1. Copyright © 2010 Pearson Education, Inc. written by Bridget Melton, Georgia Southern University Lecture Outline Chapter 19 Life’s Transitions: The Aging Process

2. Copyright © 2010 Pearson Education, Inc. Objectives Define aging, and explain the related concepts of biological, psychological, social, legal, and functional age. Explain how the growing population of older adults will impact 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.

3. Copyright © 2010 Pearson Education, Inc. Objectives (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, the stages of the grieving process, and strategies for coping with death. 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.

4. Copyright © 2010 Pearson Education, Inc. Growing Old Aging is a pattern of life changes that occurs as one grows older. Gerontology is the study of individual and collective aging processes. Biological age Psychological age Social age Legal age Functional age

5. Copyright © 2010 Pearson Education, Inc. Successful Aging Avoid serious, debilitating diseases and disability. Engage independently in most normal activities of daily living. Maintain cognitive function. Able to cope with physical, social, and emotional changes Sense of control of their lives

6. Copyright © 2010 Pearson Education, Inc. ABC News Video: Seniors Say No to Retirement Discussion Questions 1.What effects do having a purpose and being active have on attitudes toward life, wellness, and aging? 2.Do your parents intend to retire? Do you think they should? 3.Should older people be forced to stop working when they reach a certain age? | Seniors Say No to Retirement

7. Copyright © 2010 Pearson Education, Inc. Older Adults A growing population Today, there are 37 million people age 65 or older in the United States. That number is expected to increase as baby boomers age. New programs are targeting baby boomers that promote health and prevent premature disease and disability.

8. Number of Americans Age 65 and Older (in millions), Years 1900–2000, and Projected 2010–2050 Copyright © 2010 Pearson Education, Inc.

9. Health Issues for an Aging Society As the number of older Americans increases, their financial and medical needs become issues. More people will be drawing from Social Security while less people contribute to the system. Health care costs to the individual will rise as Medicare coverage becomes less adequate. Housing and living arrangements will be a problem for low-income elderly. A shortage of donor organs will present difficult ethical questions.

10. Living Arrangements of Americans Age 65 and Older Copyright © 2010 Pearson Education, Inc.

12. Theories on Aging Biological theories Wear-and-tear Cellular Autoimmune Genetic mutation Psychosocial theories of aging

13. Normal Effects of Aging on the Body Copyright © 2010 Pearson Education, Inc.

14. Changes in the Body and Mind Typical physical changes Skin Bones and joints Head Urinary tract Heart and lungs Eyesight Glaucoma Macular degeneration Hearing Sexual changes Body comfort

15. Copyright © 2010 Pearson Education, Inc. Changes in the Body and Mind (cont.) Typical mental changes Intelligence Memory Adaptability Depression Senility

16. Copyright © 2010 Pearson Education, Inc. Alzheimer’s Disease Progressive brain impairment that interferes with memory and normal intellectual functioning Most common form of dementia Affects an estimated one in ten persons over the age of 65 and nearly half of those over age 85

17. Copyright © 2010 Pearson Education, Inc. Alzheimer’s Disease (cont.) Progresses in stages First stage involves forgetfulness and memory loss. Second stage sees accelerated first-stage symptoms and agitation, restlessness, and repetitive actions. In the final stage, disorientation is complete, control of body functions are lost, and dependence on others is complete.

18. Copyright © 2010 Pearson Education, Inc. Health Challenges of Older Adults Alcohol use and abuse Prescription drug use Over-the-counter remedies

19. Copyright © 2010 Pearson Education, Inc. Strategies for Healthy Aging Develop and maintain healthy relationships Enrich the spiritual side of life Improve fitness Eat for health

20. Copyright © 2010 Pearson Education, Inc. Caring for Older Adults Older adults often experience comorbidity, or multiple chronic health problems. Respite care is care that is given by someone who relieves the primary caregiver.

21. Copyright © 2010 Pearson Education, Inc. ABC News Video: Caring for Elderly Parents Discussion Questions 1.The number-one tip for families currently caring for elderly parents is to choose a primary caregiver. Do you agree with this tip? What would rank second in importance? 2.How can family and friends support the primary caregiver? 3.Offer some suggestions on what to do if your elderly parent(s) are (is) not accepting your help. | Caring for Elderly Parents

22. Copyright © 2010 Pearson Education, Inc. Understanding Death Dying is the process of decline in body functions, resulting in death. Death is the final cessation of vital functions. Uniform Determination of Death Act, 1981 Brain death is the irreversible cessation of all functions of the entire brain stem.

23. Copyright © 2010 Pearson Education, Inc. Denying Death Denying death is an effort to limit our own discomfort Those who deny death tend to avoid people who are grieving. fail to acknowledge a dying person’s situation. use euphemisms for the word death. give false reassurances to people who are dying. avoid touching people who are dying.

24. Copyright © 2010 Pearson Education, Inc. The Process of Dying Complex process that includes physical, intellectual, social, spiritual, and emotional dimensions Kübler-Ross and the stages of dying Denial, anger, bargaining, depression, acceptance

25. Copyright © 2010 Pearson Education, Inc. The Process of Dying (cont.) Social death denies a person normal social interaction. Referring to the dying person as if they were already dead Inadvertently excluding the dying person from conversations Moving dying patients to terminal wards Avoiding bereaved family members Making degrading comments about patients in their presence

26. Kübler-Ross’s Stages of Dying Copyright © 2010 Pearson Education, Inc.

27. Coping with Loss Bereavement is the loss or deprivation experienced by a survivor when a loved one dies. Grief is a state of mental distress that occurs in reaction to significant loss. In disenfranchised grief, a person experiences a loss that cannot be openly acknowledged, publicly mourned, or socially supported. Mourning refers to culturally prescribed and accepted time periods and behavior patterns for the expression of grief.

28. Copyright © 2010 Pearson Education, Inc. What Is Normal Grief? Acute grief syndrome often includes periodic waves of physical distress lasting 20 minutes to an hour. a feeling of tightness in the throat. choking and shortness of breath. a frequent need to sigh. a feeling of emptiness in the abdomen. a sensation of muscular weakness. intense anxiety.

29. Copyright © 2010 Pearson Education, Inc. Worden’s Model of Grieving Tasks William Worden developed a more active grieving model that defined four tasks necessary for the individual to complete in the grief-work process. 1.Accept the reality of the loss. 2.Work through to the pain of grief. 3.Adjust to an environment in which the deceased is missing. 4.Emotionally relocate the deceased and move on with life.

30. Copyright © 2010 Pearson Education, Inc. When an Infant or Child Dies The grief experienced when a child dies may be overwhelming. The entire family feels pain, but it may be especially hard for siblings. A child’s response to death may be longer grieving periods.

31. Copyright © 2010 Pearson Education, Inc. Quasi-Death Experiences Losses that resemble death and that may involve a heavy burden of grief: a child running away, an abduction or kidnapping, a divorce, a retirement, or ending an athletic career

32. Copyright © 2010 Pearson Education, Inc. Life-and-Death Decision Making The right to die: Some states legally allow certain life support techniques to be refused by competent patients. Electrical or mechanical heart resuscitation Mechanical respiration Nasogastric feeding tube Intravenous nutrition Gastrostomy Medication

33. Copyright © 2010 Pearson Education, Inc. Living Will If a person is in a coma or otherwise incapable of speaking on his or her own behalf, medical personnel and administrative policy will dictate treatment. A living will contains the person’s desire not to receive artificial life support. Legal steps Be specific. Get an agent. Discuss your wishes. Deliver the directive.

34. Organ Donor Card Copyright © 2010 Pearson Education, Inc.

35. Rational Suicide The concept of rational suicide is a reasoned, coherent process in which a person chooses death as a preferable alternative to unbearable pain. Euthanasia involves ending the life of a person who is suffering greatly and has no chance of recovery. Passive euthanasia is the intentional withholding of treatment that would prolong life. Dr. Jack Kevorkian started a one-person campaign to force the medical profession to review its position regarding physician-assisted suicide.

36. Copyright © 2010 Pearson Education, Inc. Making Final Arrangements Hospice care has the primary purpose of relieving the dying person’s pain, offering emotional support to the dying person and loved ones, and restoring a sense of control to the dying person, family, and friends. Funeral arrangements Wake or viewing Burial Cremation Anatomical donation