The Challenge of Aging Chapter 17 The Challenge of Aging – Normal process of development that occurs throughout life • Generating vitality as you age – Biological aging: the normal, progressive, irreversible changes to one’s body that begin at birth and continue until death – Psychological and social aging: more abrupt changes in circumstances and emotion – Successful aging requires preparation • 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 ©2012 McGraw-Hill Higher Education. All rights reserved. 2 Life-Enhancing Measures: Age-Proofing • Challenge your mind – Older adults who stay mentally active have a lower risk of developing dementia • Develop physical fitness – Enhances both psychological and physical health • Eat wisely – Eat a varied diet full of nutrient-rich foods – Guidelines for older adults: • • • • Get enough vitamin B-12 and vitamin D Limit sodium intake and get enough potassium Consume foods rich in dietary fiber and drink plenty of water Pay special attention to food safety ©2012 McGraw-Hill Higher Education. All rights reserved. 3 Life-Enhancing Measures: Age-Proofing • Maintain a healthy weight • Control drinking and overdependence on medications • Don’t smoke • Schedule screenings and physical examinations to detect treatable diseases • Recognize and reduce stress ©2012 McGraw-Hill Higher Education. All rights reserved. 4 Dealing With The Changes Of Aging • Planning for social changes –Changing roles and relationships • Major feature of life –Increased leisure time • Many people do not know how to enjoy their free time –The economics of retirement • Financial planning should begin early in life ©2012 McGraw-Hill Higher Education. All rights reserved. 5 Adapting to Physical Changes • Hearing loss • Vision changes – Age-related macular degeneration (AMD) – Presbyopia – Cataracts • Arthritis – Osteoarthritis (OA) is the most common type of arthritis • Menopause – Usually occurs during a woman’s 40s or 50s – Perimenopause • Osteoporosis ©2012 McGraw-Hill Higher Education. All rights reserved. 6 Handling Psychological and Mental Changes • Dementia – Sever and significant brain deterioration in elderly individuals – Affects 7% of people under the age of 80 – Two most common types of dementia 1. Alzheimer’s disease – Changes in brain nerve cells 2. Multi-infarct dementia – Series of small strokes or changes in the brain’s blood supply that destroy brain tissue ©2012 McGraw-Hill Higher Education. All rights reserved. 7 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 ©2012 McGraw-Hill Higher Education. All rights reserved. 8 Aging And Life Expectancy • Life expectancy – Average length of time we can expect to live – In 2006, life expectancy for the total population was 78.1 years – Those who reach age 65 can expect to live even longer, 18 years or more longer – Women have longer life expectancy than men ©2012 McGraw-Hill Higher Education. All rights reserved. 9 Aging and Life Expectancy • America’s aging minority – People 65 and over are a large minority of American population • Over 37.3 million people • About 12% of the total population in 2006 • Expected to double by 2030 – Social Security benefits • 90% of total income for one-third of Americans over age 65 ©2012 McGraw-Hill Higher Education. All rights reserved. 10 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 settings • Of those over the age of 85, about 15% live in a nursing home ©2012 McGraw-Hill Higher Education. All rights reserved. 11 Family and Community Resources for Older Adults • Governmental aid and policies – Social security – Medicare • Pays about 30% of the medical costs of older Americans – Medicaid • Health care for older adults – Gerontologists – Geriatricians ©2012 McGraw-Hill Higher Education. All rights reserved. 12 What is Death? • Defining death – Defined as cessation of the flow of vital bodily fluids • Heart stops beating and breathing ceases • Life-support systems – Brain death • Harvard medical school committee – brain death involves: 1. 2. 3. 4. Lack of receptivity and response to external stimuli Absence of spontaneous muscular movement and spontaneous breathing Absence of observable reflexes Absence of brain activity on EEG » Check a second time after 24 hours » Excludes cases of hypothermia • Clinical death • Cellular death ©2012 McGraw-Hill Higher Education. All rights reserved. 13 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 – Impact on relationships – Religious or philosophical answers ©2012 McGraw-Hill Higher Education. All rights reserved. 14 Denying Versus Welcoming Death • Individuals often maintain conflicting or ambivalent attitudes toward death • Few people wholly avoid or wholly welcome death ©2012 McGraw-Hill Higher Education. All rights reserved. 15 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 accounts, credit cards, location of documents, people to notify etc.) ©2012 McGraw-Hill Higher Education. All rights reserved. 16 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 ©2012 McGraw-Hill Higher Education. All rights reserved. 17 Deciding to Prolong Life or Hasten Death • Persistent vegetative state • Withholding or withdrawing treatment (passive euthanasia) • Assisted suicide and active euthanasia – Physician-assisted suicide (PAS) • Physician provides lethal drugs or other interventions at the patient’s request; patient administers fatal dose – Active euthanasia • Intentional act of killing someone who would otherwise suffer from an©2012 incurable and painful disease McGraw-Hill Higher Education. All rights reserved. 18 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 decisions or communicate them later • Two forms: 1. Living will 2. Health care proxy • Surrogate (decision maker) ©2012 McGraw-Hill Higher Education. All rights reserved. 19 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 – Nearly 110,000 Americans were waiting for organ transplants as of July 2010 • Uniform Donor Card • Driver’s license designation ©2012 McGraw-Hill Higher Education. All rights reserved. 20 Planning a Funeral or Memorial Service • Disposition of the body – Burial – Cremation – Embalming – Green burial • Arranging a service ©2012 McGraw-Hill Higher Education. All rights reserved. 21 Coping With Dying • The tasks of coping – Elizabeth Kubler-Ross and the five stages of dying 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance – Charles Corr and the four primary dimensions in coping with dying: 1. Physical 2. Psychological 3. Social 4. Spiritual • Supporting a dying person ©2012 McGraw-Hill Higher Education. All rights reserved. 22 Coping With Loss • Experiencing grief – Bereavement – Mourning • Tasks of mourning 1.Accepting reality 2.Working through the pain 3.Adjusting to a changed environment 4.Emotionally relocating the deceased and moving on with life • The course of grief – Complicated grief • Supporting a grieving person • Coming to terms with death ©2012 McGraw-Hill Higher Education. All rights reserved. 23 Coping With Loss The Challenge of Aging Chapter 17