LIFETIME EXAM 3 (Middle and Older Adulthood, Loss and Grief)

Presbyopia

Age-related decline in near vision starting in middle adulthood.

Middle Adulthood Sensory Changes

Declines in vision (presbyopia) and hearing that typically begin during middle adulthood.

Menopause Physical Challenges

Hot flashes, night sweats, mood swings, sleep disturbances, and changes in libido.

Sexual Activity in Middle Adulthood

Frequency and satisfaction may decrease due to hormonal shifts, physical changes, and psychosocial factors.

Hypertension in Middle Adulthood

A major risk factor for cardiovascular and kidney disease; managed via screenings, low-salt diets, and medications.

Heart Disease in Middle Adulthood

The leading cause of death for adults aged 45 to 64.

Diabetes in Middle Adulthood

Rates have quadrupled since the 1980s, contributing to cardiovascular problems and immune dysfunction.

Emotions and Stress on Health

Chronic stress severely compromises the immune system and increases cardiovascular risks.

Fluid Intelligence

The ability to solve novel, abstract problems "on the fly" (e.g., completing analogies).

Crystallized Intelligence

Accumulated knowledge and verbal skills dependent on education and life experience (e.g., vocabulary); increases or remains stable late into life.

Encapsulation (Expertise)

The development of specialized, highly efficient knowledge and problem-solving skills in a specific domain.

Integrative Thought

The ability to synthesize and integrate contradictory ideas and emotional contexts to handle complex, real-world problems.

Phased Retirement

Gradually reducing work hours or days to phase out of the workforce over time.

Bridge Employment

Retiring from a primary career path to switch to a different company, line of work, or part-time role.

Carl Jung's Midlife Task

Individuation—balancing opposing parts of the personality (e.g., masculinity/femininity, introversion/extraversion).

Erikson’s Stage for Middle Adulthood

Generativity vs. Stagnation (Virtue: Care)—finding meaning through contributing to future generations or leaving a legacy.

Timing of Events Model

Development is driven more by when major life milestones occur (the social clock) rather than chronological age.

Midlife Crisis

A psychological transition historically viewed as a crisis of mortality, though research shows it is not universally experienced.

Identity Assimilation

Fitting new experiences into an existing self-concept without changing it.

Identity Accommodation

Adjusting your self-concept to fit new realities or roles.

Marital Satisfaction in Middle Adulthood

Fluctuates due to career stress, health issues, empty nest transitions, or growing apart; breakups often stem from unresolved conflict or infidelity.

The Empty Nest

The transition phase when children leave the family home.

The Cluttered Nest / Revolving Door Syndrome

Adult children returning home to live with parents.

The Sandwich Generation

Adults caught between caring for their own children and aging parents.

Filial Maturity

Middle-aged adults accepting and meeting the dependency needs of their aging parents.

Sibling Relationships in Middle Adulthood

Follow an hourglass shape (high contact in childhood and late adulthood, dip in middle years); caring for parents can bring siblings closer or cause resentment.

Grandparents Raising Grandchildren

Often triggered by teen pregnancy, substance abuse, illness, divorce, or death; creates heavy physical, emotional, and financial strain.

Why Women Live Longer

Biological advantages (two X chromosomes, estrogen), healthier lifestyle behaviors, lower risk-taking, and stronger social support networks.

Biological Theories of Aging

Wear-and-tear, programmed senescence, and free radical damage.

Normal Physical Changes in Older Adulthood

Decreased bone mass, reduced lung expansion, decreased renal filtration (GFR), and declines in strength.

Sensory Changes in Older Adulthood

Auditory loss (presbycusis) and decreased visual acuity.

Reasons for Falls in Older Adults

Polypharmacy, impaired vision, impaired hearing, lack of balance, orthostatic hypotension, environmental hazards, cognitive impairment, and urinary incontinence.

Sleep Changes in Older Adulthood

Decreased melatonin, increased insomnia, frequent night waking, restless legs syndrome, and early morning awakenings.

Sexuality in Older Adulthood

Continues into late life, though physical pacing and physiological responses may slow down.

Chronic Illnesses in Older Adulthood

Arthritis, hypertension, heart disease, diabetes, and osteoporosis.

Benefits of Physical Activity for Older Adults

Improves cardiovascular health, maintains bone density, prevents falls, manages weight, boosts mood, improves sleep, and preserves cognitive function.

Nutritional Challenges in Older Adults

Decreased appetite, chewing/swallowing problems, decreased saliva, difficulty cooking, fixed income, sensory loss, and medication side effects.

ADLs (Activities of Daily Living)

Basic self-care tasks essential for survival, such as bathing, dressing, eating, and transferring.

IADLs (Instrumental Activities of Daily Living)

More complex daily tasks necessary for independent living, such as managing finances, cooking, shopping, and taking medications.

Dementia (The 3 Ds)

Irreversible, progressive cognitive decline interfering with daily life; Alzheimer's is the most common form.

Delirium (The 3 Ds)

Acute, fluctuating state of confusion caused by an underlying medical trigger or medication; reversible.

Depression (The 3 Ds)

A mood disorder featuring sadness and loss of interest; treatable, and can sometimes mimic or worsen cognitive decline.

Physiological Causes of Alzheimer’s

Beta-amyloid plaques outside neurons, neurofibrillary tau tangles inside neurons, brain inflammation, and neurodegeneration.

Working with Individuals with Dementia

Use clear/simple language, maintain routines, reduce environmental distractions, and validate feelings.

Memory Changes in Aging

Episodic memory declines; semantic memory (general facts) and procedural memory (skills/habits) are typically preserved.

Erikson’s Stage for Older Adulthood

Integrity vs. Despair (Virtue: Wisdom)—reflecting on life with fulfillment vs. regret.

Psychosocial Theories of Successful Aging

Disengagement theory (mutual withdrawal), Activity theory (staying active increases life satisfaction), and Continuity theory (earlier habits predict adaptation).

Common Living Arrangements for Older Adults

Independent living, assisted living (semi-independent), nursing homes (high-level care), and adult day care.

Elder Abuse Types & Risk Factors

Physical, emotional, financial, and neglect; most at risk are older women, those in poverty, or individuals with poor health/dementia.

Elder Abuse Perpetrators & Self-Neglect

Perpetrators are most often adult children or spouses; self-neglect occurs when an adult refuses necessary help, monitored via Adult Protective Services (APS).

Social Isolation & Suicide in Older Adulthood

Isolation driven by retirement or loss of spouse; elderly men carry the highest rate of suicide, often visiting a doctor shortly before.

Social Security

Federal retirement income based on work history.

Medicare

Federal health insurance primarily covering adults 65+.

Medicaid

Joint federal/state program funding medical and long-term care for low-income individuals.

Grief

The raw emotional response experienced in the early phases of bereavement.

Bereavement

The overarching process of adjusting to the loss of someone close.

Hospice

Specialized care focused on the final phase of life when life expectancy is under 6 months.

Palliative Care

Comprehensive symptom and pain relief focused on maximizing quality of life at any stage of serious illness.

Terminal Decline

A noticeable, rapid drop in cognitive functioning shortly before death.

Passive Euthanasia

Withholding or withdrawing life-sustaining medical treatment to allow a natural death.

Active Euthanasia and Assisted Suicide

Directly administering a lethal agent or providing the means for a patient to end their own life.

Advance Directives

Legal documents specifying a person's healthcare preferences in anticipation of incapacity.

Ambiguous Loss

Confusing loss lacking clear resolution or verification (e.g., missing persons or dementia).

Thanatology

The scientific and clinical study of death and dying.

Cultural Aspects of Death

Customs regarding disposal, mourning rituals, expressions of grief, and the setting of death governed by religious or legal traditions.

Classic Grief Work Model, Kubler-Ross, & Patterns

Classic grief work involves shock, preoccupation, and resolution; Kubler-Ross stages are Denial, Anger, Bargaining, Depression, Acceptance.

Children's Understanding of Death

Grasping that death is irreversible, universal, inevitable, and nonfunctional.

Adolescents' Understanding of Death

Often view death through an invincibility fable leading to high-risk behaviors; more focused on how they live than how long.

Terror Management Theory

Proposes that human behaviors and cultural worldviews are heavily motivated by an unconscious dread of mortality.

Parental Loss

Losing a child is a shocking, unnatural trauma; miscarriage involves disenfranchised grief lacking traditional mourning rituals.

Living Will, Durable Power of Attorney, & Medical DPOA

Living will details treatment wishes; financial DPOA manages legal/money matters; medical DPOA designates a healthcare proxy.

Life Review

A therapeutic process where older adults reflect on their past through autobiographies, scrapbooks, and returning to childhood locations to find meaning.