— inflammation of the joints, accompanied by pain, stiffness, and movement problems
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Incurable disorder that affects hips, knees, ankles, fingers, and vertebrae
Symptoms reduced by drugs, range-of-motion exercises, weight reduction, and joint replacement
Gerontologists recommend strength training in addition to aerobic activity for older adults
Weightlifting can preserve muscle mass
Exercise helps people maintain independence and prevents institutionalization
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Nutrition and Weight
-Leaner adults live longer, healthier lives
-Calorie restriction works to increase life span of animals but human connection is not specifically known
about 3 percent of adults age 65 or older in the U.S. reside in a nursing home at some point in time. As older adults age, however , their probability of being in a nursing home or other extended-care facility increases. Twenty-three percent of adults aged 85 and older live in nursing homes or other extended care facilities. The quality of nursing homes and oher extended care facilities for older adults varies enormously and is a source of continuing national concern. More than one-third are seriously deficient. They fail federally mandated inspections because they do not meet the minimum standards for physicians, pharmacists, and various rehabilitation specialists. Further concerns focus on the patients right to privacy, access to medical information, safety, and lifestyle freedom within the individuals range of mental and physical capabilities. Perceived control over ones environment, then, can literally be a matter of life or death.
-Episodic memory — retention of information about the where and when of life’s happenings
-Semantic memory — person’s knowledge about the world
fields of expertise; general academic knowledge; everyday knowledge of words, places, and things
Both show declines in older adults
-Working memory — closely linked to short-term memory but emphasizes memory as a place for mental work
-Perceptual speed — amount of time it takes to perform simple perceptual-motor tasks
Decline in perceptual speed in older adults is linked to decline in working memory
-Explicit memory — memory of facts and experiences that individuals consciously know and can state
also known as declarative memory
-Implicit memory — memory without conscious recollection; it involves skills and routine procedures that are automatically performed
-Implicit memory is less likely to be adversely affected by aging
— expert knowledge about the practical aspects of life that permits excellent judgment about important matters
development of coping skills
-High levels of wisdom are rare
-Factors other than age are critical for wisdom to develop
cognitive neuroscience and aging
studies the links between brain and cognitive functioning. This field especially relies on brain imaging techniques, such as fMRI, PET, and DTI to reveal the areas of the brain that are activated when individuals are aging in certain cognitive activities. For example, as an older adult is asked to encode and then retrieve verbal materials or image of scenes, the older adults brain activity will be monitored by an fMRI brain scan. aging of the brains prefrontal cortex may produce a decline in working memory. And, when older adults do not regularly use their working memory, neural connections in the prefronatal lobe may be atrophy.
In the beginning of the 21st century, the percentage of men over age 65 who continue to work full time is less than at the beginning of the 20th century. The decline from 1900 to the beginning of the 21st century has been as much as 70 percent. An important change in older adults work patterns is the increase in part time post retirement has steadily increased since the 1960s. some individuals maintain their productivity throughout their lives. some of these older workers work as many or more hours than younger workers. in the longitudinal survey of older men, good health, a strong psychological commitment to work, and a distaste for retirement were the most important characteristics related to continued employment into old age. Older workers have lower rates of absenteeism, fewer accidents, and increased job satisfaction compared with heir younger counterparts.
Best adjustment for those who are:
healthy, have adequate income, active, educated, have an extended social network, satisfied with life before retirement
-Major depression — mood disorder in which the individual is deeply unhappy, demoralized, self-derogatory, and bored
-Predictors of depression: earlier symptoms, poor health, death of a spouse, and low social support
Insomnia is a risk factor for depression in older adults
-Depression is a treatable condition
— global term for any neurological disorder in which the primary symptoms involve a deterioration of mental functioning
Loss of ability to care for themselves and recognize familiar surroundings and people
— a progressive, irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and eventually physical function
-Causes of Alzheimer’s Disease:
No certain scientific proof of causes, Age is a risk factor, Genetic links seem to exist, Lifestyle factors, Lack of exercise
-Family members and other care providers can become physically and emotionally drained
-Need for respite care — services that provide temporary relief to caregivers
— a chronic,progressive disease characterized by muscle tremors, slowing of movement, and partial facial paralysis
-Onset is triggered by degeneration of neurons that produce dopamine in the brain
-Dopamine — neurotransmitter necessary for normal brain functioning
Erikson’s Final Stage
-Integrity versus despair — reflecting on the past and either piecing together a positive view (integrity) or concluding that one’s life has not been well spent (despair)
-Life review is an essential piece of this final stage
-Life review — looking back at one’s life experiences, evaluating them, interpreting and reinterpreting their significance
— the more active and involved that older adults are, the more likely they are to be satisfied with their lives
-Successful aging is associated with being active, energetic, and productive
-Good experience with aging relates to continuing early adult roles or finding substitutes that keep them active and involved
Socioemotional Selectivity Theory
— older adults become more selective about their social networks
-Spend more time with familiar individuals with whom they have rewarding relationships
-Challenges the stereotype that older adults are in emotional despair and isolation
selective optimization with compensation theory
states that successful aging is linked with three main factors: selection, optimization, and compensation. The theory describes how people can produce new resources and allocate them effectively to the tasks they want to master. Selection ls based on the concept that older adults have a reduced capacity and loss of functioning, which require a reduction in performance in most of life domains. Optimization suggests that it is possible to maintain performance in some areas through continued practice and the use of new technologies. Compensation becomes relevant when life tasks require a level of capacity beyond the current level of the older adults performance potential. Older adults especially need to compensate in circumstances with high mental or physical demands, such as when thinking about and memorizing new material very fast, reacting quickly when driving a car, or running fast. When older adults develop illness their need for compensation in obvious. From 25-34 yrs, participants said that they personally invested more time in work, friends, family, and independence in that order. 35-54 and 55-65 yrs, family became more important than friends to them in terms of their personal investment. Little changed from 70-84 yrs old, but for participants 85 to 105 yrs old, health became the main priority in their personal investment.
researchers have found that some personality traits are associated with the mortality of older adults. A longitudinal study of more than 1,200 individuals across seven decades revealed that the Big Five Personality traits are associated with the mortality of older adults. A longitudinal study of more than 1,200 individuals across seven decades revealed that the Big Five personality factor of conscientiousness predicted higher mortality risk from childhood through late adulthood. And in a five year longitudinal study, higher levels of conscientiousness, extraversion, and openness were related to higher mortality risk. affect and outlook are also linked to morality in older adults. older adults characterized by negative effect don’t live as long as those who display more positive affect, and optimistic older adults who have positive outlook on life live longer than their counterparts who are more pessimistic and have a negative outlook on life.
-Ageism — prejudice against others because of their age
-Increased numbers living longer and healthier serve to debunk the stereotypes
-Policy Issues — health care costs, caring for patients with chronic disease, eldercare
— physical and emotional caretaking of older members of the family
-Traditionally done by middle-aged women in the family
-With so many women in the workforce, concern arises regarding who will be the caregivers
Altruism and Volunteerism
-Older adults “give” more frequently than they “take”
-altruism: the belief in or practice of disinterested and selfless concern for the well-being of others.
-Volunteering as an older adult is associated with a number of positive outcomes
less depression and anxiety
married older adults are often happier than single older adults. Divorce and remarriage present challenges to older adults. An increasing number of older adults cohabit.
Approx. 80 percent of older adults have adult children, who are an important part of their social network.
older adults choose close friends over new friends
social support is linked to improved physical and mental health in older adults. Older adults who participate in more organizations live longer than their counterparts who have low participation rates.
Altruism and volunteering are associated with positive benefits for older adults.
-Living will — document filed while the individual can still think clearly, which expresses the person’s desires regarding extraordinary medical procedures that may or may not be used to sustain life
-All 50 states now accept advance directives as reflecting an individual’s wishes
-Euthanasia — painlessly ending lives of individuals who are suffering from an incurable disease or severe disability
active — when death is deliberately induced
passive — when a person is allowed to die by withholding available treatment
Care for Dying Individuals
End-of-life care should include respect for the goals, preferences, and choices of the patient and his or her family
Hospice — program committed to making the end of life as free from pain, anxiety, and depression as possible
Palliative care — reducing pain and suffering and helping individuals die with dignity
escalating health care costs are currently causing considerable concern. approximately one third of the total health bill of the u.s. is for the care of adults 65 and over, who comprise only 12 percent of the population. The health care needs of older adults are reflected in medicare, the program that provides health care insurance to adults over 65 under the SS system. A special concern is that while many of the health problems of older adults are chronic rather than acute, the medical system is still based on a “cure” rather than a “care” model. Chronic illness is long term, often lifelong, and requires long term, if not life term management.
Social Convoy Model
— individuals go through life embedded in a social network of individuals from whom they give and receive social support
-Social support enhances coping skills
-Being lonely and socially isolated is a significant health risk
Minority elderly are over-represented among the poor
Double jeopardy — they face both ageism and racism
History of less education, underemployment, poor housing conditions, shorter life expectancy than Whites
Strong coping mechanisms (e.g., church membership, family support for elders)
Double jeopardy for older women who face ageism and sexism
Minority females face triple jeopardy — ageism, sexism, and racism
In the past several decades, defining death has become more complex
Brain death — the neurological definition, when all electrical activity of the brain has ceased for a specified period
individual whose higher cortical areas have died may continue breathing and have a heartbeat
Kubler-Ross’ Stages of Dying
denial and isolation, anger, bargaining, depression, acceptance
-5-stage sequence has not been supported by research findings
-Stages did not account for individual circumstances of patient and support systems
-However, she did much to call attention to the issues of quality of life and coping with dying
death in different cultures
in most societies, death is not viewed as the end of existence-though the biological body has died, the spirit is believed to live on. this religious perspective is favored by most Americans as well. cultural variations in attitudes toward death include belief in reincarnation, which is an important aspect of Hindu and Buddhist religions. In gond culture of India, death is believed to be caused by magic and demons. In many ways, we in the U.S. are death avoiders and death deniers. this denial can take many forms: the tendency of the funeral industry to gloss over death and fashion lifelike qualities in the dead; the persistent search for a fountain of youth; the rejection and isolation of the aged, who may remind us o f death; and the medical community’s emphasis on prolonging biological life rather than on diminishing human suffering.
Perceived Control and Denial
PERCEIVED CONTROL may work as an adaptive strategy for some older adults who face death. When individuals are led to believe they can influence and control events-such as prolonging their lives-they may become more alert and cheerful. DENIAL also may be a fruitful way for some individuals to approach death. It can be adaptive or maladaptive: not providing adequate or appropriate adjustment to the environment or situation. Denial can be used to avoid the destructive impact of shock by delaying the necessity of dealing with one’s death. Denial can insulate the individual from having to cope with intense feelings of anger and hurt; however, if denial keeps us from having a life-saving operation, it clearly is maladaptive. Denial is neither good nor bad; its adaptive qualities need to be evaluated on an individual basis.
Coping with Death and Loss
-It is best for dying persons and their family members to know that death is immanent and a reality
individuals can close life with their own ideas about proper dying
they can complete some projects and plans and can make arrangements for funeral and for survivors
communicating with a dying person
some experts believe that conversation should not focus on mental pathology or preparation for death but should focus on strengths of the individual and preparation for the remainder of life. Because external and accomplishments are not possible, communication should be directed more at internal growth. keep in mind also that important support for a dying individual may come not only from mental health professionals, but also from nurses, physicians, a spouse, or intimate friends. Establish your presence, eliminate distraction, if frail-keep short visit, don’t insist the person feel acceptance if they want to deny and don’t insist on denial if it is accepted, allow the person to feel guilt or anger, what the expected outcome for the illness is, anyone they would like to see, encourage reminiscing, talk when he or she wants to talk, express your regard for the dying individual.
the emotional numbness, disbelief, separation anxiety, despair, sadness, and loneliness that accompany the loss of someone we love. The grieving process is more like a rollercoaster than an orderly progression of stages with clear cut time frames. The up and downs of grief often involve rapidly changing emotions. Prolonged Grief involves enduring despair and is still unresolved over an extended period of time, usually have negative consequences on physical and mental health. African american experience more prolonged grief than non Latino whites. Disenfranchised grief which describes an individuals grief over a deceased person that is socially ambiguous loss that cannot be openly mourned or supported- abortion
, aids, ex-spouse.
type of death
the impact of death on surviving individuals is strongly influenced by the circumstances under which the death occurs. Deaths that are sudden, untimely, violent, or traumatic are likely to have more intense and prolonged effects on surviving individuals and make the coping process more difficult for them. Such deaths often are accompanied by post traumatic stress disorder symptoms, such as intrusive thoughts, flashbacks, nightmares, sleep disturbance, problems in concentrating, and others. The death of a child can be especially devastating and extremely difficult for parents.
making sense of the world
One beneficial aspect of grieving is that it stimulates many individuals to try to make sense of their world. Common occurrence is to go over again and again all of the events that led up to the death. In the day and weeks after the death, the closest family members share experiences with each other, sometimes reminiscing over family experiences. When death is caused by an accident or a disaster, the effort to make sense of it is pursued more vigorously. As added pieces of news come trickling in, they are integrated into the puzzle. The bereaved want to put the death into a perspective that they can understand-divine intervention, a curse from a neighboring tribe, a logical sequence of cause and effect, or whatever it may be. A study of more than 1,000 college students found that making sense was an important factor in their grieving of a violent loss by accident, homicide, or suicide.
losing a life partner
14% of men and 42% of women aged 65 and older were widowed. Those left behind after the death of an intimate partner often suffer profound grief and often endure financial loss, loneliness, increased physical illness, and psychological disorders, including depression.
cremation and funerals
Cremation more popular in the Canada than in the US and most popular in Japan and most Asian countries. In the US the trend is away from public funerals and displaying the dead body in an open casket and toward private funerals followed by a memorial ceremony. Amish use barn in warmer months and house in cooler months to hold funeral, a high level of support is given afterwards for at least a year.
Life Span and Life Expectancy
— maximum number of years an individual can live
120-125 years; remains unchanged
— number of years that the average person, born in a particular year, will probably live
has increased 31 years since 1900
average U.S. life expectancy = 78 years
the u.s is no longer a youthful society. As more individuals are living past age 65, the portion of individuals at different ages has become increasingly similar. Indeed, the corner of a period called “late adulthood” beginning in the sixties or seventies and lasting until death, is a recent one. before the 20th century most individuals died before they reached 65
male vs female
-International differences due to health conditions, medical care, etc.
women outlive males an average of 5 years
due to health attitudes, habits, lifestyles, occupation
biological factors — females outlive males across species
A person who is 100 or more years.
15,000 in 1980
55,000 in 2008
-Genes play a role
Also family history, health, exercise, education, personality, and lifestyle
-Sexuality can be life-long
-Aging changes sexual performance, especially in males
orgasm less frequent
education may help deal with these issues
-As we age, probability of illness increases
-Arthritis and hypertension are most common chronic disorders
-Low income is strongly related to health problems in late adulthood
Approximately three times as many poor as non-poor older adults report that chronic disorders limit their activities