Ch. 9 Module

Explaining Memory Changes in Old Age

-*Environmental factors* -Medications, motivation (retirement - not relying on memory as much) etc. -*Information processing deficits* -Decline in ability to inhibit irrelevant information and thoughts -Decreased speed of processing -Attention declines -Less efficient retrieval -*Biological factors* -Brain and body deterioration - especially frontal lobe and hippocampus

Hearing

-30 percent of adults between 65 and 74 have some hearing loss -50 percent of adults over 75 have hearing loss -High frequencies are the hardest to hear -Loud noises can actually be painful -Hearing aids would be helpful 75 percent of the time. Only 20 percent of people wear them. Are imperfect and amplify all sounds so it is difficult to discern conversations. Stigma attached. -Because they cannot hear, some people withdraw from society because they feel left out and lonely

Review

-Although some intellectual abilities gradually decline throughout adulthood, starting at around age 25, others stay relatively steady.  -For example, research shows that while fluid intelligence declines with age, crystallized intelligence remains steady, and may even improve, in late adulthood. -The intellect can be maintained with stimulation, practice, and motivation. -Declines in memory affect mainly episodic memories and short-term memory. -Explanations of memory changes in old age have focused on environmental factors, information processing declines, and biological factors.

Wear-and-Tear Theories on Aging

-Argue that the mechanical functions of the body simply wear out with age. -Some theories say that the body's constant manufacture of energy to fuel its activities creates by-products, which eventually reach such high levels that they impair the body's normal functioning. -Free radicals, electrically charged atoms, are produced in the cells and may cause negative effects on other cells. -This is a more optimistic theory, which suggests that longevity can be extended by eliminating the toxins produced by the body. They suggest that if a means can be found to eliminate the toxins produced by the body and by exposure to the environment, aging might well be slowed.

Developmental Stake

-Bonds between parents and children are sometimes asymmetrical, with parents seeking a closer relationship and children a more distant one -Parents see their children as perpetuating their beliefs, values, and standards -Most parents and children remain close -75% of children live within a 30-mile drive to their parents -Daughters tend to be in more frequent contact than sons -Mothers tend to be the recipient of communication more than fathers -Children may turn to their elderly parents for advice, information, and monetary help -Some surveys even indicate that older adult parents talk about their children nearly every day

What is osteoporosis?

-Bones become brittle, fragile, and thin -More women than men -Due to decreased estrogen production in women as well as insufficient protein and calcium intake in younger years -Primary cause of broken bones -Preventable with calcium and exercise. -Also medications available for prevention and treatment -Still important to get calcium and vitamin D in diet as get older. While may not be able to reverse effects of osteoporosis, can prevent further bone loss. Medication and exercise can help the side effects.

Taste and Smell

-Both become less discriminating in old age -Decrease in number of taste buds, about half lost -Olfactory bulbs in the brain shrink and reduce the ability to smell -Results in poor nutrition, loss of weight -Possibly the addition of salt and the development of hypertension -Also decreased salivation -Taste dependent on smell so loss of smell makes food taste even blander

Depression

-Characterized by intense sadness, pessimism, and hopelessness -May be a result of cumulative losses in life -Declining health may contribute -Some caused from inappropriate drug doses

Great-Grandparents

-Close relationships tend to occur only when the great-grandparents and great-grandchildren live relatively near one another -It is not uncommon for a great-grandparent who has had a large number of children to have so many great-grandchildren that they are difficult to keep track of. -Even though most great-grandparents may not have close relationships with their great-grandchildren, they still profit emotionally from the mere fact that they have great-grandchildren.

Health Problems in Older People: Physical Disorders

-Common physical disorders -Leading causes of death are heart disease, cancer, and stroke -Higher incidence of infectious disease

Refashioned Relationships

-Couples spend more time together. -Provides an opportunity for sharing household chores. -Men become more affiliative and less competitive and women become more assertive and autonomous. -Shifts in health mean that in late adulthood men and women may have to care for an ill spouse. -May provide closeness and a sense of fulfillment. -The caregiver may not be in good health either. -In most cases, the caregiver is the wife. -More sharing in household chores -Role reversals

Symptoms of Alzheimer's Disease

-Develop gradually -Start with forgetfulness -Affect recent memories first and then older memories fade. -Causes total confusion, inability to speak intelligibly or recognize closest family members -Loss of voluntary muscle control -Because victims of the disorder are initially aware that their memories are failing and often understand quite well the future course of the disease, they may suffer from anxiety, fear, and depression.

Signs of hearing loss

-Difficulty distinguishing sounds -Withdrawing from society -Increasing volume on TV or radio -Tilting head toward person speaking -Cupping hand around ear -Watching the speaker's lips -Speaking loudly -Not responding when spoken to

Review

-Elderly people live in a variety of settings, although most live at home with a family member. -Financial issues can trouble older people, largely because their incomes are fixed, health-care costs are increasing, and the lifespan is lengthening.

Review

-Erikson calls older adulthood the ego-integrity-versus-despair stage, Peck focuses on three tasks that define the period, Levinson suggests that older people can experience liberation and self-regard, and Neugarten focuses on the ways people cope with aging. -Disengagement theory suggests that older people gradually withdraw from the world, while activity theory suggests that the happiest people continue to be engaged with the world. A compromise position—continuity theory—may be the most useful approach to successful aging, and the most successful model for aging may be selective optimization with compensation.

Caring for an Aging Spouse

-Feel great frustration and even despair -View caring for an ailing and dying spouse in more positive light, regarding it in part as a final opportunity to demonstrate love and devotion -Feel quite satisfied as a result of fulfilling what they see as their responsibility to their spouse -Find initial experience emotionally distressful but distress declines as they successfully adapt to stress of care giving -Part of the reason is demographic: Men tend to die earlier than women, and consequently they contract the diseases leading to death earlier than women. -A second reason, though, relates to society's traditional gender roles, which view women as "natural" caregivers. As a consequence, health care providers may be more likely to suggest that a wife care for her husband than that a husband care for his wife.

Death of Spouse

-Few events are more painful than death of spouse -No longer part of a couple -Must deal with profound grief -No one to share life with and social life often changes -Economic changes often occur -For most - life becomes enjoyable once again

Neugarten

-Focused on the ways people cope with aging -4 personality types -Range from unable to accept and experience despair to accepting aging and maintaining sense of self-dignity -Classic study in the 70's -Neugarten found that the majority of the people she studied fell into the final category. They acknowledged aging and were able to look back at their lives and gaze into the future with acceptance.

Lesser declines associated with:

-Good health -High SES -Intellectually stimulating environment -Flexible personality -Feeling satisfied with accomplishments earlier in life

Why our Longevity?

-Improved housing, sanitation, antiseptics -Immunizations, Public Health Programs -Antibiotics, improved medical practice, nutrition, health education -Biomedical Breakthroughs

Life Expectancy

-In 1776, the average age was 35. -In 1900, the average age was 47. -In 2002, the average age was 75. -By 2050, the average age will be 80. -Health conditions are better. -Many diseases are wiped out or better controlled through medicine. -People's working conditions are better. -We are working on improving environmental conditions. -The maximum human lifespan is believed to hover around 120. -To extend the maximum lifespan would probably take genetic alterations.

What about a genetic link?

-Inherited disorder -Non-genetic factors such as high blood pressure or diet may increase susceptibility -Cross-cultural influences -In one cross-cultural study, poor Black residents in a Nigerian town were less likely to develop Alzheimer's than a comparable sample of African Americans living in the United States. The researchers speculate that variations in diet between the two groups—the residents of Nigeria ate mainly vegetables—might account for the differences in the Alzheimer's rates.

Marriage in Later Years: Together, Then Alone

-It's a man's world—at least when it comes to marriage after the age of 65. -The proportion of men who are married is far greater than that of women. -One reason for this disparity is that 70 percent of women outlive their husbands by at least a few years. -Because there are fewer men available (many have died), these women are unlikely to remarry. -Sometimes even retirement brings about divorce - too much time together

Changes in Vision

-Lens becomes less transparent - only a third of the light reaches the retina at age 60 vs 20 -Optic nerve becomes less efficient -Distant objects are seen less clearly -Need more light to see clearly -Take longer to adjust to changes in lighting -Driving at night becomes difficult -Eye strain occurs more easily (reading) -Lacrimal glands produce fewer tears - dry eyes, irritation -Lens thickens and yellows and cells within the lens lose water and begin to shrink -*Cataracts* - lens becomes opaque, diminished vision, and increased sensitivity to glare - less light passes thru lens,lens can be surgically removed and intraocular lens implants

Caring for people with Alzheimer's Disease

-Make patients feel secure in their home environments by keeping them occupied in everyday tasks of living as long as possible. -Provide labels for everyday objects, furnish calendars and detailed but simple lists, and give oral reminders of time and place. -Keep clothing simple: Provide clothes with few zippers and buttons, and lay them out in the order in which they should be put on. -Put bathing on a schedule. People with Alzheimer's may be afraid of falling and of hot water, and may therefore avoid needed bathing. -Prevent people with the disease from driving. Although patients often want to continue driving, their accident rate is high—some 20 times higher than average. -Monitor the use of the telephone. Alzheimer patients who answer the phone have been victimized by agreeing to requests of telephone salespeople and investment counselors. -Provide opportunities for exercise, such as a daily walk. This prevents muscle deterioration and stiffness. -Caregivers should remember to take time off. Although caring for an Alzheimer's patient can be a full-time chore, caregivers need to lead their own lives. Seek out support from community service organizations.

Physical or psychological mistreatment or neglect of elderly individuals

-May affect as many as 11 percent of elderly -Often stems from economic, psychological, and social pressures on caregivers who must provide high levels of care 24 hours a day -Is most frequently committed by family member

Alzheimer's disease: A step toward prevention?

-New discovery provides hope for a cure. -Scientists have identified a rare gene mutation that keeps plaque from forming in the brain, preventing the symptoms of the disease. -If a drug can be found to mimic the effects of the mutation, a cure for Alzheimer's may be found.

Grandparents

-Not all grandparents are equally involved with their grandchildren -Grandmothers tend to be more involved with their grandchildren than grandfathers; similarly, there are gender differences in the feelings grandchildren have toward their grandparents.

Review

-Older people are often the victims of ageism—prejudice and discrimination against people based on their age. -Old age brings many physical transitions, internal changes, and changes in sensory perception. -Many of the changes associated with aging can cause social and psychological difficulties for older people. -Old age brings declines in vision, hearing, taste, and smell. -The declines in the senses can have major psychological consequences.

Living Arrangements

-Only 5% of elderly end their life in a nursing home -Cost of a nursing home is ~ 60K a year -Studies indicate that older adults who were able to make their own living choice -lived longer than those who did not have a choice of where to live -66% live with other family members -Most live with their spouse -More men are married -Adjustment to living with children is difficult -Specialized living environments include - adult daycare, assisted living, skilled nursing

Considerations when assessing intellectual functioning of older adults:

-Overall health -Medications -Polypharmacy (taking excess and unneeded combinations of drugs that may cause drug interactions, toxicity, confusion, or depression) -Sensory impairments - vision, hearing -Motivation -Spiritual beliefs and Support systems -Educational level -Length of time to do tasks

Can well-being for older adults improve?

-People can do specific things to enhance their physical and psychological well-being and their longevity - their active life spans — during old age -Eat a proper diet -Exercise -Avoid threats to health, such as smoking

Daniel Levinson

-People enter late adulthood by passing through *transition stage* -People come to view themselves as entering late adulthood—or, ultimately, as being "old." Knowing full well what society's stereotypes about elderly individuals are, and how negative they can be, people struggle with the notion that they are now in this category. -According to Levinson, with age people come to realize that they are no longer on the center stage of life, but are increasingly playing bit parts. This loss of power, respect, and authority may be difficult for individuals accustomed to having control in their lives. -Serve as resources to younger individuals -Discover new freedom to do things for simple sake of enjoyment and pleasure

Planning For—and Living—a Good Retirement

-Plan ahead financially -Consider tapering off from work gradually -Explore interests before retirement -If you are married or in a long-term partnership, spend some time discussing views of ideal retirement with partner -Consider where you want to live -Determine advantages and disadvantages of downsizing your current home. -Plan to volunteer your time

Cognitive Development in Late Adulthood

-Process of aging is unique for each person -Still have the ability to be taught and remember essential information -Stimulation, practice and motivation help maintain mental abilities

Generalized Slowing Hypothesis

-Processing in all parts of the nervous system, including the brain, is less efficient -Drivers over 70 have as many fatal accidents per mile driven as teenagers -Decision process slowed - so cannot remove selves from harms way as quickly

The Biology of Alzheimer's Disease

-Production of *beta amyloid precursor protein*—a protein that normally helps the production and growth of neurons-goes awry -Produces large clumps of cells that trigger inflammation and deterioration of nerve cells

Alzheimer's

-Progressive brain disorder -Produces loss of memory and confusion -Incidence and projection -Leads to deaths of 100,000 people in U.S. each year -Nineteen percent of people 75 to 84 have Alzheimer's -Nearly half of people over age of 85 are affected by the disease. In fact, unless a cure is found, some 14 million people will be victims of Alzheimer's by 2050 — more than three times more than the current number. -The brain , and several areas of the hippocampus and frontal and temporal lobes show deterioration. -Furthermore, certain neurons die, which leads to a shortage of various neurotransmitters, such as acetylcholine.

Review

-Proper diet, exercise, and avoidance of health risks can lead to prolonged wellness during old age. -Whether death is caused by genetic programming or by general physical wear and tear is an unresolved question. -Life expectancy, which has risen for centuries, varies with gender, race, and ethnicity.

Work and Retirement

-Retirement is major decision -A disincentive is built into Social Security by having workers taxed at higher rates on both Social Security and earnings. - the earlier you retire, the less money you get -Many people continue to work full- or part-time for some part of late adulthood. -Decision based on a variety of factors including - health, burnout, employer incentives, desire to travel or spend time with family etc.

Family Relationships

-Siblings, children, grandchildren, and great-grandchildren provide an important source of comfort to adults in last years of their lives -Siblings are important because of shared life -Children often most important -Elder abuse typically involves a socially isolated elderly parent in poor health and a caregiver who feels burdened by the parent.

Intelligence in Older People

-Some abilities gradually decline; others stay relatively steady -No uniform pattern of age-related changes across all intellectual abilities -Fluid intelligence declines with age, while crystallized intelligence remains steady and may, in some cases, actually improve. -Fluid intelligence - discussed in ch 8 - reflects information processing capabilities, reasoning, and memory. -Crystallized intelligence - is the information, skills, and strategies that people have accumulated through experience which they can apply to solve problems (such as a crossword puzzle)

Genetic Preprogramming Theories of Aging

-Suggest that our body's DNA genetic code contains a built-in time limit for the reproduction of human cells. -One theory is that genetic material has a "death gene" that is programmed to direct the body to deteriorate and die. -Another theory is that genetic instructions for running the body can be read only a certain number of times before they become illegible.

Continuity theory

-Suggests that people simply need to maintain their desired level of involvement in society in order to maximize their sense of well-being and self-esteem. -Highly active and social people will be happiest if they largely remain so. Those more retiring individuals, who enjoy solitude and solitary interests, will be happiest if they are free to pursue that level of sociability. -Old age can influence their happiness and satisfaction. Those who view late adulthood in terms of positive are apt to perceive themselves in a more positive light than those who view old age in a more pessimistic and unfavorable way. -Regardless of activity level, most older adults experience positive emotions as frequently as younger individuals -Good physical and mental health is important in determining overall sense of well-being

Activity theory

-Suggests that successful aging occurs when people maintain the interests and activities they pursued during middle age and resist any decrease in the amount and type of social interaction they have with others. -Specific nature and quality of the activities in which people engage are likely to be more critical than the mere quantity or frequency of their activities. -Some people view the ability to moderate their pace as one of the bounties of late adulthood. For them, a relatively inactive, and perhaps even solitary, existence is welcomed. -Adaptation to inevitable changes -Continuing/replacing previous activities -BUT.... Neither disengagement theory nor activity theory provides a complete picture of successful aging

Dementia

-The most common mental disorder of old people, a broad category covering several diseases, each of which includes serious memory loss accompanied by declines in other mental functioning. -Signs are declining memory, lessened intellectual abilities, and impaired judgment. -Less than 2 percent of people between the ages of 60 and 65 have it; percentages double every 5 years after 65. -One-third of those over 85 suffer from some sort of dementia.

Mandatory retirement - illegal with the exception of certain public safety jobs - police, firefighters, prison guards, and pilots.

-The retirement decision is based on a number of factors. -Workers may be burned out after working all their lives. -Jobs can be frustrating and tension-filled. -Health may decline. -Incentives are offered by their company to retire early. -Desire to travel and see more of family.

Translocation Stress Syndrome

-When an elderly person is moved from a private residence to another location they experience physical and emotional deterioration. -Greater the extent of nursing home care = greater adjustment required by the person -Loss of independence may lead to difficulties -*Reduce this risk by*: -Keeping them involved in the decision about the move -Accommodate preferences and daily practices -Family and friends should continue to visit and communicate regularly

Treatment and Care of Alzheimer's

-While understanding of the causes of Alzheimer's is incomplete, several drug treatments for Alzheimer's appear promising, although none is effective in the long term. The most promising drugs are related to the loss of the neurotransmitter acetylcholine (Ach) that occurs in some forms of Alzheimer's disease. Still, they are effective in only half of Alzheimer's patients, and only temporarily. -As victims lose the ability to feed and clothe themselves, or even to control bladder and bowel functions, they must be cared for 24 hours a day. Because such care is typically impossible for even the most dedicated families, most Alzheimer's victims end their lives in nursing homes. Patients with Alzheimer's make up some two-thirds of those in nursing homes.

Signs of Visual Changes

-Withdrawal from social contact -Mismatched clothing -Decrease in reading, holding book further away -Increase in falls, stumbling, spills, bruising, and tendency to get lost

Disengagement theory

-Withdrawal is a mutual process and not necessarily -negative. -On a physical level, elderly people have lower energy levels and tend to slow down progressively. -Psychologically, they begin to withdraw from others, showing less interest in the world around them and spending more time looking inward. -On a social level, they engage in less interaction with others, in terms of both day-to-day, face-to-face encounters and participation in society as a whole. -Outcomes of disengagement are largely positive. -According to this view, the gradual withdrawal of people in late adulthood permits them to become more reflective about their own lives and less constrained by social roles. -People can become more discerning in their social relationships, focusing on those who best meet their needs. -Disengagement can be liberating.

Rising Health Care Costs

20% of income is spent on healthcare

How can we define young old?

65 to 74 years old. Many are very active members of society.

Institutionalism is brought about in part by Learned Helplessness

A belief that one has no control over one's environment. Sense of helplessness brought about by institutionalism can literally have deadly consequences.

Institutionalism

A psychological state in which people develop indifference and a lack of caring about themselves.

Vehicle Fatalities

Accidents frequently due to med side effects (slow to react, changes vision), eye disease (nighttime becomes difficult), musculoskeletal impairments - arthritis etc, confusion gas vs. brake, cognitive degeneration - Alzheimer's

The nurse is caring for residents in a long term care setting for the elderly. Which of the following activities will be MOST effective in meeting the growth and development needs for persons in this age group?

According to Erikson"s theory, older adults need to find and accept the meaningfulness of their lives, or they may become depressed, angry, and fear death. Reminiscing contributes to successful adaptation by maintaining self-esteem, reaffirming identity, and working through loss.

What is primary aging?

Aging that involves universal and irreversible changes that, due to genetic programming, occur as people get older. (Senescence)

Arthritis

An inflammation of one or more joints, afflicts roughly half of older people. Arthritis can cause painful swelling in various parts of the body, and it can be disabling. Sufferers can find themselves unable to carry out the simplest of everyday activities, such as unscrewing the cap of a jar of food or turning a key in a lock. Although aspirin and other drugs can relieve some of the swelling and reduce the pain, the condition cannot be cured.

Hypertension

Around one-third of older people have hypertension, or high blood pressure. Many people who have high blood pressure are unaware of their condition because it does not have any symptoms, which makes it more dangerous. Can raise the risk of cerebrovascular disease, or stroke, if it is not treated.

Social Support

Assistance and comfort supplied by another person or a network of caring, interested people

When is late adulthood?

Begins at 60 and ends at death

Glaucoma

Caused by too much fluid in the eye - over production or poor drainage and causes- damage to optic nerve from increased intraocular pressure - It must be detected early enough.

What is secondary aging?

Changes in physical and cognitive functioning that are due to illness, health habits, and other individual differences, but which are not due to increased age itself and are not inevitable. Can prevent or decrease effects of secondary aging by exercising, eating healthy, avoiding smoking and drugs, limiting alcohol consumption etc.

Integrity

Comes when people feel they have fulfilled the possibilities that have come their way and have few regrets. Views life with satisfaction and contentment. Ego integrity is the result of the positive resolution of the final life crisis. Ego integrity is viewed as the key to harmonious personality development. The ego quality that emerges from a positive resolution is wisdom.

Macular Degeneration

Common but slow to be detected - occurs when the macula, the most light sensitive portion of the retina, begins to deteriorate leaving only peripheral vision intact. Most common cause of blindness over age 60. If diagnosed early, macular degeneration can be treated.

What is discrimination?

Culture shapes our way of treating elderly. Identical behavior by an older person and a younger person is interpreted differently. People talk baby talk to persons in nursing homes. Most negative views are based on misinformation.

What does the respiratory system do when it ages?

Efficiency of respiratory system declines with age.

According to Erikson, individuals in late adulthood engage in looking back over their lives, evaluating their experiences and coming to terms with decisions. This is also known as ______________.

Ego integrity versus despair

3rd

Elderly *people must come to grips with their coming death* and understand that although death is inevitable, and probably not too far off, they have made contributions to society. If people in late adulthood see these contributions, they will experience ego transcendence. If not, they may become preoccupied with the question of whether their lives had value and worth to society.

Memory in late adulthood

Even when memory declines that can be directly traced to aging do occur, they are limited primarily to *episodic memories*, which relate to specific life experiences such as recalling the year one first visited New York City. In contrast, other types of memory, such as *semantic memories* (general knowledge and facts, e.g., the fact that 2 + 2 = 4, the name of the capital of North Dakota) and *implicit memories* (memories about which people are not consciously aware, such as how to ride a bike), are largely unaffected by age. Memory capacities do change during old age. For instance, short-term memory slips gradually during adulthood until age 70, when the decline becomes more pronounced. The largest drop is for information that is presented quickly and verbally, such as when someone staffing a computer helpline rattles off a series of complicated steps for fixing a problem with a computer. In addition, information about things that are completely unfamiliar is more difficult to recall.

The nurse who volunteers at a senior citizens center is planning activities for the members who attend the center. Which activity would best promote health and maintenance for these senior citizens?

Exercise and activity are essential for health promotion and maintenance in the older adult and to achieve an optimal level of functioning. About half of the physical deterioration of the older client is caused by disuse rather that by the aging process or disease. One of the best exercises for an older adult is walking, progressing to 30 minutes session 3 to 5 times each week. Swimming and dancing are also beneficial.

1st

First task in old age is that people must *redefine themselves in ways that do not relate to their work-roles or occupations*. People must adjust their values to place less emphasis on themselves as workers or professionals and more on attributes that don't involve work, such as being a grandparent or a gardener.

What is oldest old?

Frail and need care

Friendships

Friendships are very important in later life, providing social support and companionship from peers who are likely to understand the older adult's feelings and problems.

According to the ______________ slowing hypothesis, for elderly individuals processing in all parts of the nervous system, including the brain, is less efficient.

Generalized

You know you are aging when...

Grey and white hair, thinner, diminished height, he face and other parts of the body become wrinkled as the skin loses elasticity and collagen, the protein that forms the basic fibers of body tissue, cartilage in backbone becomes thinner

What is young old?

Healthy and active

What does the heart do when it ages?

Heart pumps less blood and the walls of the veins become thicker. 75 year olds heart pumps less than 3 quarters of the adult blood it pumped in early adulthood.

2nd

In second major developmental task in late adulthood, elderly individuals can undergo significant changes in their physical capabilities as a result of aging. In the body transcendence versus body preoccupation stage, *people must learn to cope with and move beyond those physical changes (transcendence)*.

Cognitive fitness and innovative therapies

Intervention that makes modifications in lifestyle factors thought to prevent the disease from getting a toehold in the first place, or at least slowing it down.

Reminiscence

Involves informal sharing of bits and pieces of the past that surface to the consciousness and involves the feeling related to the memories - thus includes effective and cognitive functions. Can trigger other memories and bring back sights, sounds, and even smells of the past.

What does the digestive system do when it ages?

Less digestive juices, less efficient peristalsis (constipation big problem for elderly).

Financial Issues of the Elderly

Many living below poverty level Some cannot afford assisted living so live with children Overall, 10% of people age 65 and older live in poverty, and 6% in near poverty

Autobiographical Memory

Memories of information about one's own life, frequently follows the *Pollyanna principle*, in which pleasant memories are more likely to be recalled than unpleasant memories. People recall material that "fits" their current self-view. Particular periods of life are remembered more easily than others.

The home care nurse is visiting an older female client whose husband died 6 months ago. Which behavior, by the client, indicates ineffective coping?

Neglecting her personal grooming

The nurse is caring for an agitated older client with Alzheimer's disease. Which nursing intervention most likely would calm the client?

Nursing interventions for the client with Alzheimer's disease who is angry, frustrated, or hostile include decreasing environmental stimuli, approaching the client calmly and with assurance, not demanding anything from the client, and distracting the client. For the nurse to reach out, touch, hold a hand, put an arm around the waist, or in some way maintain physical contact is important. Playing a radio may increase stimuli, and turning the lights out may produce more agitation. The client with Alzheimer's disease would not be a candidate for group work if the client is agitated.

Despair

Occurs when people feel dissatisfied with their life, and experience gloom, unhappiness, depression, anger, or the feeling that they have failed. The result of the negative resolution or lack of resolution of the final life crisis. This negative resolution manifests itself as a fear of death, a sense that life is too short. Despair - feel life has been too short and futile. Person wants another chance to redo life because of regrets.

Peripheral Slowing Hypothesis

Older adults' reaction time slows significantly. Suggests that overall processing speed declines in peripheral nervous system (nerves that branch from spinal cord and brain to body's extremities).

Passive-dependent personalities

Others become fearful - of falling ill, of the future, of their own inability to cope. They are so fearful that they may seek help from family and care providers, even when they don't need it.

Defended personalities

Others respond to the fear of aging quite differently-by trying to stop it in its tracks. They may attempt to act young, exercising vigorously and engaging in youthful activities. Unfortunately, they may set unrealistic expectations and run the risk of disappointment as a result.

Robert Peck

Personality development in elderly people is occupied by three major developmental tasks or challenges

When it comes to autobiographical memories, older individuals, like younger individuals, follow the ______________, in that they are more likely to remember pleasant memories.

Pollyanna principle

What is ageism?

Prejudice and discrimination directed at older people, manifested in several ways. Negative attitudes about older people, especially about competence and attractiveness. Talking to older people differently than younger adults. Job discrimination. How they function in society. culture influences how we treat the elderly - some culture, highly respected while in others, elderly may be seen as dependent so seen more negatively. Children appear most positive in their view of the elderly.

______________ aging involves universal and irreversible changes that, due to genetic programming, occur as people get older.

Primary

Ego-Integrity-versus-Despair

Process of looking back over one's life, evaluating it, and coming to terms with it. Stage begins when the individual experiences a sense of mortality. This may be in response to retirement, the death of a spouse or close friends, or may simply result from changing social roles. No matter what the cause, this sense of mortality precipitates the final life crisis.

According to Peck, the first major developmental task is to decide on your identity even though you are no longer employed. This is also known as ______________.

Redefinition of self versus preoccupation with work role

Fixed Income

Social security Pensions Savings

What is old old?

Some health problems and difficulties

Disintegrated and disorganized personalities

Some people are unable to accept aging and experience despair as they get older. They are often found in nursing homes or hospitals.

What are gerontologists?

Specialists who study aging Growth in some areas, decline in others Considerable diversity in which people change

What does the brain do when it ages?

The brain becomes smaller and lighter, reduction in blood flow to the brain, and number of neurons declines. Space between the skull and the brain doubles between age 20 and age 70.

Integrated personalities

The most successful individuals cope comfortably with aging. They accept it with a sense of self-dignity.

How can we define old old?

The old old are between 75 and 84

How can we define oldest old?

The oldest old are people 85 and older.

What is the fastest growing segment of the population?

The oldest old—people who are 85 or older. In the last two decades, the size of this group has nearly doubled. The population explosion among older people is not limited to the United States.

The Flourishing Elderly

The percentage of people over the age of 65 is projected to rise to almost 25 percent of the population by the year 2050. Because people are living longer, late adulthood is increasing in length.

The nurse is providing an educational session to new employees, and the topic is abuse to the older client. The nurse tells the employees that which client is most characteristic of a victim of abuse?

The typical abuse victim is a woman of advanced age with few social contacts and at least one physical or mental impairment that limits the ability to perform activities of daily living. In addition, the client usually lives alone or with the abuser and depends on the abuser for care.

How can we define old age?

We cannot define old age by chronological years alone; we must also take into account people's physical and psychological well-being, their functional ages.

Life Review

Where people examine and evaluate their lives. Involves deliberately recalling memories about life events; it is the life history or story in a structured, sequential, autobiographical way. It is a guided or directed cognitive process, used with a goal in mind. Life review triggered by increasing prospect of death. But sometimes life review can lead to sadness or anger if obsessive about reliving old unpleasant memories.

Explanations for changes in memory tend to focus on three main categories: environmental factors, biological factors, and ____________.

information processing deficits