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Chapter
12
Older Adulthood:
Age 66 Plus
Objectives
• Analyze physical changes that occur in older
adults.
• Analyze cognitive changes that occur in
older adults.
• Analyze socio-emotional changes that occur
in older adults.
• Summarize how older adults might express
integrity rather than despair.
continued
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Objectives
• Identify how supportive relationships impact
physical, cognitive, and socio-emotional
well-being in older adulthood.
• Compare and contrast the stages of dying
and the stages of grief.
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Physical Qualities and Changes
• Older adulthood typically refers to the stage of
life when people are age 66 and above
• Centenarian is a person age 100 or older
• Changes in physical appearance and
functioning are common for many older adults
• People become more wrinkled as they age
and harmless age spots, or liver spots, occur
continued
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Physical Qualities and Changes
• Muscle loss affects range of motion, and
movements become slower
– Physical activities can slow this process
• Internal body organs age and lose some
efficiency of their function
• Incontinence may occur as health problems
increase
continued
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Physical Qualities and Changes
• Sensory changes from middle adulthood
continue throughout older adulthood
• Presbyopia progressively worsens
• Other vision conditions often develop
• Eye doctors recommend scheduling visits at
least every 1–2 years, but sooner if changes
in visual acuity are noted
continued
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Physical Qualities and Changes
• The most common vision conditions in older
adulthood are
– cataracts (causes cloudy or distorted vision)
– glaucoma (involves damage to the optic nerve)
– macular degeneration (causes difficulty seeing
objects in the center of the field of vision, while
objects in the periphery are clearly visible)
continued
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Physical Qualities and Changes
• Diabetic retinopathy is an eye disease that
involves damage to the blood vessels in the
retina
continued
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Physical Qualities and Changes
• Hearing loss associated with age is called
presbycusis
• Many older adults complain of hearing a
ringing sound in their ears, called tinnitus
• Hearing aids can help older adults cope with
hearing loss
continued
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Physical Qualities and Changes
• Other sensory changes that typically occur in
older adulthood include
– a decrease in the sense of taste and smell
– less sensitivity to pain and touch
• Both of these sensory changes can affect
quality of life
continued
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Physical Qualities and Changes
• Sarcopenia, the loss of muscle mass and
strength, continues to increase through older
adulthood
• Many adults feel more stiffness in their bones
along with muscle aches and pains
• Conditions affecting the bones, such as
osteoporosis, continue to cause brittle, less
dense bones
continued
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Physical Qualities and Changes
• As in any other stage of life, proper nutrition
is vital to maintain health
• Older adults may need to take dietary
supplements to ensure they are meeting
nutritional needs
• Physical activity recommendations for older
adults vary depending on ability and health
continued
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Physical Qualities and Changes
• Older adults need 7 to 9 hours of sleep
• Frequent waking can disrupt sleep, and as a
result, older adults may take frequent naps
• Changes in sleep patterns, such as those
caused by sleep apnea, often result in a poor
sleep quality
continued
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Physical Qualities and Changes
• For healthy older adults, doctors continue to
recommend regular health exams
• Dentists recommend scheduling annual
exams and cleanings every six months
• For older adults who lose some or all of their
natural teeth, dentures can help them
comfortably eat, speak, and smile
continued
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Physical Qualities and Changes
• There is a high incidence of chronic disease
in older adults, especially those over age 85
– Cardiovascular disease
– Cancer
– Diabetes
– Arthritis
– Hypertension
• Older adults are more likely to catch common
colds and flu
continued
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Physical Qualities and Changes
• Concerns of older adults include
– increasing the quality and years of healthy life
– eliminating health disparities
• Many diseases can be prevented or at least
symptoms can be relieved with
– proper nutrition, physical activity, food availability,
and weight management
– regular oral health, vision, and hearing care
continued
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Physical Qualities and Changes
• 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
– have met employment contribution eligibility
standards
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Checkpoint
1. What age range does older adulthood
typically include? What is a centenarian?
 ages 66 and above, a person age 100 or older
2. List three common changes older adults may
experience in body composition and strength.
 (List three:) muscle mass and strength decline,
fatty tissue increases, joints often ache, bones
become brittle and less dense
continued
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Checkpoint
3. Describe common sensory changes in older
adulthood.
 Hearing and vision loss occur, resulting in
vision problems such as cataracts, glaucoma,
macular degeneration, and diabetic
retinopathy; and hearing problems such as
presbycusis and tinnitus. Decreases in the
senses of taste, smell, and touch occur as
well.
continued
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Checkpoint
4. Explain the increase for nutritional needs in
older adults.
 The body’s ability to absorb certain nutrients
decreases in older adulthood. Medications and
state of health can have an effect on nutritional
needs as well.
5. Describe sleep apnea.
 condition in which the airway collapses or
becomes blocked and causes a person to
have pauses in breathing while sleeping
continued
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Checkpoint
6. Compare and contrast Medicare and Social
Security.
 Both are government programs that have been
offered to older Americans for many decades.
Medicare is a health insurance program that
helps older adults pay for medical costs. Social
Security is a retirement fund that provides
supplemental income to Americans who are at
least 62 years old.
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Signs of Cognitive Change
• In older adulthood, cognitive abilities may
decline and adults may have more trouble
– processing new information
– recalling memories
– concentrating
• Two theories help explain memory loss
– Data overload (because the brain can only hold
so much information)
– Decrease in brain functioning
continued
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Signs of Cognitive Change
• Verbal ability remains stable and may actually
increase slightly during older adulthood
• Older adults remain in Kohlberg’s
postconventional morality stage of moral
development
• Traits of this stage include
– valuing society as a whole
– contributing to the well-being of others
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Checkpoint
1. How do older adult cognitive skills change?
 Cognitive abilities decline in the form of
impaired brain processing and memory loss.
continued
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Checkpoint
2. Compare and contrast two theories that
explain memory loss in older adults.
 One theory states that memory loss occurs as
a result of too much information being
compiled over time and that the brain can only
hold so much information. The second theory
states that memory decline occurs as a result
of declining brain functioning.
continued
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Checkpoint
3. How do long-term memories influence older
adult’s language abilities?
 Verbal ability is built on long-term memory.
4. Older adults are in which stage of Kohlberg’s
moral development theory?
 postconventional morality
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Signs of Socio-emotional Change
• The need to be connected with others does
not diminish in older adulthood, although
social roles may change
• Erikson theorized that older adults experience
a period of reviewing their life and accepting
or struggling with experiences and decisions
• This stage is called integrity versus despair
continued
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Signs of Socio-emotional Change
• Family relationships remain important
• Social roles change as new relationships
develop and new bonds form
• Older adults may require more help and
support from their adult children
continued
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Signs of Socio-emotional Change
• Many older adult siblings face the passing of
their parents and other siblings
• These transition periods are significant as
remaining siblings take on new roles
• A woman may become the matriarch or a
man may become the patriarch of the family
continued
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Signs of Socio-emotional Change
• Maintaining relationships that include friends
and community members helps fulfill societal
and social needs
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continued
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Signs of Socio-emotional Change
• The decision to retire is a major life decision
that affects not only the worker, but also his or
her spouse
• Options available after retirement may include
– traveling
– participating in hobbies
– spending more time with family and friends
– getting a part-time job
– volunteering
continued
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Signs of Socio-emotional Change
• Depression is common in older adulthood as
work and family roles change and physical
abilities decrease
• Loss of friends and family members increase
these feelings
• Many medications also have side effects that
cause depression
continued
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Signs of Socio-emotional Change
• Myths on aging come from societal sharing of
false or inaccurate beliefs
• Bias against, or unfair treatment of, older
adults is termed ageism
• Although people often remain true to their
temperament or personality, most tend to
mellow with age
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Checkpoint
1. According to Erikson, what is the primary
socio-emotional task of older adulthood?
 integrity versus despair
2. List three examples of how social roles
change during older adulthood.
 adults move out of parenting roles, take care
of grandchild or great-grandchildren, and
retire
continued
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Checkpoint
3. Why is social interaction important in older
adulthood?
 fulfills the need for love, acceptance, and
companionship; helps reduce feelings of
depression, sadness, or loneliness; provides
help and support when needed
continued
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Checkpoint
4. Why may older adults view retiring as
challenging?
 They have come to be defined by their
profession and must find a new self-identity.
5. Describe ageism and give an example.
 bias against, or unfair treatment of, older
adults (Examples will vary.)
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Special Needs
• Special needs in older adulthood vary
• Many special needs are related to physical
ailments, as the body is declining in ability
• In addition to medications, adults may need
to make other lifestyle adjustments to
accommodate for changes
continued
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Special Needs
• In older adulthood, dementia is common
• Memory loss for those with dementia differs
from normal forgetfulness
• Dementia does not have a cure, but with
some medications, symptoms may
significantly improve
continued
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Special Needs
• Alzheimer’s disease is a progressive brain
disorder that includes memory loss and
progressively severe confusion
• With decreasing physical abilities, many older
adults have difficulty caring for themselves
• They may need alternative living
arrangements
continued
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Special Needs
• Many older adults want to stay in their homes
• Some older adults are not able to live
independently because of poor health
• Moving from independence to increasing
dependence is a major family-life transition
• Some older adults may move into new living
communities
continued
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Special Needs
• New living arrangements can be an option to
provide more care as needed
• Three main types of living communities offer
different levels of support
– Independent living communities
– Assisted living housing
– Retirement homes
continued
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Special Needs
• Caring for a loved one who is terminally ill is
beyond what many people can do
• Hospice care is a form of care given by
trained medical professionals
• It focuses on making a person comfortable in
his or her last days and hours of life
• Care can be provided either in the patient’s
home or in a hospice living center
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Checkpoint
1. What is dementia? How does dementia differ
from normal memory loss?
 Dementia describes cognitive decline and
memory loss caused by damage to the
brain. A person with normal forgetfulness
may simply need a prompt to remember. A
person with dementia may ask the same
questions repeatedly and not realize they
asked the questions. Dementia can also
affect language ability and personality.
continued
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Checkpoint
2. Define Alzheimer’s disease. What are
treatment options available for Alzheimer’s
disease?
 Alzheimer’s is a progressive brain disorder
that includes not only memory loss, but
also progressively severe confusion.
Treatment options include therapy,
medications, help from a caregiver, and
adjustments to housing.
continued
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Checkpoint
3. Why may living arrangements need to change
as an adult ages?
 With declining physical abilities, older adults
may have difficulty caring for themselves and
may need to live with family or in a living
community.
4. What are three main types of living
communities available for older adults?
 independent living communities, assisted living
housing, and retirement homes
continued
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Checkpoint
5. Explain hospice care and the needs it serves.
 Hospice care focuses on making a person
comfortable in his or her last days and hours of
life by controlling pain and serving emotional
and sometimes spiritual needs. Hospice
caregivers also focus on the needs of the
family and loved ones as well.
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Death and Grief
• Older adults will often plan for their inevitable
passing in a rational and organized way
• A Last Will and Testament gives directions
on how to divide financial assets
• Those who receive the financial assets are
called beneficiaries
continued
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Death and Grief
• Many people have a living will that indicates
medical preferences in the event they are
unable to make decisions themselves
• Dying intestate means to die without a will
• When there is no will, state laws determine
the division of assets
continued
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Death and Grief
• Stages people experience when coping with
their own death or grieving for another are
– denial
– anger
– bargaining
– depression
– acceptance
• Each person is different and will not
experience these stages in the same way
continued
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Death and Grief
• One of the most difficult losses for older
adults is losing a spouse and becoming a
widow or widower
• Different cultures may have different customs
involved with bereavement, grief, and
mourning
• Friends and family can help individuals cope
with the natural grieving process
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Checkpoint
1. Compare and contrast the difference between
a Last Will and Testament and a living will.
 Both are legal documents concerning actions
that need to be taken regarding a person’s
death. A Last Will and Testament gives
directions on how to divide financial assets,
while a living will gives directions on whether to
keep the person alive by artificial means or to
let them pass, when there is no chance of
recovery.
continued
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Checkpoint
2. List and explain the five stages of dying.
 denial—individuals reject the idea of dying and
ignore the concept of their own death; anger—
individuals experience feelings of negativity
and resentment; bargaining—individuals
propose deals or exchanges in order to
preserve their own life; depression—
individuals struggle with the loss of life and
become sad and withdrawn; acceptance—
individuals understand and accept that the
reality of their own death is near
continued
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Checkpoint
3. Differentiate between the terms bereavement,
grief, and mourning.
 Bereavement is the state of losing a loved one
through death. Grief is the mental anguish or
sadness that accompanies bereavement.
Mourning is the period when family members
and friends remember and grieve for the loss
of a beloved one.
continued
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Checkpoint
4. How do the five stages of dying differ from the
five stages of grieving?
 The five stages of grieving typically occur after
an individual’s death, and involve loved ones
coming to terms with the individual’s death and
moving forward with their own lives.
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