Life-Span Development in
Late Late Adulthood
dealing with end of life
developmental tasks and issues
Caitlyn Andrews
Vanessa Barriga
Anna Clark
Jennifer Jaber
Beth Lee
Alisa Meyer
Agenda
•
Relationships
 Vanessa Barriga
•
Physical Health
 Caitlyn Andrews
•
Brain Changes
 Anna Clark
•
Mental Health / Behavioral Health
 Alisa Meyer
•
Death and End of Life Preparation
 Beth Lee
•
The Best Parts of Being at Late Late Age
 Jennifer Jaber
•
Age Groups
 Level two
•
Life Expectancy
 Level two
•
Stereotypes
 Level two
•
Work and Retirement
 Level two
•
Theories
 Level two
•
Religion
 Level two
•
Political Issues
 Level two
•
Social Support and Integration
 Level two
•
Friendship
 Level two
Vanessa Barriga
• Statistics
Level two
• Level 3
• Romance and Sex
Level two
• Level 3
Vanessa Barriga
http://www.youtube.com/watch?v=fT4KovVUc78
Vanessa Barriga
• Marriage Statistics
Level two
• Level 3
• Divorce and Remarriage
Level two
• Level 3
• Cohabitation
Level two
• Level 3
• Grandparents, Parents
Level two
Vanessa Barriga
At my age, happy hour is nap time.
Caitlyn Andrews
• Shorter in height
 drop in weight
 lose muscle
 move more slowly
• Vision/visual acuity
 color vision and depth of perception decline
•
Hearing:
 Can be significant loses in high and middle frequencies
• Smell and taste
 Decreases in sense of taste and smell
• Touch and pain
 Declines in sensitivity
• Changes in Sexuality
 Sexuality can be life long!
 Men have more trouble with sexual performance at this
age; orgasms become less frequent.
Caitlyn Andrews
• Arthritis: An inflammation of the joints
accompanied by pain, stiffness, and movement
problems
• Osteoporosis: Extensive loss of bone tissue
 80% of people affected are women.
 Prevention: Diet, Bone density checks, and EXERCISE
• Danger of Accidents: 7th leading cause of death
for older adults.
 Fall at home, Traffic accident, Slower recuperation time
• Substance Abuse: Danger when taking multiple
medications
 “Invisible epidemic”
• Nursing Homes
 23% of adults over 85 live in nursing homes or extendedcare facilities
 Concerns for privacy, medical information, safety and
lifestyle freedom, expensive, quality
Caitlyn Andrews
My forgetter's getting better
But my rememberer is broke
To you that may seem funny
But, to me, that is no joke.
At times I put something away
Where it is safe, but, Gee!
The person it is safest from
Is, generally, me!
When shopping I may see someone,
Say "Hi" and have a chat,
Then, when the person walks away
I ask myself, "who was that?"
Yes, my forgetter's getting better
While my rememberer is broke,
And it's driving me plumb crazy
And that isn't any joke.
Caitlyn Andrews
•
Progressive, irreversible brain disorder
 that is characterized by a gradual deterioration of memory, reasoning,
language and physical function.
•
•
•
25 million people world wide
Deficiency in chemical acetylcholine
Genes play an important role
•
Prevention
 Diet: Vitamin D3, antioxidants found in green tea, naturally occurring
compound found in extra-virgin olive oil.
 EXERCISE
 Complex thinking and socialization: “exercising the brain”
•
Treatment
 Cholinerase inhibitors (Drugs)
 NMDA drugs
 Marijuana
Caitlyn Andrews
• Body mass declines with age
6.6 pounds of lean muscle each decade during
the adult years
• 60 years +
30 minutes of moderately intense activity (brisk
walk)
five or more days a week
• Strength training
 two or more days a week
Caitlyn Andrews
• Dietary restrictions
• Risk of malnutrition
• Antioxidants
•
Caitlyn Andrews
Increased longevity
Prevention of diseases
Improvement of treatment of many diseases
Improves cellular functioning
Optimize body composition and reduce decline
in motor skills
Reduces likelihood of developing metal health
problems
Improve brain and cognitive functioning
Caitlyn Andrews
• Cellular Clock Theory
 cells can divide a maximum of 75 to 80 times
• Free Radical Theory
 free radicals damage DNA and other cellular structures
causing the aging of the body
• Mitochondrial Theory
 aging is due to the decay of mitochondria which supplies
the cell with essential energy for function, growth and
repair
• Hormonal Stress Theory
 aging in the body’s hormonal system can lower
resistance to stress and increase the likelihood of disease
Anna Clark
• Cognitive Mechanics
the “hardware” of the mind
speed and accuracy of processes
declines as one ages
• Cognitive Pragmatics
the “software” of the mind
learned skills and knowledge
does not necessarily decline
Anna Clark
Cognitive changes in older adults:
• Decreased speed of processing
• Decline in ability to control attention
 selective attention-being able to focus on relevant stimuli
and ignoring irrelevant stimuli
 divided attention-concentrating on more than one activity
at the same time
 sustained attention-vigilance
• Memory
 decline in episodic, working, perceptual speed, explicit,
source, and perspective
 very little decline in semantic and implicit
 those with positive beliefs about their memory remember
more
• Correlated to higher cognitive ability:
Anna Clark
 Education level
 Cognitively complex work
 Health (lifestyle and exercise)
• Physical changes in older adults:
Brain Shrinkage
Brain Slowing
Lack of Dendritic Growth
Reduction in Neurotransmitter Production
Anna Clark
• Neurogenesis
the generation of new neurons
• Rewiring
older brains rewire themselves to compensate
for losses
• Decrease in lateralization
older adults are more likely to use both
hemispheres in carrying out tasks
Anna Clark
Ways to Counteract Brain Decline :
Cognitively complex activities
Physical exercise
Diet
Minimize stress
Anna Clark
“A
lot of what passes for depression these days is nothing more than a body
saying that it needs work.” –Geoffrey Norman
• What is Depression?
 According to Santrock, depression is a mood disorder in which the
individual feels deeply unhappy, de-moralized, self-derogatory, and
bored.
• Research Studies
 Researchers found that depressive symptoms vary from less frequent
to no more frequent in late adulthood than middle adulthood.
What do these studies show?
 Lower freq of depressive symptoms in older adults compared to middle
aged was linked with fewer economic hardships, fewer negative social
interchanges and increased religiosity.
•
Who is affected?
 More common in males than females.
• Predictors
 Poor health, disability, loss, low social support.
• Treatment
Alisa Meyer
 Depression IS treatable.
• Fear
The decline and limitations in late adulthood
contribute to sense of vulnerability and fear.
• Crime
Older adults less likely than younger adults to
be victim of crime
• How often does it occur?
Found 6 percent experienced abuse in the past
month.
• Type of abuse
Institutional abuse
• What can we do?
Alisa Meyer
• Affect and Outlook
Positive and Negative outlook
• Self Esteem
Low self-esteem in the elderly population
Alisa Meyer
“…There are chapters for pain, anger, guilt, and grief, but there are also
opportunities for resolution and celebration, for affirmation and hope, for
reconciliation and personal growth.” – Robert Butler
• Erickson’s Theory
 Integrity vs. Despair (8th and final stage of development)
 Life review (Robert Butler)
 use of Reminiscence Therapy
• Activity Theory
 Increased happiness with increased activity
• Socioemotional Selectivity Theory
 Theory that older adults become more selective about their
social networks
• Selective Optimization with Compensation Theory
 Composed of selection, optimization, compensation (SOC)
 Proposed by Paul Bates, based on Rubenstein who was
interviewed at 80 years old about what factors were
responsible for his ability to maintain his status as an
admired pianist
Alisa Meyer
• Know the psycho-social aspects of Death
among the elderly
Elder death touches everyone at some time
Counselors often serve as
• Containers of difficult or awkward feelings
• The neutral party who can raise important
topics
• Theorists and researchers consider
Awareness (insight)
Increasing certainty in a culture that denies it
Temporal nearness (salience)
Qualitative nature of preparedness
(developmental tasks)
• Cultural definitions of a “good death”
Beth Lee
 Elderly people think and talk readily about death
• Non-institutionalized more frequently
• Institutionalized, less opportunity
– “the belief that discussing death creates a negative mental
framework and self-image that may interfere with the best
possible client care” (Leif, 1982)
 More thinking and talking than preparedness
• 74% have a will, but only 53% & 65% spoke to family &
friends about end of life wishes
Beth Lee
Schrader, Nelson, & Eidsness (2009)
• Existential Definition
It's not that
I'm afraid to
die, I just
don't want to
be there when
it happens.
Woody Allen
Beth Lee
Although the physicality of death destroys us,
it is the idea of death that saves us (Yalom, 1980)
Death is the condition that makes it possible for
us to live in an authentic fashion (Heidegger, 1926)
• By allowing us to embrace our possibilities
and limits
• Boundary pressure drives choices towards
authenticity
• This is the death driven developmental task of
late late age
• Geriatric care providers (medical, behavioral,
pragmatic) encounter DA daily in clients and
their families
 May impair the ability to make unbiased decisions
 May prevent the flow of information, sometimes
against the law (Sinoff, et al, 2008)
 DA on the part of care givers may obstruct an
elderly person’s right to die naturally
• 4 out of 5 people would prefer to die at home
(Hine, 1979)
• DA is functionally two constructs:
 Fear of death
 Fear of the dying process
• DA as a function of age
 Peaks in middle- age
 All but disappears in elderly (Twelker, 2006)
Beth Lee
Death Anxiety as a Function of Age
Sinoff, Iosipovici, Almog, & Barnett-Greens (2008)
• Cultural Sensitivity about Death rituals requires
investigation
 In the US, preparedness for death has a legal and
psycho-social component
 Excellent resource on emerging ritual:
http://www.dailyundertaker.com
Beth Lee
• Emerging EOL Traditions
 There’s an app for that….
• Kaddish, the Jewish Mourner's prayer, is recited publicly every day for
11 months after a parent's death as a reaffirmation of faith. This
requirement can be difficult for many to fulfill properly though, as the
prayer is in Aramaic. Now there is help in the form of an iPhone app
to tutor mourners in the pronunciation of this important prayer.
• Bosan, which in Japanese means grave honoring, is a newly
released iPhone app from KnowledgEx which allows you to
register information about and carry photos of a loved one’s
grave, as well as photos of the deceased. Whenever you want and
where ever you are in your busy schedule, you can virtually
honor the grave of your loved one with a prayer, along with
offerings of incense, flowers, food and water.
Beth Lee
Jennifer Jaber
Benefits of Late Late Adulthood
Jennifer Jaber
• Positive Aspects being studied
 Growing subject in psychology
• Factors linked with Successful Aging
 Active lifestyle
 Positive coping skills
 Good social relationships
 Support
 Absence of disease
• Being Active is especially important to
successful aging
 Mental and Physical exercise
 Generativity
• Self -efficacy
 Control over the environment
 Keeping a positive attitude
 Result: higher levels of happiness
Jennifer Jaber
• Felice News
Not- for- profit based in Toronto that tells only
good news
•
http://www.felicenews.com/the-five-best-things-about-getting-older.html
Late Age gives you ready made excuses!
• Failing memory (even if your hearing is fine!)
• Hearing “loss” (selective hearing)
• Other people get to take care of you
• Freedom to do what you want
•
Jennifer Jaber
Secrets of the Centenarians (NYTimes.com)
http://www.nytimes.com/interactive/2010/10/19/health/20101018-centenarians-voices-photos.html
Jennifer Jaber
Age is an issue of mind over matter.
If you don't mind, it doesn't matter.
Mark Twain
1855, aprox 20 yrs old
Jennifer Jaber
Much older:
Be good, and you will be lonesome.
references
Alzheimer’s Disease Research. August 8. 2010. American Health Assistance Foundation. Ahaf.org.
http://www.ahaf.org/alzheimers/about/risk/?gclid=CJuA-ZWF8aQCFQIGbAodeFsV1w
Denny’s Poems and Quotes. http://www.dennydavis.net/poemfiles/aging2b.htm
Knoth, R., Singec, I., Ditter, M., Pantazis, G., Capetian, P., et al. (2010). Murine features of neurogenesis in the human hippocampus across the
lifespan from 0 to 100 years. PLoS ONE 5(1). doi:10.1371/0008809
Kennard, Christine. Marijuana May Prevent Alzheimer’s Disease. About.com. October 6.2006.
http://alzheimers.about.com/od/research/a/marijuana_alz.htm
Kramer, A.F., Fabiani, M., & Colcombe, S.J. (2006). Contributions of cognitive neuroscience to the understanding of behavior and aging. In
handbook of the psychology of aging (4). doi: 10.1016/B978012101264-9/50007-0
Lieff, Jonathan D. (1982). "Eight reasons why doctors fear the elderly, chronic illness, and death." Journal of Transpersonal Psychology 14, no. 1:
47-60.
May, R., & Yalom, I. (1989). Existential psychotherapy. Current psychotherapies (4th ed.) (pp. 363-402). Itasca, IL US: F E Peacock Publishers.
Schrader, S., Nelson, M., & Eidsness, L. (2009). 'South Dakota’s dying to know': A statewide survey about end of life. Journal of Palliative
Medicine, 12(8), 695-705.
Sinoff, G., Iosipovici, A., Almog, R., & Barnett-Greens, O. (2008). Children of the elderly are inapt in assessing death anxiety in their own
parents. International Journal of Geriatric Psychiatry, 23(11)
Twelker PA. 2006. The relationship between death anxiety, sex, and age. Internet resource available at URL:
http://www.tiu.edu/psychology/deathanxiety.htm
Weed, W.S. (n.d.). 7 anti-aging tips to keep your brain young. Retrieved from http://www.rd.com/living-healthy/7-anti-aging-tips-to-keep-yourbrain-young/article28203.html
Yalom, I. (2008). Staring at the sun: Overcoming the terror of death. The Humanistic Psychologist, 36(3-4), 283-297.