FINAL

spouses

buffer each other against the problems of old age, thus extending life

How do older adults compensate for physical changes

by optimizing their relationship in other ways - companionship, affection, friendship, deep love and respect, comfort

Mourning

ceremonies, custom, behaviors that we use to express our bereavement after a death •a community process EX: viewings, crying together, gathering in a home, sharing a meal, widows wearing black for a year, funeral

Incomplete grief -

circumstances interfere with the process of grieving •EX: a police investigation, autopsy, unknown reasons for death, suicide •Mourning is cut short or delayed

Ecological validity

cognition should be measured in our natural settings and schedules

social convoy

collective group of people who age together and provide protective layer of social relations throughout life • everyone is apart of one

Elderspeak

condescending way of speakin to older adults that resembles baby talk •Use - simple and short sentences, exaggerated emphasis, repetition, a slower rate and a higher pitch than normal speech •EX: when we shout at an old person because we think they have a hearing problem

Organ donation - opinions

conflicts between religion and politics in many nations

beanpole family

consists of multiple generations but only a few members in each one

Double effect of palliative medicine

An ethical situation where the action has a good ~intended~ positive effect and an unforeseen unintended negative effect Ex: Insurance refuse to pay for palliative care if the patient has ANY treatment that is considered "curative"

Stereotype threat

Anxiety about the possibility that other people have prejudiced beliefs EX: i'm afraid that you will think that way towards me

Neurocognitive diseases

DSM-IV: - Dementia "demon" DSM-5: major or mild cognitive impairment

Ethical issues involving death?

Deciding when death occurs • death does NOTnecessarily occur when vital organs stop

Skin changes in adulthood

Skin: • drier, rougher, thinner, less flexible and less firm •Collagen decreases, age spots, tiny blood vessels showing on skin • wrinkles appear (esp around eyes)

Working memory -

Slows down and takes longer to perceive and process sensations EX: have to repeat instructions step by step

Flynn Effect

each generation gains and builds on the knowledge of the previous one We don't need to reinvent the wheel each generation! •Rise in average IQ scores occurs each decade in many nations •It is unfair and scientifically invalid to compare IQ scores of different age groups •Older adults - score lower, but that does not mean that they have lost intellectual power •Younger generation - has advantages from the previous generations

activity theory

elderly want and need to remain socially active but are forced to withdraw due to ageism and aging Not by choice nor self-imposed - they are limited from other forces Ex: others, family, physical, loss of driver's license

Stratification theories

emphasize social forces that limit our individual choice and affect our ability to function in late adulthood • our social categories "stratum" • these past social categories continue to limit our life in various ways •EX: income and ability to pay for care/help •EX: physical ability over tome

Square shape -

equal rate of replacing young to old "1 to 1" • same amount of children to older people alive

Rate of neurocognitive disorders increases with

every decade after age 60 •Ageism & ageist terms -distort and exaggerate that fact Wrong or insensitive words can be damaging and confusing

Life review

examine your whole life If viewed overall as: •Good - "Integrity" and ready for eventual death •Bad - "despair" fear and anxiety of death

family caregivers

experience substantial stress and their own health may suffer •Risks of depression increase esp if family member has dementia •In US - spouse is primary caregiver

Wisdom

expert knowledge dealing with the conduct and understanding of life •Doesn't always increase with age •EX: latent variables such as self-actualizations

sandwich generation

generation of middle aged people wo are squeezed by the needs of younger and older family members Ex: demands of children but must also take care of aging parents

personalities influenced by

genes, parental practices, culture & adult circumstances

Weathering -

gradual accumulation of stressors over a long period of time, wears down resiliency and resistance •EX: think of weathered wood.. Overtime it weakens us •Chronic stress

Older children and their perspective on death

have a more concrete operation cognition •EX: can handle more information and are less anxious and fearful

married older adults

healthier, wealthier, and happier than unmarried people at their age

unemployment

higher rates of child abuse, alcoholism, depression, and many other social problems •more stress over long term than divorce or bereavement • negative impact to mental and physical health • psychological needs unmet higher rate of domestic and substance abuse

Stereotype threat

if older people suspect their memories are fading, anxiety can impair memory EX: I can't take a test at my age!

Avoidant coping -

ignoring, forgetting or hiding it = the worst way to cope •EX: ignoring the virus being in our communities

Locked-in syndrome -

inability to move, except for the eyes BUT brain waves are still apparent (not dead)

Overall social context may impact stress.

increase or diminish it!

In ancient times, what were the consistent themes relating to death

life actions affect destiny after death • afterlife was assumed • particular prayers and offerings needed to prevent haunting from the spirit of the death EX: Egyptians were buried with items for the afterlife, preserving their organs

Useful control processes -

memory and retrieval strategies, selective attention, rules or strategies for problem solving •Less effective with age •EX: older professors having to learn how to use a computer and new software for online teaching

objects and places

more precious in late adulthood as a way to hold on to identity •EX: compulsive hoarding, cling to driving license and vehicle, or home

Traditional Pyramid shape -demographic shift

more young people at bottom and fewer older people at top "3 to 1" • more children are born than those dying

raising a child

most stressful family life experience • intimacy needs get postponed • children reordered adult perspectives and priorities • adjustment necessary •Ex: less or no alone time, sports and hobbies, sex, etc...

Intelligence is ______________________

multi-directional, multi-cultural, multi-contextual, and plastic

Do most elderly people experience a NCD?

no

frail elderly

over 65 (often over 85) who are physically infirm, very ill or cognitively disabled • frail are not the majority • eventually 1/3 will become frail before they die

what influences love

passage of time, differences in age, ethnicity, personality, education, and circumstances

Selective optimization with compensation -

people increase abilities that help them to overcome physical and cognitive losses •Maximize gains while minimizing ___losses_____ •Maximize your current strengths while overcoming or compensating for any weaknesses •EX: when motivated, there are les deficient are evident: taking your medication or watching your favorite movie

intrinsic rewards of work

personal gratification, such as pleasure in work or friendships with coworkers such as pleasure in work or friendships with coworkers EX: more important to older people

Factors influencing grandparent-grandchild relationship:

personality, ethnicity, national background, past family interactions, age, personality of child

How a person thinks of old age affects ___________________________

recovery from major illness •EX: Positive attitudes 44% more likely to recover from surgery & be completely independent than those with negative attitudes

adult children: frequency of contact

related to geographical proximity, NOT affection

Prospective memory:

remember to do something in the future EX: take my medicines? Turn off the stove?

family links

span generations and endure over time more than friendships or romantic partners BUT - family closeness can sometimes be destructive

Secondary aging

specific physical illnesses or conditions that become more common with aging, but are caused by health habits & other influences particular to that person EX: smoking and lungs, alcohol and liver, eating and diabetes Modern medicine slows down primary aging & prevents secondary aging

stagnation

stagnant, failed, stuck, personal impoverished Ex: don't care about the next generation, only about themselves Ex. Infertility when you want a family??

U.S. trend is "aging in place"

staying in our homes for as long as possible

marriage

still a major life event • less common now •Married people - are a little happier, healthier and richer than never-married ones ... but not by much

Childhood perceptions of death

• different perspective on death than adults •EX: don't say a dead person is "sleeping" - anxiety and fear about sleeping

Contemporary religions and death

• each faith has diverse practices EX: Hinduism, Island, Buddhism, Native Americans, NA Christians

stratification by ethnicity

• ethnicity affects every aspect of development • lifelong •Includes education, health, place of residence, and employment •EX: discrimination, racism, certain areas of the US, other countries, limit opportunities

erikson's integrity vs despair

• final stage of developmental • seek to integrate their unique experiences with their vision of community •EX: life review, acceptance of death or anger and bitterness in life

Maslow's Self-actualization & Self-transcendence

• last needs in hierarchy •Characterized by aesthetic, creative, philosophical, spiritual understanding and helping others

stepparents

• more complicated than they expect • changes are disruptive for children • effects are cumulative • major problems with attachment both ways

foster parents

• most difficult form of parenting • focus on emotional and behavioral needs of children • require intense involvement, support, and resources

grandparents

• opportunity for generativity • often enjoy their roles

Our reactions to death are filtered through:

• our culture, history, region and the age of the deceased and those grieving

Describe when modern medicine makes a bad death

• people submit to surgery and drugs prolong pain and confusion - especially when a cure is not possible • Hospital restrictions make dying in peace more difficult

Personality Traits: Age

• personality shift slightly with age • general trend is more to become more POSITIVE with age • our traits become more stable •EX: self-esteem improves over time

Hospice caregivers

• provide skilled treatment to relieve pain and discomfort • measure to delay death are avoided (NOT stopping death) • focus is to make dying easier • also provide support to the family

Auditory Problems in old age

• small and sensitive hearing aids are available •BUT many people resistant to getting them • missing out on bits of conversations cuts down on communication and precipitates other social loses EX: miss vital information from doctor, family, etc.

Intimacy varies by culture, age & personality:

• social beings versus loners •EX: tendency to live in isolation in caves, wilderness OR having contact with others for different needs.. Like family, doctors, groceries

Maslow's hierarchy of five needs

•" pyramid " • 5 levels •added a 6th later on "self-transcendence" •Satisfy needs enough to then be able to move on to the next need •You don't need to meet each need 100% to focus on the next need •EX: thirst and hunger

romantic partners

•"Intimacy" - implies sexual intimacy BUT includes more than romance •Adults seek - committed sexual partnerships •Partners help meet - needs for intimacy, raise children, share resources and provide care when needed

Stratification by income

•*Most harmful - Financial - directly from poverty •Negatively affects our well-being •Followed by gender and ethnicity stratums • income correlates with all 3 but is not caused by them •EX: money to access care and medication, save for your future, or lower pay related to gender and ethnicity

Stressor - external stress - internal stress - disasters

•- ANY situation, event or experience that causes a person to feel stressed •External (Covid-19) - internal (increased anxiety thinking we're all going to die) •Disaster - unexpected events from nature (flood, earthquake) or nurture (war, bombs, epidemics) these are increasing •Globalization & high speed communication adds stress far from events & may contribute to the cumulative stress. • personal stressful event are more common (tests, bills) • Every life has many minor stresses

activities in late adulthood: home

•2 Favorite activities - take care of home and garden •Demonstrate "age in place" - remain in home and community in later life • need to adjust BUT not leave when health declines • •EX: handrails, ramps, walk in shower, meals on wheels, groceries, medication delievered

grandparents

•85% of US age 65+ are grandparents

Most bereaved people recover within a year:

•A feeling of having an ongoing bond with the deceased is no longer thought to be pathological. •First year is often the most difficult - 1st holidays, birthdays, anniversaries without them

near-death experience (NDE)

•A person - comes close to dying BUT survived and reports having left his/her body • often moved toward a bright white light while feeling peacefulness and joy •Often includes RELIGIOUS elements •Survivors - have a more spiritual and less materialistic view of life •--> may prove there is a heaven?? OKAY •Scientists - skeptical, neurological brain response to reduces in oxygen in the brain

Controversial ethical issues with physician-assisted suicide

•Acceptance varies by culture, religion, education & local values •Some states in the US - allow physician-assisted suicide

Activities of daily life (ADLs)

•Actions important for •5 tasks of self-care: eating, bathing, toileting, dressing, and moving from bed to chair •Inability to perform any - signs of frality

Instrumental activities of daily life (IADLs)

•Actions important to independent living AND require intellectual competence and forethought

" Right to Die " laws

•Age requirements - adult over 17 •Resident requirements - have to live in the state for a certain period of time •Request in writing - you NEED documented proof •Process that allows for time to pass - allows you time to make SURE •Be diagnosed with a terminal illness (<6 months to live) - giving you a god reason •Person is competent - and able to make this decision •Current states - CA, CO, HI, OR, MT, VT, WA

changing locations

•Hiring and firing - more common •Every change - severs friendships, adds stress •Age discrimination - less likely to be hired or promoted •EX: loss of seniority

Prevention and care for the frail

•If IADL problems are worse ADL problems - family and community involvement is crucial •Social support networks - prevent physical and mental decline • safeguards and education helps

Illegal drug use in adulthood

•Illegal drug abuse decreases over adulthood •But abuse of prescribed medication increases •Opioid deaths - increased every year past 10 years.. Especially for 26-44 year olds

Immigration paradox: and health!

•Immigrants are usually healthier, yet poorer than native-born people of the same ethnicity (ex: less heart disease, drug abuse, obesity and birth complications) •As education level increases, income and English fluency increase among immigrant children, so does every illness!

Adolescence & Emerging Adulthood perspective on death

•Teenagers - little fear of death •Adolescents - often predict dying young and have a tendency toward risk-taking that can be fatal •Romanticizing death - makes people more vulnerable to cluster suicides, foolish dares, fatal gang fights and drunk driving

Reactions to death vary ...

•Tell people what you specific need or ask the person what they need •Don't expect other to grieve the same way you do •Be responsive to their needs & requests •Grief is better handled when markers or rituals are observed

Andropause

•Testosterone levels drop in older men •Normally results in a reduction in sexual desire, erections, & muscle mass •Treatment •Drugs (e.g., Viagra, Levitra)

Work

•varies during this time •Volunteer work - psychological benefits • provides social support and status • boosts self-esteem and sense of purpose • employment allows generativity • additional income health benefits for FT work

Old-old

Old-old - suffer losses in body, mind, or social support •BUT able to care for themselves

3. Cellular aging theory

•the ways molecules and cells are affected by aging - Hayflick limit - telomere impacts

3 "types" of old

1. Young-old 2. Old-old 3. oldest-old

Name some examples of visual issues that occur with old age

(a) normal vision (b) cataracts (c) glaucoma (d) macular degeneration

Two principles for hospice care:

1. each patient's autonomy and decisions are respected 2. Family members and friends are counseled before death, shown how to provide are and helped after the death

What increases practical intelligence?

- Experience increases practical intelligence • needed in adult life • cannot by assessed by abstract tests •Crucial on the job - probationary periods. Internships and apprentices are common

Hospice

- an institution/program that provides palliative care to terminally ill patients

universally humans are

- healthier with social support and sicker when socially isolated

Cremation, autopsy & organ donation practices depend on what

- these depend on local norms and religious authority

cohabitation

- varies - preference for many people - common in emerging adulthood - SES and gender differences -à woman normal push for cohabitation

_________ of adults are obese

-1/3rd of them are obese -the increase in obesity rates cannot be solely blamed on genes cultural influences = important

Psychoactive drug prescriptions in adulthood

-12% of young adults -20% of _ older__ adults -Such as antidepressants + OTC drugs: widely used, no actual tally of them

Adult diet in the United States:

-Obesity - increases risk of almost every disease -EX: diabetes - we gain about 1-2 pounds a year -Metabolism decreases by 1/3 between ages 20- 60

Palliative care is care designed to provide

-Physical and emotional comfort to the patient -Support and guidance to his/her family -NOT treating the illness

Population of 65+ in these countries in 2015: -United States: -Canada: -Italy: -Japan:

-United States: 15% -Canada: 16% -Italy: 22% -Japan: 26%

living apart together (LAT)

-steady romantic partner - monogamous - separate residencies and activities - sexually faithful - BUT tend to struggle with separate financial aspects of the relationship

2 foundations for wellness

. Sleep: • spend more time in bed, take longer to fall asleep, and wake frequently •BUT they feel less tired than young adults when on their own schedules • they need less sleep 2. Exercise: • exercise less than younger adults do • movement of any kind is better than sitting • regular exercise can reduce illness and decline in health •BUT accommodation to disability may be needed to allow them •EX: hand railings, smooth bike paths, no steps, easy access

3 forms of intelligence according to sternberg

1. Analytic intelligence 2. Creative intelligence 3. Practical intelligence

Changes that occur as we grow older

1. Breathing •Lung - capacity declines •Ex - heavy smokers and obesity 2. Sleep - crucial to health 3. Naps - good and bad 4. Senses Vision - peripheral vision narrows before frontal vision and our lens shape changes Hearing - high frequencies lost before low ones

elder abuse is less likely if

1. Care is introduced in timely and appropriate manner 2. Staffing and supervision are adequate 3. Public and personal safety nets exist

STAGES OF DYING (Elisabeth Kübler-Ross identified emotions & stages experienced by dying people)

1. Denial "I am not really dying." 2. Anger "I blame my doctors, or my family, or God for my death." 3. Bargaining "I will be good from now on if I can live." 4. Depression "I don't care about anything; nothing matters anymore." 5. Acceptance "I accept my death as part of life."

Where can we reverse Neurocognitive Disorder?

1. Depression treatment 2. Address malnutrition and dehydration 3.Polypharmacy - taking too many medication, so reduce or adjust

paid work and retirement

1. Need money and appreciate the social recognition and self-fulfillment •EX: gaps in financial resources • 2. Increases health and happiness of older adults • •EX: social support from co-workers, purpose, benefits, income 3. Some employers provide "bridge jobs" to retiring • •EX: part-time, reduced hours, St Vincent does this

common problems for caregivers

1. if one adult child is primary caregiver, other siblings tend to feel relief or jealousy 2. care receivers and givers often disagree about their schedules, menus, doctor visits, etc 3. resentments on both sides disrupt mutual affection and appreciation 4. public agencies rarely provide services unless an emergency arises

3 theories of aging

1. wear and tear theory 2. genetic theory 3. cellular aging theory

Stages of Alzheimer Disease:

1.Forgetfulness, especially for recent events or new information 2. Generalized confusion 3. Dangerous memory loss (leaving stove on) 4. Impaired communication 5.Unresponsiveness

3 aspects of Sternberg's romantic love

1.Passion - sex, strong feelings 2.Intimacy - emotional connection, make love 3.Commitment - promises, most crucial, correlates with health and happiness throughout life

Maslow's Hierarchy of Needs and DEATH

1.Physiological needs - freedom from pain and suffering 2.Safety - safe and not abandoned 3.Love and acceptance - from close family and friends 4.Respect - from caregivers and others 5.Self-actualization - lived to their full purpose, good life review 6.Self-transcendence - able to help others, and often seek to comfort others as they are the ones dying

4 Types of involvement from least to most:

1.Remote - hardly see them 2.Companionate - fun grandparent 3.Involved - help with care 4.Surrogate - in parenting roles

6 characteristics of a good death

1.The end of a long life 2. peaceful 3. quick 4. familiar surroundings 5. with family and friends present 6. without pain, confusion or discomfort People in all religious & cultural contexts hope for a "good death"

elder abuse is more likely if

1.caregiver suffers from emotional problems or substance abuse 2. care receiver is frail, confused, and demanding 3. Care location is isolated

lifeline if

1.rejected by original family - toxic, abusive 2.isolated far from home - moved, immigrants, college 3.changing family habits - addiction, recovery, illness

_______ of adults are overweight

2/3

200 yrs ago - we had 20x more ______________ than people over ___________

200 yrs ago - we had 20x more children under 15 than people over 64 -more children born and fewer older people alive - Now - only 3x as many children to 65+ Projected to be in 2075: 1:1

Adulthood age range

4 decades from 25-65 years old

Often 35-65 year olds feel ________ younger than their chronological age

5 - 10 years younger! - most adults consider themselves to be strong, capable and healthy

________ of the world's prescribed drugs are taken by the U.S. population and we pay the most for them

70-85%

World's population 65+ in 2015

8%

Does ageism impair daily life? How?

Ageism impairs daily life - prevents older people from seeking help because they resign themselves to infirmity EX: I don't have anything to contribute to society now

Changes in agility in adulthood

Agility: Reduced - strength agility and speed

What happens to the brain with age?

Brain slows down and shrinks EX: takes longer to read (eyesight), talk (thinking), reflexes (driving), small and large motor skills

Compensation in the brain

Cognition - can improve with exercise, eating well and avoiding drugs •Use other parts of their brain to problem solve

Symptoms of "unbearable suffering"

Fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness, & being tired of living a life of unbearable suffering

Source amnesia:

Forget the origin of a fact, idea or conversation EX: who said it, where did I read it?

Hair changes in adulthood

Hair: • begins to turn gray and thin •Men - balding

Each culture has its own concept of __________________

INTELLIGENCE •Cognitive artifacts - intellectual tools (writing and reading) passed on to the next generation to foster learning •Aids in - survival and longer life •EX: US computer and internet skills now vs Congo poisonous plants and animals information ... survival??

General intelligence -

Intelligence is one basic trait, underlying all cognitive abilities

What happens with Parkinson's disease?

It is an NCD It begins with impaired motor control before impaired •EX: Parkinson's Disease

Where do most people actually die, despite their preferences?

Most die - in an institution, surrounded by medical personnel & high-tech equipment hospital = 35.9% nursing home = 19.3%

Can intelligence be measured directly?

NO, •Intelligence cannot be measured directly BUT can be inferred from various abilities (latent variable) - Can I look at you and know that you are intelligent? •Many scientists seek to find 1 common factor of intelligence = IQ tests • •EX: testing for vocabulary, memory, reasoning, ability

Diseases in adulthood - changes in health in adulthood

Our habits before age 30 affect our health after age 60: -Cancer -Pollution -Neighborhood stress -Genes • Some adults become healthier - it is not too late to make healthy changes •EX: Noom App - behavior modification •Attitudes - can influence health Ex: happiness, menopause

Programming

Part of information-processing system that consists of methods for regulating the analysis & flow of information in our brain

relationships with younger generations

Past centuries - most adults died before their grandchildren were born Today - families span 5 generations

What provides variances in longevity?

Personal choice & social context - provides variances in longevity • gradual physical decline - Body becomes less strong and efficient • aging differs for all of us but we live within a certain range •120, 130 year olds??

Where do most people prefer to die?

Preference - to die at home surrounded by loved ones

Seeking Meaning when death occurs

Preserving memories - photographs, stories •Close family members - comfort and understanding •Support groups - specific reasons in common, cancer, suicide •Organizations & Charity - when someone dies... starting a charity or donating to one

Primary aging

Primary aging - universal & irreversible physical changes that occur in all living creatures as they age EX: bodily changes Modern medicine slows down primary aging & prevents secondary aging

Effects of regular exercise in adulthood

Regular exercise - • protects us against serious ailments • even those who smoke, drink and overeat! •Strengthens immune system

Changes in shape in adulthood

Shape: • "middle age spread" ex: "menopot"/"sparetire" • posture change and reduced height • muscle atrophy, joint flexibility decreases, stiffness

Active euthanasia -

Someone takes action to bring about another person's death - with the intention of ending that person's suffering •Legal under some circumstances - Netherlands, Belgium, Luxembourg and Switzerland •Illegal yet rarely prosecuted in most other nations Ex: provide a lethal dose of medication for the patient to take

Medication in the U.S. = prescriptions

Take at least one prescription: -39% of 25-44 year-olds -66% of _45-64__-year-olds - about half of prescriptions are for chronic conditions, such as high blood pressure

Does marriage lead to personal happiness?

TedTalk video on long term study: •Increases happiness of a community •Improves health, wealth & happiness •Varies by gender, education & age BUT must note confounding variables: •make it difficult to control for all variables •which variables have a "cause & effect" relationship

Senescence -

The process of aging • our genetic codes are specific for every species • human genes provide a range for us to live within •EX: we live longer than dogs but less than some tortoises

What is the "slippery slope" associated with "right to die" laws?

The slippery slope - will this eventually allow society to kill sick people who aren't ready to die, like the old and poor? EX: the right to die OR the right to kill/murder?

Bereave

To deprive of something, to take away by force

Tobacco use in adulthood

Tobacco: • cigarette harm is dose-related •Influences - vary by cohort and culture •Causes more deaths than any other drug •Usage has decreased in the last half century but seeing rise of e-cigarettes and are vaping now •Poor nations - increases with income as they can now afford to buy cigarettes

Selective Optimization with Compensation

We "select" ways to "optimize" what skills we still have that "compensate" for what we don't have Increase our strengths to overcome our weaknesses EX: paralyzed person gains greater arm strength EX: loss of sight overcome with increase in hearing and smelling Three our text focuses on: 1.Sex - personal thinking and behavior 2.Driving - community laws and practices Medical - bodily changes

Absent grief

When we don't allow ourselves to grieve and we withdraw from others and the community... we isolate EX: a personal choice.. Medicated, anger

social compensation in old age with driving

With age - reading road signs takes longer, turning the head becomes harder, reaction time slows, night vision worsens Compensation - many drive slowly and reduce driving in the dark Society-wide initiatives - changes in driver license renewal laws, larger road signs, verbal directions with waze app

gender differences in divorce

Women - suffer more than men, esp financially, end up with expenses of house and children Men - loss of companionship and social interaction, but better financially

Advance directive

a document that has an individual's instructions for dying or after EX: medical, funeral/burial and DNR

Health care proxy

a person chosen to make medical decisions if a patient is unable to do so

Coma -

a state of deep unconsciousness and person cannot be aroused... can awake spontaneously (improve) or enter a vegetative state (worsen) - not dead!

Vegetative state -

a state of deep unconsciousness, all cognitive function are absent, eyes may still open, sounds may be emitted and breathing may continue - the person is not yet dead •Can be transient (in and out), persistent or permanent •No one has ever recovered - after 2 years •Most recover - about 15%, improve within 3 weeks •After time has elapsed, the person may be considered "DEAD"

Emotion-focused coping -

a strategy to deal with stress by changing feelings and interpretation about the stressor rather than changing the stressor itself •EX: take time to get projects done around the house, declutter, catch up on HW and work, rest, reconnect with family

fictive kin

accept as family but no genetic or legal relationship to the family

When do new neurons form and dendrites grow ?

adulthood New neurons form & dendrites grow in adulthood: •Olfactory region - smell •Hippocampus - remember Old neurons can develop new dendrites!

Who contribute more to society than any other age group (working years!) ?? -

adults 26-60

generativity

adults seek to be productive in a caring way (create, care, vs. reject, selfish) •Satisfy this need thru: parenthood, caregiving, and employment •Chief manifestation - establish and guide the next generation "generate" •EX: have and raise children "next generation"

adult children: assistance

arises from need and from ability to provide it

Disengagement theory

aging shrinks our social life • results in role relinquishment, withdrawl, and passivity Can be by choice & self-imposed

Physician-assisted suicide -

an active euthanasia in which a doctor provides the means for someone to end his/her own life -Conflict with ethical and medical oath to do no harm -Illegal in some states/ countries

When do most cases of alzheimer's disease occur

begin much later and many genes have some impact

Oldest-old

dependent, relatively few

Problem-focused coping -

developing a strategy to deal with stress by tackling a stressful issue directly •EX: hand-washing, social distancing, sanitizing, masks

Destructive protection

discourage the elderly from leaving home, thus contributing to ageism EX: you don't have anything to contribute to society now

Physical & mental health is closely connected and influenced by

family, friends and community

familism

feelings and desires to seek out relatives Ex: want family contact

Reverse Pyramid -

fewer young people at bottom and more older people at top • fewer children are born and more older people living longer

Describe when modern medicine makes a good death

for most people, death occurs at the end of a long life • illness is often treated effectively • death at a young age is often quick

Erikson's final stage: integrity and dispair

gain interest in the arts, children and human experience as a whole

Practical intelligence

intellectual skills used in everyday problem solving - kitchen, around the home, school , ADLs -------------------- •Adaptive actions •Understanding and assessing daily problems •Applied skills and knowledge •Adaptability •Concrete knowledge •Real-world experience •Performance in real situations •"Street smarts"

Creative intelligence

involves capacity to be flexible and innovative ------------------ •Imagination •Appreciation of the unexpected or unusual •Originality •Vision •Intellectual flexibility •Originality •Future hopes •Inventiveness •Innovation •Resourcefulness •Ingenuity

Analytic intelligence

involves logic, planning, strategy selection, focused attention and information processing -Valued in high school and college -Students are tested - Analyzing questions to get the answer ---------------- •Abstract planning •Strategizing •Focused attention •Verbal skills •Logic •Analyzing •Learning and understanding •Remembering •Thinking •Multiple-choice tests •Brief essays •Recall of information

Major Neurocognitive Disorders (NCD) -

irreversible loss of intellectual functioning caused by organic brain damage or disease (formerly dementia) •Normal with age (we expect it to happen) •BUT it is abnormal and pathological even in very old age

Older people are most likely to estimate that their own functioning is ___________________--

is BETTER than the average older person. •EX: Memory, speed, making new friends

Autopsies opinions

legally required versus a religious sacrilege (mutating the dead body)

disabled elderly

less depressed and anxious if they are in a close marital relationship •EX: tedtalk video in long-tern research of men •Ex: think about ourself, it is generally always better when we have someone with us when times are rough

kinkeeper

main family member who gathers the family and communicates for family system Ex: role is to keep family connected Who is it in your family?

Alzheimer Disease (AD)

major NCD •Characterized by - gradual deterioration of memory and personality •Can be modified by - education (use of cognitive reserve) •Is partly genetic

Frail elderly

me after 2 vodka crans

Smaller friendship circle

not a problem if a person has at least a few close friends •Much harder for those who were more physically, emotionally, or financially dependent on spouse & then loses them

consequential strangers

not in a person's closest friendship circle but can have an impact EX: informal social support, contact with neighbors, people at an activity, church

Hayflick limit -

number of times cells can divide is limited

•Average life expectancy -

number of years average person in a population group are likely to live •Ex: humans 122 years

divorce

occurs when one partner believes that he/she would be happier without the other •1st marriages - since 1980, more than 1/3rd end in divorce •Subsequent marriages - increase odds of divorcing again

Socio-emotional selectivity theory

older people regulate emotions & seek familiar social contacts who reinforce generativity, pride & joy • selective optimization with compensation • maintaining the self is central •EX: increase strengths to make up for weaknesses

Maximum life span -

oldest possible age for a species •" genetic clock "

Neurogenerative disease rates?

only 1 in 20 does & most of those who reach 90-100 do not suffer significant cognitive decline

Grief "normal grief"

powerful sorrow that we feel at a profound loss in our lives •an individual process EX: crying, missing the person, our memories, cemetery visits

Intellectual skills used in everyday problem solving

practical intelligence

Self-fulfilling prophecy

prediction that comes true because we believe it to be true EX: i'm going to fail a test

Ageism

prejudice where we categorize and judge people based on their age •People seen as a category & not as individuals •EX: "old" vs "you are still able to work"

Vascular disease

progressive loss of intellectual functioning caused by repeated strokes or temporary obstruction of brain blood vessels •Series of stokes (transient ischemic attack "TIA")

Brain death -

prolonged cessation of all brain activity with complete absence of voluntary movements, no spontaneous breathing, no response to pain, noise and other stimuli - No brain waves and EEG is flat

AD in middle age

rare, usually caused by genes and progresses quickly

Settings

safe, social, respected, and as independent as possible

filial responsibility

sense of obligation of adult children to care for aging parents •major goal in US - self-sufficiency •Common - adult children offer support but parents resistant to accepting it

Frontotemporal NCDs

serious impairment of frontal lobes •Most common, 15% of all U.S. NCDs cases

Passive euthanasia -

seriously ill person is allowed to die naturally, through the cessation of medial intervention EX: request DNR, no life-saving medications or treatment

Senility

severe mental decline due to old age

Demographic shift

shift in proportions of various ages

Compression of morbidity

shorten the illness before death EX: personal habits, medications, therapies, surgeries

Living arrangements

should focus on selective optimization with compensation

Polypharmacy

taking too many medication, so reduce or adjust

extrinsic rewards of work

tangible benefits, usually in salary, insurance, pension, and status EX: more important to younger people

positivity effect

tendency to perceive, prefer & remember positive images & experiences more than negative ones •Selective memory compensates for our troubles •Unpleasant experiences can be reprocesses as insignificant

Young-old

the largest group of older adults • healthy, active, financially secure and independent

Bereavement

the state of being bereaved, our sense of loss that we experience following a death

self theories

theories of late adulthood that emphasize the core of self • search to main one's integrity and identity

Changes in Death in the Past Century:

• death occurs later • dying now takes longer • death often occurs in hospitals • the causes of death have changed • and after death...

Living will

this is a document of medical interventions an individual wants or does not want if they are incapable of expressing their wishes EX: unconscious, coma, unresponsive

Sexually active older adults -

those in good health have sexual intercourse within the past year •Sexual needs & interactions - varies greatly •Sexual activity - more a social construction than a biological event, still able •Women - decrease in arousal •Men - decrease in ability

Telomeres and aging

tips of chromosomes that reduce each time cells divide

5 Common Causes of pathological brain changes:

traumatic brain injury, poor circulation, viruses, genes, substance abuse

Crystallized intelligence

type of intellectual ability that reflects accumulated learning •Such as: vocabulary and general information •Build on previous knowledge more about CONTENT (facts)

Fluid intelligence

types of basic intelligence that make learning quick and thorough •Such as: working memory, abstract though and speed of thinking • Quick, flexible and helps us learn anything •More about the PROCESS

Elders who never married

usually content, not lonely

Elderly people who have spent years without a partner

usually have friendships, activities, and social connections

Social support

utilize others to cope with stressors Gender differences: •Men - problem solve, fight or flight •Women - emotional focus, tend-and-befriend •à genders are more alike than different and need both types •

Types of care

very inequality, availability, and cost

Sensory threshold

what is actually sensed and what is not

consummate love

when all three are evident, "ideal relationship"

empty nest

when children leave the family home to pursue their own lives

Disenfranchised grief -

when someone is prevented from participating in the mourning process •EX: ex-wife, ex-husband, ex-lover, estranged or cut-off family members are now allowed to come to the funeral or viewing

DNR (Do not resuscitate) -

written order from a physician to NOT revive a patient if he/she suffers cardiac or respiratory arrest EX: written order in a patient's chart at a patient's advance directive or health care proxy's request

Erickson's stages

• 8 DEVELOPMENTAL STAGES • 3 STAGES IN ADULTHOOD BUT the adult stages are less age-based •Adolescent stage (5th stage) of identity v. role confusion - can linger into adulthood •EX: more varied in adulthood - age of marriage, first child or retirement

In vitro fertilization (IVF)

• Ova (egg cells) are surgically removed from a women are fertilized with sperm in a laboratory •After fertilized cells (zygotes) divide several times, they are artificially inserted into a women's uterus by a physician

Assisted Reproductive Technology (ART)

• advances in medicine have solved about half of all fertility problems •Helps overcome obstacles such as a low sperm count and blocked fallopian tubes

Evidence of death controversy?

• cessation of brain waves? • no spontaneous breathing •Current criteria - several tests of brain functioning

Most older people - see that their personalities and attidues remained stable over their life spans

•BUT - recognize their bodies have physical changed •EX: appearances change but personalities are the same

1. Wear and tear theory of aging

•Body suffers from overuse, weather, harmful food, pollution and radiation • theory discounted •Calorie restriction - reduces calorie intake which has shown to increase life span in some species and situations

Pathological Changes in the aging brain

•Brain - shrinks and slows down • slower firing of neurons • slower reaction time • still some growth and development • myelination reduces • significant brain loss before 65? = Only 1% Pathological means "disease-connected", not the result of normal aging:

personality traits: cohort

•Cohort affects the interaction betw/ personality and behavior •EX: number of children in families changes from 1920-1960 •How might being in a smaller family with fewer siblings or only children affect our personalities s a large family with numerous siblings? Sharing/ helping others etc

Placing Blame when death occurs

•Common - medical mistakes, laws not enforced, unhealthy habits not changed •Who to blame? - the dead person, others, ourselves •Nations - blame one another for public tragedies (not necessarily rational)

friends

•Crucial members of social convoy •Differences between friend & casual acquaintance

activities in late adulthood: religious involvement

•Decline in - attending religious services •BUT increase in - faith and prayer Religious institutions fulfill many needs: • rules and rituals encourage good habits • faith communities promote caring relationships • beliefs give meaning to life and death and reduces stress

theories of late adulthood

•Development - greatly varied than at any other age •Social scientists - try to understand these variations and paths of old age •Ex: run marathon and lead nations while others can no longer move or think •Frail 60 year old or spry 90 year old

Socioeconomic status (SES) and health

•Differences are apparent within every nation • well-educated, financially secure adults live longer •EX: better healthcare, better food, less stress of basic needs being met (Maslow's hierarchy of needs)

Actions & attitudes & the Big Five: correlations found in research

•Education - conscientious people are more likely to complete college •Cheating on exams - low on agreeableness •Marriage - extroverts more often marry •Divorce - more likely for neurotics •IQ - higher in openness •Verbal fluency - openness and extroversion •Political views - conservatives are less open

Infertility in adulthood - why is the date set at 2 years and not 1?

•Failure to conceive a child after trying for at least a year •Controversy to one year... some thing it should be 2 years •Why one year versus 2 years?? Why gains from having it be less?? •- puts more stress on couples if you say 1 year

parents and adult children

•Family separation - can strengthen relationships •While living together often - weakens it •Poorer nations - living together related more to poverty than affection •Happiness - strongly affected by adult child well-being •Research - parents provide more financial and emotional support to adult children than vice versa

Output of information in our brain:

•In daily life - output is usually verbal •Output on cognitive tests may not accurately reflect actual ability •Abilities measured - should be ones needed in real life •EX: testing someone is laboratory or doctor's office versus having them actually cook a meal/drive a car

What is a bad death?

•Lacks the 6 characteristics of a "good death" •Is dreaded!

2. Genetic theory of aging

•Maximum life span - oldest possible age for a species •" genetic clock " •Average life expectancy - number of years average person in a population group are likely to live •Ex: humans 122 years

Menopause

•Menstrual periods cease completely •Usually by age 50 •Production of estrogen, progesterone, & testosterone drops considerably •Treatment •Hysterectomy •Hormone replacement therapy (HRT)

Exercise as you grow older

•More adults 51% meet the U.S. weekly goal of 150 mins minutes of moderate or 75 minutes of intense exercise than 15 years ago

Expert cognition

•More skilled and knowledgeable than the average person about a specific interest - Personally meaningful interest - More intuitive, automatic, strategic and flexible in their chosen field Expertise & age: - task-related - practice improves our abilities - motivated to do a good job

Where is infertility most common?

•Most common in nations where medical care is scare and STIs are common •12 % of U.S. couples are infertile • partly because many postpone childbearing •Involves factors that impair physical functioning: - male infertility female fertility

Honest conversations with people who are dying

•Most dying people want to spend time with loved ones •Talk honestly with medical & religious professionals •Unethical to withhold information if the patient asks for it •Some people do not want the whole truth •Hospital personnel - NEED to respond to each dying person as an individual, not merely as someone who must understand that death is near

Barriers to hospice care

•Must be terminally ill •Death anticipated within 6 months •Must accept death •Must stop curative care •Is very costly •Availability varies greatly - from region, agency, & even provider •Ethnic differences influence

acquaintances

•provide information, support, social integration, and new ideas • peripheral friends decrease due to personal choice and social context • decrease with age

Research identified 5 clusters of personality traits in every culture & era

•O - Openness - curious, creative, open to new experiences •C - Conscientiousness - deliberate, thoughtful •E - Extroversion - outgoing, assertive, active •A - Agreeableness - kind, easygoing, helpful •N - Neuroticism - anxious, moody, critical

volunteer work

•Offers generativity and social connections • strong link between health and volunteering • older adults are less likely to volunteer than middle aged employed ones • only 23% of 65+ volunteer •EX: usually the ones who are financially okay and physically able to help others • •Remember - Maslow's hierarchy of needs with self-actualization & self-transcendency

How does personality have a major effect on grief and mourning?

•Only 10-15 % exhibit extreme or complicated grief General trends •Past marriages - were idealized •Thoughts of dead spouse gradually decrease

disengagement positive and negative reasons

•Positive - don't want to burden others, more self-reflection •Negative - cut off needed resources and support EX: loss of family, friends, coworkers, support system as we age, limited social support and resources

consequences of divorce

•Reduces - income, severs friendships and weakens family ties • lasts for decades •Children - negative and positive • impacts income and family welfare BUT can sometimes lead to - stronger and warmer parent/child relationships

Four types of responses after a death

•Resilient - 66% (2 out of 3) •Depressed - 15% •Less depressed after death than before - 10% •Slow to recover/complicated grief - 9% (1 in 10)

Prevention of Impairment

•Severe brain damage cannot be reversed •Although the rate of decline & some symptoms can be treated •Education, Exercise, Good health can overcome mild loss & prevent worse ones

Sexual responsiveness in adulthood

•Sexual arousal is slower and orgasm takes longer • distress at slower responsiveness •But, some say sexual responses improve with age •Increase in sexual satisfaction and physical pleasure better know your body and its responses

adult children: gender differences

•Sons - feel stronger obligation •Daughters - feel stronger affection

changing schedules

•Standard 9-5 schedule - decreasing •Nonstandard schedules - 1/3 of U.S. workers •Non-standard shifts - cause stress for families and parents •EX: mandatory overtime, 2nd and 3rd shifts

genes

•The most influence • lifelong (so our personality is relatively stable our whole lives)... like your temperament • do not change • research finds substantial continuity in our personalities

Adulthood perspectives on death

•With age, work and family - death is avoided or at least postponed for as long as possible •EX: they stop taking addictive drugs, wear seat belts •Terminally ill adults - worry about leaving something undone or leaving family members

Alcohol use in adulthood

•adults who drink in moderation live longer than abstainers BUT that is no more than 2 drinks a day • excessive drinking = harmful Damage to the body: brain cells, liver, linked to cancers, osteoporosis, lowers fertility PLUS homicides

parents

•alone again • focus on each other • do activities they enjoy • more time for themselves and each other • improve the relationship Couples increasingly link their lives over time

family bonds: siblings

•become closer •But, one factor that decreases sibling closeness - Parental favoritism of one child over another • cultural influences • help cope with children, marriage, and elderly relatives

changing workplace

•change occupation over time (now every ten years or so) •Younger adults - greater advantage, more diverse •EX: demand and need vs. no longer needed

biological parents

•children influence parents through their personalities, needs, and existence "bidirectional"

friends over the years

•chosen for mutual loyalty and aid • provide practical help and advice • tend to improve over time • aid physical and mental health • provide encouragement

Work meets these needs by allowing people to do the following:

•develop and use personal skills • expressive creative energy • aid and advise coworkers, mentors, or friends • support education and health of their families • contribute to the community by providing goods or services

collective social convoy group includes

•family members • friends • acquaintances • strangers When family bonds are similar to friendship bonds, relatives stay in our social convoy

activities in late adulthood: political activity

•fewer older people turn out for massive rallies • only 2% volunteer in political campaigns •More write letters to their elected representatives, vote and identify with a political party Many government policies - affect the elderly, esp housing, pensions, prescription drugs, and medical costs EX: ages at rallies v older adults writing letters to representatives, which is easier for them to do??

skipped-generation families

•grandparents that parent and raise grandchildren •Ex: common with substance use and mental health disorders

marriage ceremony

•in every culture and era

stratification by age

•industrialized nations segregate elderly • shut them out of work and society as they age • harmful to everyone as it creates social discrepancies EX: limits us by age, bot by ability, ageism

adult children: love

•influenced by the interaction remembered from childhood

adoptive parents

•legal connection to child •Open adoption - ongoing contact, most common • mental health issues with bonding • unknown histories and health issues

Stratification by gender

•males and females on separate tracks through life •EX: motherhood and careers

domains of IADLs

•manage medical care, food prep, transportation, communication, maintain household, manage finances •Often more critical to self-sufficiency than ADLs

caregiving

•more difficult with failing IALDs • selecting a designated caregiver varies by nations, cultures, and ethnic groups • disagreements common about nutrition, medical help, and dependence • integrated care is deal

erikson's intimacy vs. isolation

•needs are lifelong • needs for social connection through our family ,etc

Late adulthood perspectives on death

•older adults typically accept death •EX: life review... they know it is inevitable

Visual problems in old age

•only 10% of people over age 65 see well without glasses •EX: cataracts, glaucoma