Chapter 14: Preparing for Aging, Death, and Dying © 2017 Pearson Education, Inc.

Learning Outcomes Explain how the growing population of older adults will affect society, including considerations of economics, health care, living arrangements, and ethical and moral issues. Describe the physical and mental changes associated with aging and the unique health challenges faced by older adults. List strategies for successful and healthy aging. Define death and discuss strategies for coping with death. © 2017 Pearson Education, Inc.

Learning Outcomes (cont.) Describe typical grief symptoms and the grieving process. 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. © 2017 Pearson Education, Inc.

Aging 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. © 2017 Pearson Education, Inc.

Aging (cont.) Older adults: a growing population Life expectancy for a child born in the United States in 2014 is 79.5 years—over 30 years longer than for a child born in 1900. 14 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. © 2017 Pearson Education, Inc.

Number of Americans 65 and Older © 2017 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 or partner, or they live alone; others live with family, friends, or pay for home health services. An increasing number opt for assisted living with supportive services. © 2017 Pearson Education, Inc.

Health Issues for an Aging Society (cont.) 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? © 2017 Pearson Education, Inc.

Living Arrangements for Americans Age 65 and Older © 2017 Pearson Education, Inc.

Physical and Mental Changes of Aging Typical physical changes Skin Bones and joints Urinary tract Heart and lungs Senses Sexual function (men and women) © 2017 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. © 2017 Pearson Education, Inc.

Normal Effects of Aging on the Body © 2017 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 © 2017 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. © 2017 Pearson Education, Inc.

Exercise Recommendations for Adults over Age 65 © 2017 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 © 2017 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 © 2017 Pearson Education, Inc.

Kübler-Ross's Stages of Dying © 2017 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 © 2017 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 © 2017 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 © 2017 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. © 2017 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. Name a health care proxy. Discuss your wishes. Deliver the directive. One alternative to a living will is a document called Five Wishes. © 2017 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 © 2017 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. © 2017 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. © 2017 Pearson Education, Inc.