Psychology Exam Study Guide

What are chronic disorders? Examples?

characterized by slow onset and long duration are much more common in later adulthood Arthritis: most common chronic disorder in older adults•Involves inflammation of joints with stiffness, pain and restriction of movement. Osteoporosis: involves an extensive loss of bone tissue•Women are more vulnerable.•Leading cause of broken bones in elderly adults.•Main reason why older adults often walk with a stoop. Dementia & Parkinson Disease: (discussed later with mental health)

characteristics of Parkinson disease.

chronic and progressive disease characterized by muscle tremors, slowing of movement and partial facial paralysis. •Associated with decreased production of dopamine.•Main method of treatment are drugs that mimic the effects or encourage the production of dopamine.•Deep Brain Stimulation (DBS) involves putting electrodes in the brain. The electrodes are stimulated by a pacemaker-like device. Can improve function, but improvement declines over time...

What are pathological aging factors? Examples?

cumulative affects of disease and accidents that accelerate aging (i.e. not part of the normal aging process) Heart disease is the #1 killer in the U.S.; men develop it earlier and more often than women

Define dementia. What are the primary / secondary causes?

Dementia - a term for neurological disorders that involve a nonreversible decline in mental function severe enough to interfere with daily life. Alzheimer Disease and Parkinson Disease are types of dementia. Primary causes: Alzheimer / Parkinson / Cerebrovascular dementia (stroke) Secondary causes: lack of physical fitness, nutritional deficits, over use of alcohol, misuse of drugs, disuse of mental functioning

method is provided to an individual allowing them to take own life - much legal gray area with this

assisted suicide

anticipatory grief

emotionally preparing self for the death of a loved one. Can help if not last longer than 18 months. After that the emotional drain outweighs any effects.

behavioral slowing

motor responses, reaction time, problem solving, memory skills and information processing are all affected

w/ holding or discontinuing life sustaining equipment so that death will come naturally (i.e. turning off a respirator or heart-lung machine) - is legal if have a DNR

passive euthanasia

chronic grief

pathological mourning process when person never quite overcomes the grief.

What is advanced care planning?

refers to the process of patients thinking about and communicating their preferences about end-of-life care

What is meant by aging in place?

remaining in a familiar setting where they have control over their everyday life. •90% of older adults remain in or near their old home. •About 15% of elders live in residential communities that range from independent dwellings to assisted living facilities.

Stigmatized deaths: deaths in which people attribute the death to an immoral, illegal or evil cause.ex: dying during commission of a crime / of a drug overdose / suicide* Mourners for those affected by stigmatized death often receive less support from society

stigmatized death.

Selective optimization with compensation (SOC) theory

successful aging is linked with 3 main factors:• Selection - because of reduced capacities and loss of function, a reduction in performance is required. (ex: shuffleboard instead of tennis) • Optimization - can maintain performance in some areas with the use of technology. (ex: use of hearing aids) • Compensation - if life tasks require capacity beyond current abilities, individual must compensate (ex: driving slower)•Individuals can produce new resources and allocate them effectively to tasks they want to master. (ex: older pianist)

how concerns over money and healthcare affect the elderly.

•A common concern for later adults is having enough money to live a good life.•Most early and middle adults save a smaller percentage of their income than earlier generations. •Health care is another concern of older adults. Medicare is often overburdened and the affordable care act is falling short for many people.

Name seven factors associated with maintaining high levels of cognitive functioning in late adulthood.

•Absence of chronic disease •High socioeconomic status •Intellectually stimulating environment •Flexible personality style •High cognitive functioning of spouse •Maintaining high level of processing speed •Life satisfaction

What tasks might help a person start to recover from the loss of a loved one?

•Accepting the reality of the loss•Working through the pain of grief•Adjusting to a world without the loved one•Developing an inner bond with the deceased and moving on

What is resistant hypertension?

•Although medications, diet and exercise can often help reduce high blood pressure, some elderly adults experience resistant hypertension (hypertension not easily controlled with multiple interventions).

historical and cultural issues associated with death.

•Historical changes include:• 200 years ago, half of the children died before age 10 and at least one parent died before the kids grew up - average life expectancy in 1900 was barely 50 years.• Today, 2/3 of deaths occur in the late adulthood age group and average life expectancy is around 78 years.• In 1900, most people died at home.• Today, most die in hospitals or institutions. •Most cultures have philosophical or religious beliefs about death and most have rituals that deal with death.•Death may be seen as a punishment for one's sins, an act of atonement, redemption or a relief from earthly issues.•In most societies, death is not viewed as the end. The biological body may have died but the spiritual body may live on.

statistics associated with suicide in the elderly.

•The greatest number of suicides occur to those over age 45 (of those, most are over age 65)•Older males are five times more likely to commit

Know the difference between a living will and a medical power of attorney.

(advanced directive) formal request, generally prepared by an attorney, that informs others of the person's wishes for health care (such as no "heroic measures" be taken to prolong life) •is not necessarily legally bindingMedical power of attorney: grants loved one power to make medical decisions for you•Is legally binding

What is wisdom? Name some important findings

- expert knowledge about the practical aspects of life that permits excellent judgment about important matters. Important findings about wisdom:• High levels of wisdom are rare• Factors other than age are critical for wisdom to develop at a high level• Personality related factors (openness to experience, generativity, creativity) are better predictors of wisdom than intelligence.

Name 5 personality characteristics linked to satisfaction in later life.

1) Extroversion: outgoing and enjoy being around others 2) Lack of neuroticism: not having hostility, anxiety, negativity or hopelessness 3) Usefulness/competence: still feel involved and able to lend something to society 4) Optimism: positive mental outlook 5) Sense of control: still able to make decisions about one's life

BFW aspects of mourning.

1) How to treat the physical body (corpse) 2) How to address the spiritual aspect of the person (soul) 3) How to meet the emotional needs of the survivors

Peck's developmental tasks.

1. Ego Differentiation: must redefine selves in a ways that do not relate to occupation or work roles (i.e. achieve a sense of self esteem that does not involve work) 2. Body transcendence: must learn to cope with physical changes associated with aging 3. Ego transcendence: come to grips with impending death

What are the important issues of filial obligation?

1. Helping to understand resources 2. Giving emotional support 3. Taking over matters of importance

activity theory of aging

Adults who are more active and involved will be healthier and more satisfied with life.•Social barriers to engagement (less mobility, poorer health) - not desires of elders - cause declining rates of interaction. When elders lose certain roles (retirement etc.) they seek out other roles to maintain activity levels.•Elders life satisfaction depends on conditions that permit them to remain engaged in roles and relationships

Know the difference between bereavement, grief and mourning.

Bereavement: is the period after a loss during which grief is experienced and mourning occurs. Grief: is the normal process of reacting to the loss of a loved one. Often involves emotional numbness, disbelief, separation anxiety, despair, sadness and loneliness. Mourning: (outward expression of grief) is the process by which people adapt to a loss. Strongly influenced by societal and cultural customs and rituals.

What is a persistent vegetative state?

Brainstem functions can continue even with no cortical functioning

•Genes only allow cells to replicate a certain number of times

Cellular clock

Socioemotional Selectivity theory of aging

Focus is on how time is spent and the recognition that time is limited. Older adults become more selective about their activities and social relationships in order to maintain social and emotional well-being. (i.e. they have less time left and get pickier about how they spend it)• Elders sustain contacts with family and friends and gradually "downsize" in favor of a few very close relationships.• Elders spend more time with familiar individuals with whom they have had rewarding relationships• Explains how elders' social networks sustain continuity but narrow with age

• Aging occurs from cell metabolism producing unstable O2 molecules called free radicals that bounce around inside the cell and cause damage that can lead to many disorders including cancer and arthritis • Overeating increases this

Free-radical

sensory changes during late adulthood.

Hearing: hearing loss generally increases w/ age. Some is a part of aging and some is due to environmental influences.•Most common hearing problem associated with age is presbycusis or decreased sensitivity to high pitched sounds•Many hearing problems are correctable. Vision: accommodation problems generally start in 40's (i.e. short arm syndrome, mentioned earlier) and are a normal part of aging•Maladies such as cataracts and glaucoma are common in the elderly but are pathological.•Pupils do not adjust as rapidly to changes in light thus making the elderly more sensitive to glare.•Macular degeneration - progressive deterioration of the retina becomes more common with age but is influenced by pathological factors.•Certain diseases and ethnic backgrounds put people at greater risk for some eye disorders. Taste: wide variation in taste among individuals, but the number of taste buds do decrease w/ age.•Could cause problems with food preparation (such as over salting food and increasing risk for high blood pressure) Smell: similar to taste in that the decreased ability to smell often affects appetite (and therefore interferes w/ proper diet) Kinesthetic / touch: sensations of touch, temperature and pain remain relatively constant as we age•Decreased sense of balance my lead to falls and injury.

• Aging lowers the resistance to stress and increases the likelihood of disease.

Hormonal stress

What is the difference between hospice and hospital care.

Hospice: designed to help terminally ill live out the remainder if their lives as comfortably as possible•Emphasizes palliative care - reducing pain and suffering so that patients can die with dignity•See death as a natural part of life Hospital: goal is to preserve life at all costs•See death as the enemy

-Name Erikson's life crisis associated with late adulthood.

Integrity: ability to accept the facts of one's life and face death w/out great fear (looking back and being satisfied w/ what you accomplished) Despair: realization that one did not meet own expectations and did not do all that he/she wanted to do (regret way life turned out)

• Aging is due to the decay of mitochondria (structures that supply the cell with energy for function, growth and repair) within the cells.

Mitochondrial

How perceived control and denial are associated with death.

Perceived control may work as a coping strategy as people face death.•Individuals who believe (even erroneously) that they can influence and control their own lives may show more comfort and less stress associated with impending death.•Denial may also be an affective coping mechanism. •It may insulate an individual from the stress of dealing with the illness, but it can be destructive (such as choosing not to seek necessary medical treatment).

What is POLST?

Physician Orders for Life-Sustaining Treatment It is a document that is more specific than previous advanced care directives and outlines particular treatment preferences.

•Body ages as a result of random assaults from the environment (wear and tear)

Stochastic

What are the four biological theories of aging?

Stochastic Cellular clock Free-radical Mitochondrial Hormonal stress

the three passive forms of suicide.

Submissive death: simply letting self die (taking no steps to treat or prevent the progression of illness)Suicidal erosion: excessive drinking, smoking or drug abuse (especially w/ conditions that warrant discontinuing these habits)Going postal: overt act to ensure you will be killed (pointing gun at police officers assuming you will be shot)

low risk for disease, high mental and physical functioning and active engagement in life

Successful aging

What is the gender gap?

The majority of those in the very old category are women (and the percentages dramatically increase by age 85) different opportunities given to men and women

compression of mobility

a public health goal to increase quality of life and decrease diminished functioning before death

Define sex role convergence as associated with late adulthood?

a transformation of sex role orientation during later life•Men become more nurturing and more concerned w/ social relationships•Women become more assertive and independent* Often happens out of necessity

positive steps are taken - deliberately induced (by another person) to bring about death - considered murder in the U.S.

active euthanasia

prejudice against others because of their age

ageism

(1) Person is missing and presumed dead but with no physical remainsex: soldiers missing in action / natural disaster / terrorist attack(2) Person is physically present but unable to participate in meaningful way w/ family interactions.ex: person in coma or advanced stages of Alzheimer'sex: COVID patient

ambiguous loss.

grief work

dealing w/ the emotional reactions to the loss of a loved one.

What is the filial obligation?

feeling of responsibility to care for one's parents

disenfranchised grief

involving a deceased person that is a socially ambiguous loss that cannot be openly mourned or supported. May also be associated with a stigmatized death.

How is a standard will different than a living will?

legal document whose purpose is to provide direction for disposal of all the property and assets of the deceased.•Without a formal will, the state will often decide on distribution of property and assets•Things to be considered besides who gets what:• Paying for the funeral (since estate assets are often frozen immediately after death, arrangements should be made ahead of time for funeral and hospital bills)

BFW life review.

looking back on one's life experiences, interpreting them and evaluating them. •Might involve looking back at not just positive experiences but also regrets. Although it important to come to terms with regrets, it is also important not to dwell on them. •Obsessing about the past tends to make for a less well adjusted later adulthood. •Contrary to popular belief, older adults report experiencing more positive and less negative emotions than younger adults.

characteristics of Alzheimer disease.

symptoms : gradual or dramatic memory loss, depression, loss of basic self care skills.causes : plaques and tangles (scar tissue), decrease in acetylcholine • New neuroimaging techniques have been developed that can detect the early development of plaques and tangles in the brainrisk factors: heredity, toxic substances, cardiovascular disease, living longerprevention: vitamins, medications• 10% of those over age 65 have Alzheimer Disease• Women are more likely to develop than men

BFW the issue of right to die.

the view that death is a right to be exercised at an individual's discretion.

What are centenarians?

those 100 years or older -more today and women -men over 100 tend to be more healthier than the women

functioning fairly well but at high risk for disorders, disability and loss of functional independence

usual aging

What factors might predict high status for older adults in a given culture?

• Belief that older persons have valuable knowledge• Older persons control key family/community resources• Older adults are allowed to engage in useful and valued functions as long as possible.• Age-related role changes involve greater responsibility, authority and advisory capacity. • The older person is integrated into the extended family.

What is meant by a good death?

• Face death on their own terms • As free of suffering as is possible• Not being a burden to loved ones

how to define brain death.

• No spontaneous movement in response to any stimuli• No spontaneous respirations for at least one hour• Total lack of responsiveness to even the most painful stimuli (ex: knuckle to sternum)• No eye movements, blinking or pupil responses• No postural activity (swallowing, yawning, or vocalizing)• No motor reflexes• Flat EEG for at least 10 min• No change in any of these criteria when tested 24 hours later

statistics about living arrangements of those in late adulthood.

•Approximately 77% of U.S. adults aged 75+ own their own homes•Less than half (42%) live w/ a spouse•About 75% of females, but only 25% of males live alone•Many are involved in seasonal migration•About 80% of those in nursing homes (or assisted living facilities) are aged 75+, and a majority of these don't have living spouses•An increasing number of older adults cohabit.•Older adults who cohabit tend to have a more stable relationship and were less likely to have plans to marry than younger adults

BFW with issues associated with retirement including conditions that encourage/discourage retirement and a balanced retirement plan.

•Conditions that encourage retirement:• Adequate retirement benefits• Compelling leisure interests• Low work commitment• Declining health• Spouse retiring• Routine, boring job •Conditions that encourage continued working:• Limited or no retirement benefits• Few leisure interests• High work commitment• Good health• Spouse working• Flexible work schedule• Pleasant, stimulating work environment

Name some problems associated with studying development in late adulthood.

•Differences b/t "age differences" and "age changes" - not just how old they are but what opportunities they had growing up•"cognitive functioning" is a relative term - depends upon what abilities are being tested and what abilities the individual used in life•Relevance of skills tested - many tests of cognitive functioning are focused toward school success. One may need different skills to be successful in school than to be successful in life.•Chronic illness affects intellectual functioning - if physical functioning is hampered, cognitive functioning is often affected as well

What are important principles of successful aging?

•Don't feel sorry for self•Try to be independent•Don't just sit there, do something•Focus on what is important•Maintain a positive outlook•Above all - be sociable

How does education and work history affect health in later adulthood?

•Education, work and health are important influences on the cognitive functioning of older adults. •Education: today's older adults were much more likely to have gone to college that those in previous generations. Many more older adults are going back to further their education than in times past.• Older adults with less education tend to show poorer cognitive abilities •Work: later generations are more likely to have worked in fields that required higher levels of cognitive processing. • Since more jobs today require higher order processing, more older adults have better cognitive skills.

How might ethnicity and gender be affected by aging?

•Ethnic minority older adults are overrepresented in poverty statistics.•They often face problems with both ageism and racism. •Older adult females often face the added burden of sexism.•Many older adults cope with these issues by increased involvement in their communities and church activities.

How are fine motor skills affected by aging? What conditions might contribute?

•Fine motor skills may begin to decline in middle to late adulthood

statistics associated with caring for aging parents.

•In caring for aging parents, daughters are more likely to give physical care and support. •Sons are more likely to give financial support •Aging adults w/ 3 or more kids are more likely to end up living w/ one of them than those who have fewer kids•80% of elderly adults have at least one kid w/in an hour's drive•75% talk to a child at least once a week

how technology use can affect the lives of those in late adulthood.

•In the last 20 years, more older adults report using the internet (59%)•Older adults in their 60's and early 70's who are more highly educated and more affluent are more likely to use the internet. As middle adults, these individuals were more likely to have had the internet as an integral part of their lives. •Older adults in their late 70's and 80's who were less educated and affluent may not have used the internet as much when younger and tend to be less proficient. •Studies have found that frequent computer use was linked to higher performance on cognitive tasks in older adults.

physical changes associated with late adulthood.

•Is a good deal of variation in levels of fitness in late adulthood •Most physical decline starts in the 30's - but by 70, one has about the same capacity for moderate exercise that had in 40's (barring any pathological aging factors) •Decreased endurance •Slowed metabolism decreases need for calories (but can lead to malnutrition if not eat enough)** Having an inactive, unhealthy early life contributes greatly to problems in old age •Changes in appearance are more pronounced (wrinkles, age spots etc.) •Loss of muscle mass •Most common marker of ageing is "behavioral slowing" - motor responses, reaction time, problem solving, memory skills and information processing are all affected.•Is more apparent in tasks requiring increased mental processing (not so much with routine tasks)

Kubler-Ross's stages of death.

•Kubler-Ross viewed the progression toward death as a series of stages. These are stages often experienced by those facing a terminal illness.•Denial•Anger•Bargaining•Depression•Acceptance

What is the difference between maximum life span and average life expectancy?

•Maximum Life Span - the upper boundary of life, the maximum number of years and individual can live. (believed to be around 125) •Average Life Expectancy - the number of years that will probably be lived by the average person born in a particular year. -US= 78 • Females= longer life span

suggestions for dealing with a dying person.

•Most psychologists believe that dying individuals should know they are dying and significant others should know that their loved one is dying • Allows individual to close their lives on their own terms• Allows them to complete plans or projects, make arrangements for survivors and participate in funeral planning• Allows individual the opportunity to reminisce and share valued information with others• Individuals have more awareness of what it going on around them. • Establish your presence - keep eye contact and make physical contact• Eliminate distractions• Keep visits brief (especially if person is frail)• Don't insist they accept death• Allow them to express feelings and be honest about own concerns• When in doubt, ask (how do you feel, what do you feel, who can we contact etc.)• Stay in the present• Listening is healing (encourage reminiscing especially if you have common memories)• Loved ones need to know they have some decision making powers• Offer any practical assistance that you can give• Don't be afraid to express emotions or say good-bye

What factors might affect the distress of survivors after a loved one's death?

•Sudden death•If loved one could not get effective pain control in last days•Physician's negligence•Use of a nursing home•If survivor experienced positive benefits of caregiving•Ambiguous loss*•Stigmatized death*

Name some factors that affect the grieving process.

•Sudden, unanticipated death•How close one is to the loved one•Available social support•Anticipatory grief

characteristics and functions of late adult friendships.

•New friendships are less likely to be developed during later adulthood unless out of necessity (death of a spouse etc.)•Friendships are more important than family relationships in predicting mental health in older adults.•Older adults with close friendships are less likely to die (prior to age 75) •Unmarried older adults with close friendships were healthier and happier than unmarried older adults with limited social outlets. •Older adults are more likely to have a close circle of friends who are the same age, gender, ethnicity, and have similar values. •Other secondary friends - those who they occasionally spend time with (playing bridge, church trips etc.) - may vary more in age and gender. •Older adults often report more favorable experiences with friends than with family members - why?•Functions of elder friendships: • Intimacy and companionship• Acceptance• A link to the larger community• Protection from the psychological consequences of loss

statistics about widows and widowers.

•Of those over age 65, 14% of men and 45% of women are widowed (5 times more women than men) •Most older men are married, most older women are not.•Women survive about 50% longer after the spouse's death than men •Widowers suffer from depression more often than widows

Specifically, how does exercise affect the health of those in late adulthood?

•Older adults who exercise regularly tend to live longer.•Both moderate aerobic and anaerobic exercise are advised for older adults - this helps to keep the body leaner, improves bone mass and strengthens the core.•Besides improving longevity, exercise in later life helps to• Prevent or decrease chronic disease• Improve cellular functioning• Improve functioning of the immune system• Slow the decline of motor skills• Reduce the occurrence of mental health problems• Improve brain and cognitive functioning

What changes occur in the brain as we age and how do these changes affect cognitive functioning?

•On average, the brain loses 5 - 10% of its weight between the ages of 20 and 90.•In healthy aging, the decrease in brain volume is due mainly to shrinkage of neurons, lower numbers of synapses and reduced length of axons - but only to a minor extent to neuron loss.•Some brain areas shrink more than others. The shrinkage of the prefrontal cortex is associated with a decrease in working memory. •Aging has also been linked to the decline in the production of some neurotransmitters.

BFW the death with dignity act and the four conditions associated with it.

•Patient has less than 6 months to live•Patient requests it 3 times•Second opinion from another doctor•15-day waiting period for patient to change mind

sexuality during late adulthood

•Physiological changes associated with aging can decrease sexual desire and performance to a degree. However, otherwise healthy older adults still desire and participate in sexual activity. •73% of 57-64 year olds are sexually active•53% of 65-74 year olds are sexually active•26% of 75-85 year olds are sexually active

issues associated with elder maltreatment.

•Risk factors for maltreatment of the elderly include the following:• Dependency of the victim• Dependency of the perpetrator• Psychological disturbance and stress of the perpetrator• History of family violence• Institutional conditions

What is the difference between selective attention and sustained attention?

•Selective attention - focusing on a specific aspect of experience that is relevant while ignoring others that are irrelevant - generally decreases in older adults. •With sufficient practice of certain skills, declines in selective attention are less pronounced. •Sustained attention - the ability to focus attention on a selected stimulus for a prolonged period of time - is still comparable with younger adults. •However, older adults who have poorer sustained attention are more likely to experience falls.

health challenges associated with late adulthood.

•The immune system experiences a mild but persistent decline w/ age. Therefore older adults are more susceptible to infections and take longer to heal.•One of the most difficult challenges is dementia (discussed later in chap) •Although the majority of elderly have some form of chronic condition, only about 34% require personal assistance w/ daily life •Only about 3% of adults 65 + reside in a nursing home. •Those age 65+ are more than twice as likely to die from unintentional injuries than adolescents. •Only about 17% of adults aged 65-75 have a disability, and the percentage of Americans with a disability stays below 50% until about age 85. •However, 80% of those over age 65 have at least one chronic health condition

What is a dying trajectory?

•The time during which the person's health goes from good to death.

BFW statistics associated with aging.

•Today almost 1 in 8 people are over age 65. (only 1 in 22 were in that age range 50 years ago) •Those who were 60 in 1997 could expect to live almost 20 more years; therefore life expectancy is around 80+ years (slightly longer for females than males) •6% of the U.S. population is over age 75•85 and over is the fastest growing segment of the population and is expected to triple in the next 15 years

What are the most common injuries to those in later adulthood? Why are these more common?

•Two of the most common unintentional injuries are motor vehicle accidents and falls.

What is "use it or lose it" associated with late adulthood?

•Use it or lose it: as other sections have alluded to, those who continue to find ways to be active mentally and physically tend to have fewer instances of cognitive decline in later adulthood.