Lifespan Test #4

Explain how one might communicate effectively with a dying person.

Be at eye level and don't be afraid to make eye contact If dying person wants to deny reality of death, don't insist he/she accept it. If dying person indicates acceptance of death, don't insist on denial. Allow the dying person to express feelings, including guilt and anger. Encourage the dying individual to reminisce, especially if you have memories in common. Don't be afraid to express your love and don't be afraid to say good-bye.

Discuss the complexity of defining death and the concept of "brain death".

Brain Death - All electrical activity has ceased for a specified period of time.

1. Explain Baltes' concept of cognitive mechanics and cognitive pragmatics

Cognitive mechanics- (Baltes) Hardware of the mind, involves speed and accuracy of processing sensory input, both visual and motor. Influenced by heredity and health, decline is likely Cognitive pragmatics- (Baltes) Based on culture, analogous to software programs Involves reading, writing skills, language comprehension: improvement is possible into old age.

Explain Erikson's Integrity vs. Despair

Integrity vs. Despair: late adulthood as a time for looking back at what we have done with our lives

Widsom

Knowledge about practical aspects of life, good judgment, how to cope with difficult problems.

Discuss the "life review process" and life satisfaction in late adulthood

Life Review 1. Looking back at one's life experience and evaluation, interpreting and reinterpreting them 2. Individual may revise or expand their understanding of the past, can also lead to guild about old mistakes 3. Life review may help prepare the individual for death Life Satisfaction 1. Psychological well-being; satisfaction with life as a whole 2. Includes zest (vs. apathy) and relationships between desired and achieved goals, self-esteem and mood tone 3. Income, health, active lifestyle and network of family and friends are associated with life satisfaction

7. Explain the search for meaning from the perspective of Frankl and Baumeister and Vohs.

Viktor Frankl i. Emphasizes each person's uniqueness and the finiteness of life ii. Three most distinctive human qualities are spirituality, responsibility and freedom Baumeister and Vohs i. Quest for meaning is understood as four main needs: Need for purpose(goals), values, self-efficacy, and self-worth

7. Discuss health treatment in late adulthood, including quality of care

a. 23% of adults 85 and older live in nursing homes or extended care facility b. Quality: one-third of homes are seriously deficient, failing to meet standards for number of physicians, pharmacists and various rehab specialists. c. Important factors in health and survival of patients are feelings of control and self-determination

Define "ageism" and "double jeopardy"

Ageism: Prejudice toward others due to age i. Often seen as incapable of the following: thinking clearly, learning new things, enjoying sex, contributing to the community or holding a responsible job. ii. Most frequent form of ageism is that of disrespect and assumption about frailty Double Jeopardy: ethnic minority groups might suffer from both ageism and racism

Describe the various living arrangements in late adulthood

Continuing Care i. All residents are retirement age, with various levels of care ii. May start out in separate residence and as they age move into assisted living iii. Can extend to full time nursing care Adult Day-Care Receive care only during the day but nights and weekends they are at home Skilled Nursing Facilities Full time nursing care, some residents are chronically ill and some with temporary conditions

Define dementia, Alzheimer's disease as well as stages of Alzheimer's

Dementia- Any neurological disorder involving deterioration of mental functioning. Alzheimer's- Involves gradual deterioration of memory, reasoning, language and physical functioning Most common form of dementia and most serious. Deficiency in messenger chemical in the brain that is important to memory (acetylcholine) Deposits of proteins accumulate in blood vessels (amyloid plaques) Twisted fibers that build up in neurons (neurofibrillary tangles) Stages of Alzheimer's Disease- Stage 1: absent-mindedness about recent events or newly acquired information Stage 2: generalized confusion: deficits in concentration and STM Speech seems aimless and repetitive, vocabulary more limited Read a newspaper article and forget it the next minute Stage 3: Memory loss is dangerous; may forget to eat, fail to dress properly, leave a lit stove on, get lost Stage 4: need for full time care; may be irrational and angry

Describe Robert Peck's Differentiation vs. Role Preoccupation, Body Transcendence vs. Body Preoccupation, Ego Transcendence vs. Ego Preoccupation

Differentiation vs. Role preoccupation: 1. Older adults must redefine their worth in terms of something other than work roles Body Transcendence vs. Body Preoccupation: 1. Older adults must cope with declining physical well-being Ego transcendence vs. ego preoccupation 1. Older adults recognize that death is inevitable but gain comfort by realizing that they have contributed to the future

Discuss the social theories of aging, including Disengagement Theory, Activity Theory, Socioemotional Selectivity Theory and Selective Optimization with Compensation

Disengagement Theory i. As adults age, they slow down and gradually withdraw from society ii. Mutual process: older adult disengages from society and society also disengages from the older adult iii. Reduction of social interaction in inevitable and supposedly increases life satisfaction; not supported by research Activity Theory i. The more active, energetic and productive adults are, the more likely they will experience life satisfaction ii. Older adults should continue middle adulthood roles and if they can not do this, find substitute roles to keep them active Socioemotional Selectivity Theory i. Older adults become more selective about their social networks ii. Place a high value on emotional satisfaction, spend more time with people with whom they have had rewarding relationshipsSelective Optimization with Compensation i. Selection: reduced capacity and loss of functioning leads to reduction of performance ii. Optimization: possible to maintain performance in some areas by practice and use of new techniques iii. Compensation: when life's tasks require a level of capacity beyond the current level of older adult's performance potential

8. Know the effects of exercise in late adulthood

Exercise i. Can minimize the physiological changes associated with aging and contribute to health and well-being. ii. Can optimize body composition, increasing muscle and bone mass iii. Can reduce the risk of common chronic diseases such as cardiovascular disease, diabetes and osteoporosis iv. Can reduce likelihood of mental health problems such as depression v. Can increase longevity vi. Can improve brain and cognitive functioning.

Describe expert cognition during middle adulthood; practical problem-solving

Expertise shows up on middle age: extensive, highly organized knowledge in a particular domain Practical problem-solving- Stable in early and middle adulthood, declines in late adulthood Example: landlord refuses to fix stove; bank fails to deposit a check. What do you do? Expert Cognition More skilled, proficient and knowledgeable at a particular task than the average person Intuitive- Novices follow formal procedures and rules; experts rely more on past experience Automatic- Complex actions and thoughts have become routine; process information more quickly and efficiently Strategic- More and better strategies especially for unexpected problems Flexible- more willing to deviate from textbook strategies and experiment

Grief process

Grief Emotional numbness, disbelief, separation anxiety, despair, sadness and loneliness. Grief Stages Shock - Lasts for the first few days after death Despair - Painful longing for dead person, memories and visual images of the deceased as well as sadness and insomnia. May subside after several months. Can persist for one to two years. Recovery - Resumption of ordinary activities, greater probability of recalling pleasant memories.

6. Know health issues in late adulthood, chronic disorders and the leading causes of death

Health As we age, probability of disease or illness increases Chronic disorders- disorders that are slow to develop but are of long duration. Arthritis is most common Leading cause of death in late adulthood: heart disease, cancer or cerebrovascular disease (stroke) Falls most common cause of accidental deaths; mostly women over 65, fracture a hip, usually die of pneumonia. Osteoporosis- loss of bone tissue, especially for women. Estrogen therapy, calcium and weight training all help.

Non-cognitive factors that affect cognition's

Health, education and socioeconomic status can influence performance on memory tasks.

Care for the terminally ill, including home care and hospice care.

Home Care i. Stay home and receive treatment from family and visiting medical staff; can be hospice care. ii. Can be difficult on family members; physically and emotionally draining. Hospice Care i. Institution devoted to terminally ill, provides warm, supportive environment. ii. Not about extending lives but making final days pleasant and meaningful.

Know the stages of retirement

Honeymoon: engage in a variety of activities, traveling, etc. Disenchantment- Retirement is not what they want, miss stimulation and companionship of work Reorientation i. Reconsider options, become more engaged in new fulfilling activities ii. Retirement routine stage: come to grips with retirement Termination Go back to work or if health is so bad, can no longer function independently

Define the "living will", "durable power of attorney" and active and passive Euthanasia.

Living Will A document that ensures the right of individuals to choose whether heroic measures should be used to sustain their lives. Durable Power of Attorney Specifies a legal designate (lawyer, doctor, relative or friend) who can make health-care decisions if one is incapacitated. Euthanasia Active: Death is induced deliberately, as by injection of a legal dose of a drug. Passive: A person is allowed to die by withholding an available treatment, such as withdrawing a life-sustaining therapeutic device (e.g. respirator).

Understand depression as it occurs in late adulthood

Major Depression Mood disorder: person is deeply unhappy, demoralized Symptoms might include poor appetite, listlessness and lack of motivation No evidence that is more common in late adulthood Predictors: Earlier depression, poor health, lack of social support and loss of spouse. 80% of depression in late adulthood goes untreated; 25% of suicides occur at age 65 and over.

Know the effects of returning to education later in life, especially for women

Majority of adult learners are women Women feel more self-conscious and inadequate than returning men or traditional students (under 25) Anxiety due to lack of practice in academics, also negative aging and gender stereotypes Middle age women take fewer hours and progress at slower pace than middle age men Role overload is most common reason for not completing education

Discuss career pathways for men and women and work issues in middle adulthood

Men: most men begin work in early adulthood and work until they retire Women: (career paths for professional women) i. Regular- Pursue professional training and work uninterrupted through the years ii. Interrupted Career- Begin regular pattern but interrupt career (usually for child rearing) and then go back to work full time Work issues for Men and Women-Recognize limitations in career progress, decide whether to change jobs or careers, plan for retirement

Know the changes in language processing during late adulthood

Retrieving words from long-term memory- Difficulty coming up with right word, even words often used Speech contains more pronouns and other unclear references compared to younger adults Speak slower and pause more often because they need time to search memory for certain words Planning what to say and how to say it- more hesitation, false starts, word repetition and sentence fragments. Decline in associative memory affects word retrieval Decline in working memory- less information can be processed at once

Discuss the changes in attention during late adulthood

Selective Attention- the ability to focus on a relevant, specific aspect of experience and ignore the irrelevant In general, older adults are not as adept as younger adults Divided Attention- ability to concentrate on more than one activity at a time The more difficult the competing tasks are, the less effectively they perform than younger adults Sustained Attention- The state of readiness to detect and respond to small changes occurring in the environment. Older adults tend to perform as well as middle-aged and younger adults

5. Describe late adulthood sexuality, including changes in sexual functioning

Sexuality Sexuality is lifelong unless there is disease or belief that older people should be asexual. Two major factors determine sexual activity: previous regular sexual activity and good physical and mental health Changes in Sexual Functioning Testosterone declines in late adulthood; takes a longer time and more stimulation for men to get a full erection When in late adulthood produce less natural lubrication making intercourse more difficult.

Describe Kubler-Ross's Stages of Dying.

Stage 1: Denial and Isolation Person denies that death is going to take place. Stage 2: Anger Denial gives way to anger and resentment. Stage 3: Bargaining Hope that somehow death can be postponed. Stage 4: Depression Person comes to accept reality of death and a period of preparatory grief or depression occurs. Stage 5: Acceptance Person develops a sense of peace and acceptance of his/her fate.

3. Explain the sub-periods of late adulthood, primary and secondary aging, outward and inward signs of aging

Subperiods of Late Adulthood i. Young Old: 65-74 years of age. ii. Old Old: 75-84 years of age. iii. Oldest Old: over 85 years (mostly female, widowed, some functioning at much higher level than others) Primary Aging- universal and irreversible change due to genetic programming, occurs as people get older. Secondary Aging- changes due to illness, health habits but do not due to increased age itself and not inevitable Outward Signs of Aging- wrinkles, age spots, getting shorter, hair thins and turns grey. Inward signs of Aging- decrease in lung capacity, digestive system is less efficient, reduces ability of heart to pump blood.

4. Discuss the aging brain and plasticity; sensory development

The aging Brain- Plasticity and Adaptation i. Prefrontal cortex shrinks with aging, decrease in working memory ii. Brains of older adults can rewire themselves to compensate for losses. (plasticity) Sensory Development i. Vision: decline began in middle adulthood, becomes more pronounced. Night driving more difficult: less tolerance for glare, dark adaptation is slower. ii. Hearing: decline begins in middle adulthood but usually not much of an impediment until late adulthood. iii. Smell and Taste: lose some of these senses in late adulthood, which can decrease the enjoyment of food. iv. Pain: less sensitive to pain in late adulthood, but can be a problem

2. Explain Kotre's Paths to generativity

a. Biological- adults conceive and give birth b. Parental- Nurturance and guidance of children c. Work- middle age adults pass skills on to a younger generation d. Cultural- Adults create, renovate or conserve some aspect of the culture that survives

2. Describe the three theories of aging as described in class

a. Cellular clock theory- cells can divide a maximum number of times (approximately 75-80) and that as we age, they become less capable of dividing b. Free radical theory- the cells normal metabolism produces unstable oxygen molecules, known as free radicals i. These molecules can damage DNA and other cellular structures c. Hormonal stress theory- aging of body's hormonal system can lower resistance to stress and increase likelihood of disease

5. Know Costa and McCrae's "Big Five" personality factors

a. Emotional Stability i. Calm vs. anxious; secure vs. insecure b. Extraversion i. Sociable vs. retiring; fun loving vs. sober c. Openness i. Imaginative vs. practical; variety over routine d. Agreeableness i. Trusting vs. suspicion; helpful vs. uncooperative e. Conscientiousness i. Organized vs. disorganized; careful vs. careless

Understand changes in fluid and crystallized intelligence; memory and information processing in middle adulthood.

a. Fluid Intelligence- Abstract reasoning: Tends to decline b. Crystallized Intelligence- Accumulated information and verbal skills: Continues to increase c. Memory Some Memory decline but mostly due to not using effective memory strategies More decline in "recall" or information rather than "recognition"

1. Describe Erkison's Generativity vs. Stagnation

a. Generativity i. Adult plans for leaving legacy for the next generation and achieve a kind of immortality. ii. Through generativity adults guide the next generation by parenting, teaching, leading and doing things that benefit the community. iii. The opposite of generativity is stagnation or "self-absorption".

3. Discuss Levinson's season of a Mans Life, transitions, times of stability and four polarities, mid-life crisis

a. Levinson conducted extensive interviews with forty middle-aged men. b. Discovered that men go through a number of developmental transitions that are also separated by times of relative stability. c. 17-22 yrs: early adult transition( formation of "dream") d. 22-28 yrs: establish life structure for early adulthood e. 28-33 yrs: age 30 transition f. 33-40 yrs: culminating the life structure for middle adulthood (focus on family and career) g. 40-45 yrs: middle adult transition- must come to grips with polarities: i. Bing you vs. being old ii. Being destructive vs. being constructive iii. Being masculine vs. being feminine iv. Being attached vs. being separated from others

1. Know life expectancy and life span, gender and life expectancy

a. Life Span- the maximum number of hears an individual can live. (maximum is approximately 120 years) b. Life expectancy- number of years that the average person can be expected to live based on year of birth c. Gender and Life Expectancy i. Average life expectancy of individuals born today 80.8 yrs for women and 75.6 yrs for men ii. Social factors: Men's shorter life expectancy is based in large part on lifestyle, habits and health attitudes iii. Biological Factors: women have more resistance to disease and infections. Estrogen helps protect against hardening of the arteries.

Describe the factors associated with high status of older persons in a culture

a. Older persons have valuable knowledge b. Older persons are permitted to engage in useful and valued functions as long as possible c. The extended family is a common family arrangement and the older person is integrated into the extended family d. Respect for older adults is greater in collectivistic cultures (China and Japan) than in individualistic cultures (US)

6. Explain how marriage can change from young adulthood to middle adulthood and the "empty nest syndrome"

a. Some marriages that started off with difficulty in early adulthood turn out better adjusted over time b. Many earlier conflicts brought about by differences in religion, ethnicity, family background etc. have either worked out or have resulted in breakup of the marriage c. Couples who survive have "worked through" power struggles to finally accept their relationship with all its pluses and minuses d. Most positive outcomes in marriage based on sharing of mutual activities e. "empty nest syndrome"- marital satisfaction decreases because parents derive satisfaction from children f. When children move back home, requires adaptation on part of parents and their adult children "disequilibrium" may occur.

9. Explain substance abuse in late adulthood, including "late onset alcoholism"

a. Sometimes know as the "invisible epidemic", goes undetected or attributed to other medical conditions b. Often taking multiple medications which increases the risk, especially in combination with alcohol c. Late Onset Alcoholism (over age 65): related to loneliness, loss of spouse or disabling condition

4. Describe the Mills College Longitudinal study, including "midlife consciousness"

a. Studies 132 women in college in the late 1950s. Studied again in their 30s, 40s, and 50s. b. Distinguish three main groups: family oriented, career oriented and those who followed neither path c. During their forties, many had some of the same concerns as the men in Levinson's study: awareness of limitations and death and introspectiveness d. Rather than being in midlife crisis, experienced a "midlife consciousness" ** e. Commitment to tasks in early adulthood (career, family or both) helped women develop interpersonal skilss, become independent and work toward goals. f. Some women became "pillars of the society" in their forties and fifties.

Describe the "denial of death" in the U.S. and why this occurs.

a. The tendency for the funeral industry to gloss over death and portray lifelike qualities in the dead. b. Use of euphemistic language for death: exiting, passing on etc. c. Search for the fountain of youth. d. Rejection and isolation of the aged, who may remind us of death. e. Medical community's emphasis on prolonging biological life.

Describe the Seattle Longitudinal Study in terms of changes in cognitive development

a. Vocabulary- Ideas expressed in words b. Verbal memory- encode and recall list of words c. Number- Ability to perform simple math d. Spatial orientation- mentally rotate objects e. Inductive reasoning- recognize patterns, use the information to solve problems f. Perceptual speed- quickly discriminate visual stimuli (reaction time). g. Results: only number and perceptual speed declined

Changes in memory during late adulthood

a.Episodic memory- Information about when and where of events. The older the memory, the less accurate. b.Semantic memory- Knowledge about the world: field of expertise, everyday knowledge, academic and meanings of words. May take longer to retrieve but usually can retrieve it. c.Working memory- Allows person to manipulate information when making decisions and solving problems. Aka short term memory. Declines in late adulthood.

7. Describe the different grandparenting styles and the changing roles of grandparents

i. Frequent contact with grandchildren predicted high levels of satisfaction with grandparenting i. Grandparenting Styles i. Involved- actively engaged in and have influence over their grandchildren's lives ii. Companionate- More relaxed, informal and playful; act as supporters and buddies to grandchildren iii. Remote- detached and distant, showing little interest ii. Changing roles of Grandparents i. Number of children living with grandparents 2010: 7.5 million (one-fifth without parents in home) ii. Divorce, adolescent pregnancy and drug use are the main reasons that grandparents are back into the parenting role.