Life

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Chapter 14

• Lifes Transitions The Aging Process

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LIFES TRANSITIONS
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Old People Are Useless!
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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

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Studying Aging

• Connotations
• A negative psychological shift. Western
  cultural views are different from others
• GERONTOLOGY
• The study of aging.
• GERONTOLOGIST
• One who studies aging.

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Old People Should Retire So That Younger 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 Slow And Get In My Way!
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Old People Arent Beautiful!
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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 Never Get That Old!
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TYPES OF AGING

• BIOLOGICAL
• physical changes with time
• relative age condition of organs / body systems
  
• arthritis / osteoporosis / accelerate aging
  process

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PSYCHOLOGICAL

• adaptive capacity
• coping abilities intelligence
• individual capabilities
• self-efficacy
• biological
• social changes

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SOCIAL

• habits and roles relative to societys
  expectations
• people sharing common interests
• changes in person's familial, occupational and
  social roles (retirement, loss of income, etc.)

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GETTING OLDER
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Legal

• chronological age
• driving
• drinking ( not together !)
• voting
• old age security
• Canada Pension Plan

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Functional

• how people compare at similar ages..
• health
• capacity
• activity
• interests
• mobility

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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)

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THE AGING PROCESS a function of three factors

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

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THEORIES ON AGING

• Biological
• the wear and tear theory Its Not the
  Years.., Its the Mileage
• the human body simply wears out
• some activities may predispose this condition
  (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
• (30s)thinner loses elasticity /(40s) lines on
  the face /
• (50s) crows feet /(60s) loses colour sags /
  (70s) age spots etc.
• Bones and Joints
• constantly changing accumulating and losing
  minerals (modeling)
• 30 and 40s net loss of minerals 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
• features of the head enlarge ( nose, ears, head -
  skull thickens)
• Brain shrinks
• 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

• 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
• 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)

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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

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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

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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

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Confusion and Frustration

• Senility
• over-generalization
• misinterpreted as senility memory failure /
  judgment error / disorientation / erratic
  behaviours.. (any age!)

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Alzheimers Disease and other Dementias

• Dementias progressive
• brain impairments that
• interfere with memory
• and intellectual
• functioning

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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

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ALZHEIMER'S DISEASE

• three quarters (75) dementias 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
• lt 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 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

• 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 respect wisdom
  of elderly

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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
• "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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ANGER

• ANGER
• "Why me?"
• resentment and rage over impending death
• may be directed outwards at loved ones.

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BARGAINING

• acknowledgement but...
• try to bargain with
• GOD
• in this stage e.g
• Exchange recovery
• promise to be a better
• person

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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 isnt an asset now!

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ACCEPTANCE

• Im scared but, I'm ready."
• These stages may overlap and repeat.

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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..

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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 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

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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

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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

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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.

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Stages and Experiences when 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.

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Stages and Experiences 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

• A number of considerations cost, embalming,
  burial, and cremation.
• Rites of passage - A process - saying goodbye
  very important for closure - found in most
  cultures

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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.

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HELPING SOMEONE FACE DEATH

• Hospices
• concept rather than a place
• provides health care
• support
• free of pain
• death with dignity