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Powerpoint TemplatesPage 1
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PSYCHOLOGY OF OLD AGE
- DR DEEPIKA SINGH DEPT OF PSYCHIATRY, SETH GSMC & KEMH
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For many individuals, the passage from youth to old age is mirrored by a shift from the pursuit of wealth to the maintenance of health.
In late adulthood, the aging body increasingly becomes a central concern, replacing the midlife preoccupations with career and relationships.
This is so because of normal diminution in function, altered physical appearance, and the increased incidence of physical illness
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Old age, usually refers to the stage of the life cycle that begins at age 65. Gerontologists divide older adults into 3 groups:
young-old: ages 65 to 74; old-old : ages 75 to 84 & oldest old: age more than 85.
Older adults can also be described as well-old (persons who are healthy) &sick-old (persons who have an infirmity that interferes with functioning and requires medical or psychiatric attention).
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Developmental Tasks of Late Adulthood
-To maintain the body image and physical integrity-To conduct the life review-To maintain sexual interests and activities-To deal with the death of significant loved ones-To accept the implications of retirement-To accept the genetically programmed failure of organ systems-To divest oneself of the attachment to possessions-To accept changes in the relationship with grandchildren
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DEMOGRAPHICS
-The number of individuals over age 65 is rapidly expanding.-In 1900, for example, 4 percent of the U.S. population was older than 65 years-By 2003 it was 12.4 percent, and by 2030, it is projected to be 20 percent
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BIOLOGY OF AGINGThe aging process, or senescence (from the Latin senescere, to grow old), is characterized by a gradual decline in the functioning of all the body's systems cardiovascular, respiratory, genitourinary, endocrine, and immune, among others.
But the belief that old age is invariably associated with profound intellectual and physical infirmity is a myth.
Many older persons retain their cognitiveabilities and physical capacities to a remarkable degree
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BIOLOGICAL CHANGES ASSOCIATED WITH AGING--Cellular Level Change in cellular DNA and RNA structures: intracellular organelle degeneration Neuronal degeneration in CNS--Immune System Increased susceptibility to infection
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MUSCULOSKELETAL
-Decrease in height because of shortening of spinal column (2-inch loss in both men and women from the 2nd to the 7th decade) -Reduction in lean muscle mass and muscle strength. -Loss of bone matrix,leading to osteoporosis -Degeneration of joint surfaces may produce osteoarthritis -Risk of hip fracture is 10%-25% by age 90 -Graying of hair results from decreased melanin production in hair follicles
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Genitourinary and Reproductive Decreased glomerular filtration rate and renal blood flow Decreased hardness of erection, diminished ejaculatory spurt Decreased vaginal lubrication Enlargement of prostate Incontinence
Cardiovascular Decreased elasticity of heart valves Increased susceptibility to arrhythmias Altered homeostasis of blood pressure
Gastrointestinal (GI) System Altered absorption from GI tract (at risk for malabsorption syndrome and avitaminosis) Constipation
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Endocrine -Estrogen levels decrease in women -Testosterone production declines in men - Increase in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in postmenopausal women
Respiratory Decreased vital capacity Diminished cough reflex Brain Widened sulci, smaller convolutions, gyral atrophy Ventricles enlarge
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Special Senses
-Thickening of optic lens, reduced peripheral vision -Inability to accommodate (presbyopia) -High-frequency sound hearing loss (presbyacusis)25% show loss by age 60, 65% by age 80 -Reduced acuity of taste, smell, and touch -Decreased light-dark adaption
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Neuropsychiatric Takes longer to learn new material, but complete learning still occurs Intelligence quotient (IQ) remains stable until age 80 Verbal ability maintained with age Psychomotor speed declines
Memory Tasks requiring shifting attentions performed with difficulty Encoding ability diminishes (transfer of short-term to long-term memory and vice versa)
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PSYCHOSOCIAL ASPECTS OF AGINGSOCIAL ACTIVITY-Healthy older persons usually maintain a level of social activity that is only slightly changed from that of earlier years.
-In some cases, however, physical illness or the death of friends and relatives may preclude continued social interaction.
-Moreover, as persons experience an increased sense of isolation, they may become vulnerable to depression.
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-Growing evidence indicates that maintaining social activities is valuable for physical and emotional well-being.
-Old persons can pass on cultural values and provide care services to the younger generation and thereby maintain a sense of usefulness that contributes to self-esteem
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AGEISMAgeism, a term coined by Robert Butler, refers to discrimination toward old persons and to the negative stereotypes about old age that are held by younger adults.
Old persons may themselves resent and fear other old persons and discriminate against them.
In Butler's scheme, persons often associate old age with loneliness, poor health, senility, and general weakness or infirmity
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SOCIOECONOMICS
The economics of old age is of paramount importance to older persons themselves and to society at large.
-The past 30 years has Seen a dramatic decline in the proportion of the U.S. elderly population who are poor, primarily as a result of Medicare, Social Security, and private pensions
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RETIREMENTFor many, retirement is a time for the pursuit of leisure and for freedom from responsibility.For others, it is a time of stress, especially when retirement results in economic problems or a loss of self-esteem.
Most of those who retire voluntarily reenter the work force within 2 years, for a variety of reasons, Including negative reactions to being retired, feelings of being unproductive, economic hardship, and loneliness.
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SEXUAL ACTIVITY-The frequency of orgasm, from coitus or masturbation, decreases with age-factors determining the level of sexual activity with age are the health and survival of the spouse, one's own health & the level of past sexual activity. -Although some degree of declining sexual interest and function is inevitable with age, social and cultural factors appear to be more responsible for the sexual changes observed than the psychological changes of aging per se.
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LONG-TERM CARE-Many older persons require institutional care -Although only 5 percent are institutionalized in nursing homes at any one time, about 35 percent of older persons require care in a long-term facility at some time during their lives
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MENTAL DISORDERS OF OLD AGE
The most common mental disorders of old age are depressive disorders, cognitive disorders, phobias, and alcohol use disorders.
Older adults also have a high risk for suicide and drug-induced psychiatric symptoms.
Many mental disorders of old age can be prevented, ameliorated, or even reversed.
Of special importance are the reversible causes of delirium and dementia; if not diagnosed accurately and treated these conditions can progress to an irreversible state.
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