CDFS 390 A Chapter 14

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CDFS 390 AChapter 14

• Biological Aspects of Later Adulthood
• Fall 2006
• Ginger Wyatt, Christopher Sarafin

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I. WHAT IS LATER ADULTHOOD?

• Last major segment of the life span
• 65 yrs dividing line b/w middle age and old age
• Older people diverse group, 30 year range

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Gerontologists

• Doctors that specialize in care of older people
• Divide later adulthood into 2 groups
• Young-old-ages (65-74yrs)
• Old-old-ages (75yrs )
• Everyone at 65 does not have the same mental and
  physical conditions

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• SENESCENCE- process of aging
• Normal process of bodily change that accompanies
  aging
• APPEARANCE- changes in physical appearance
• Increased wrinkling, reduced agility and speed of
  motion, stooping shoulders, increased
  unsteadiness of hands and legs, increased
  difficulty moving, thinning of hair, and
  appearance of varicose veins
• Wrinkling of skin due to partial loss of elastic
  tissue and of the fatty layer of skin

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• SENSES- generally decrease in later years
• Touch- decline due to drying, wrinkling,
  toughening of skin
• Skin has increased sensitivity to changes in
  temperature
• Hearing- ability to hear high tones generally
  affected first
• Impairment 5 times more likely in ages 65-79 than
  a 45-64 yr old
• Feel lonely and isolated
• Feelings of isolation facilitate the development
  of personality quirks

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• Vision- deterioration of lens, cornea, retina,
  iris, and optic nerve
• Most 60 need glasses/contacts to see well
• Light adjustment/color perception reduced
• Eyes eventually look sunken due to loss of
  orbital fat
• Cataracts- a clouding of lens of eye, or its
  capsule, that obstructs the passage of light
• Consequences depend on location
• Hardening of cell tissues in the lens most common
• Causes blurred vision, blindness, or
  double-vision in severe cases
• Surgical removal and substitute lens implanted

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• Glaucoma- fluid pressure in eye builds up but can
  be treated and controlled with eye drops or
  surgery or laser treatments
• Damages eye internally
• Macular Degeneration- center of retina gradually
  loses ability to sharply distinguish fine details
• Leading cause of functional blindness during
  advancing years
• Smokers 2 ½ times as likely to develop

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• Taste and Smell- appears to be related to illness
  and poor health rather than to a deterioration of
  sense organs due to age
• Taste based on what you can Smell
• More than 4 out of 5 people over 80 have major
  impairments in smell
• More than ½ have no sense of smell at all
• Those affected eat less and are undernourished
  because food loses its taste

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• Vestibular Senses- maintain posture and balance
• Lose some efficiency
• Older people more prone to falls
• More apt to suffer dizziness, increases
  likelihood of falling

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• TEETH
• Gums gradually reduce
• Teeth get yellowish color
• Periodontal disease increasing problem
• Eventually lose many teeth
• Dentures take several weeks to get used to and
  cant eat/sleep as well at first
• Persons disposition can be affected because loss
  of teeth or dentures can be traumatic
• For some dentures improve appearance and
  self-concept

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• VOICE
• Less powerful and restricted in range
• Due to hardening and decreasing elasticity of the
  laryngeal cartilages
• Speech slower, pauses longer and more frequent
• Slurring may occur with pathological changes in
  the brain
• SKIN
• Splotchy, paler, loses some elasticity
• Some subcutaneous muscle and fat disappears
  causing the skin hanging in folds and wrinkles

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• PSYCHOMOTOR SKILLS- a slowdown in processing of
  information by the CNS
• Takes longer to assess environment, make
  decision, and to implement the right action
• Rate of learning new material slowed
• Rate of retrieving information from memory
  reduced
• Implications for Drivers - higher accidents rates
  similar to those of teenagers, but reasons why
  are different
• Slower getting out of the way of potential
  problems
• Less efficient sensor motor coordination
• Driving can mean being actively participating in
  society or facing a life of forced isolation

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• Papalia and Olds (1992) suggest what needs to be
  done
• Regularly re-test vision, coordination, and
  reaction time
• Compensate for loss of abilities by driving
  slower, shorter distances, choose easier
• Enroll in defensive course
• Physical exercise and mental activity help reduce
  loss of psychomotor skills (speed, strength,
  stamina)
• Regular exercise helps circulatory and
  respiratory systems

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• INTELLECTUAL FUNCTIONING- most abilities hold up
  in old age
• IQ Scores decline as years pass, but doesnt mean
  competence declines
• Reasons for Lower IQ Scores
• Difficulty perceiving instructions and executing
  tasks due to declines in sight and hearing
• Perform less well due to reduced powers of
  coordination and agility
• More fatigued which can supress intellectual
  performance
• Less speed thats needed for IQ tests
• Increased anxiety because its a timed test and
  makes them take more time on it

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• Designed for younger people so older people are
  less familiar with test items
• More cautious, hinders performance
• Self-defeating attitudes become self-fulfilling
  prophecies
• Less continuing education as they get older
• Terminal drop- sudden drop in intellectual
  functioning- occurs a few weeks/ months before
  death from a terminal illness (not limited to old
  people)
• Not possible to draw definite conclusions that
  intellectual functioning actually decreases in
  later adulthood

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• HEIGHT AND JOINTS
• Max. height reached by late teens, early 20s
• Older peoples reduction in height due to
  progressive decline in discs b/w spinal vertebrae
• Bones less dense, more brittle
• Jones stiffer and more restricted
• Risk of bone disease affecting joints increases
  with age
• Need to stay physically active to exercise joints

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• HOMEOSTASIS
• Less efficient in later adulthood
• Stabilizing mechanisms sluggish
• Physiological adaptability reduced
• Heart and breathing rates longer to return to
  normal
• Wounds longer to heal
• Thyroid gland shrinks and lowers basal metabolism
• Pancreas loses some capacity to produce enzymes
  used in protein and sugar metabolism

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• NERVOUS SYSTEM
• Little functional change, some nerve tissue
  replaced by fibrous cells
• Reflex/reaction time slower
• Number of brain cells may decease
• Certain medical conditions (cerebral
  arteriosclerosis) have progressive deterioration
  of brain tissue causing
• Loss of recent and/or past memories
• Less coordination
• Less attention to grooming habits
• May have personality changes

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• DIGESTIVE SYSTEM
• Age increases and reduces enzyme action, gastric
  juices, and saliva upsetting digestive process
• Complaints about digestive disorders most common
  complaints of older people
• Highly sensitive to stress, emotional
  disturbances, and anxieties
• Problems with regularity of bowel movements
  causing diarrhea and constipation

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• RESPIRATION
• Lungs decrease in size resulting in decrease of
  oxygen utilization
• Some air sac membranes replaced by fibrous tissue
• Max. breathing capacity/oxygen intake of a 75-yr
  old is about 40 that of a 30-yr old
• Moderate exercise throughout life keeps oxygen
  intake and blood flow at higher levels

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• HEART
• Heart and blood vessels most destructive changes
• Ways heart is affected
• Shrinks in size
• Percentage of fat in heart increases
• Heart muscles become stringy and dried-out
• Deposits of brown pigments restrict blood flow
  and absorption of oxygen through heart walls
• Valve elasticity reduced
• Deposits of calcium in valves decreases efficiency

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• Heart pumps 70 as much blood as heart of a
  younger person
• Rhythm slower and more irregular
• Fat deposits around heart interfere with
  functioning
• Blood pressure rises
• Nutritious diet, moderate exercise, adequate
  sleep, and positive mental attitude help keeps
  heart functioning properly
• Coronary artery hardens and narrows
• Lead to partial blockage
• Site of many heart attacks
• Increases blood pressure and reduces blood flow
• Poor circulation can lead to
• Brain deterioration and personality changes
• Kidney problems and/or failures

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• RESERVE CAPACITY- backup capacity which allows
  organs and body systems to respond to greater
  levels during times of stress
• Helps preserve homeostasis
• As it diminishes those affected are less able to
  care for themselves and become more dependent on
  others

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• SEXUALITY CONCEPTUALIZING SEXUAL RESPONSE
• Masters and Johnson (1966) identified 4 stages of
  sexual response in males and females
• Excitement
• Plateau stage
• Orgasm
• Resolution
• Similar body changes in male and female are
  myotonia ( muscle tension) and Vasocongestion
  (blood engorgement)

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• VALUES AND SEXUALITY
• Misconception Older people lose their sexual
  drive.
• Sexual interest and activity gradually decline
  among the elderly
• In a sample of healthy 80 to 102 yr olds, 62
  males and 30 of females said they still engage
  in sexual intercourse. (Bretschneider and McCoy,
  1988).
• Papalia and Associates (2004) note The most
  important factor in maintaining sexual
  functioning is consistent sexual activity over
  the years.
• TRUE If you dont use, youll lose it

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• Deterrents to Sexual Activity
• Lack of partner/ bored with partner
• Overindulgence in drinking/ eating
• Poor physical/ mental health
• Fear of poor performance
• Negative attitudes toward menopause
• Negative attitudes toward sex
• Living arrangements (nursing homes)
• Fear of death due to heart attack or stroke
• Feelings of guilt, anxiety, depression, or
  hostility
• Erectile dysfunction in men (exViagra)
• Younger adults and societys attitudes towards
  sexual activity b/w elderly and unmarried
  (widows/widowers)

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• WHAT CAUSES AGING??
• No one knows all of the reasons
• Theories involve biological, sociological,
  environmental, and psychological factors
• Genetic Theories- hypothesize that aging occurs
  due to damage or changes in genetic information
  involved in the formation of cellular proteins,
  such changes can cause cells to die resulting in
  aging
• Cellular Genetic Theory of DNA Damage
• Running-Out-of-Program Theory
• Error Theory of Aging

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• Nongenetic Cellular Theories- postulate that
  changes take place in cellular proteins after
  theyve been formed and this causes cells to die
  resulting in aging
• Deprivation Theory
• Accumulation Theory
• Wear-and-Tear Theory
• Free-Radical Theory
• Cross-Linkage Theory

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• Physiological Theories- aging is due to either
  the breakdown of an organ system or an impairment
  in physiological control mechanisms
• Single Organ System Theory
• Endocrine Control System Theory
• Stress Theory
• Immunological Theory
• Control-Mechanisms Theory of the Central Nervous
  System
• Sufficient evidence has not been presented to
  prove which, if any, theory is valid

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• FACTORS THAT INFLUENCE THE AGING PROCESS
• Serious long-term illness or severe disability
  increases aging
• Decreased exercise, unknown bio-chemical changes,
  greater stress
• Biological Insults such as accidents, severe
  alcohol or drug abuse, and poor eating habits

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• Environmental Factors
• Being physically and mentally active slows aging
• A positive outlook slows aging
• Insecurity, lack of someone to talk to, negative
  thinking, and being in a strange environment
  speeds aging
• Prolonged exposure to heat/cold speeds aging
• Genetic inheritance may play a role in aging
• People whose parents lived longer and have a
  longer life expectancy and vice versa
• Our bodies have a genetic time clock

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• Health Practices and Longevity(14.2 page 533)
• Eating breakfast
• Eating regular meals and not snacking
• Eating moderately to maintain normal weight
• Exercising moderately
• Not smoking
• Drinking alcohol moderately or not at all
• Regularly sleeping 7 to 8 hours a night
• Avoiding use of illegal drugs
• Learning to cope with stress
• Leading a healthy sexual life

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• DISEASES AND CAUSES OF DEATH AMONG OLDER PEOPLE
• Most frequent chronic conditions
• arthritis, hypertension, hearing impairments,
  heart disease, orthopedic impairments, cataracts,
  diabetes, visual impairments, and sinusitis.
• See doctors more frequently, higher proportion of
  income used on prescription drugs, stay longer
  once in hospitals
• Medical expenses 4 times more than a young-adult
• Suffer more long-term illnesses like cancer,
  heart problems, and diabetes

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• Personal/ Social Stresses- play a major role in
  causing diseases
• Stressful Situations death of family members and
  friends, retirement, loneliness, changes in
  living arrangements, decline in physical
  capacities and physical energy
• Medical conditions- result from inadequate
  exercise, sub-standard diets, smoking, and
  excessive drinking
• Special Problems when elderly become ill
• Their illness is often imposed on an assortment
  of preexisting chronic illnesses and on organ
  systems that no longer function well due to
  diminished reserve capacities
• Health more fragile
• Minor illness, such as the flu, can lead to major
  consequences or even death

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• Majority of older people ARE reasonably healthy
• Advantages of people over 65
• Fewer infections, colds, and acute digestive
  problems
• LIFE EXPECTANCY
• Gradual increase for Americans due to better
  sanitation, nutrition, and disease control
• Average in 2004 was 77 years
• Improvements in infant survival, medical care,
  diets, sanitation, and immunization efforts

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• Two life events predicting death of an elderly
  person
• Death of a spouse
• Moving to a nursing home (may no longer have the
  will to live)
• Sex Differences in Life Expectancy
• In 2003, females life expectancy was 80 years
  while males was only 75
• Environmental factors
• Men are more likely to die from suicide,
  accidents, homicides, lung cancer, heart disease,
  emphysema, asthma, and have more stress

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• Biological Factors
• Higher mortality rates in males in the fetal
  stage and infancy support the notion of an inborn
  difference in resistance
• Women are more apt to be widows
• 2003, the sex ratio among 65 was 141 women for
  every 100 men

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• Factors that influence life expectancy
• Parents and grandparents lived to 80
• Being married for most of adult years
• Not being overweight
• Exercising regularly
• Light drinking
• Not smoking
• Being basically happy and content with life
• Graduating from college
• Living in rural environments
• Having regular medical checkups and regular
  dental care
• Routinely using stress management techniques

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• Factors associated with shorter life expectancy
• Parents/ grandparents died of an illness fairly
  early in their life
• Parents/ grandparents had diabetes, thyroid
  disorder, breast cancer, cancer of the digestive
  system, asthma, or chronic bronchitis
• Being unmarried for most of adult years
• Overweight
• Not exercising regularly
• Having a sedentary job
• Heavy drinkers
• Smoking
• Being aggressive, intense, and competitive
• Often being unhappy, or worried, or feeling
  guilty
• Not completing high school
• Living in urban environment that has moderate to
  high levels of smog
• Frequent illness
• Experiencing high levels of stress without
  routinely using stress management techniques
• Engaging in activities that are high risk for
  AIDS

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Wellness The Strengths Perspective

• Older people are apt to experience little
  physical or mental deterioration (until near
  death) if they have a nutritious diet, are
  successful in managing stress, and stay mentally
  and physically active. A real key to good mental
  and physical health in later years is having a
  lifestyle throughout life that incorporates
  healthmaintenance principles.
• Traditionally, the health profession in this
  country has focused on treatment of diseases
  rather than on prevention. The Chinese approach
  to medicine has focused on helping patients
  maintain good health. The holistic concept of
  treating the whole person is gaining ground in
  America. There is now greater emphasis on
  prevention, wellness, and treating a patient
  psychologically and socially as well as
  physically.

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• Physical Exercise
• For people who have had poor health-maintenance
  habits, it is nearly never too late to change.
  Many studies have shown that older people benefit
  from a variety of exercise programs that include
• Walking
• Swimming
• Weight lifting
• There is also evidence that, as people grow
  older, continued exercise reduces the degree of
  physical and mental slowness that occurs in many
  older people. They should have a physical
  examination to identify heart conditions and
  other medical problems that may be aggravated by
  exercise.

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• Mental Activity
• Just as physical exercise maintains the level of
  physiological functioning, mental exercise
  maintains good cognitive functioning. As
  mentioned, there are some age-related declines in
  cognitive functioning, but if a person is
  mentally active, the declines begin to appear at
  a later age and are less severe.
• Our society needs to put more emphasis on
  ensuring that older people are exposed to
  intellectual stimulation. Some nursing homes and
  retirement communities now have daily programs
  that provide such stimulation national issues or
  local issues are discussed, and guest speakers on
  a variety of subjects are sometimes brought in.

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• One innovative program is Elderhostel, which
  offers low-cost courses, often held on college
  campuses, for people over 55. People sign up for
  1-, 2-, or 3-week sessions to study a variety of
  topics at a relaxed pace. Some public
  universities also have provisions for those over
  65 to attend regular classes with either reduced
  or no tuition.
• Most authorities on aging now believe that an
  intellectual decline in later adulthood is
  largely a myth. Our society needs to develop more
  educational programs to help older people
  maintain their intellectual functioning, and we
  must find additional ways to allow older people
  to be productive, contributing members to
  society.

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• Sleep Patterns
• Many older people have one or more sleep
  disturbances, such as insomnia difficulty in
  falling asleep restless sleep falling asleep
  when company is present frequently awakening
  during the night and feeling exhausted or tired
  after a night of fitful sleep.
• Sleep disturbances that older people experience
  tend to be a result of anxiety, depression,
  worry, or illness. Restless sleep is common for
  those who are inactive, those who catnap too
  much, and those who have physical discomforts
  (such as arthritic pain).

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• Some normal changes occur in sleep patterns for
  older people. Deep sleep virtually disappears.
  Older people generally take a longer time to fall
  asleep and have more frequent awakenings. More
  important, older people distribute their sleep
  somewhat differently. They generally have several
  catnaps of 15 to 60 minutes during the day.
  Catnaps are normal, and caution should be used in
  attempting to use sleep medication to keep an
  older person asleep for 8 hours throughout the
  night, as they need less sleep when they have
  catnaps.

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• Nutrition and Diet
• The majority of older people have inadequate
  diets (Newman Newman, 2003). Because of the
  relationship between diet and cardiac problems,
  physicians recommend that the elderly have
  low-fat, high-protein diets.
• Older people are the most undernourished group
  our society (Papalia et al., 2004). A number of
  reasons given for chronic malnutrition of older
  people a lack of money transportation problems
  a lack of incentive to prepare a nutritious meal
  when one is living alone inadequate cooking and
  storage facilities a decreased or altered sense
  of taste poor teeth and lack of good denture and
  a lack of knowledge about proper nutrition

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• Some older people have a tendency to overeat. One
  way for people to occupy their free time is to
  eat, and most older people have a lot of free
  time. The caloric requirements decrease somewhat
  in the later years, and the extra calories that
  are consumed turn into fat, which increase the
  risks of heart disease and other medical
  conditions.
• To improve the nutritional health of older people
  some programs have been developed. Many
  communities with the assistance of federal funds,
  now provide meals for older people at group
  eating sites. These meals are generally provided
  four or five times a week and usually are
  luncheon meals. These programs improve the
  nutrition of older people and offer opportunities
  for socialization. Meals on Wheels is a service
  that delivers hot and cold meals directly to
  housebound recipients who are incapable of
  obtaining or preparing their own meals, but who
  can feed themselves.

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• Stress and Stress Management
• Stress is a contributing factor in a wide variety
  of emotional and behavioral difficulties,
• Stress is a contributing factor in most physical
  illnesses (Davis et al., 2000). These illnesses
  include hypertension, heart attacks, migraine
  headaches, tension headaches, colitis, ulcers,
  diarrhea, constipation, arrhythmia, angina,
  diabetes, hay fever, backaches, arthritis,
  cancer, colds, flu, insomnia, hyperthyroidism,
  dermatitis, emphysema, Raynauds disease,
  alcoholism, bronchitis, infections, allergies,
  and enuresis. Stressrelated disorders have been
  recognized as being our number-one health problem
  (Romas Sharma, 1995).

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• The increased recognition of stress management in
  treating physical and emotional disorders is
  gradually altering the traditional
  physician-patient relationship. Instead of being
  passive participants in the treatment process,
  patients are increasingly being taught (by social
  workers and other health professionals) how to
  prevent illness and how to speed up the recovery
  from illness by learning stress management
  strategies (Romas Sharma, 1995).
• People who are successful in managing stress have
  a life expectancy that is several years longer
  than those who are continually at high stress
  levels (Romas Sharma, 1995). Effective stress
  management is a major factor in enabling people
  to live fulfilling, healthy, satisfying, and
  productive lives (Davis et al,, 2000).

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• Conceptualizing Stress
• Stress can be defined as the physiological and
  emotional reactions to stressors.
• There are an infinite variety of possible
  stressors loss of a job, a loud noise, toxic
  substances, retirement, arguments, the death of a
  spouse, a move to a nursing home, hot or cold
  weather, serious illness, a lack of a purpose in
  life, and so on.
• For every second we are alive, our bodies are
  responding to stressors that call for adaptation
  or adjustment. Our bodily reactions are
  continually striving for homeostasis, or balance.

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• Selye (1956), one of the pioneer researchers on
  stress, found that the body reacts to all
  stressors in the same way, regardless of the
  source of stress.
• This means that the body reacts to positive
  stressors (for example, a romantic kiss) in the
  same way it reacts to negative stressors (for
  example, an electric shock). Selye found that the
  body has a three-stage reaction to stress
• The alarm phase
• The resistance phase
• The exhaustion phase
• Selye called this three-phase response the
  general adaptation syndrome (GAS).

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• In the alarm phase the body recognizes the
  stressor and responds by preparing to fight or
  flee. The body sends messages from the
  hypothalamus (a section of the brain) to the
  pituitary gland to release its hormones. These
  hormones trigger the adrenal glands to release
  adrenaline. The release of adrenaline and other
  hormones results in
• Increased breathing and heartbeat rates
• A rise in blood pressure
• Increased coagulation of blood, which minimizes
  potential loss of blood in ease of physical
  injury
• Diversion of blood from the skin to the brain,
  the heart, and contracting muscles
• A rise in serum cholesterol and blood fat
• Decreased mobility of the gastrointestinal tract
• Dilation of the pupils

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• In the resistance phase (the second phase) bodily
  processes seek to return to homeostasis. The body
  seeks, during this phase, to repair any damage
  caused by the stressors. In handling most
  stressors, the body generally goes through only
  the two phases of alarm and repair. During a
  lifetime a person goes through these two phases
  hundreds of thousands of times.
• The third phase, exhaustion, occurs only when the
  body remains in a state of high stress for an
  extended period of time. If the body remains at a
  high level of stress, it is unable to repair
  damage that has occurred. If exhaustion
  continues, a person is apt to develop a stress
  related illness.

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• Stress is heavily dependent on what a person
  thinks about events.
• Stress at times is often beneficial to us. It
  stimulates and prepares us to perform a wide
  variety of tasks. Students, for example, often
  find they need to feel a moderate level of stress
  before they can study for an examtoo little
  stress results in their being unable to
  concentrate and may even result in their falling
  asleep, while too high a level of stress results
  in too much anxiety and interferes with their
  concentration.
• The kind of stress that is harmful has been
  called distress by Selye (1974). Long-term
  distress occurs when we continue to think
  negatively about events that have happened to us.
  When unpleasant events occur, we always have a
  choice to think negatively or positively. If we
  continue to think negatively about the situation,
  our thinking keeps the body under a high level of
  stress and can lead to stress related illnesses.

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• Empowerment Approaches to Stress Management
  Application Theory
• Of the five major categories of approaches to
  stress management, only three are constructive in
  terms of empowering a person and helping him or
  her gain greater control over life.
• The three constructive approaches are (1)
  changing the distressing event (2) changing
  ones thinking about the distressing event and
  (3) taking ones mind off the distressing event,
  usually by thinking about something else.
• There are also two destructive ways that some
  people use to relieve stress. One involves
  resorting to alcohol, other drugs, or food.
  Perhaps the major reason for abusing alcohol and
  other drugs is to seek relief from stress and
  unwanted emotions. Drugs will provide temporary
  relief but the next day a persons problems still
  remain, and there is a serious danger that drug
  abuse may become a destructive habit. Compulsive
  overeating is also an unhealthy way of
  temporarily relieving stress.
• The second destructive way of escaping stress is
  suicide.

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• Changing a Distressing Event. When distressing
  events occur, it is desirable to confront them
  directly to try to improve the situation. If an
  older person is concerned about what to do with
  his or her time after retiring, the person needs
  to work on finding meaningful and enjoyable
  activities to become involved in.
• Changing Ones Thinking About a Distressing
  Event. When unpleasant events occur, we have a
  choice to take either a positive or a negative
  view. If we take a negative view, we are apt to
  experience more stress, and also to alienate
  friends and acquaintances.
• Sharing concerns with someone helps to vent
  emotions. The listener may be a neighbor, friend,
  member of the clergy, or professional counselor.
  Talking a concern through often helps in two ways
  to reduce stress. It may lead to a new
  perspective on how to resolve the distressing
  event, or it may help by changing ones thinking
  about the distressing event to a more positive
  and rational attitude.

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• Taking Ones Mind Off the Distressing Event
• Usually by Thinking About Something Else. There
  are a variety of ways to stop thinking about a
  distressing event.
• Relaxation Approaches. Deepbreathing relaxation,
  imagery relaxation, progressive muscle
  relaxation, meditation, and biofeedback are
  effective techniques for reducing stress and
  inducing the relaxation response.
• Exercise. Since the alarm phase of the general
  adaptation syndrome automatically prepares us for
  large muscle activity, it makes sense to
  exercise. Through exercising, we use up fuel in
  the blood, reduce blood pressure and heartbeat
  rate, and reverse the other physiological changes
  set off during the alarm state of the general
  adaptation syndrome. Exercising helps keep us
  physically fit so that we

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• Pleasurable Goodies. Pleasurable goodies relieve
  stress, change our pace of living, are enjoyable,
  make us feel good, and are, in reality, personal
  therapies. What is a goody (pleasurable
  experience) to one person may not be to another.
  Common goodies are being hugged, listening to
  music, going shopping, taking a bath, going to a
  movie, having a glass of wine, taking part in
  family and religious get-togethers, taking a
  vacation, and singing.

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• Application of Theory to Client Situations.
• Social workers are one of the groups of helping
  professionals, along with psychologists,
  psychiatrists, and guidance counselors, who are
  involved in developing and providing
  stress-management programs.
• Social workers can serve as
• Brokers in referring highly stressed individuals
  to stress management programs
• Group facilitators in leading therapeutic groups
  that emphasize stress management.
• Initiators and consultants in developing stress
  management programs in schools, businesses, and
  industries, and in medical settings.

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• Alzheimer's disease.
• Most sufferers are over 65. About 4 million
  Americans have Alzheimers 5 to 10 percent of
  all people over 65 have it, but 47 percent of
  those 85 and over have it (Papalia et al., 2004).
• Alzheimer's disease is a degenerative brain
  disorder that gradually causes deterioration in
  intelligence, memory, awareness, and ability to
  control bodily functions.
• In its final stages, Alzheimer's leads to
  progressive paralysis and breathing difficulties.
  The breathing problems often result in pneumonia,
  the most frequent cause of death for Alzheimers
  victims. Other symptoms of Alzheimers include
  irritability, restlessness, agitation. and
  impairments of judgment. Although most of those
  affected are over 65, the disease occasionally
  strikes people in middle age.
• Over a period lasting from as few as 5 years to
  as many as 20, the disease destroys brain cells.
  The changes in behavior that are displayed by
  those afflicted have a degree of variation,
  Brownlee 11991)

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• Researchers in recent years have made tremendous
  strides in identifying the causes of Alzheimers
  disease. At least three different genes have been
  identified as being linked to the disease, and
  there may be more genes involved. Yet, having one
  or more of these genes does not necessarily mean
  one will develop this disorder, Therefore,
  researchers believe there must be some as yet
  unidentified triggers.
• An examination of the brains of victims have
  found a distinctive tangle of protein filaments
  in the cortex, the part of the brain responsible
  for intellectual functions. This research shows
  that there are biochemical causes for the disease
  and leads to the conclusion that aging does not
  automatically include senility.
• Diagnosing the disease is difficult because the
  disorder has symptoms that are nearly identical
  to other forms of dementia. The only sure
  diagnosis at the present time is the observation
  of tissue deep within the brain, which can be
  done only by autopsy after death. Doctors usually
  diagnose the disease in a living person by ruling
  out other conditions that could account for the
  symptoms.

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• Early symptoms (which are often overlooked) are
  the reduced ability to play a game of cards, a
  reduced performance at sports, and sudden
  outbreaks of extravagance. More symptoms then
  developirritability, agitation, confusion,
  restlessness, and impairments of concentration,
  speech, and orientation. As the disease
  progresses, the symptoms become more disabling.
  The caregiver or caregivers eventually have to
  provide 24-hour care, which is a tremendous
  burden for caregivers. As the disease progresses
  in its final stages, a nursing home is often
  necessary. Near the end, the patient usually
  cannot recognize family members, cannot
  understand or use language, and cannot eat
  without help.
• Alzheimer's disease results from an accumulation
  of the amyloid protein, and if the early
  accumulation of this protein can be detected,
  then it is likely that drugs can be developed to
  treat the disorder by blocking the formation of
  amyloid in the brain. There are high hopes that
  the causes of Alzheimer's can be found soon and
  treatment developed.

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• Early diagnosis and treatment can slow the
  progress of the disease and improve the quality
  of life. Cholinesterase inhibitors (such as
  Aricept) can stabilize or slow symptoms for 6
  months to a year in one third to one half of
  patients (Papalia et al., 2004, p.629).
• Behavioral therapies can improve communication,
  slow the deterioration in capabilities, and
  reduce disruptive behaviors.
• Certain drugs can lighten depression, relieve
  agitation, and assist patients in sleeping.
• Proper nourishment, appropriate exercise,
  physical therapy. and social interaction may slow
  the progression of the disease.
• Memory training and memory aids in the early
  stages may improve cognitive functioning.
• Also being tested for effectiveness in protecting
  against Alzheimers or slowing its deterioration
  are the herbal remedy ginkgo biloba, vitamins,
  anti-inflammatory drugs. and antioxidants such as
  selenium.
• Research is now being conducted on developing
  drugs that increase transthyretin expression in
  the brains of humans so as to combat the
  neurotoxicity of beta-amyloid, which is thought
  to cause Alzheimers disease .