©2010 McGraw-Hill Higher Education. All rights reserved. The Challenge of Aging Chapter 17

©2010 McGraw-Hill Higher Education. All rights reserved.

The Challenge of Aging

Chapter 17


Generating Vitality as You Age

• Physical and mental change occur gradually, over a lifetime.

• What Happens as you age?–Characteristics associated with aging are not

due to aging at all.• Result of neglect and abuse of our bodies and

minds

2


Life-Enhancing Measures: Age-Proofing

• Challenge your mind– Older adults who stay mentally active have a lower risk of

developing dementia• Reading • Doing puzzles• Learning language• Studying music

• Develop Physical Fitness– Enhances both psychological and physical health

• Eat Wisely– Eating a varied diet full of nutrient-rich foods– Follow the recommendations in the 2005 Dietary Guidelines

for Americans

3


Life-Enhancing Measures: Age-Proofing

• Maintain a Healthy WeightA program that expends more calories through exercise,

cutting calorie intake, or a combination of both.

• Control Drinking and Overdependence on Medications

• Abstain from Tobacco Smoke• Schedule Physical Examinations to Detect

Treatable Diseases• Recognize and Reduce Stress

4


Dealing with the Changes of Aging

• Planning for Social Changes–Retirement– Important relationships–Developing satisfying interests outside work–Saving for an adequate retirement income

• Changing Roles and Relationships• Increased Leisure Time• The Economics of Retirement

5


Adapting to Physical Changes

• Hearing Loss• Vision Changes

– Age-related macular degeneration (AMD)• Slow disintegration of the macula (tissue at the center of the

retina)– Presbyopia– Cataracts– Glaucoma

• Arthritis• Osteoarthritis is the most common

• Menopause– Usually occurs during a woman’s forties or fifties– Hormone Replacement Therapy (HRT)

• Osteoporosis

6


Cataracts and Presbyopia


Glaucoma


Handling Psychological and Mental Changes

• Dementia–Brain deterioration in elderly individuals–Affects 7% of people under the age of 80–Two types of dementia

1. Alzheimer’s diseasea. By changed in brain nerve cells

2. Multi-infarct dementiaa. Series of small strokes or changes in the brain’s blood

supply that destroy brain tissue

9


Handling Psychological and Mental Changes

• Grief–Dealing with grief and mourning–Aging is associated with loss

• Depression–Unresolved grief can lead to depression, a

common problem in older adults

10


Aging and Life Expectancy

• Life expectancy–Average length of time we can expect to live.–2006 – Life expectancy for the total

population was 78.1 years• Average life expectancy of white Americans is

78.5 years• Average life expectancy of black Americans is

73.6 years

–Maximum Life span – 100-120 years

11


Life In An Aging America

• America’s Aging Minority–People 65 and over are a large minority

• Over 37.3 million people• About 12% of the total population in 2006• Expected to double by 2030

12


Family and Community Resources for Older Adults

• 66% of noninstitutionalized older Americans live with a spouse or family member.

• 30% live alone

• Only 4% live in institutional setting

• Over the age of 85, about 15% live in a nursing home.

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• Family Involvement in Caregiving– Medical power of attorney

• Other Living and Care Options• Community Resources

– Senior citizens’ centers or adult day-care centers– Homemaker services– Visiting nurses– Household services– Friendly visitor or daily telephone reassurance services– Home food delivery– Adult day hospital care– Low-cost legal aid– Transportation services– Case management

• Transportation


14


• Governmental Aid and Policies– Food stamps– Housing subsides– Social Security– Medicare

• Two parts of funding– Payroll deduction by FICA tax– Monthly premiums paid by people who choose to enroll (Medicare Part

D)• Pays about 30% of the medical costs of older Americans

– Medicaid– Changing the Public’s Idea of Aging


15


Understanding Death and Dying

• Defining Death– Defined as cessation of the flow of vital bodily

fluids.• Cessations of the heart beating and breathing• Life-support systems• Brain death• Harvard medical School committee – death involves:

1. Lack of receptivity and response to external stimuli2. Absence of spontaneous muscular movement and spontaneous

breathing3. Absence of observable reflexes4. Absence of brain activity

• Clinical death (sudden cessation)• Cellular death (gradual)

16


Learning About Death

• A child’s understanding of death evolves greatly from about age 5 to age 9.– Most children come to understand that death is

final, universal, and inevitable• Mature understanding of death• Mark Speece and Sandor Brent – Facts about

death includes four components:1.Universality2.Irreversibility3.Nonfunctionality4.Causality

17


Planning For Death

• Making a Will– A legal instrument expressing a person’s

intentions and wishes for the disposition of his or her property after death.

– Estate– Testator– Intestate– Testamentary letter

• Document includes information about your personal affairs (bank statements, credit cards, documents etc.)

18


Considering Options for End-of-Life Care

• Home Care

• Hospital-Based Palliative Care– Focuses on controlling pain and relieving

suffering by caring for the physical, psychological, spiritual, and existential needs of the patient.

• Hospice Programs– Palliative care

19


Deciding to Prolong Life or Hasten Death

• Withholding or Withdrawing Treatment (Passive Euthanasia)

• Assisted Suicide and Active Euthanasia– Physician-assisted suicide (PAS)

• Physician provides lethal drugs or other interventions

– Active euthanasia• Intentional act of killing someone who would

otherwise suffer from an incurable and painful disease

20


Completing an Advance Directive

• Any statement made by a competent person about choices for medical treatment should he or she become unable to make such a decisions.

• Two forms:1. Living will

2. Health care proxy• Surrogate (the decision maker)

21


Becoming an Organ Donor

• Each day about 77 people receive an organ transplant while another 19 people on the waiting list die because not enough organs are available.– 98,000 Americans waiting for organ

transplants

• Uniform Donor Card

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Sample organ/tissue donor card Figure 17.2

23


Coping With Dying

• Awareness of Dying• The Tasks of Coping

– 1969 book On Death and Dying, Elisabeth Kubler-Ross• 5 psychological stages

1. Denial2. Anger3. Bargaining4. Depression5. Acceptance

– Charles Corr• 4 primary dimensions in coping with dying

1. Physical2. Psychological3. Social4. Spiritual

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Coping with Dying

• The Trajectory of Dying– Understanding patients’ experiences as they near

death• Supporting a Dying Person• Coping With Loss

– Experiencing Grief• Bereavement• Mourning

– Tasks of Mourning1. Accepting reality2. Working through the pain3. Adjusting to a changed environment4. Emotionally relocating the deceased and moving on with life

25


Recommended Readings


Connect Assignment

• Chapter 17 Connect Assignment Due Tuesday, April 20th

Documents

©2010 McGraw-Hill Higher Education. All rights reserved. The Challenge of Aging Chapter 17