Week 13 Psychology Lecture Notes PDF

Week 13: Psychology lecture notes Physical development in late adulthood: Late adulthood: 65+ - significant individual variability in physical capacities → biological age → Chronological age → psychosocial age → social age - increasing life expectancy: Canadians are living longer than any prior pe...

Week 13: Psychology lecture notes Physical development in late adulthood: Late adulthood: 65+ - significant individual variability in physical capacities → biological age → Chronological age → psychosocial age → social age - increasing life expectancy: Canadians are living longer than any prior period → Life expectancy is 81 years for Canadians born between 2007-2009 - number of centenarians doubled between 2001 (19.7/1000) and 2021 (33.5/1000) - Healthy life expectancy: number of years we will live in good health - increasing globally - positively correlated with income - WHO projected healthy life expectancy by country in 2030 - Men in Canada 84 years, women 87 years of good health - declining mobility and strength 1) Sarcopenia: age related loss of muscle mass - protective factors: regular exercise - risk factors: smoking, diabetes, obesity * We lose an average of 1-2% muscle mass per year after the age of 50. 2) Arthritis: inflammation of joints accompanied by pain and stiffness - protective factors: regular exercise - risk factors: joint injuries, repetitive motions, obesity ** common for adults who have had occupations in repetitive motions (lifting, typing, etc) 3) Osteoporosis: extensive loss of bone tissue - protective factors: male, exercise, adequate nutrition - risk factors: female, smoking, nutrient deficiency, falls Sensory Perception: Vision: Visual acuity declines in late adulthood ** begins to decline between 40-59 years (ex. Viewing close objects) - in late adulthood, this becomes more pronounced - ex. Eyes don’t adjust so quickly to changes in brightness etc. - Cataracts: thickening of the lens of the eye - By 70, approx. 30% of people experience partial loss of vision due to cataracts - Can be corrected with glasses or surgery - Glaucoma: Damage to the optic nerve caused by fluid build up - Less common, 1% of people in their 70s, 10% in their 90s - Treated when diagnosed - Often goes undiagnosed for a lot of time and therefore can cause blindness if not treated - Macular degeneration: deterioration of the retina - Person has normal peripheral vision but cannot see clearly what is in front of them - ex. Regulating in difficulty to driving Hearing: 94% of Canadians aged 70-79 report hearing loss - men usually lose their hearing ability faster than women - 51% of Canadians between 50-59 report some kind of hearing loss - Hearing aids are the best current intervention to help with hearing loss Smell and Taste: begins to decline at 60. Declines more slowly in healthy older adults than in less healthy adults Touch and pain: decline in touch sensitivity compared to earlier life stages. - presence of pain increases but sensitivity to pain decreases - an international study of older adults living in community settings revealed that 70% had impaired perceptions of touch 2 ways to look at the study finding: 1) it is adaptive for older adults to become less sensitive to touch overtime - perhaps it helps us cope with the experience of pain and discomfort in our  bodies as we age 2) Combination of more pain and decreased touch sensitivity: - can have – consequences, if injuries or illnesses are masked due to decreased touch sensitivity Increase in sensory-related vulnerabilities - Driving: declining visual and auditory perception increases risk - Slips, Trips, and Falls: Declining visual perception and balance increases risk - Detecting danger: declining vision, hearing, smell, and taste increases risk Sexuality: Sexuality is part of healthy aging: - Cohort study of 3000 men and women over 55. - Sexual activity reported in half of the 65-74 years age range and a quarter of the 75+ age range - frequency is determined by health and availability of healthy partners - Some remain sexually active in long term care facilities - Older adults identifying as LGBTQIA+ have fewer potential partners - Report stigma and negative views of Long Term Care staff and fellow residents towards same sex relationships and intimacy - Rates of sexually transmitted infections are increasing - CDC Health Data collected between 2009-2019 - 5 fold increase in rates of syphilis among adults 65+ - 2 fold increase in gonorrhea among adults 65+ - 2 fold increase in chlamydia among adults 65+ * One issues is with memory capacities: is it effective if you are dealing with a patient population with dementia, to just be informing them of safe sex practices? - IF they cant retain that info, what other options are there? - routine screening? Physical health examinations? To identify infections and treat them - Barriers to addressing sexual health in older adults 1) - agism: commonly assumed that older adults are asexual - not discusses by primary care providers - sexual health training is inconsistent in medical curricula 2) - stigma/sex negativity: lack of disclosure due to shame or embarrassment 3) - shifting cultural expectations  - lack of condom use - Recommendations for addressing sexual health in older adults: - Normalize sexuality as a healthy part of aging - Standardize sexual history taking as a part of routine care in older adults - education and safer sex counseling - regular screening and testing (to compensate for things like memory deficits, etc) Cognitive development Cognition - Fluid intelligence: Abstract reasoning and problem solving - Crystalized intelligence: accumulated knowledge and verbal skills - thought to increase across middle adulthood and even into late adulthood - but there is issue with recalling info, and delays in processing speed Memory: decline varies across individuals and across types of memory - explicit memory: declines faster than implicit memory - explicit memory: facts, figures, experiences that a person knows (names of different countries and their capitals, plot of a movie, name of protagonist in a book) - implicit memory: embodied memory of how to do a task that you do routinely (driving a car, preparing a meal, typing on a computer) - less vulnerable to aging - Episodic memory declines faster than semantic memory - semantic: knowledge that is relevant to a persons field of expertise - increases in middle adulthood, and held in memory more successfully though ability to recall delays - episodic memory for where and when things happen (when did you meet this friend, what did you have for breakfast, where is your grandchild attending uni?) - autobiographical memory: a type of episodic memory related to your personal life story ** subtype of episodic memory. - adults remember more events from adolescence and early adulthood  compared to any other life stage (including the present) - Memories are rated as more important and more positive than other life stages - Executive function: decrease in selective attention and inhibition - less efficient in preventing irrelevant information from entering working memory - older adults are attempting to process too much information * older adults have a harder time separating what is important vs. not - decision-making: reduced capacity for complex decision making - older adults prefer fewer options and are inclined to make good enough decisions - more content to select in imperfect solution study: - Participants were presented (Sullivan and colleagues) low and high choices under conditions of low and high arousal. - low risk choices involved smaller high probability bets, whereas the high risk choices involves larger, low probability bets - researches played sounds that are likely to either increase or decrease heart rate and blood pressure Findings: - Older adults make riskier decisions in high arousal settings in late adulthood compared to early adulthood - Young people when their HR is elevated, blood pressure is up is more likely to make conservative choices * Important findings when you consider that many older adults have a lot of high risk decisions to make: regarding finances, healthcare, end of life. Neurologic development: - General slowing of function in the brain and spinal cord begin in late middle adulthood and accelerate in late adulthood - deterioration of myelination causes neural transmission to slow - myelin is the fatty membrane that encases axons and speeds up transmission of signals - slows everything from reflexes to word recall - loss of synapses in key regions including prefrontal cortex  - ex. Hippocampus (memory), prefrontal cortex (long term planning, executive function) - neural compensation: recruit different brain regions and larger brain networks for complex tasks - attempt to compensate for functional limitations by activating more and more of the brain - makes neurological functioning, less efficient Neurological disorders: Dementia: brain disorders affecting memory and other cognitive abilities 1) Occurs when at least 2 parts of the brain are dying 2) Is chronic 3) is progressive 4) is terminal - Over 500,000 Canadians live with dementia today - 1 in 5 Canadians experience caring for someone with dementia * forget details of recent events, struggle to complete tasks → Alzheimer’s Disease: 65% of cases - healthy brain cells are replaced with amyloid plaques - amyloid plaques: dense deposits of protein that accumulate in the blood vessels of the brain - as the disease progresses, abnormal proteins spread across the brain in neurofibrillary tangles which lead to cell death - risk factors: genetic predisposition, sex, age - More are female than male (a bit misleading because females tend to live longer than men + increase in age increase chances of alzheimers) → Vascular dementia: 25% of cases - insufficient or interrupted blood flow to the brain, often due to one or more strokes - when there is not enough oxygen or nutrients in the brain, the cells die - risk factors: vascular health (exercise, smoking, hypertension) - decreasing risk factors: increase vascular health, treating hypertension before serious, not smoking ** Dementia villages: - extended supported living campuses, where people with dementia can move around freely, have access to some familiar amenities - Idea is the cognitive decline will increase rapidly if people with dementia are left in a room - Family support: caregivers quality of life significantly increases - Higher family burn out in Alzheimers than cancer or schizophrenia Parkinson’s Disease: Chronic progressive disorder characterized by muscle tremors, slowing movement, and partial facial paralysis - triggers by degeneration of dopamine producing neurons - Still not clear why these neurons accelerate at such an increased pace in those with Parkinsons - treatments: neuropharmacology that increases dopamine - efficiency of these interventions decrease over time - risk factors: age, sex - men more likely to have it and most people are diagnosed over the age of 65 Death and Dying: - Most Canadians die in a hospital (55%). - Others die in long term care, at home, or in a hospice setting - top 5 leading causes of death: cancer, accidents, injuries, stroke, diabetes, flu, liver diseases like cirrhosis, respiratory conditions, COVID19 - When has death occurred? - Challenging to determine when death has occurred according to either of these definitions because life support technologies can do the work of most of our vital organs (ex, ventilators, dialysis machines, resuscitation for heart beating stops) ** not intended to be a method of preventing death - Cardiac death: the absence of the heart contracting and pumping blood due to a disturbance in its electrical activity. - Brain death: the irreversible absence of all electrical activity in the brain Planning for death: MAID: Medical Aid in Dying decriminalized by supreme court in 2016. - Eligibility criteria: - 18+ - Grievous and irremediable condition - condition is bad an irreversible - capacity to consent - understand and appreciate - voluntary and not coerced - provide consent - procedure: 1) - request maid 2) - assessment by two independent practitioners 3) - formalize written request (with witnesses) 4) - provide final consent ** administered intravenously or pills can be given to the patient to take themselves - process usually takes weeks to months - Advanced care planning: document patient’s end of life choices before they loose capacity - Palliative care: branch of medicine specializing in reducing physical and psychological pain and suffering (rather than during illness) Identity: - According to Erikson, in late adulthood we become very occupied in reflecting back on our past (ego integrity vs. despair stage) - if we feel our life has been well lived and we have pursued interest we have valued, more likely to experience ego integrity - This doesn’t have to mean that a person has lived a perfect life - it means, when you look back at your life, that you have a feeling of pride or feeling of being at peace of how you navigated those challenges - the opposite, may fall into identity despair: feeling bitter about our life - person feels they haven’t lived in line with their values, or they have situations they can’t fix at this stage of life ** not about how other people evaluate your life, but rather how you view your life - Reminiscence therapy: - Discuss past experiences - identify regrets and ways to make amends - identify points of pride across the life course  - reduces depressive symptoms and increases quality of life Retirement: - Median age of retirement in Canada is 64.9 - People who work in the public sector: government (teachers, letter carriers, some healthcare providers, military personnel) tend to retire the earliest - incentive structures - secure pensions - private sector: work a bit later until around 65 - self employed: tend to work the longest - fewer safety nets for those self employed - retirement is a process, not event - increased life expectancy means that more people are delaying retirement and moving in and out of work in late adulthood - identity adjustment predicted by: Research shows that people are best able to adjust to retirement, when they are not concerned with finances, are in good health, have extended social networks, and have been able to cultivate leisure activities that they enjoy - Things that make it difficult: - financial instability - poor health - not having good social networks - having leisure activities that are sedentary and isolating or are inaccessible in late adulthood Politics of aging: - Population Projections - Number of seniors 65+ growing 6x faster than children 0-14  - 85+ has doubled since 2001, and is projected to triple by 2050 - Population projected to peak between 2031 and 2036 as first cohorts of “baby boomers” reach 85 - larger cohort of baby boomers - increase life expectancy - Women are having fewer children, having them later in life - economy plays a role - population of new babies born is not keeping pace with the population of aging seniors Economic Projections: - Labor market shortages - increased demands for health care, long term care, home care and assisted living - Ageism: age related discrimination - systematic de-valuing of elders - prevalent attitude in our society that younger people are more valuable than older people - Perceived as incapable, needy, burdensome, dangerous, infirm, or treated with disrespect. Relationships: Love and Partnership: - relationship quality predicts health and happiness of both partners - relationship satisfaction is associated with better subjective well being and better physical health - reduced mortality, fewer health conditions, faster recovery time from illness - promotion of healthy behaviours, reduction of risky behaviours, increased financial security, access to insurance, social support, etc - relationship stress: associated with lower subjective well-being and self reported health - individuals who report that they are not happy in their relationship exhibited equal or worse risk of fair/poor health and mortality than those who never married, divorced or separated, and widowed. Study: Kulik (2001). Martial relations in late adulthood, throughout the retirement process Design: cross sectional study investigating heterosexual relationships in late adulthood. - sample of 569 participants who were either planning for retirement, in the process of retiring, or recently retired - Research questions: are there differences in relationship satisfaction during these 3 life stages? - Are those differences evident for both men and women? Findings: - relationships were more strained prior to retirement (more complaints, less satisfaction) compared to couples during and after retirement. - division of household labour was found to more egalitarian during and after retirement Sources of relationship satisfaction: - Shared identity as parents and grandparents - Shared interests and hobbies - Shared friendships and community - Companionship and affection - trying new things/ having new experiences Sources of relationship stress: - poor health/disabilities - high levels of conflict - social isolation - negative or conflictual family relationships Grandparenting: - grandparents contribute to family functioning and well being in many ways - ex. Providing childcare or being a knowledge keeper - Evolutionary theory of aging: → What is the adaptive value of living past child bearing years? - Inclusive fitness: the grandmother hypothesis - idea is that the prolonged life of females is an evolutionary adaptative  mechanism because having a grandmother to provide help with child rearing is associated with more grandchildren - why do humans have such long lifespans? - Presence of a helping grandparent is associated with: - younger maternal age at first birth - reduced time between births - increased time between the births of first and last children - close emotion bonds benefit both grandparent and grandchild - increases grandchild resilience and coping - provides grandparent with emotional gratification, attachment, and continued family contribution - Strength of relationship predicted by: - grandparent age, education, health, frequency, and duration of contact, emotional investment, parental encouragement - Continuing benefits in adolescence and young adulthood - continued affection, reassurance of worth, and reliable alliance Friendship and community: - Strong friendships and community in late adulthood predict relationship satisfaction and personal health - having a spouse who participates in social groups increases relationship satisfaction in late adulthood - buffering hypothesis: individuals with strong social support are better at coping with stress. - Lower stress is associated with improved cardiovascular, neuroendocrine, and immune functioning in older adults - socioemotional selectivity theory: older adults become more selective about their social networks - time is perceived as more limited and so more valuable - spend time with people who are familiar and likely to deliver emotional satisfaction - withdraw from relationships that are peripheral or negative - systematically prune their social networks so that available social partners satisfy their emotional needs - Reduced social networks is not necessarily indicative of loneliness - Altruism and volunteering - sense of purpose and accomplishment - improved social networks - increased appreciation for quality of life - increase self-efficacy - Older adults perceive their own well-being as better when they provide social support to other people, rather than when they receive support from others. Spirituality and Religion: - Spirituality: a search for meaning in life through connection to something larger than ourselves - increase in self-reported spirituality between middle and late adulthood. - regular religious practice is associated with improved physical health in late adulthood - lifestyle - social networks - coping with stress through meaning-making Death and Dying: Kubler-Ross (1969) Death and Dying stages: 1) Denial: - usually a short term, temporary defense mechanism (weeks to months) 2) Anger: displaced onto the doctors, family members, random acquaintances 3) Bargaining: a hope that death can be delayed - any final treatments, interventions? Study? - can also be made with supernatural forces 4) Depression: when bargaining doesn’t work or you run out of options - finality of the end of life comes into consciousness, people can become silent, refuse visitors, spend time crying or grieving - Kubler ross thought this was a very normal part of facing one’s own death 5) Acceptance: facing one’s own death ideally with feelings of peace or acceptance critiques: 1) Applies best to patients with a terminal diagnosis 2) Order of stages is not fixed Losing a life partner: - variability in how surviving spouse copes with loss, depending on relationship, circumstances of death, and financial security - Often suffer profound grief, loneliness and depression. May also experience financial loss, feelings of relief, feelings of guilt, and increased physical illness - The Widowhood effect: - “In the year after losing a spouse, men were 70% more likely to die than similarly aged men who did not lose a spouse. Women were 27% more likely to die compared to women who did not become widowed”. - Belief in the afterlife effects coping → In one study, widowed people who did not believe that they would be reunited with their spouse in the afterlife experienced more depression, anger, intrusive thoughts at 6 and 18 months following the spouses death, compared to those who did believe they would be reunited with their loved ones. * Men tend to rely heavily on women for caregiving, making doctor appointments, etc. - when the caregiving support is suddenly gone, widowed men are at a dramatically increased risk of dying themselves. Cross-cultural approaches: - For many people, death is not viewed as the end of existence - Buddhism, Christianity, Hinduism, Islam and Judaism all postulate some form of continuation after death - Diverse practices concerning honoring the body of the deceased  - many diverse practices and rituals surrounding death - continued obligations to (and relationship with) the deceased ** tie us back to making meaning of death