Chapter 14
Life’s Transitions: The Aging Process
LIFE’S TRANSITIONS
Old People Are Useless!
AGING: The process of growing
old – IT WILL HAPPEN to
YOU !!!!
• In 1975  350 million
people over 60 years
• In 2050  1.1 billion
over 60 years
PERCEPTION:
HOW YOU VIEW
PEOPLE OLDER
THAN YOU
Studying Aging
Connotations:
• A negative
psychological shift.
Western cultural views
are different from others
• GERONTOLOGY:
The study of aging.
• GERONTOLOGIST:
One who studies aging.
Old People Should Retire So
That Younger People Can Work?
Why study the effects of aging?
(5 reasons):
• biology of aging (genetic
and environmental factors
associated with aging)
• shift in survival and life
expectancy has itself
driven the inquiry about
the social implications
• medical science
documents the diseases
of old age and attempts to
moderate their effects
Aging
• health care costs of
an older society
• psychologists
attempting to
understand the
negative attitudes
toward the elderly
Old People Are Slow And Get In
My Way!
Old People Aren’t Beautiful!
The Changing Face of the
Nation
• Baby Boomers approaching
retirement.
• Elderly are living longer combination of modern
medicine and lifestyle related
factors = age 115 years
Changing Face of the Nation
• higher quality of life therefore older people are a
major social, political and
economic factor in society.
• Changing demographics
also reflected in fact that not
as many children are being
born in first world countries.
I Will Never Get That Old!
TYPES OF AGING:
BIOLOGICAL:
• physical changes with
time
• relative age – condition of
organs / body systems
• arthritis / osteoporosis /
accelerate aging process
PSYCHOLOGICAL
adaptive capacity =
• coping abilities
intelligence
• individual capabilities
• self-efficacy
• biological
• social changes
SOCIAL
• habits and roles
relative to society’s
expectations
• people sharing
common interests
• changes in person's
familial, occupational
and social roles
(retirement, loss of
income, etc.)
GETTING OLDER
Legal
chronological age
driving
drinking ( not together !)
voting
old age security
Canada Pension Plan
Functional:
• how people compare
at similar ages……..
• health
• capacity
• activity
• interests
• mobility
THE AGING PROCESS:
a function of three factors:
True aging (also called primary
aging):
• unavoidable result of chronology that
affects all species sooner or later
Disease processes (secondary aging)
• aging due to diseases, such as trauma,
illness, stress, etc.; lifestyle can be
classified in this factor (smoking)
THE AGING PROCESS:
a function of three factors:
Disuse phenomena
(secondary aging)
• aging due to the lack
of activity (Sedentary
Lifestyle)
THEORIES ON AGING
Biological:
• the wear and tear theory
– “ It’s Not the Years..,
It’s the Mileage”
• the human body simply
wears out
• some activities may
predispose this condition
(running)
THEORIES ON AGING
• the cellular theory – limited
number of cells / capacity to
reproduce / once exhausted
body begins to deteriorate /
varies from individual to
individual
• the autoimmune theory –
declining immune system /
loses control attacking body
THEORIES ON AGING
• the genetic mutation
theory – the older you
are the more mutant
cells develop/ function
differently than
intended / dysfunction
of body organs +
systems
Physical Changes
The Skin:
• (30’s)thinner + loses elasticity
/(40’s) lines on the face /
• (50’s) crow’s feet /(60’s) loses
colour + sags / (70’s) age spots
etc.
Bones and Joints:
• constantly changing
accumulating and losing
minerals (modeling)
• 30’ and 40’s – net loss of
minerals – could lead to
Physical Changes
OSTEOPOROSIS:
• loss of bone material /
bone mass
• post-menopausal women
• fractures common
• very debilitating
• risk factors: calcium, lack
of exercise, lack of
estrogen therapy postmenopause
Physical Changes
The Head:
• features of the head
enlarge ( nose, ears,
head - skull thickens)
Brain shrinks
The Urinary Tract:
• urinary incontinence
• individual
• treatable - drug therapy
Physical Changes
Heart and Lungs:
• Resting Heart Rate stays about
the same throughout life
• stroke volume decreases
• heart muscle deterioration
• Vital Capacity decreases
(max. inhalation + exhalation)
• exercise slows these changes
Eyesight:
• 30 years of age – lens harden
• 40 years of age – lens: yellow
and looses transparency
• Cataracts – (clouding of the
lens) / focus on retina / blurred
vision / blindness possible
• glaucoma – ( increased
pressure within the eyeball)
• hardening of the eyeball ,
impaired vision, eventual
blindness
Hearing and Taste
Hearing:
• range diminishes / normal and
conversational retained
Taste:
• age 30 – each papilla has 245 taste
buds - # diminishes over time
• age 70 – 88 remaining
• Smell and Touch:
• pain and tactile sensors decline
• sense of smell also declines / may lead
to malnutrition ( food lacks appeal)
Getting Around and body Comfort
Mobility:
• 50% of older Canadians Report some
disability related to mobility or agility
Body Comfort:
• loss of body fat / thinning of epithelium
/ diminished glandular function
• body temperature
• hypothermia / heat stroke / heat
exhaustion
Mental Changes:
Intelligence:
• unchanged - except for
illness
• continue to learn and
develop (time?)
• compensate with
practical knowledge
Memory:
• short-term can be
memory - affected
• long-term unchanged
Coping with Change
Flexibility vs. Rigidity:
• LIFE = diverse joys, sorrows,
and obstacles –developed coping
methods
Depression:
• most adults continue to lead
healthy, fulfilling lives
• however, depression is the most
common
Confusion and Frustration
Senility:
• over-generalization
• misinterpreted as senility =
memory failure / judgment
error / disorientation /
erratic behaviours……..
(any age!)
Alzheimer’s Disease and other
Dementias
Dementias – progressive
brain impairments that
interfere with memory
and intellectual
functioning
ALZHEIMER'S DISEASE
The disease most dreaded by the elderly is
dementia; loss of mental functions in an alert
individual, characterized by group of symptoms :
• memory loss
• loss of language functions
• inability to think abstractly
• inability to care for oneself
• personality change
• emotional instability
• loss of sense of time
ALZHEIMER'S DISEASE
• three quarters (75%) dementia’s caused by
Alzheimer's disease - chronic, degenerative
dementing illness / cause unknown
• no known cure to stop the progression
• 6% of people over 65 years have Alzheimer's
disease
• Alzheimer's disease 4th leading cause of
death - older adults
• < seventy conditions can cause dementia
Types of Dementia:
• Degenerative = Alzheimer's, Parkinson's,
Huntington's.
• Vascular dementia: cerebral embolisms,
blood clots, and infarctions.
• Traumatic dementia: head injuries.
• Lesions: tumors, hematomas, and cancers.
• Toxic dementia: alcohol, poisons.
• Others: epilepsy, post-traumatic stress
disorders, and heat stroke.
THEORIES OF AGING:
• Brain size & longevity
• Biological clock determines how
long we live.
• Disposable soma: Allocation of
resources - optimal is as little as
possible to body repair, and more to
other functions.
• Wear and tear: Accumulated
damage leads to breakdown - like a
machine!
Genes and Aging
• Genetic theories: Loss of
genetic info. over time = loss
of protein to rebuild.
• Immunological: Breakdown
of immune system.
• Others: Error accumulation,
cell loss, nutritive,
environment, and brain
chemistry.
AGEISM
• discrimination
• stereotyping - generalization of
characteristics - + / - without
knowing the individual
• concept of young or old
• healthy or unhealthy
• value youth, devalue old age
• western culture vs. other
cultures respect wisdom of
elderly
DEATH AND DYING
• THANATOLOGY: the
study of death and dying.
• PSYCHOLOGY:
fascination yet denial in
western society.
• people not prepared!
• DEATH - a process, not a
point in time
KUBLER ROSS: STAGES OF
DYING (5):
• Dying person may experience
several intense emotions.
DENIAL:
• "No, not me!"
• patient rejects the news
• initial positive defense
mechanism but can become a
problem if reinforced by family
and friends, leading to poor
coping.
ANGER
ANGER:
• "Why me?"
• resentment and rage
over impending death;
• may be directed
outwards at loved
ones.
BARGAINING
acknowledgement
but……...
try to bargain with
GOD
in this stage e.g
Exchange recovery
promise to be a better
person
DEPRESSION:
• gradual realization of
consequences
• difficult time - persons needs
to be watched and supported
• a period of grieving
must be allowed to work
through this stage
• trying to cheer up isn’t an
asset now!
ACCEPTANCE
• “I’m scared but,
I'm ready."
• These stages may
overlap and
repeat.
DEFINITION OF DEATH:
Spiritual death:
• death of meaningful life
• including responsiveness to others, with activity of the
brain and consciousness
ALSO: Unreceptive and unresponsive to
painful stimuli - CPR
•
No movement for an hour
•
No breathing for 3 minutes
•
No reflexes
•
Pupils fixed and dilated - flat EEG
• LIFE SIGNS………………..
DEFINITION OF DEATH:
Traditional legal definition:
• failure of heart and lungs = functional
death.
Modern medicine:
• brain death = absence of electrical impulse
activity in the brain (EEG).
Cellular death:
• Cells die- e.g., heart, brain, muscle
CIRCUMSTANCES OF DEATH
• Death at/or before 50 years of age
or younger emotional trauma –
unexpected
• Religious belief = less fear
• Pain and physical distress.
• Immediately prior to death there
is often an increased in vitality
• People often "hold on" for a
specific life event or person
EUTHANASIA: Mercy killing.
INDIRECT INVOLUNTARY
(PASSIVE) remove life support
DIRECT VOLUNTARY
administer fatal drug as condition
worsens
DIRECT INVOLUNTARYdrug once a patient is in a coma.
ILLEGAL / ETHICAL ISSUES
LIVING WILL
• A statement requesting
removal from life support
systems……. if the chance
for survival is limited….
• Not accepted in all
provinces, e.g.
Saskatchewan
DEATH OF A LOVED ONE:
STAGES OF GRIEF:
• Bereavement: the experience of
loss
• Grief: intense emotional
suffering
• Mourning: social response e.g.
wearing black, funerals, etc.
Stages and Experiences
when coping with loss….
• Physical: Exhaustion, feeling weighed
down - stress. - nutrition, rest, exercise
crying very important
• Emotional: ask or accept help
• Ask for what you need! Being alone or
with friends and family
• Talk to others with similar experiences take the time
• Sadness and crying natural - share
feelings.
Stages and Experiences
when coping with loss….
• Intellectual: Avoid making major
life decisions at this time.
• Process includes anger,
resentment, and negative emotions.
• Work through the feelings - don't
avoid or deny them
• Spiritual: surviving loss and
finding meaning to continue, look
inside yourself, your faith, and
your life!
FUNERALS:
• A number of
considerations: cost,
embalming, burial, and
cremation.
• Rites of passage - A
process - saying goodbye
very important for
closure - found in most
cultures
SOME IMPORTANT TERMS
• 1. SIDS: Sudden infant death
syndrome - babies 1 to 3
months.
2. STILLBIRTH: Infant is born
dead.
3. PERINATAL DEATH: Death
occurs within hours or days of
birth.
HELPING SOMEONE FACE
DEATH:
Hospices:
• concept rather than
a place
• provides health care
• support
• free of pain
• death with dignity