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

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

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

©2010 McGraw-Hill Higher Education. All rights reserved. Life-Enhancing Measures: Age-Proofing Maintain a Healthy Weight A 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

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

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

©2010 McGraw-Hill Higher Education. All rights reserved. Cataracts and Presbyopia

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

©2010 McGraw-Hill Higher Education. All rights reserved. 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 disease a.By changed in brain nerve cells 2.Multi-infarct dementia a.Series of small strokes or changes in the brain’s blood supply that destroy brain tissue 9

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

©2010 McGraw-Hill Higher Education. All rights reserved. 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 – years 11

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

©2010 McGraw-Hill Higher Education. All rights reserved. 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. 13

©2010 McGraw-Hill Higher Education. All rights reserved. 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 Family and Community Resources for Older Adults 14

©2010 McGraw-Hill Higher Education. All rights reserved. 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 Family and Community Resources for Older Adults 15

©2010 McGraw-Hill Higher Education. All rights reserved. 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 stimuli 2.Absence of spontaneous muscular movement and spontaneous breathing 3.Absence of observable reflexes 4.Absence of brain activity Clinical death (sudden cessation) Cellular death (gradual) 16

©2010 McGraw-Hill Higher Education. All rights reserved. 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.Universality 2.Irreversibility 3.Nonfunctionality 4.Causality 17

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

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

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

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

©2010 McGraw-Hill Higher Education. All rights reserved. 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 22

©2010 McGraw-Hill Higher Education. All rights reserved. Sample organ/tissue donor card Figure

©2010 McGraw-Hill Higher Education. All rights reserved. Coping With Dying Awareness of Dying The Tasks of Coping –1969 book On Death and Dying, Elisabeth Kubler-Ross 5 psychological stages 1.Denial 2.Anger 3.Bargaining 4.Depression 5.Acceptance –Charles Corr 4 primary dimensions in coping with dying 1.Physical 2.Psychological 3.Social 4.Spiritual 24

©2010 McGraw-Hill Higher Education. All rights reserved. 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 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 25

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

©2010 McGraw-Hill Higher Education. All rights reserved. Connect Assignment Chapter 17 Connect Assignment Due Tuesday, April 20 th