The Challenge of Aging Chapters 22 and 23

The Challenge of Aging Biological aging: Normal process of development characterized by a decline in body processes from sexual maturity until death. What happens as you age? Some characteristics associated with aging are not due to aging at all Result of neglect and abuse of our bodies and minds Inactivity vs. Aging

THEORIES OF AGING Genes and aging – Genes account for about 35% of the differences in Lifespan Studies of identical and fraternal twins supports this theory Environmental Factors – pollution, free radical damage increase rate of aging. Death is Programmed into our genes – (Perhaps through gene manipulation we can extend life?) Calorie Restriction – some proof for this in mice and now primates

Key factors in successful aging Low blood pressure Low serum glucose levels Health body weight/not being obese Not smoking while young If all of the above are true in middle age you are likely to have a healthy old age.

Life-Enhancing Measures: Delaying the Aging Process and maintaining independence 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

Delaying the Aging Process and maintaining independence 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 Use it or lose it!

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

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 Sexual functioning Osteoporosis

Handling Psychological and Mental Changes Dementia Severe and significant brain deterioration in elderly individuals Affects 7 percent of people under 80 Two most common types of dementia Alzheimer’s disease Changes in brain nerve cells Multi-infarct dementia Series of small strokes or changes in the brain’s blood supply that destroy brain tissue

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

Aging and Life Expectancy Average length of time we can expect to live In 2009, life expectancy for the total population was 78.5 years Those who reach age 65 can expect to live even longer, 18.5 years or more longer Women have longer life expectancy than men

Aging and Life Expectancy America’s aging minority People 65 and over are a large minority of American population Over 40.1 million people About 13 percent of the total population in 2010 Expected to double by 2030 Social Security benefits Meant to be a supplement, not sole source of income

Family and Community Resources for Older Adults Over half of noninstitutionalized older Americans live with a spouse or family member 30 percent live alone Only 4 percent live in institutional settings Of those over the age of 85, about 15 percent live in a nursing home

Family and Community Resources for Older Adults Governmental aid and policies Social security Medicare Pays about 30 percent of the medical costs of older Americans Medicaid Health care for older adults Gerontologists Geriatricians

Brain death Cellular death What Is Death? Clinical Death= --Cessation of the flow of vital bodily fluids --Heart stops beating and breathing ceases Brain death Harvard Medical School committee defined brain death: Lack of receptivity and response to external stimuli Absence of spontaneous muscular movement spontaneous and breathing Absence of observable reflexes Absence of brain activity on EEG Check again after 24 hours Excludes cases of hypothermia Cellular death The gradual breakdown of metabolic processes at the cellular level due to the cessation of heart, lung and brain activity.

Mature understanding of death Learning about Death: “To fear death, gentlemen is nothing other than to think oneself wise when one is not; for it is to think one knows what one does not know. No man knows whether death may not even turn out to be the greatest blessings for a human being; and yet people fear it as if they knew for certain that it is the greatest of evils.” -Spoken by Socrates in Plato’s Apology A child’s understanding of death evolves greatly from about age 6 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 Do we have proof of life after dead NDEs DiCiccohealth.weebly.com

Denying Versus Welcoming Death Individuals often maintain conflicting or ambivalent attitudes toward death Few people wholly avoid or wholly welcome death

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-money, property, etc Testator-person who makes a will Intestate-Die w/o making a will (state gets it!)

Considering Options for End-of-Life Care Home care Majority of people would like home care Family members may or may not be capable of providing care Hospice programs Palliative care- make comfortable, no longer trying to cure the disease Patients who are likely to die within six months

Deciding to Prolong Life or Hasten Death Persistent vegetative state- profound unconsciousness, lacking normal reflexes, unresponsive to stimuli, lack of awareness, for an extended period of time (?) 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 incurable and painful disease

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: Living will Health care proxy Surrogate (decision maker)

Becoming an Organ Donor Each day about 77 people receive an organ transplant while another 18 people on the waiting list die because not enough organs are available More than 113,000 Americans were waiting for organ transplants as of February 2012 Uniform Donor Card Driver’s license designation

Planning a Funeral or Memorial Service Disposition of the body Burial Cremation Embalming Arranging a service

Coping with Dying The tasks of coping Supporting a dying person Elisabeth Kübler-Ross and the five stages of dying Denial Anger Bargaining Depression Acceptance (diciccohealth.weebly) Charles Corr and the four primary dimensions in coping with dying Physical Psychological Social Spiritual Supporting a dying person

Coping with Loss Experiencing grief Tasks of mourning Bereavement Mourning Tasks of mourning Accepting reality Working through the pain Adjusting to a changed environment Emotionally relocating the deceased and moving on with life The course of grief Complicated grief Supporting a grieving person Coming to terms with death