Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Chapter 13 Late Adulthood Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Definition Encompassing the ages between 65 and 74 years Many people in the late-adulthood phase of the life cycle postpone retirement and remain active in the workforce Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Health Concerns Development of osteoporosis-encourage to increase calcium and vitamin D Risks for falls and fractures Poor awareness of healthy behavior options Increased risk of influenza and pneumonia-encourage immunizations Development of cataracts-vision checks on regular basis Increased loss of hearing Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Statistics Healthy People 2020 supports services that aid in the maintenance of independence for the elderly, including transportation to health-care facilities, housing, and an increasing number of certified specialists to care for the elderly. Important goals in managing the aging process include preventing illness and disability, maintaining cognitive functioning, and promoting an active and healthy lifestyle. In 2009 over 39.6 million Americans were 65 years or older By 2050, it is estimated that there will be over 86 million 65 years or older See Table 13-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Income Social security, pensions, personal assets, and earnings Covered by Medicare and private insurance Health Care Affordability Act of 2010-purpose was to be able to provide wider health coverage Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Education Level As of 2009, approximately 77% of people over 65 years of age were high school graduates and 15% of those over 75 were college graduates Understanding these statistics enables the health-care worker to plan for the needs and limitations of the elderly population they serve in the twenty-first century Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Challenges And Problems Access to health care-transportation Reduced income Changes in living arrangements Caregiver assistance Altered nutritional needs Assistive devices Preventing falls Polypharmacy Elder or dependent abuse Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Psychosocial Development Many developmental tasks and related challenges Those with healthy attitudes and coping skills are able to find fulfillment and meaning in their lives Weight gain, dental problems, diminished eyesight and hearing, decreased mobility, and changes in body image are some issues that create difficulty See Box 13-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Psychosocial Issues These psychosocial areas help to motivate social activities and enhance well being. Autonomy-able to self direct Competence-describe the older adult’s ability to engage in effective interactions Relatedness-feeling of belonging See Figure 13-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Grandparenting Enhances self-image, increases activity level, creates feelings of self-worth and usefulness, and contributes to the meaning and quality of life When grandparents become ill or disabled the roles can reverse and the older adult needs more assistance Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Postmenopause Important developmental task of the older woman Defined as the absence of menstruation for a period of at least 1 year A natural occurrence in the life cycle Hormone replacement therapy (HRT) and Complementary and alternative therapy (CAM) Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Lifestyle Changes Hotflashes Vaginal dryness Mood swings Urinary leakage Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Driving Safety Undetected impairments Occupational and physical therapy License may be taken away Alternative transportation Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Health Screenings Dental and eye checkups Physical evaluation that includes weight, blood pressure, thyroid, and blood glucose and lipid levels Assess for substance abuse, overmedication, sexual dysfunction, urinary incontinence-can happen due to decreased liver and kidney function Papanicolaou (Pap) smear and mammography Bone mass-osteoporosis, exercising Cardiovascular-smokers, hypertensive clients-assess chol, HDL, LDL, Trig, etc Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Sexuality This is an area that can be sensitive to the older adult Most common cause of sexual dissatisfaction is the lack of a partner Men may develop erectile dysfunction-now is treatable with success Painful intercourse (dyspareunia) for women-ask if has affected them; what are some things that can be done to help Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Memory Loss Normal memory loss can be associated with aging Temporary memory loss can be caused by depression or anxiety Preclinical manifestations of Alzheimer's disease Engage clients to continue active lifestyles that will exercise their mind and memory functions Age-associated memory loss is characterized by a temporary memory loss or benign forgetfulness such versus abnormal cognitive abilities When getting a health history remember sometimes may need to give person more time to answer See Boxes 13-2 and 13-3 and Table 13-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Emotional Health Emotions and emotional control develop during the growth and development process Disengagement Continues emotional learning and emotional competencies In cultures that respect and include older adult in lives of the family encourages a emotional competencies and also enhances quality of life Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Depression Should not be automatically expected to appear in the older adult Rapid onset depression related memory loss has rapid onset Age related memory loss is slow progression Late onset depression-changes in brain Side effects of medication may mimic depression Depression can trigger physical illness Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Clinical Disease Good health in older people is often defined as the absence of disease or disability Normal body changes resulting from aging, such as ovarian failure or menopause, place a risk on the cardiovascular, bone, and metabolic systems See Lifespan Consideration Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Physical Activity Exercise can significantly slow the aging process Resting metabolic rate decreases with age Muscle strengthening exercises Regular balance exercises May have a protective effect on cognitive function Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Teaching Techniques Learner must be motivated to learn Teaching must be relevant to the learner and appropriate to the developmental stage and abilities of the learner Learning relates better when related to actual experiences Learning is enhanced if mutual respect exists between teacher and learner Helping this age group to learn to manage stress can help development of depression and clinical disease Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.