Late Adulthood - PDF

Late Adulthood Physical Development Prejudice and Predictions  Ageism  Prejudice in which people are categorized and judged solely on the basis of their chronological age  Shares parallels with other prejudices  Considers people as part of a category and not as individuals;...

Late Adulthood Physical Development Prejudice and Predictions  Ageism  Prejudice in which people are categorized and judged solely on the basis of their chronological age  Shares parallels with other prejudices  Considers people as part of a category and not as individuals; can target people of any age  Associated with negative outcomes for older adults  Ageism & Self-Fulfilling Prophecy Potential consequences when ageism becomes a self-fulfilling prophecy More dependency on others Giving up when young-adult norms are not met Feeling feeble and consequently avoiding social interaction and caring for self Cultural attitudes toward aging may influence longevity.  Impact of Ageism  Elderspeak A condescending way of speaking to older adults that resembles baby talk, with short and simple sentences, exaggerated emphasis, repetition, and a slower rate and higher pitch than used in normal speech  Destructive protection Discouraged to leave home Physical Changes  Senses become slower and less sharp Vision Increased likelihood of needing bifocals, cataracts, glaucoma, and macular degeneration Hearing Everyone loses some hearing with age A passive acceptance of sensory loss increases morbidity Compensation can reduce this.  Activity Changes: Intimacy Often older adults and women are seen as genderless and asexual (this is a stereotype) However, the opposite is true! Older adults may face more satisfaction than they did when they were younger. Fewer distractions, more time & privacy, and no worries about getting pregnant There are still some barriers due to medical issues that result from arthritis, diabetes, heart disease, stroke, hormonal changes and dementia Activity Changes: Driving  Older adults drive more slowly, may not drive at night or when there is bad weather, and may give up driving completely.  Societal compensations for age-related driving deficits are generally not available, but they might help reduce accidents and provide more independence. Activity Changes: Exercise  Exercise On average, only 35% of people over age 65 meet recommended guidelines for aerobic exercise On average, 11% for muscle strengthening. Activity Changes: Sleep  Need 7-8 hours of sleep  Advanced Sleep Phase Syndrome: tendency to go to bed earlier and wake earlier than those who are young o Though to occur due to challenges in circadian rhythms  Other sleep issues develop such as: o Insomnia o Sleep apnea o Restless leg syndrome  Sleep during this period is often disturbed due to physical conditions such as these  Division of Older Adulthood  Young-old Are healthy, active, financially secure, and independent  Old-old Suffer some losses in body, mind, or social support, but take pride in self- care  Oldest-old Are dependent and most noticeable  12 Youngest-Old vs. Oldest-Old YOUNGEST-OLD SIMILARITIES OLDEST-OLD Ranges from 65-84 Both ages groups Ranges from 85 and years experience an increase older Includes the Golden in risk of diseases such More likely to require Years as arteriosclerosis, long-term care, to be Most experience good cancer, and cerebral placed in nursing health, social vascular disease. homes and engagement and a These risks happen hospitalized source of happiness & primarily after the age Almost half of well-being of 75 as individuals individuals in this More likely to be living experience group need independently and less more physical assistance with daily likely to require long- impairments living activities. term care Theories of Aging: Wear & Tear  This theory suggests that aging is a process by which the human body wears out due to the passage of time and exposure to stressors  "Wear & Tear" refers to the gradual deterioration of the cells and tissues of the body due to oxidative stress, exposure to radiation, toxins, or other deteriorative processes.  Basically, we wear out over time through repeated use and exposure to stress. https://youtu.be/BkcXbx5rSzw Theories of Aging: Genetic Clock  Suggests that a mechanism in the DNA of cells regulates the aging process by triggering hormonal changes and controlling cellular regeneration  Based on the idea that normal cells cannot divide indefinitely  This biological clock controls the pace of aging  Average Life Expectancy versus Maximum Life Span https://youtu.be/GASaqPv0t0g Theories of Aging: Cellular Aging  The cumulative effect of stress and toxins, causing cellular damage first and eventually the death of cells. Centenarians  Comprehensive studies found that their lifestyles were similar in four ways: Diet Work and activity Family and community Exercise and relaxation https://youtu.be/9AThycGCakk Cognitive Development Brain Changes  Loss in brain volume  Due to shrinkage of neurons, lower numbers of synapses & shorter length of axons  Loss in white matter connections between brain areas  Specifically in the hippocampus and basal forebrain region However, the brain still has plasticity in late adulthood  Seen through evidence of neurogenesis (i.e., new neurons do continue to form)  Scaffolding Theory of Aging suggests that the brain can adapt to neural atrophy (dying of brain cells) by building alternative connections (AKA scaffolding)  Those with cognitive impairment show lower numbers of developing neurons Promoting Healthy Brain Functioning in Late Adulthood Older adults can protect against the primary aging of the brain  Cognitive training improves prefrontal cortex and executive functions such as working memory, and strengthens the plasticity of neural circuits  Physical activity & stimulating cognitive activities results in reductions of neurocognitive disorders. These activities promote the structural and dynamic capacities of the brain that buffer against atrophies and lesions. Cognitive Changes: Memory  Central Executive of Work Memory System  Oversees working memory, allocating resources where needed & monitors whether cognitive strategies are being effective  Most negatively impacted by age, as older adults find it harder to multitasks  Learning/ performing tasks at the same time are too taxing  Long-term Memory  Episodic memory is seen to decline more than semantic memory  Episodic uses both memory of time & place  Semantic experiences more blocks of retrieving information  Prospective memory & general recall abilities also seen to decline with age  Cognitive Changes Attention  Declines due to sensory function & speed of processing  Older adults less able to selectively focus on information while ignoring distractors & shifting their attention between objects or locations Problem Solving  Performance in problem solving tasks seen to decline, however if given more time older adults can typically be successful Why do these cognitive changes happen?  Processing Speed Theory: as our nervous system slows with advanced age, our ability to process information declines as 24 well Neurocognitive Disorders Commonly known as dementia, neurocognitive disorders (NCD) are characterized by experiencing difficulties with : o Memory o Reasoning o Language o Decision Making o Abstract thinking o Problem Solving Classified as:  Major Neurocognitive Disorder o Significant cognitive decline from a previous level of performance in one or more cognitive domains & interfere with independent functioning  Minor Neurocognitive Disorder o Modest cognitive decline from a previous level of performance in one or more cognitive domains & DOES NOT interfere with independent functioning Types of Neurocognitive Disorders: Alzheimer’s Disease  Affects ~50% of those with an NCD  Symptoms occur gradually  Subtle personality differences & memory loss  Continues with confusions, difficulty with change & deterioration in language, problem solving skills and personality  Late stages include loss of physical coordination & inability to complete everyday tasks including self-care and personal hygiene Main Symptom: severe and worsening memory loss is the main symptom https://youtu.be/bLzO1zVvglQ Types of Neurocognitive Disorders: Parkinson’s Disease  Caused by deterioration of a part of the brain that send dopamine to a different part of the brain that impacts motor activity  Main symptom: rigidity or tremor of the muscles https://youtu.be/6_I5WQ_TOOQ Types of Neurocognitive Disorders: Vascular Neurocognitive Disorder  Associated with blockage of cerebral blood vessels that affects one part of the brain rather than a general loss of brain cells.  More abrupt than Alzheimer’s disease and has a shorter course before death  Main symptom: sporadic and progressive loss of intellectual functioning https://youtu.be/9luNs6AvQK8 Types of Neurocognitive Disorders: Neurocognitive Disorder with Lewy Bodies  Lewy bodies = microscopic proteins found in neurons seen postmortem (after death)  Affect chemicals in brain that lead to difficulties in thinking, movement, behavior and mood  Impact both the cortex and brain stem, meaning it results in cognitive AND motor symptoms, which occur at the same time. Main symptom: Loss of inhibition https://youtu.be/zKRGBKPKTHA Neurocognitive Disorders (NCDs) NCDs are complex and can be caused due to various reasons. Identifying NCDs can assist with developing appropriate treatment plans METHODS USED TO IDENTIFY NCDS Blood/ Lab Tests Determine if there are certain infections known to cause dementia Can be used to help identify Alzheimer's disease through cerebrospinal fluid Rules out other conditions such as hormone balance, or vitamin deficiency that can lead to similar symptoms Brain Scans Helps to identify strokes, tumors or other problems that are identifiable on brain scans. Also, it can assist with identifying brain changes in the structure and function that suggest Alzheimer’s disease. CT/ MRI EEG METHODS USED TO IDENTIFY NCDs Neuropsychological Evaluations (Multiple measures/ tasks, Questionnaires  Measure memory, language skills, math skills and visual and spatial skills.  Use multitude of specific tests such as: o MoCA (Montreal Cognitive Assessment) o SLUMS (Saint Louis University Mental Status) o HRNES-R (Halstead Russell Neuropsychological Evaluation System)  Questionnaires: o Patient Memory Assessment Questionnaire (AD8) o The Lewy Body Composite Risk Score (LBCRS) No one method is used on its own. Most times, it is necessary to use a wholistic approach where multiple methods are used to diagnose. Misdiagnosis Multiple factors can lead to misdiagnosis of NCD  Depression  Malnutrition and dehydration  Alcohol  Brain tumor  Physical illness  Medication Psychosocial Development Psychosocial Theories of Late Adulthood: Returning to Erikson: Integrity vs Despair  Older adults seek to integrate their unique experiences with their vision of community  Accepting one’s whole life and reflecting on that life in a positive manner Psychosocial Theories of Late Adulthood: Self Theories  Emphasize the core self, or the search to maintain one’s integrity and identity  Holding on to the self Most older people feel their personalities and attitudes have remained stable over their life span, even as they recognize the physical changes of their bodies. Objects and places become more precious, as a way to hold on to identity. Psychosocial Theories of Late Adulthood: Convoy Model of Social Relations  Suggests that the social connections that people accumulate differ in levels of closeness Innermost circle (partner and family members) should be relatively stable across the lifespan Outer circles (coworkers, neighbors, acquaintances) are less stable  Social connections are held together by exchanges in social support Psychosocial Theories of Late Adulthood: Socioemotional Selectivity Theory  Older people prioritize regulation of their own emotions and seek familiar social contacts who reinforce generativity, pride, and joy.  Invest in existing relationships  Positivity effect Psychosocial Theories of Late Adulthood: Stratification Theories  Emphasize that social forces limit individual choices and affect a person’s ability to function in late adulthood as past stratification continues to limit life in various ways  Every stereotype adds to stratification.  Stratification by Gender Income Ethnicity Psychosocial Theories of Late Adulthood: Disengagement Theory  Aging makes a person’s social sphere increasingly narrow, resulting in role relinquishment, withdrawal, and passivity. Psychosocial Theories of Late Adulthood: Activity Theory  Elderly people want and need to remain active in a variety of social spheres—with relatives, friends, and community groups— and become withdrawn only unwillingly, as a result of ageism. Psychosocial Theories of Late Adulthood: Continuity Theory  Effort to maintain consistency between past and anticipated future  Maximizes aging through internal and external structures  Long-term partnerships Buffer against old age problems Relationships  Parent-child relationships Role of geographical proximity Gender differences  Grandparenting 85% of adults over 65 are grandparents  Friendship Friendship networks reduce with each decade More likely to put effort into maintaining friendships  The Frail Elderly  People over age 65, and often over age 85, who are physically infirm, very ill, or cognitively disabled Most older adults become frail if they live long enough. Frailty is most common in the months preceding death (terminal decline).  The Frail Elderly  Inability to perform Activities of Daily Life (ADLs) are a sign of fragility Actions that are important to independent living, typically identified as five tasks of self-care: Eating Bathing Toileting Dressing Transferring from a bed to a chair  The Frail Elderly  Inability to perform Instrumental Activities of Daily Life (IADLs) are a sign of fragility Actions (for example, paying bills and driving a car) that are important to independent living and that require some intellectual competence and forethought Examples Managing medical care Food preparation Transportation Communication Maintaining household Managing one’s finances  Caring for the Frail Elderly  Cultural differences in elder care Cultural values of filial responsibility and independence Filial responsibility: obligation of adult children to care for their aging parents  Family caregivers experience substantial stress In the US, the spouse is most likely to be the caregiver Elder Abuse  When caregiving results in resentment and social isolation, the risk of elder abuse escalates More likely to occur when: Caregiver suffers from emotional problems or substance abuse Care receiver is frail, confused, and demanding Care location is isolated, where visitors are few Positive Characteristics of Aging  Self-actualization  Artistic expression may aid social skills, resilience, and even brain health  Life review/Narrative making An examination of one’s own role in the history of human life, engaged in by many elderly people  Wisdom Expert knowledge system dealing with the conduct and understanding of life https://youtu.be/IuL-l2L_8Rk