Aging, Death, and Bereavement Quiz

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Questions and Answers

What is the primary reason for depression in the elderly?

Loss of spouse and family members

Decreased social status

Decline of health

All of the above (correct)

Which of the following is NOT a factor associated with longevity?

Decreased social support systems (correct)

Family history of longevity

Advanced education

Continuation of physical and occupational activity

What is the term for the depression that often mimics Alzheimer's disease?

Ego integrity

Psychoactive disorder

Depressive disorder

Pseudodementia (correct)

What is the average life expectancy in the United States?

78.6 years Signup and view all the answers

Which of the following is NOT a stage of dying according to Dr. Elizabeth Kübler-Ross?

Acceptance of fate Signup and view all the answers

What is the primary reason for the 'cultural effect' in Hispanic individuals?

Strong social and family networks Signup and view all the answers

What is the term for the return of immigrants to their original country to die?

Salmon bias effect Signup and view all the answers

Which of the following is a common psychiatric disorder in the elderly?

All of the above Signup and view all the answers

What is the recommended approach to evaluating the functioning level of elderly patients?

Evaluating patients in familiar surroundings Signup and view all the answers

What is the effect of antihistamines such as diphenhydramine on elderly patients?

They may cause delirium Signup and view all the answers

What is the primary response of a physician to a dying patient and their family?

To give support to the dying patient and the patient's family Signup and view all the answers

What is the characteristic of a patient who is 'stuck' in the depression stage of grief?

They are diagnosed with a complicated grief reaction Signup and view all the answers

What is the typical duration of a typical grief reaction?

1-2 years Signup and view all the answers

What is the mortality rate of close relatives in the first year of bereavement?

High Signup and view all the answers

What is the characteristic of a patient in the bargaining stage of grief?

They try to strike a bargain with God or some higher power Signup and view all the answers

What is the primary reason why physicians may become emotionally detached from patients?

They feel a sense of failure at not preventing the patient's death Signup and view all the answers

What is the term for the symptoms that return on holidays or special occasions after a typical grief reaction has subsided?

Anniversary reaction Signup and view all the answers

What is the characteristic of a patient in the anger stage of grief?

They are angry at the physician and hospital staff Signup and view all the answers

What is the primary responsibility of the physician when informing a patient of their diagnosis and prognosis?

To follow the patient's lead as to how much they want to know about the condition Signup and view all the answers

What is the characteristic of a patient in the acceptance stage of grief?

They are calm and accept their fate Signup and view all the answers

What percentage of the U.S. population is over 65 years of age?

More than 15% Signup and view all the answers

What is the primary focus of geriatrics in managing chronic illnesses?

Managing the chronic illness to maintain mobility Signup and view all the answers

What is the most common cause of loss of mobility leading to disability and death in the elderly?

Hip fracture Signup and view all the answers

What is a medication that decreases bone resorption by blocking osteoclasts?

Alendronate sodium (Fosamax) Signup and view all the answers

What is a characteristic of somatic changes in aging?

Decreased renal function Signup and view all the answers

What is a characteristic of neurologic changes in aging?

Decreased cerebral blood flow Signup and view all the answers

What is a characteristic of the typically aging brain?

Amyloid plaques and neurofibrillary tangles are present to a lesser extent than in Alzheimer disease Signup and view all the answers

What is the fastest growing segment of the population?

People over 85 years of age Signup and view all the answers

What is a key aspect of prevention and management of osteoporosis?

Increasing weight-bearing exercise Signup and view all the answers

What is the primary goal of gerontology?

Studying the process of aging Signup and view all the answers

What is the primary reason for physicians to become emotionally detached from patients?

To deal with their sense of failure at not preventing the patient's death Signup and view all the answers

Which of the following neurotransmitters is NOT decreased in availability during aging?

Serotonin Signup and view all the answers

What percentage of the U.S. population is currently over 65 years of age?

15% Signup and view all the answers

What is the primary cognitive change associated with typical aging?

No significant changes in cognitive abilities Signup and view all the answers

What is the main difference between typical grief and complicated grief reaction?

Pathologic nature of the reaction Signup and view all the answers

What is the fastest growing segment of the population?

People over 85 years of age Signup and view all the answers

What is the typical response of the bereaved in the initial stage of grief?

Shock and denial Signup and view all the answers

Which of the following psychological changes is associated with Erikson's stage of ego integrity vs. despair?

Sense of ego integrity Signup and view all the answers

What is a key aspect of prevention and management of osteoporosis?

Increasing weight-bearing exercise Signup and view all the answers

What is a characteristic of somatic changes in aging?

Decreased muscle mass and strength Signup and view all the answers

Which of the following factors is associated with depression in the elderly, but NOT with longevity?

Decreased social status Signup and view all the answers

What is the primary responsibility of the physician when interacting with the dying patient and their family?

To give support to the dying patient and the patient's family Signup and view all the answers

What is a characteristic of neurologic changes in aging?

Impaired vision and hearing Signup and view all the answers

What is the characteristic of a patient who is experiencing an 'anniversary reaction'?

They are experiencing a return of symptoms on holidays or special occasions Signup and view all the answers

What is the effect of supportive psychotherapy in conjunction with pharmacotherapy or electroconvulsive therapy on depression in the elderly?

It can manage the symptoms successfully Signup and view all the answers

Which of the following is a characteristic of sleep patterns in the elderly?

Loss of sleep Signup and view all the answers

What is a characteristic of the typically aging brain?

Decreased brain weight, enlarged ventricles and sulci Signup and view all the answers

What is the primary goal of the physician when informing a patient of their diagnosis and prognosis?

To follow the patient's lead as to how much they want to know Signup and view all the answers

What is the characteristic of a patient who is 'stuck' in the depression stage of grief?

They are experiencing a prolonged and intense emotional detachment Signup and view all the answers

Which of the following is a factor associated with the 'cultural effect' in Hispanic individuals?

Strong social and family networks Signup and view all the answers

What is the primary aim of geriatrics?

To manage chronic illnesses Signup and view all the answers

What is the primary reason for a patient's anger towards the physician and hospital staff?

They blame the physician and hospital staff for their condition Signup and view all the answers

According to Dr. Elizabeth Kübler-Ross, which of the following stages of dying may occur simultaneously or in another order?

All stages of dying Signup and view all the answers

What is the primary cause of loss of mobility leading to disability and death in the elderly?

Fractures, such as hip fractures Signup and view all the answers

What is the characteristic of a patient in the bargaining stage of grief?

They are trying to strike a bargain with a higher power Signup and view all the answers

What is an example of a medication that decreases bone resorption by blocking osteoclasts?

Alendronate sodium (Fosamax) Signup and view all the answers

Which of the following is a characteristic of the process of dying according to Dr. Elizabeth Kübler-Ross?

It involves only five stages Signup and view all the answers

What is the primary focus of the physician's response to the patient's grief?

To provide emotional support to the patient and their family Signup and view all the answers

What is the primary focus of gerontology?

The study of aging Signup and view all the answers

Which of the following is a factor associated with the longevity of Hispanic individuals?

Strong social and family networks Signup and view all the answers

What is the main neurochemical change associated with aging?

Decreased responsiveness of neurotransmitter receptors Signup and view all the answers

According to Erikson's stage of ego integrity vs. despair, what is the primary psychological change associated with late adulthood?

Sense of ego integrity and pride in past accomplishments Signup and view all the answers

What is the primary factor associated with depression in the elderly?

All of the above Signup and view all the answers

What is the primary effect of antihistamines such as diphenhydramine on elderly patients?

Delirium Signup and view all the answers

What is the primary factor associated with increased longevity in Hispanic individuals?

Strong social and family networks Signup and view all the answers

According to Dr. Elizabeth Kübler-Ross, what is the first stage of dying?

Denial Signup and view all the answers

What is the primary cognitive change associated with typical aging?

Decreased learning speed Signup and view all the answers

What is the primary characteristic of sleep patterns in the elderly?

Decreased sleep quality Signup and view all the answers

What is the primary aim of geriatrics?

To promote healthy aging Signup and view all the answers

What is the primary factor associated with the 'cultural effect' in Hispanic individuals?

Strong social and family networks Signup and view all the answers

What is the primary responsibility of the physician when interacting with the dying patient and their family?

To give support to the dying patient and the patient's family Signup and view all the answers

What is the characteristic of a patient who is experiencing an 'anniversary reaction'?

They are experiencing a return of grief symptoms on holidays or special occasions Signup and view all the answers

What is the primary goal of the physician when informing a patient of their diagnosis and prognosis?

To follow the patient's lead as to how much they want to know about their condition Signup and view all the answers

What is the characteristic of a patient in the bargaining stage of grief?

They try to strike a bargain with God or a higher power Signup and view all the answers

What is the main difference between typical grief and complicated grief reaction?

Typical grief lasts for 1-2 years, while complicated grief is pathologic Signup and view all the answers

Why may physicians become emotionally detached from patients?

Because they feel they have failed in preventing the patient's death Signup and view all the answers

What is the characteristic of a patient in the anger stage of grief?

They become angry at the physician and hospital staff Signup and view all the answers

What is the characteristic of a patient who is 'stuck' in the depression stage of grief?

They become preoccupied with death and emotionally detached Signup and view all the answers

What is the typical duration of a typical grief reaction?

1-2 years Signup and view all the answers

What is the mortality rate of close relatives in the first year of bereavement?

High Signup and view all the answers

What is the primary goal of gerontology?

To understand the physical and psychological changes that occur with aging Signup and view all the answers

What is the most common cause of loss of mobility leading to disability and death in the elderly?

Fractures, particularly of the hip Signup and view all the answers

What is the primary focus of geriatrics in managing chronic illnesses?

To manage the symptoms and prevent further complications Signup and view all the answers

What is the characteristic of somatic changes in aging?

Decreased immune responses and increased fat deposits Signup and view all the answers

What is the primary aim of preventing and managing osteoporosis?

To prevent falls and fractures Signup and view all the answers

What is the characteristic of neurologic changes in aging?

Decreased brain weight and cerebral blood flow Signup and view all the answers

What is the fastest growing segment of the population?

People over 85 years of age Signup and view all the answers

What is the primary goal of geriatricians in managing elderly patients?

To keep the patient mobile and active Signup and view all the answers

What is the characteristic of the typically aging brain?

Decreased brain weight and cerebral blood flow, with amyloid plaques and neurofibrillary tangles Signup and view all the answers

What is a key aspect of prevention and management of osteoporosis?

Increasing weight-bearing exercise and calcium and vitamin D intake Signup and view all the answers

Which symptom distinguishes complicated grief reaction from typical grief reaction regarding feelings of guilt?

Intense feelings of guilt and worthlessness Signup and view all the answers

What type of management is recommended for complicated grief reactions?

Antidepressants, antipsychotics, electroconvulsive therapy, increased contact with the physician Signup and view all the answers

What is a key difference in the resolution of severe symptoms between typical and complicated grief reactions?

Severe symptoms resolve within 2 months in typical grief Signup and view all the answers

Which of the following is a symptom specific to complicated grief reaction but not typical grief reaction?

Hallucinations or delusions Signup and view all the answers

How does social activity differ between individuals experiencing typical grief and those with complicated grief?

Attempts to return to work and social activities Signup and view all the answers

Which condition involves considering or attempting suicide?

Complicated grief reaction Signup and view all the answers

What duration distinguishes moderate symptoms in typical grief from complicated grief reactions?

Moderate symptoms persist for >1 year Signup and view all the answers

Which statement about sleep disturbances is correct regarding typical versus complicated grief reactions?

Significant sleep disturbances are a hallmark of complicated grief reactions Signup and view all the answers

Study Notes

Demographics of Aging

Over 15% of the US population is over 65 years old.
The fastest-growing segment of the population is people over 85 years old.

Gerontology and Geriatrics

Gerontology is the study of aging, and geriatrics is the care of aging people.
Geriatricians manage chronic illnesses, aiming to keep elderly patients mobile and active.
Prevention and management of osteoporosis include increasing weight-bearing exercise, calcium, and vitamin D in the diet, and medications that decrease bone resorption or increase bone formation.

Somatic and Neurologic Changes

Strength and physical health gradually decline with aging, leading to impaired vision, hearing, immune responses, and other physical changes.
Changes in the brain include decreased brain weight, enlarged ventricles and sulci, and decreased cerebral blood flow.

Cognitive Changes

Learning speed may decrease, but intelligence remains approximately the same throughout life in the absence of brain disease.
Some memory problems may occur in typical aging, but they do not interfere with daily functioning.

Psychological Changes

In late adulthood, people often experience a sense of ego integrity (satisfaction and pride in past accomplishments) or despair and worthlessness.
Depression is the most common psychiatric disorder in the elderly, often mimicking Alzheimer's disease.
Sleep patterns change, leading to loss of sleep, poor sleep quality, or both.
Anxiety and fearfulness are associated with realistic fear-inducing situations.
Psychoactive agents can produce different effects in the elderly than in younger patients.

Life Expectancy and Longevity

The average life expectancy in the US is about 78.6 years, varying by gender and ethnicity.
Factors associated with longevity include family history, physical and occupational activity, advanced education, and social support systems.

Stages of Dying and Death

According to Dr. Elizabeth Kübler-Ross, the process of dying involves five stages: denial, anger, bargaining, depression, and acceptance.
The stages usually occur in the following order but may be present simultaneously or in another order.

Bereavement and Complicated Bereavement

Typical grief reaction occurs after the loss of a loved one, characterized by shock and denial, and generally subsiding after 1-2 years.
Complicated grief reaction is often pathologic, requiring a diagnosis and treatment.
Physicians should provide support to the dying patient and their family, being mindful of their own emotional response to the patient's death.

Demographics of Aging

Over 15% of the US population is over 65 years old.
The fastest-growing segment of the population is people over 85 years old.

Gerontology and Geriatrics

Gerontology is the study of aging, and geriatrics is the care of aging people.
Geriatricians manage chronic illnesses, aiming to keep elderly patients mobile and active.
Prevention and management of osteoporosis include increasing weight-bearing exercise, calcium, and vitamin D in the diet, and medications that decrease bone resorption or increase bone formation.

Somatic and Neurologic Changes

Strength and physical health gradually decline with aging, leading to impaired vision, hearing, immune responses, and other physical changes.
Changes in the brain include decreased brain weight, enlarged ventricles and sulci, and decreased cerebral blood flow.

Cognitive Changes

Learning speed may decrease, but intelligence remains approximately the same throughout life in the absence of brain disease.
Some memory problems may occur in typical aging, but they do not interfere with daily functioning.

Psychological Changes

In late adulthood, people often experience a sense of ego integrity (satisfaction and pride in past accomplishments) or despair and worthlessness.
Depression is the most common psychiatric disorder in the elderly, often mimicking Alzheimer's disease.
Sleep patterns change, leading to loss of sleep, poor sleep quality, or both.
Anxiety and fearfulness are associated with realistic fear-inducing situations.
Psychoactive agents can produce different effects in the elderly than in younger patients.

Life Expectancy and Longevity

The average life expectancy in the US is about 78.6 years, varying by gender and ethnicity.
Factors associated with longevity include family history, physical and occupational activity, advanced education, and social support systems.

Stages of Dying and Death

According to Dr. Elizabeth Kübler-Ross, the process of dying involves five stages: denial, anger, bargaining, depression, and acceptance.
The stages usually occur in the following order but may be present simultaneously or in another order.

Bereavement and Complicated Bereavement

Typical grief reaction occurs after the loss of a loved one, characterized by shock and denial, and generally subsiding after 1-2 years.
Complicated grief reaction is often pathologic, requiring a diagnosis and treatment.
Physicians should provide support to the dying patient and their family, being mindful of their own emotional response to the patient's death.

Demographics of Aging

Over 15% of the US population is over 65 years old.
The fastest-growing segment of the population is people over 85 years old.

Gerontology and Geriatrics

Gerontology is the study of aging, and geriatrics is the care of aging people.
Geriatricians manage chronic illnesses, aiming to keep elderly patients mobile and active.
Prevention and management of osteoporosis include increasing weight-bearing exercise, calcium, and vitamin D in the diet, and medications that decrease bone resorption or increase bone formation.

Somatic and Neurologic Changes

Strength and physical health gradually decline with aging, leading to impaired vision, hearing, immune responses, and other physical changes.
Changes in the brain include decreased brain weight, enlarged ventricles and sulci, and decreased cerebral blood flow.

Cognitive Changes

Learning speed may decrease, but intelligence remains approximately the same throughout life in the absence of brain disease.
Some memory problems may occur in typical aging, but they do not interfere with daily functioning.

Psychological Changes

In late adulthood, people often experience a sense of ego integrity (satisfaction and pride in past accomplishments) or despair and worthlessness.
Depression is the most common psychiatric disorder in the elderly, often mimicking Alzheimer's disease.
Sleep patterns change, leading to loss of sleep, poor sleep quality, or both.
Anxiety and fearfulness are associated with realistic fear-inducing situations.
Psychoactive agents can produce different effects in the elderly than in younger patients.

Life Expectancy and Longevity

The average life expectancy in the US is about 78.6 years, varying by gender and ethnicity.
Factors associated with longevity include family history, physical and occupational activity, advanced education, and social support systems.

Stages of Dying and Death

According to Dr. Elizabeth Kübler-Ross, the process of dying involves five stages: denial, anger, bargaining, depression, and acceptance.
The stages usually occur in the following order but may be present simultaneously or in another order.

Bereavement and Complicated Bereavement

Typical grief reaction occurs after the loss of a loved one, characterized by shock and denial, and generally subsiding after 1-2 years.
Complicated grief reaction is often pathologic, requiring a diagnosis and treatment.
Physicians should provide support to the dying patient and their family, being mindful of their own emotional response to the patient's death.

Typical Grief Reaction vs Complicated Grief Reaction

Physical Symptoms

Typical grief reaction: Minor weight loss (e.g., 5% of body weight), minor sleep disturbances
Complicated grief reaction: Significant sleep disturbances

Emotional Response

Typical grief reaction: Mild guilty feelings, cries and expresses sadness
Complicated grief reaction: Intense feelings of guilt and worthlessness, considers or attempts suicide

Hallucinations and Delusions

Typical grief reaction: Illusions
Complicated grief reaction: Hallucinations or delusions

Typical grief reaction: Attempts to return to work and social activities
Complicated grief reaction: Resumes few, if any, work or social activities

Duration of Symptoms

Typical grief reaction: Severe symptoms resolve within 2 months, moderate symptoms subside within 1 year
Complicated grief reaction: Severe symptoms persist for >2 months, moderate symptoms persist for >1 year

Management and Treatment

Typical grief reaction: Management includes increased calls and visits to the physician, grief peer support groups, and short-acting sleep agents (e.g., zolpidem) for transient problems with sleep
Complicated grief reaction: Management includes antidepressants, antipsychotics, electroconvulsive therapy, as well as increased contact with the physician

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Description

Test your knowledge of aging demographics, gerontology, and geriatrics, including medical fields and aims of geriatric care.