1. PHYSICAL AND COGNITIVE DEVELOPMENT IN LATE ADULTHOOD CHAPTER 17

2. PHYSCIAL DEVELOPMENT IN LATE ADULTHOOD

3. What is old age?

4. GERONTOLOGISTS Specialists who study aging Late adulthood as a period of considerable diversity in which people change Growth in some areas, decline in others Geriatrics: Is associated with the medical care of older people.

5. Aging: Myth and Reality Late adulthood holds a unique distinction among the periods of human life: It is actually increasing in length Greater proportion of people living in late adulthood Elderly population now divided by functional aging –Young old (65 to 74 years) –Old old (75 to 84 years) –Oldest old (85 years and older)

6. How is old age divided? Some researchers divide aging people into three groups: Young old are healthy and active Old old have some health problems and difficulties Oldest old are frail and need care

7. Who are the oldest old? Oldest old Fastest growing segment of the population People who are 85 or older Group's size has nearly doubled in the last 20 years Trend is occurring in every developed country in the world

8. Ageism Prejudice and discrimination directed at older people is manifested in several ways Discrimination based on age. Negative attitudes about older people, especially about competence and attractiveness Job discrimination Nurses need to reflect on personal beliefs and values toward older adults

9. Discrimination Identical behavior by an older person and a younger person is interpreted differently People talk baby talk to persons in nursing homes Most negative views are based on misinformation

10. Myths of Aging

11. Myths and Realities of Aging

12. You know you are aging when… Grey and white hair; thinner Wrinkles Diminishing height

13. Osteoporosis Bones become brittle, fragile, and thin, often brought about by a lack of calcium in the diet 25 percent of women over 60 have osteoporosis Largely preventable with sufficient calcium and exercise

14. Double Standard Women, especially in Western cultures, suffer from the double standard for appearance Women who show signs of aging are judged more harshly than are men Women are more likely to dye their hair Women are more likely to have plastic surgery

15. Changes in Internal Function Brain becomes smaller and lighter with age –Reduction of blood flow to the brain –Space between the skull and the brain doubles from age 20 to 70 –Number of neurons, or brain cells, declines

16. All Systems Go…or Gone? 75-year-old's heart pumps less than three-quarters of the blood it pumped during early adulthood Efficiency of the respiratory system declines with age Digestive system produces less digestive juice and is less efficient in pushing food through the system

17. Peripheral Slowing Hypothesis Older adults’ reaction time slows significantly Suggests that overall processing speed declines in peripheral nervous system (spinal cord and brain)

18. Generalized Slowing Hypothesis Processing in all parts of the nervous system, including the brain, is less efficient Older people have more accidents Decision process is slowed down

19. Senses Old age brings a distinct declining in the sense organs of the body Vision –Lens becomes less transparent and the pupils shrink –Optic nerve becomes less efficient –Distant objects become less acute

20. The Eyes Have It! Cataracts Cloudy or opaque areas of the lens of eye that interfere with passing light, frequently develop Cataracts can be surgically removed Intraocular lens implants

21. Glaucoma Pressure in the fluid of the eye Glaucoma can be corrected with drugs or surgery Age-related macular degeneration (AMD) –Affects the macula

22. Hearing 30 percent of adults between 65 and 74 have some hearing loss 50 percent of adults over 75 have hearing loss High frequencies are the hardest to hear Overall, more than 10 million elderly people in the United States have hearing impairments of one kind or another

23. Hearing Aids Hearing aids would be helpful 75 percent of the time Only 20 percent of people wear them Are imperfect and amplify all sounds so it is difficult to discern conversations There is a stigma attached to wearing a hearing aid Because they cannot hear, some people withdraw from society because they feel left out and lonely

24. Taste and Smell Both senses become less discriminating in old age Due to decline in taste buds on tongue Olfactory bulbs in the brain shrink and reduce the ability to smell –People eat less and get poor nutrition –Older people may over-salt their food and develop hypertension, or high blood pressure

25. HEALTH AND WELLNESS IN LATE ADULTHOOD

26. Health Problems in Older People People of all ages suffer from cancer, heart disease, and other diseases and illnesses Incidence of these diseases increase with age Rebound is often slower

27. Physical Disorders Common Physical Disorders Leading causes of death are heart disease, cancer, and stroke. Higher incidence of infectious disease ArthritisHypertension

28. Psychological and Mental Disorders Common Psychological Disorders Major depression Drug-induced psychological disorders Dementia

29. Alzheimer's Disease Progressive brain disorder Produces loss of memory and confusion Incidence and projection

30. Symptoms of Alzheimer's Disease Symptoms Develop gradually Start with forgetfulness Affect recent memories first and then older memories fade Causes total confusion, inability to speak intelligibly or recognize closest family members Loss of voluntary control of muscles occurs

31. What about a genetic link? Genetics Inherited disorder Nongenetic factors such as high blood pressure or diet may increase susceptibility Cross-cultural influences

32. Treatment and Cure Treatment and cure No cure Treatment deals only with the symptoms Drugs effective in only half of Alzheimer's patients Many end in nursing homes

33. Caring for People with Alzheimer's Disease Make patients feel secure Provide labels for everyday objects Keep clothing simple Put bathing on a schedule Prevent people with the disease from driving Monitor the use of the telephone Provide opportunities for exercise Take care of caregiver!

34. Relationship Between Aging and Illness Certain diseases, such as cancer and heart disease, have clear genetic component Economic well-being also plays role Psychological factors play important role in determining people's susceptibility to illness—and ultimately likelihood of death

35. Chronic Illness Most older people have at least one chronic, long-term condition Arthritis –Inflammation of one or more joints, is common, striking around half of older people Hypertension –High blood pressure, striking about one-third of older people

36. Psychological Illness 15 to 25 percent of those over age 65 show some symptoms of psychological malady Depression Dementia

37. Can well-being improve? People can do specific things to enhance their physical and psychological well-being and their longevity – their active life spans -- during old age Eat a proper diet Exercise Avoid threats to health, such as smoking

38. Malnutrition and Hunger Sometimes older people experience difficulties that prevent them from following even these simple guidelines. Varying estimates suggest that between 15 and 50 percent of elderly people do not have adequate nutrition, and several million experience hunger every day –Poverty –Physical inability to shop or cook –Lack of motivation to eat properly –Decline in taste and smell sensitivity

39. Sex in Old Age: Use It or Lose It Related to physical and mental health and previous sexual activity Evidence suggests that people are sexually active well into their 80s and 90s Previous sexual activity increases the desire for sex Having sex regularly is associated with lower risk of death

40. Animal Life Spans Maximum recorded life spans for animals found in the wild. (Source: Based on Kirkwood, 2010).

41. Environmental Factors Certain environmental and cultural factors are related to greater or lesser degrees of intellectual decline Lesser declines are associated with many factors

42. 1, 2, 3…Think! Exercising the aging brain Continued cognitive stimulation keeps cognitive abilities sharp Training showed long-term effects Engaging in some form of mental workout- consistently and continually increasing the level of difficulty-is key to success

43. Physiological Aging: –Lean body mass is reduced, fat tissue increases, and bone mass decreases. –Decreased total body fluids

44. Integument Dry skin, less elastic Hair loses color Thick toenails Increased facial hair Loss of elastic fiber, resulting in double chin, sagginf eyelids and earlobes and wrinkles of skin

45. Neuromuscular Reduction in speed and power of skeletal or voluntary muscle contractions Diminished physical activity Kyphosis (humpback of the upper spine Osteoporosis: decrease in bone density

46. Sensory/Perceptual Changes in vision, changes around the eye, shrunken appearance of the eyes, decreased visual acuity Atrophy of the lacrimal glands – eye dryness By 80 all older adults have some lens opacity, cataract Loss of hearing – presbycusis. Poorer sense of taste and smell Loss of skin receptors loss of sensations of pain, touch and temperature

47. Pulmonary Decreased respiratory efficiency Dyspnea Mucous secretions collection in respiratory tree - infections

48. Cardiovascular Reduced working capacity of the heart Reduced arterial elasticity Orthostatic hypotension

49. Gastrointestinal Periodontal disease – loss of teeth Reduced saliva production Decreased esophageal motility – lead to slow emptying process Decreased stomach motility- increased incidence of gastric irritation Decreased intrinsic factor – pernicious anemia Decreased intestinal absorption

50. urinary Decreased secretory function Urinary urgency and frequency Nocturia Urinary incontinence

51. Genitals Degenerative changes in the gonads Breast tissue atrophy

52. Psychosocial aging Erikson: Integrity versus despair – sense of wholeness and satisfaction from past accomplishments. Death is an acceptable completion of life. By contrast with people who believe that they made poor life choices and wish they could live life over

53. Cognitive abilities Perception –Brain loses mass –Reduced blood flow to brain

54. Moral reasoning Older adult at the preconventional level obeys rules to avoid pain and the displeasure of others Older adults at conventional level follow society’s rules of conduct in response to the expectations of others

55. Health problems Injuries: car accidents, fire hazards, hypothermia –Alzheimer people suffer safety problems Chronic disabling illness: arthritis, osteoporosis heart disease, stroke, obstructive lung disease, hearing and visual alterations, cognitive dysfunctions, fractures, pneumonia, trauma from falls, motor vehicle crashes Drug misuse Alcoholism Dementia Mistreatment of older adults