1. Chapter 4 Life Transitions and Story

2. Terms to Know
Ageism: applying prejudices to older adults due to their age
Inner resources: strength within the person that can be drawn upon when needed
Life review: a process of reminiscing or reflecting on one's life
Retirement: the period in which one no longer works

3. Introduction Growing old is not easy.
Multitude of changes during the aging process require
Stamina
Ability
Flexibility
Many factors affect older adults’ ability to cope with multiple changes of aging.

4. Ageism Prejudices and stereotypes applied to older adults based on age
Ageism in society
Biases against older adults
Stereotypes and misconceptions
Consequences of ageism: eroding dignity
Need to heighten societal awareness of the realities of aging

5. Question Is the following statement true or false?
Ageism is a concept described by Robert Butler several decades ago that is defined as “the prejudices and stereotypes that are applied to older people sheerly on the basis of their age…”

6. Answer
True
Rationale: Although older adults constitute the most diverse and individualized age group in the population, they continue to be stereotyped by many misconceptions that are not based on facts.

7. Changes in Roles and Relationships
Changes in today’s nuclear family affect the roles and functions of the older adult within the family unit.
Both negative and positive changes for older adults.
Adjustment to changes in responsibilities and roles is a challenge of aging.

8. Parenting Changes in the parental role Sense of loss
Historical role of wife and mother influenced today’s older women
Changing roles for men influences our view of provider role of today’s older men
Regular contact by children usually maintained
Role adjustment can provide enjoyment

9. Grandparenting
Grandparenting is a new role in life, as is step- grandparenting.
Changes in family structure and activities bring new challenges.
Active lifestyles of older adults require adaption by children and grandchildren.
Grandparenthood: a learned role.

10. Grandparenting (cont.)
Grandparents raising grandchildren
Many older adults assume primary caregiving responsibilities for their grandchildren.
Nurses can guide older adults as they contemplate assuming this new role.
Organizations are available to assist those who choose the caregiving role.

11. Question
Which statement is true related to the older adults’ role of being a grandparent?
Stay-at-home grandmas are the norm.
There are many similar styles of grandparenting.
Grandparents are often not involved in the caregiving role.
Grandparenthood is a learned role.

12. Answer D. Grandparenthood is a learned role.
Rationale: Grandparenthood is a learned role, and some older individuals may need guidance to become effective grandparents.

13. Loss of Spouse Death of spouse is a common event that alters life
Adjustments to widowhood:
Task of living alone
Developing alternative roles
Income issues
Loss of an intimate partner
Choosing a new lifestyle

14. Retirement Loss of work role May need to adjust to a reduced income
May be viewed as an undesirable state
Occupational identity and social position/role in society
Stereotypes of work roles
Sense of identity may be effected
Potential void in one’s life related to loss of the work role

15. Question Is the following statement true or false?
Retirement is a major adjustment for an individual, and this transition is often an individual's first experience with the impact of aging.

16. Answer
True
Rationale: Retirement is especially difficult in Western society, in which worth is commonly measured by an individual's productivity, and unemployment is viewed as an undesirable state.

17. Phases of Retirement Preretirement phase Retirement phase
Disenchantment phase
Reorientation phase
Retirement routine phase
Termination of retirement

18. Nurses’ Evaluation of Retirement
Nursing interventions are applicable to each phase of retirement.
Nurses must evaluate own attitudes toward retirement.
Nurses can be good role models of constructive retirement practices and attitudes.

19. Reduced Income Importance of financial resources
Retirement income is less than half of earned income
Social security income: intended as supplement but is often primary source of income
Nursing implications
Encourage financial preparations for old age
Recognize the impact of economic welfare on health status

20. Changes in Health and Functioning
Adjustment to new body image
Affects on body image and self-concept
Self-concept and roles
Difficulty in acceptance of physical changes
Illness and disability
Societal expectations of the decline in function

21. Nursing Interventions for Decline in Function
Educate about common changes of aging
Promote optimum function
Promote optimum health
Prevent disease
Preserve independence and dignity

22. Cumulative Effects of Life Transitions
Shrinking social world
Loss of social connections
Risk of loneliness
Facing fact of growing old
Potential failure to thrive
Nursing interventions for loneliness and isolation; engaging faith community

23. Awareness of Mortality
Heightened awareness of reality of death
Death is more tolerable if life has depth and meaning
Signs of reality of mortality
Accepting the increasing awareness of mortality

24. Question
Which statement is true related to the shrinking social world of the older adult?
There is a decreased risk of loneliness.
Hearing deficits can foster loneliness.
Children do not avoid older adult parents.
Functional limitations have minimal impact.

25. Answer B. Hearing deficits can foster loneliness.
Rationale: Hearing and speech deficits can foster loneliness. Changes associated with aging result in loss of social connections and increasing risk of loneliness as children are often grown and gone, and others who could allay loneliness may avoid the older individual as they find it difficult to accept the changes they see in the older adult.

26. Responding to Life Transitions
Coping with life transitions
Integrity versus despair
Nursing interventions
Life review
Eliciting a life story
Promoting self-reflection
Strengthening inner resources

27. Life Review and Life Story
Process of intentionally reflecting on past experiences
Significance of life review
Positive or painful experience
Benefits to the younger generation
Approaches used to elicit life stories

28. Self-Reflection Hallmarks of successful aging Knowledge of self
Personal identity
Body
Mind
Spirit

29. Self-Reflection (cont.)
Writing as a facilitator of self-reflection
Keeping a journal
Writing letters and s
Reflecting through art
Facilitates self-reflection and expression

30. Strengthening Inner Resources
Physical, emotional, and spiritual resources that older adults may possess that enable them to survive to old age.
Behaviors that exemplify survivor capabilities.
Nursing interventions offer positivity to champion older adults’ inner strengths.
Hope fosters empowerment.

31. Question
Which intervention by the nurse facilitates empowerment of the older adult?
Allowing care providers to make decisions
Limiting options for living arrangements
Including older adults in care planning
Providing care in a long-term care facility

32. Answer C. Including older adults in care planning
Rationale: In addition to being role models, nurses can facilitate empowerment by including older adults in care planning and caregiving activities to the maximum extent possible.