Preparing for Aging, Death, and Dying © 2015 Pearson Education, Inc.

Learning Objectives Define aging, and list the characteristics of successful aging. Explain how the growing population of older adults will affect society, including considerations of economics, health care, living arrangements, and ethical and moral issues. Discuss the biological and psychosocial theories of aging, and summarize major physiological changes that occur as a result of the normal aging process. © 2015 Pearson Education, Inc.

Learning Outcomes (cont.) Discuss unique health challenges faced by older adults, and describe strategies for successful and healthy aging that can begin during young adulthood. Discuss death and the stages of the grieving process. Explain strategies for coping with death and loss. © 2015 Pearson Education, Inc.

Learning Outcomes (cont.) Explain the ethical concerns that arise from the concepts of the right to die and rational suicide. Review the decisions that need to be made when someone is dying or has died, including hospice care, funeral arrangements, wills, and organ donation. © 2015 Pearson Education, Inc.

Preparing for Aging, Death, and Dying Aging refers to the patterns of life changes that occur in members of all species as they grow older. Gerontology is the study of individual and collective aging processes. © 2015 Pearson Education, Inc.

Aging Older Adults: A Growing Population Life expectancy for a child born in the United States in 2012, is 78.9 years—over 30 years longer than for a child born in 1900. 13 percent of the population is now over 65. Those who are the oldest of the baby boom population are just beginning to retire. Their impact on the economy, housing market, health care system, and Social Security will be profound in decades to come. © 2015 Pearson Education, Inc.

Number of Americans 65 and Older © 2015 Pearson Education, Inc.

Health Issues for an Aging Society Health Care Costs As people live longer, the chances of developing a costly chronic disease increase, and as technology improves, chronic illnesses that once were quickly fatal may now be treated successfully for many years. Most older adults have at least one chronic illness. Housing and Living Arrangements Most older people never live in a nursing home. Many live with a spouse, partner, or alone; others live with family, friends, or pay for home health services. An increasing number opt for assisted living with supportive services. Ethical and Moral Considerations The cost of care versus the quality of life it buys, particularly for terminally ill older people, is something society must weigh. Is prolonging life a moral imperative or should a set of criteria for deciding who will be helped and who will not be devised? © 2015 Pearson Education, Inc.

Living Arrangements for Americans Age 65 and Older © 2015 Pearson Education, Inc.

ABC News Video: Myth-Busting Longevity Discussion Questions What take home points did you learn from the video with regards to longevity? What can you implement in your life now that will have an impact on longevity? How does consciousness come into play when determining longevity? According to the study presented in the video, what personality traits may help you live a longer life? Why? © 2015 Pearson Education, Inc.

Theories of Aging Wear-and-tear theory Like everything else in the world, the human body wears out. Cellular theory At birth we only have a certain number of usable cells, which are programmed to reproduce a limited number of times. Genetic mutation theory The number of body cells exhibiting unusual or different characteristics increases with age. Autoimmune theory Attributes aging to the decline of the body's immunological system. © 2015 Pearson Education, Inc.

Physical and Mental Changes of Aging Typical physical changes Skin Bones and joints Head and face Urinary tract Heart and lungs Senses Sexual function (men and women) © 2015 Pearson Education, Inc.

Mental Function and Memory Dementias and Alzheimer's Disease Dementias are progressive impairments that interfere with memory and normal intellectual functioning. Alzheimer's disease is a chronic condition involving changes in nerve fibers of the brain that result in mental deterioration. The key to maintaining memory is keeping your mind active. People who engage in reading, solving mental puzzles, and learning to play musical instruments have a better chance of keeping their memory sharp. © 2015 Pearson Education, Inc.

Normal Effects of Aging on the Body © 2015 Pearson Education, Inc.

Alcohol and Drug Use and Abuse A person who is prone to alcoholism during his or her younger years is more likely to continue that pattern during later years. Alcohol abuse is five times more common among older men than among older women. Older people rarely use illicit drugs, but some mistakenly overuse or misuse prescriptions. Polypharmacy—use of multiple medications To avoid drug interactions and other problems, older adults should use the same pharmacy consistently, ask questions about their medications and dosages, and read directions carefully. © 2015 Pearson Education, Inc.

Strategies for Healthy Aging Develop and Maintain Healthy Relationships Social bonds and support lend vigor and energy to life. Enrich the Spiritual Side of Life Developing bonds with nature, the environment, a higher being, and yourself is important. Improve Fitness Sarcopenia—age-associated loss of muscle mass © 2015 Pearson Education, Inc.

Exercise Recommendations for Adults over Age 65 © 2015 Pearson Education, Inc.

Strategies for Healthy Aging (cont.) Eat for Longevity Certain nutrients are essential to healthy aging. Calcium—to prevent bone loss Vitamin D—for calcium absorption Protein—for muscle mass Healthy diet should help meet all other nutrient needs. © 2015 Pearson Education, Inc.

Understanding the Final Transitions: Dying and Death Defining Death Death is the final cessation of vital functions Brain Death Irreversible cessation of all functions of the entire brain stem The Harvard Medical School states that brain death occurs when the following occurs: Unreceptivity and unresponsiveness No movements for a continuous hour, and no breathing after 3 minutes off a respirator No reflexes A flat encephalogram No changes in these tests 24 hours later Certainty that drugs are not responsible for these conditions © 2015 Pearson Education, Inc.

Dying and Death The Process of Dying The process of the decline in body functions that results in the death of an organism It is complex and includes physical, intellectual, social, spiritual, and emotional dimensions. Coping Emotionally with Death Kübler-Ross's stages of dying Denial Anger Bargaining Depression Acceptance © 2015 Pearson Education, Inc.

Kübler-Ross's Stages of Dying © 2015 Pearson Education, Inc.

Social Death Social death can occur when a person is not treated as an active member of society. Loss of being valued or appreciated by others Denying a person normal social interaction © 2015 Pearson Education, Inc.

Coping with Loss Bereavement: the loss or deprivation experienced by a survivor when a loved one dies Grief: an individual's reaction to significant loss, including one's own impending death, the death of a loved one, or a quasi-death experience; grief can involve mental, physical, social, or emotional responses. Mourning: the culturally prescribed behavior patterns for the expression of grief © 2015 Pearson Education, Inc.

What Is "Typical" Grief? Symptoms frequently include Periodic waves of prolonged physical distress A feeling of tightness in the throat, choking, and shortness of breath A frequent need to sigh, feelings of emptiness, and muscular weakness Intense anxiety that is described as actually painful Insomnia, memory lapses, and loss of appetite Difficulty concentrating, and other symptoms © 2015 Pearson Education, Inc.

Worden's Model of Grieving Tasks Accept the reality of the loss. Work through the pain of grief. Adjust to an environment in which the deceased is missing. Emotionally relocate the deceased and move on with life. © 2015 Pearson Education, Inc.

Life-and-Death Decision Making The Right to Die Advance directives are documents that stipulate an individual's wishes about medical care; used to make treatment decisions when and if the individual becomes unable to voice his or her preferences. Living wills are a type of advance directive. A living will includes specific wishes about dying. Be specific. Get an agent. Discuss your wishes. Deliver the directive. One alternative to a living will is a document called Five Wishes. © 2015 Pearson Education, Inc.

Rational Suicide and Euthanasia Rational suicide is the decision to kill oneself rather than endure constant pain and slow decay. Active euthanasia—when a person or an organization knowingly acts to end the life of a terminally ill person Passive euthanasia—the intentional withholding of treatment that would prolong life © 2015 Pearson Education, Inc.

Making Final Arrangements Hospice Care: Positive Alternatives Hospice is a concept of end-of-life care designed to maximize quality of life and help dying people have peace, comfort, and dignity. Palliative care aims to relieve the dying person's pain, symptoms, and stress of serious illness in order to improve quality of life for patients and their families. Making Funeral Arrangements Many different customs Funerals exist to assist survivors coping with loss. © 2015 Pearson Education, Inc.

ABC News Video: Understanding the Difficulties of Care Givers Discussion Questions Discuss the cost of part time care versus that of a nursing home. Which option is more affordable and may appeal to the average income family? Discuss the advantages of enrolling an elderly family member in the “village” type program. Before enrolling an elderly family member in either program, what questions would you need to ask to determine the best type of care? © 2015 Pearson Education, Inc.

Making Final Arrangements Wills Intestate—dying without a will Procedure for establishing a legal will is relatively simple and inexpensive Organ Donation Uniform donor cards are available through the U.S. Department of Health and Human Services, as well as many health care foundations and nonprofit organizations. © 2015 Pearson Education, Inc.