deceased and moving on

Chapter FourteenChapter Fourteen

The Challenge of AgingThe Challenge of Aging