1. ELDER DEVELOPMENT Human Development College of Public and Community Service University of Massachusetts at Boston ©2009 William Holmes 1

2. ELDER PHYSICAL CHANGES Physical decline before cognitive decline Onset varies widely Loss of indivisible cells Accumulation of genetic errors Mitochondrial energy loss Cumulative disease effects 2

3. ELDER PHYSICAL DECLINE: 1 Vision Hearing Touch (including pain receptors) Neural response Lung function Digestion 3

4. ELDER PHYSICAL DECLINE: 2 Bones Dentistry Reproduction Heart Gastourinary Stamina White-matter lesions increase 4

5. COGNITIVE CHANGES Slower thinking More knowledge/wisdom Reduced perception/awareness Increased distractibility More gestalt awareness Affected by education Related to “metabolic syndrome” 5

6. ELDER DIMENTIA: 1 Dietary factors Drug interaction Environmental stimulation Brain lesions Natural brain decay 6

7. ELDER DIMENTIA: 2 High blood pressure Low blood pressure Alzheimer's Alcohol damage Substance abuse 7

8. REASONS FOR ELDER ABUSE AND EXPLOITATION Payback Financial gain Stress response Burnout False expectations Inadequate system response 8

9. ELDER INDEPENDENCE: 1 Financial Personal care Shopping Social interaction/ participation Creativity 9

10. ELDER INDEPENDENCE: 2 Family ties Friends Neighborhood environment Exercise Gene therapy 10

11. ELDER PSYCHOSOCIAL DEVELOPMENT: 1 Gender roles—crossover and discontinuity Sexuality—desire, impotency, love Familial relations Caretaking 11

12. ELDER PSYCHOSOCIAL DEVELOPMENT: 2 Employment Leisure Activity versus disengagement Integrity versus despair 12