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Do Now What do you believe are the changes that come with being 66+ Older Adulthood Age 66 Plus Physical Qualities and Changes Older adulthood typically refers to the stage when people are age 66 and above. This spans a wide range of ages. Those entering older adulthood are just starting to see perceptual declines when compares to people ages 85 years older. Centenarians refers to a person age 100 or older. Physical Qualities and Changes Changes in physical appearance and functioning are common for older adults. Skin becomes less elastic more wrinkles Age spots known as Liver spots – flat gray, brown or black. They vary in size and may appear on the face, hands, shoulders and arms Older adults become shorter in stature or height as they experience cartilage loss in their vertebrae Muscle tissue and body weight decreases Physical Qualities and Changes Muscle loss also affects range in motion and movement becomes slower. Physical activity such as strengthening exercises can slow this process, improving both physical appearance and abilities Other signs of aging cannot be seen externally. Internal body organs lose some efficiency of their function. The brain shrinks and pulls away skull Heart capacity decreases and blood vessels harden (Heart may have to pump harder to get blood to other organs) Lungs have a lower air capacity Digestive system slows (which can result in constipation) Physical Qualities and Changes Incontinence – involuntary urination or defecation may occur as health problems increase. Sensory Skills Sensory changes from middle adulthood continue throughout older adulthood. Presbyopia progressively worsens. The ability to adjust from light to darkness, from low glare to high glare and to see objects in the side view becomes more challenging. Vision Conditions The most common vision conditions in older adulthood Cataracts Glaucoma Age-related macular degeneration (AMD) Diabetic retinopathy Dry eye Retinal detachment Vision Conditions As people age the lens of the eye thickens causing cloudy or distorted vision. This condition is known as Cataracts. As the disease progresses surgery is necessary. What is Cataracts (click) Macular Degeneration is an eye disease that causes people to have difficulty seeing objects inside the center of the field of vision. Objects in the Periphery, the outer edge of the center view, are clearly visible. What is Macular Degeneration (click) Vision Conditions Glaucoma is an eye condition that involves damage to the optic nerve. This is caused by fluid buildup that puts pressure on the nerve. Glaucoma is far less common than cataracts What is Glaucoma (click) Vision Conditions Macular degeneration is the leading cause of blindness in older adults which occurs in the retina. Diabetic Retinopathy- is an eye disease that involves damage to the blood vessels in the retina. The blood vessels becomes blocked and leak fluid into the eye. What is Diabetic Retinopathy (click) Hearing Loss Hearing loss can happen for a variety of reasons Genetics Illness Exposure to Loud Sounds Damage to Inner or Middle Ear Turn down the music volume. Buy power tools that have sound controls. When you must be around noise, either at work or at play, use something to protect your hearing. Hearing Loss Hearing loss associated with age is called Prebycusis, which is most often caused from damage to the inner ear. Many older adults complain of hearing a ringing sound in their ears called Tinnitus Hearing loss can lead to increased feelings of isolation from family and friends, which may then lead to depression. Changes in Body Composition and Strength Fat tissue increases, and fat deposits continue to change as well. Joints often ache. Many adults feel more stiffness in their bones along with muscle aches and pains. Bones break more easily. Nutrition and Physical Activity The body’s ability to absorb certain nutrients decreases in older adulthood. Older adults may need to take dietary supplements to ensure they are meeting nutritional needs. The need for: Calcium and Vitamin D – increase to help promote bone strength Vitamin B12 and Potassium needs also increase Fiber and water may prevent constipation Nutrition and Physical Activity Caloric needs vary depends on age, weight, height, and level of activity. Calories consumed should come from nutrient dense, well balanced sources that include protein, vitamins and minerals. Physical activity recommendations for older adults vary depending on ability and condition of health. The Physical Activity Guidelines for Americans recommend 150 minutes of physical activity per week for older adults in good health. Sleep Older adulthood adults need 7-9 hours of sleep. As adults age they may experience more trouble falling and staying asleep. As a result older adults may take frequent naps. Sleeping can become a safety issue for some people. Sleep apnea, is a condition in which the airways collapses or becomes blocked and causes the person to have pauses in breathing while sleeping. Can last for several seconds to a few minutes Resumes often with a loud snort or choking sound Medical Care Specific exams are recommended in older adulthood Blood Pressure – Recommended yearly Cholesterol – Periodic Diabetes - Periodic Colon Cancer - Periodic Women should still have an annual mammogram Mammogram Men should schedule a prostate exam What to expect Rectal Exam Dental Care Older adults are at a higher risk for developing cavities. Cavities often develop because many medications interfere with the level of saliva produced in the mouth. Saliva acts as a natural cleaner for teeth. Schedule annual exams and cleanings every six months Dental Care For a variety of reasons, older adults may lose some or all of their natural teeth. Missing teeth can interfere with the ability to eat and speak. Missing teeth can also change smile structure, altering facial appearance. Dentures, or manufactured teeth that replace natural teeth can be custom made to help adults comfortably eat, speak, and smile Health and Disease There is a high incidence of chronic disease in older adults, especially those over age 85. Cardiovascular disease and cancer are the most prevalent Diabetes is a concern Arthritis can make movement difficult Hypertension is also common. If undetected, hypertension can damage blood vessels, increasing the risk of cardiovascular disease More likely to catch common colds and flu. Which many times may develop into conditions that are more serious. Since the body’s immune system becomes less effective in fighting illness, diseases can progress more rapidly Health Care A growing older adult population can be seen around the world. The reduction in deaths due to heart disease is one of the largest contributing factors toward increased life expectancy. Many diseases can be prevented or at least symptoms can be relieved with Proper nutrition Physical Activity Food Availability Weight Management Oral Health Vision Care Hearing Care Health Care In the U.S., Medicare and Social Security have been offered to older Americans for many decades – some in the form of aid, some in the form of prepaid care. Medicare, a government health insurance program, helps older adults pay for medical costs. Social Security a government retirement fund, provides supplemental income to Americans who are at least 62 years of age and who have met employment contribution eligibility standards. Other assistance programs are available for special needs population RECAP 1. What age range does older adulthood typically include? What is a centenarian? 2. List three common sensory changes in older adults. 3. List three common changes older adults may experience in body composition and strength 4. Explain the increase for nutritional needs in older adults 5. Describe sleep apnea 6. Compare and contrast Medicare and Social Security Cognitive Development Brain Functioning As in any stage of life, aging affects cognitive changes and development. Aging brains are resilient, and they respond to stimulating experiences. How aging affects each person’s cognitive abilities will vary among individuals. Since the brain is shrinking in older adulthood, older adults may have more trouble processing new information, recalling memories and concentrating. The ability to learn can be affected by decline in cognitive abilities. With a slower learning pace and much repetition, older adults can learn as effectively as younger ones Alzheimer’s • Discovered by German neurologist Alois Alzheimer in 1906, but did not gain attention until the 1970s • Researchers now believe a gene is involved • Difficult to diagnose and treat Vascular Dementia • Decreased blood flow to the brain Dementia In older adults dementia is common. Dementia is a term used describe cognitive declines and memory loss, which are caused by damage to the brain. Dementia impairs a person’s ability to perform everyday tasks, such as self dressing, cleaning, eating, and remembering where items are placed. An example of a dementia concern would be noted when an adult asks the same question repeatedly, without realizing they already asked the question. Dementia does not have a cure, but with some medications, symptom may significantly improve. Alzheimer’s Disease Whereas dementia is a slow decline, Alzheimer’s Disease is a progressive brain disorder that includes not only memory loss, but also progressive severe confusion. People with Alzheimer’s Disease may not be able to Recall past life events Know where they are Know how they got there Know how to leave Eventually they may: Have trouble speaking or recognizing family and friends Suffer from hallucination and depression Like dementia, there is no current cure. Treatment options include therapy, medications, help from caregiver and adjustment to housing Diagnosing Alzheimer's Disease Vascular Dementia (click) (click) Preventing Brain Loss Brain Help Memory Older adults may remember some details easier than others. For example, they may search for a word that is “on the tip of their tongue” but can easily remember very specific details of a childhood experience. Why does this happen? One theory claims: Memory loss comes from having too much information compiled over time Another theory claims: Memory declines occurs as brain functioning decreases. Most likely: Memory loss occurs because of a combination of both theories Moral Development Older adults remain in Kohlberg’s post conventional morality stage of moral development. Traits of this stage includes valuing society as a whole and successfully contributing to the well-being of others. Signs of Socio-Emotional Change The need to be connected with others do not diminish in older adulthood, although social roles may change. Taking care of grandchildren or great grandchildren may occur less often as physical abilities diminish. At the beginning of older adulthood many people retire. Socio-Emotional Change Erickson theorized that older adults experience a period of reviewing their life and accepting or struggling with experiences and decisions. This stage of Erickson’s psychosocial development theory is called integrity versus despair. Integrity – involves accepting one’s life choices, including successes and failures. Faces challenging roles with optimism and enthusiasm. Do not despair over what did not happen and what they cannot change Acknowledge and accept what has been and who they are today. Achievements, career choices, and relationships Socio-Emotional Change Despair – refers to dissatisfaction with ones life choices. This final stage begins around 60 years of age and involves evaluating integrity in one’s life versus despair over reaching the end of life. Summary of Major Development Theories Related to Older Adulthood Type of Development Theory Description Cognitive Fluid and Crystallized Intelligence Crystallized intelligence continues to dominate as fluid intelligence continues to decrease. Socio-emotional Development Erickson: Integrity versus Despair The final socio-emotional stage in older adulthood in which adults come to terms in which adults come to terms with their life review rather than despairing over what did not happen and what they cannot change Activity Theory The more active and involved older adults are, the more satisfied they are with life Kubler-Ross: Stages of Dying The 5 mental and emotional stages facing death: denial, anger, bargaining, depression, and acceptance. Family Relationships The relationship between aging parents and adult children may change. Older adults may require more help and support from their adult children. Older adults may also struggle with accepting help. They may see acceptance as a sign of losing independence. As aging parents learn to accept help, they can continue to offer advice to their adult children who are also experiencing another stage of the aging process Family Relationships Many older adult siblings face the passing of their parents and other siblings. If there is a surviving parent the sibling often help the remaining parent adjust. The oldest remaining sibling may take on the role of becoming the oldest adult in the family. A woman may become the matriarch, the oldest influential female family member. A man may become the patriarch, or the oldest influential male family members. Emotional Changes Most studies indicate that despite physical and social roles, many older adults report a higher level of happiness than younger adults. Depression is common in older adults as work and family roles change and physical abilities decrease. Intense sadness, pessimism, and hopelessness may follow. Depression may increase if Independence and control are lost Financial resources are scarce Familial and social interaction reduce Emotional Changes Many older adults take multiple medications and supplements to relieve pain and other symptoms. Many of these medication have side effects that cause depression especially when adults take more than one prescription. Maintaining social relationships with old and new friends and spending time participating in club or community events positively affect self-esteem. Cultural and Societal Influences Myths on aging come from societal sharing of false or inaccurate beliefs. Bias against or unfair treatment of older adults is termed Ageism. Myths: Older Adults are rigid and inflexible They do not like new ideas or ways of doing things They become crabby and impatient with young people Reality Older adults have a lot to offer society Often more accepting of differences on others Most tend to mellow with age Older adults are the carriers of cultural traditions. They have lived life and have wisdom or expert knowledge in practical issues Living in New Communities During older adulthood abilities often decline and older adults may need help with daily tasks or require new living arrangements. There are (3) three main types of living communities: Independent Living Communities: Provide housing for older adults who can care for themselves, but desire the community support of those of similar age Assisted living housing: Environments provide gradually expanded oversight an help with daily activities. Medical care can be provided when necessary Retirement homes: Provide more intense nursing care for residents, usually with a medial staff that provides oversight as needed DO NOW Plug them up or put them away At the back of your eulogy paper from yesterday… Create your Bucket List Hospice Care Hospice Care is a form of care given by trained medical professionals, focuses on making a person comfortable in his or her last days and hours of life. Hospice Caregivers Attempt to control their patient’s pain while serving emotional and sometimes spiritual needs Focus on the needs of the family and loved ones as well. Care can be provided either in the patient’s home or in a hospice living center. RECAP 1. What is dementia? How does dementia differ from normal memory loss? 2. Define Alzheimer’s disease. What are treatment options available for Alzheimer’s disease? 3. Why may living arrangements need to change as an adult ages? 4. What are three main types of living communities available for older adults? 5. Explain hospice care and the needs it serves. Death and Grief Facing death is one of the most significant life events one experiences. As adults progress through older adulthood they become aware of impending death. They see this event as a reality in the relatively near future. Older adults may arrange their own funeral or memorial service in advance. They may seek burial plots or crenation holdings. They may prepare a Last Will and Testament (a will) which is a legally binding document that gives directions on how to divide financial assets. Those who receive the financial assets are called Beneficiaries. Death and Grief A living will is a legal document that informs family and medical workers of preferences for being kept alive by artificial means, or allows the decision to let them pass, when there is no chance of recovery. Creating these legal documents eases the process of dying for the individual, family and friends Some older adults do not make any advance preparations. Dying intestate means to die without a will. This can cause problems for remaining loved ones. When there is no will state laws determine the division of assets among remaining family members. The Stages of Dying Denial 1st stage – Individuals who learn they are terminally ill reject the idea of dying. They may ignore the concept of their own death and decide not to acknowledge it. They cannot believe that this could be happening to them Anger 2nd Stage – Feelings of negativity and resentment develop. Individuals may be angry at the illness or disease. They may be angry that they will experience death and possible pain, while others are still going to be alive and healthy Bargaining 3rd Stage - Individuals realize their own death, but wish for more time. They may propose deals or exchanges in order to preserve their own life. Bargaining may be with doctors, family, friends, or a higher power. Ex: They may offer to become a “better person” if their life is extended Depression 4th Stage - Individuals struggle with the loss of life. They may think about people, activities, and even events they will miss. They may become sad, withdrawn, and lose interest in activities, They may be afraid or feel they are not ready Acceptance Final Stage - Individuals understand accept that the reality of their own death is near. They may no longer be afraid or resentful. This stage is usually calm which can transition into a peaceful passing Widowhood For those who have spent time as a couple for many years they may feel like a part of themselves is gone forever. In marriage, when a husband passes away the wife becomes a widow. If the wife dies the surviving husband becomes a widower. Bereavement is a term used to describe the state of losing a loved one through death. Grief describes the mental anguish or sadness that accompanies bereavement. Great distress and sorrow are often part of grieving Mourning includes the period when family members and friends remember and grieve for the loss of the beloved one. The length of mourning varies per individual. Stages of Grieving Denial Survivors of the loved one may not believe or fully understand that the loved one passed away. They may ignore the death and continue in daily activities as if it did not happen Anger After denial feelings of anger may arise. The individuals may be angry that he or she is left to deal with many new issues and possibly new roles. The individual may also be angry toward other family members, friends, and coworkers in the belief that others do not understand Bargaining This stage occurs before the loved ones die. The individual may try to offer a deal or exchange in order to extend the life of a lived one. Depression Feelings of sadness, despair, withdrawal and possible loneliness may dominate now that the survivor understands the loved one will no longer be alive Acceptance Individuals begin to accept or feel comfortable with the loss of the loved one. They recognize that death is a normal part of the lifespan. They are able to move forward, without forgetting the loved one’s death. Stages of Grieving Experiencing grief is normal and healthy. Individuals may not experience these stages in order. There is no right or wrong amount of time to spend grieving. After experiencing death the survivors may continue to grieve for weeks, months or years after the death. Friends and family can help individuals cope with the natural grieving process. Celebrating the life, unique contributions, and personality of the one lost through death may ease the feeling of loss. Death is inevitable and although is not always easy to accept it’s the final chapter of life.