1. Aging KNR 270

2. GROUP ACTIVITY List 8-10 words to describe being old List 8-10 bad things about growing old List 8-10 good things about growing old When you are 75, in what ways will you look like you do now? In what ways will your appearance be different?

3. GROUP ACTIVITY cont. Which of your current leisure activities will be similar to what you will do when you are 75? Which will be different? What might you like about being 75?

4. AGING Not homogeneous group Young old65-74 Old75-84 Old old85+ 2000: 36 million Americans over 65 yrs. (1/8) 2030: 70 million projected  Smith, Austin, Kennedy, Lee, & Hutchison, 2005

5. AGING Life expectancy is 75+ Men 72 Women 79  Carter, Van Andel, & Robb, 2003 Increased numbers living to 100 Baby boomers are changing aging Only about 5% in nursing homes

6. General Effects of Aging Decreased visual acuity Some hearing loss Especially higher pitched sounds Some memory loss Some motor coordination problems Not all older people have disabilities

7. AGING Increased incidences of all disabilities previously discussed Chronic conditions Diabetes, COPD, orthopedic impairments Hip replacements Falls What is the number 1 disease that impacts mobility? Arthritis

8. AGING What are the 4 leading causes of death? Heart disease Cancer Stroke Dementia (Alzheimer’s is 1 form) Increased depression Increased addictions Alcohol, over-counter prescriptions, prescribed medications, laxatives

9. Other Potential Issues Decreased financial resources Living on fixed income Medication/insurance costs Lack of companionship Loss of driving privileges or limited transportation Fear of crime Facing own mortality

10. Alzheimer’s Disease Do you know anyone? Which former President had AD? Alzheimer’s is just 1 form of dementia

11. Alzheimer’s Disease 4 million Americans By 2050 over 14 million 1/10 over 65 1/ 2 over 85 ½ of all people in NH have AD Can live 8-20 years after onset Average = 8-10 years Effects cognitive first, then physical Death often from pneumonia

12. Top 10 Warning Signs Memory loss (esp. recently learned info) Difficulty performing familiar tasks (prepare meal, take bath) Problems with language (substitute words) Disorient to time & place (later person)

13. Top 10 Warning Signs Poor or decreased judgment (give $ away) Problems with abstract thinking (balance checkbook) Misplacing things (iron in freezer)

14. Top 10 Warning Signs Changes in mood or behavior Changes in personality Suspicion, fearful, dependent on family member Loss of interest Passive, increased sleeping (Wandering & catastrophic reactions)

15. Alzheimer’s Disease: Criteria Manifested by both impaired memory (long or short term) & learning (can’t learn new information or can’t recall information previously learned) with 1 or more: Aphasia (language disturbance) Apraxia (impaired ability to carry out motor activities despite intact motor function) Agnosia (failure to recognize or identify objects despite intact sensory function) Disturbance in executive functioning (e.g., planning, organizing, sequencing, abstracting)

16. Alzheimer’s Disease: Criteria Cognitive deficits cause significant impairment in social or occupational functioning & represent significant decline from previous functioning Cognitive decline begins gradually & worsens steadily

17. Alzheimer’s Disease: Criteria Cognitive deficits are not due to any of the following: Other central nervous system conditions (e.g., CVA, Parkinson’s, Huntington’s, subdural hematoma, brain tumor) Systemic conditions that cause dementia (e.g., hypothyroidism, vitamin B-12 or folic acid deficiency, HIV infection) Substance-induced conditions

18. 3 Stages Losses & rate of progression is unique to each person Early Recent memory deficits yet good memory for past events Lack of awareness of personal difficulties Word-finding problems & confusion with words that sound alike Decreases in spontaneity

19. 3 Stages Middle Restless at night Irritability & mood swings Wandering & pacing Mispronunciation of words & naming losses Inability to initiate a movement & gait disturbances

20. 3 Stages Advanced Dependent on others for self-care needs Inappropriate outbursts & babbling Disorientation towards time, space, and people Problems like depression & aggressiveness Inability to walk  Carter, Van Andel, & Robb, 2003

21. Global Deterioration Scale (GDS) 1: No cognitive decline 2: Very mild cognitive decline  Age associated memory impairment 3: Mild cognitive decline 4: Moderate cognitive decline  Mild dementia 5: Moderately severe cognitive decline  Moderate dementia 6: Severe cognitive decline  Moderately severe dementia 7: Very severe cognitive decline  Severe dementia

22. Considerations/ Accommodations Exercise & physical activity Fitness & wellness programs Fitness Centers Share life experience Socialize with age cohorts Step-by-step directions Consider cost of programs Consider transportation Close parking Provide transportation

23. Considerations/ Accommodations Restrooms near activity site Contrasting colors & light Listen to participants Show respect Enunciate clearly Speak in lower voice Use talents Volunteer opportunities

24. Considerations/ Accommodations Lifelong learning programs Travel Elder hostel programs Intergenerational programs Nature Stress management Thai Chi

25. Considerations/ Accommodations Adult day care programs Swimming Reality orientation Remotivation Reminiscence Support for caregivers Others???