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Chapter 13
Late Adulthood
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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
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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
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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.
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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
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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
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7. 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
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8. 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.
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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.
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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
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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)
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Lifestyle Changes
Hotflashes
Vaginal dryness
Mood swings
Urinary leakage
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Driving Safety
Undetected impairments
Occupational and physical therapy
License may be taken away
Alternative transportation
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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
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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
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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.
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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
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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
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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
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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
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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
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