LATE ADULTHOOD + DEATH

Ego integrity vs. Despair

Wisdom. Evaluating one's past life, integrating accomplishments, and accepting it without major regrets to accept death peacefully or experiencing deep regret and feeling that life was wasted, leading to fear of death.

Presumption (Maladaptive): Claiming full integrity without facing the actual difficulties of aging.

Disdain (Malignant): Expressing contempt or bitterness toward life and humanity.

Ageism

Prejudice or discrimination directed against individuals based on their age.

Example: Refusing to hire a qualified applicant purely because they are over 65.

Primary Aging vs. Secondary Aging

Primary is gradual, inevitable process of biological bodily deterioration while secondary is deterioration resulting from disease, abuse, or disuse.

Substages of Late Adulthood

Young Old: Individuals aged 65 to 74 years.

Old Old: Individuals aged 75 to 84 years.

Oldest Old: Individuals aged 85 years and older.

Functional Age

A measure of how efficiently a person functions in physical and social environments compared to others of the same chronological age.

Example: An 80-year-old running marathons having a younger functional age than an inactive 65-year-old.

Gerontology

The multidisciplinary study of the aged and the biological, psychological, and social processes of aging.

Geriatrics

The branch of medicine specializing in the health and diseases of older adults.

Life Expectancy

The statistically probable age a person born at a specific time and place will live, based on current health status.

Longevity

The actual length of life achieved by an individual or population.

Mortality Rates

The proportion or rate of deaths within a given population.

Human Life Span

The maximum theoretical limit of years a member of the human species can live.

Senescence

The universal decline in organ and cellular functioning associated with biological aging.

Genetic Programming Theories

Theories holding that aging follows a built-in genetic timetable.

Programmed Senescence Theory

Our cells have a limited number of times they can divide. Every time a cell divides, its telomeres get shorter. Eventually, the cell can't divide properly anymore.

Endocrine Theory

As we get older, our hormone levels change, which can affect things like metabolism and body functioning.

Immunological Theory

Our immune system gets weaker as we age, so older people become more vulnerable to infections and diseases.

Evolutionary Theory

Natural selection prioritizes reproductive traits over long-term life extension, so genes protecting older age are not selected for.

Variable-Rate Theories (Error Theories)

Theories viewing aging as the result of random, accumulated environmental/internal damage.

Wear-and-Tear Theory

The body wears out from years of use.

Free-Radical Theory

Certain unstable molecules called free radicals damage our cells over time. Like rust damaging metal.

Rate-of-Living Theory

If the body's metabolism is constantly working at a very high rate, the body may theoretically age faster. faster metabolism = faster aging.

Autoimmune Theory

As we age, the immune system can become confused and attack the body's own healthy cells.

Reserve Capacity

Backup capacity enabling organ systems to function at maximum output under extreme stress.

Example: The heart pumping extra blood during a sudden, strenuous sprint.

Cataracts

Opaque, cloudy areas on the eye lens that blur vision.

Age-Related Macular Degeneration

Degeneration of retinal cells in the macula, causing loss of central vision while peripheral vision remains intact.

Glaucoma

Irreversible damage to the optic nerve caused by elevated fluid pressure inside the eye.

Functional Fitness

Physical capabilities and exercises aimed at preserving the ability to execute everyday activities independently.

Example: Squat exercises performed to maintain the leg strength needed to stand up from a chair independently.

Dementia

An overarching term for physiological cognitive and behavioral decline severe enough to disrupt daily functioning.

Alzheimer’s Disease

The most common form, marked by neurofibrillary tangles and amyloid plaques.

Amnesia

Memory loss.

Aphasia

Loss of speech expression or comprehension abilities.

Agnosia

Inability to recognize or identify familiar objects or sensory information despite having the ability to sense them.

Apraxia

Inability to perform a purposeful learned movement despite having the physical ability to do it. They know what a fork is and can physically move their hand, but they can't figure out how to properly use.

Anomia

Inability to recall the names of everyday objects. They see a pencil and know what it is and what it's used for, but can't remember the word.

Vascular Dementia

Cognitive decline caused by minor strokes or interrupted cerebral blood flow.

Lewy Body Dementia

Marked by daytime drowsiness, visual hallucinations, stiffness, and sleep disturbances.

Frontotemporal Dementia

Characterized by early, drastic changes in personality, social behavior, and language skills.

Example: A person who was previously polite suddenly becomes socially inappropriate and impulsive.

Parkinson’s Disease vs. Huntington’s Disease

Parkinson's is caused by degeneration of dopamine-producing neurons, leading to muscle stiffness and slow movement. Huntington's is a genetic disorder that causes involuntary movements.

Sensory Memory

Initial, momentary storage of raw sensory input; exhibits minimal age decline.

Episodic Memory

Memory of specific personal events linked to time and place; most vulnerable to age-related decline.

Example: Forgetting what you ate for breakfast yesterday.

Semantic Memory

General world knowledge, facts, and vocabulary accumulated over a lifetime; shows minimal decline.

Example: Remembering that Paris is the capital of France.

Procedural Memory

Motor skills, habits, and automatic tasks; remains stable with age.

Example: Remembering how to ride a bicycle.

Prospective Memory vs. Source Memory

Prospective is remembering to perform an intended action such as taking meds at 8pm. Source memory is ability to recall where, when, whom you got the info from.

Cognitive Mechanics vs. Pragmatics

Mechanics is "hardware" of the mind (processing speed, visual-motor memory, task switching); declines start in early midlife. Pragmatics is "software" of the mind (reading/writing, language, professional expertise); can remain stable or improve into late adulthood.

Selective Attention

Focusing on relevant stimuli while tuning out distractions.

Example: Reading a book in a noisy café.

Divided Attention

Concentrating on multiple tasks or streams of information simultaneously.

Example: Driving while conversing on a hands-free phone.

Sustained Attention vs. Executive Attention

Sustained is prolonged focus on a single stimulus. Executive is planning, goal allocation, error detection, and monitoring task progress.

Positivity Effect

The tendency for older adults to selectively attend to and recall positive information over negative information.

Example: Recalling a vacation's fun moments while forgetting travel delays.

Terminal Drop

A sharp, rapid decline in cognitive function, well-being, and life satisfaction occurring 3 to 5 years prior to natural death.

Primary Appraisal vs. Secondary Appraisal

Primary evaluating a situation to determine if it is threatening or stressful. Secondary is assessing available resources and options to manage or resolve the stressor.

Disengagement Theory

A psychosocial theory of aging where aging normally involves a gradual and mutual withdrawal between the older person and society.

Example: An older adult retires from work and gradually reduces their involvement in community activities.

Activity Theory

A psychosocial theory that suggests that older adults experience better well-being when they remain active and socially engaged.

Example: After retirement, an older adult joins a senior club, exercises, spends time with friends, and volunteers.

Continuity Theory

A psychosocial theory which suggests that successful aging involves maintaining familiar lifestyles, values, relationships, and activities, while adapting them when necessary.

Example: A person who loved gardening throughout adulthood continues gardening after retirement, but perhaps does it for shorter periods or uses raised garden beds.

Selective Optimization with Compensation (SOC)

Choose what matters, improve it, and find ways around your limitations. Compensating for losses using alternative strategies.

Phases of Retirement

1. Pre-retirement: Plan goals

2. Retirement: Leave work

3. Contentment: leisure and freedom

4. Disenchantment: feeling useless or bored

5. Reorientation: new purpose

6. Routine: stable and satisfying new lifestyle.

PLAN → LEAVE → ENJOY → BORED → FIND NEW PURPOSE → STABLE ROUTINE

Single Strain

Chronic emotional and practical stressors linked to lacking a supportive intimate partner.

Aging in place vs. Group living models

Remaining in one's own home vs. Shared Housing, Congregate Housing, Assisted-Living.

Thanatology

The scientific study of death, dying, bereavement, and social attitudes surrounding mortality.

Care Models for Terminally Ill

Hospice care is compassionate, family-centered care focused on comfort for terminally ill individuals. Palliative Care is patient care centered on pain management, symptom relief, and stress reduction rather than curative treatments.

Kübler-Ross’s Five Stages of Dying (DABDA)

DENY→ ANGER→ BARGAIN→ BORED → DEPRESSED → ACCEPT

Grief vs. Bereavement

Grief is the emotional response to loss while bereavement is the objective state of loss experienced.

Grief Work

The psychological processing of loss, moving through Shock/Disbelief, Preoccupation with memories, to Resolution.

Recovery Pattern

Initial high distress that gradually decreases to normal baseline levels.

Delayed Grief

Low initial distress followed by worsening grief symptoms later.

Chronic Grief

Persistent, long-term severe distress that does not ease over time.

Terror Management Theory

A framework holding that human awareness of mortality, combined with survival instincts, triggers anxiety that individuals manage through cultural worldviews and self-esteem.

Brain Death

Neurological diagnosis established when all electrical activity in both the higher brain (cortex) and lower brain stem has permanently ceased.

Passive Euthanasia

Withholding or disconnecting life-prolonging treatments (e.g., removing a ventilator).

Active Euthanasia

Deliberate action taken directly to end a patient's life to end suffering (e.g., administering a lethal injection).

Assisted Suicide

A doctor or third party provides the means (e.g., prescription medication) for an individual to end their own life.

Advance Directives

Legal documents specifying medical treatment preferences if an individual becomes incapacitated.

Living Will

Document specifying desired or refused medical treatments in end-of-life scenarios.

Durable Power of Attorney

Appoints a designated surrogate decision-maker to make healthcare choices if the individual becomes incompetent.