1. Chapter 14: Preparing for Aging, Death, and Dying
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2. 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.
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3. 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.
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4. 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.
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5. 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.
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6. Number of Americans 65 and Older
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7. 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.
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8. 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?
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9. Living Arrangements for Americans Age 65 and Older
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10. Physical and Mental Changes of Aging
Typical physical changes
Skin
Bones and joints
Urinary tract
Heart and lungs
Senses
Sexual function (men and women)
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11. 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.
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12. Normal Effects of Aging on the Body
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13. 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
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14. 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.
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15. Exercise Recommendations for Adults over Age 65
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16. 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
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17. 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
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18. Kübler-Ross's Stages of Dying
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19. 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
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20. 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
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21. 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
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22. 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.
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23. 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.
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24. 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
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25. 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.
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26. 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.
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