Chapter 9: Later Adulthood: Physical, Cognitive, Emotional & Social Development

aging population

- later adulthood begins at age 65 (1/8 people in US > 65)

- life expectancy in the US

-> women: 79.3/80

-> men: 73.5/75

- among the older americans, the fastest growing segment is the 85 and older group

- causes of increased lifespan: immunizations, advancements in tech, effectiveness of healthcare trends

aging

begins at conception and ends with death; is the process of growing older regardless of chronological age

senescence

the mental and physical decline associated with aging

senility

physical and mental deterioration

- this is derogatory and should not be used

gerontology

the study of the aging process

geriatrics

branch of medicine

- medical speciality caring and treating clients in the older age group

society stereotypes the older person as being:

asexual, unemployable, socially incompetent

ageism

prejudice and discrimination directed at older people

stereotypes on aging

- educate to overcome myths

- recognizer that older Americans feel disrespected or unneeded

cataracts

a thickening of the lens of the eye that causes vision to become cloudy, opaque, and distorded

gluacoma

damage to the optic nerve because of the pressure created by a buildup of fluid in the eye

macular degeneration

deterioration of the macula of the retina, which corresponds to the focal center of the visual field

nutritional needs

- appropriate caloric intake based on activity

- restriction of fats, sodium

- adequate vitamin C & D, calcium, zinc

- fluids and fiber increased

- elder have a decrease in thirst drive -> dehydration

- good nutrition can contribute to a healthy immune system and an increased quality of life

rest and sleep

- stage 1 NREM is longer (difficulty falling/staying asleep)

- stage 3 deep sleep is decreased (insomnia -> risk of falls and cognitive impairment)

- REM sleep is decreased

- need at least 7-8 hours

delirium

decreased clarity of awareness of the environment

- direct physiological consequence of a general medical condition

- reversible

sundown syndrome

increase in confusion and agitation that occurs at the end of the day

dementia

symptoms involve a deterioration of mental functioning

- 20% of individuals over the age of 80 have dementia

- irreversible

alzheimer's disease

a common form of dementia that is characterized by a gradual deterioration of memory, reasoning, language, and eventually physical function

familial alzheimer's

- defect in chromosome 1, 14, and 21

- runs in families

- earlier onset

- progresses quicker

sporadic alzheimer's

- no family history

- appears after age 65

- r/t: high cholesterol and diabetes

wisdom

"expertise in the conduct and the meaning of life"

- Baltes & Smith

memory

- long term

- short term

reminiscence

informed sharing of bits and pieces of the past

disengagement theory

claims that elderly people systemically disengage from social roles due to the inevitability of death

- state of elderly depression

activity theory

successful aging occurs when older adults stay active and maintain social interaction

- same person as they were age 40/50

erikson's integrity vs self- despair: integrity

- coming to terms with life

- accepts decisions made

- accepts the course taken in life

- does not fear death

erikson's integrity vs self- despair: despair

- feeling of usefulness

- many regrets

- preoccupied with the thought of death

marriage

responsibility of parenthood and employment diminish

offspring

provides significant support

grandparents

most have special closeness to grandchildren

friends

provides for safety, support and companionship

pets

great companion

- loss of pet can cause DEEp grief

physical abuse

intentional infliction of pain, discomfort or injury

physical neglect

failure to fulfill caregiving obligations

- withholding meds, food, not taking them to doc appointments, etc

- most reported

emotional abuse

verbal assault and humiliation

sexual abuse

unwanted sexual contact of any kind

financial abuse

illegal exploitation of the elder's property or financial resources

- most reported

hoarding

- may be adaptive behavior, although usually regarded as a disagreeable, messy, unsafe characteristic of the elderly or signs of illness

- may be life long habit

- saving items fives the person a sense of security or a reminder of a happier past

health promotions: immunizations

- flu

- pneumonia

health promotions: safety

- falls are the leading cause of injury in the older adult

- motor vehicle accidents

health promotion: special considerations

- assess for syndrome of fragility

- home security, solicitors take advantage

common health problems: polypharmaciy

- comorbidities resulting in many pills

common health problems: failure to thrive

a decline in physical &cognitive function that occurs without explanation

- weight loss, social withdrawal, depression

gariatric care management

elderly who live in their home

assisted living

available for frail or who have physical limitations

- the resident has the independence to come and go

- not confined to one room

extended care facility

increase social withdrawal

- 5% of Americans >65 are living in nursing homes