1. Slide 1 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. CHAPTER 8 Life Span Development -65 years and older CHAPTER 8 Life Span Development -65 years and older

2. Slide 2 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Late Adulthood: 65 Years and Older  Aging is normal condition of human existence  Studied from sociologic, physiologic, psychologic perspective Interrelated throughout the life span  Gerontologists Study the older adult and aging process  Persons’ response to age-related changes visible in mirror is related to person’s self-esteem  Sociologic issues of aging concerned with Work, retirement, social security, health care Stages of Growth and Development

3. Slide 3 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Response to getting older are related to Lifelong health habits, diet and exercise  Factors important to survival and well-being Family, love, friendships and intimate relationships  Love relationships vary in intensity and meaning in adulthood Early: intense physical basis leading to intimacy, respect and commitment Intense sexual drive decreases with age, sexual behavior remains important part of adult relationship

4. Slide 4 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Ageism form of discrimination and prejudice against the older adult  definitely exists Prevent people from being happy and productive Passed on from generation to generation by process of socialization By 2020, about 20% of population is >65 y/o

5. Slide 5 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Keys to Successful Aging Practice pleasurable activity View life as meaningful Maintain a positive self-image Accept responsibility for the past Be optimistic Remain motivated to maintain or expand intellectual capacity Participate in a planned exercise program

6. Slide 6 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Theories of aging Earliest theories of aging generated by Hippocrates  Aging was irreversible natural event caused by a decrease in body heat Galen  Aging was a lifelong process rather than an event occurring at the end of life span

7. Slide 7 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Theories of aging Autoimmunity theory  Body becomes less able to recognize or tolerate the “self”  Immune system produces antibodies that act against the self  Supported by increased lymphocytes, plasma cell in tissues of normal, healthy, older people  Thymus and bone marrow are affected by aging Wear-and-tear theory  Age is based on chronologic age but determined by amount of wear and tear that one experiences  Structural and functional changes associated with growing old are accelerated by abuse of body

8. Slide 8 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Theories of Aging Free radical theory  Highly reactive cellular components from unstable atoms or molecules  Have reduced cellular efficiency and cause accumulation of cellular waste  Produced by radiation, heat or oxidation  Accelerates aging and result in death of organism  Lipofuscin o Pigment material that accumulates in many organs o Interferes with diffusion and transportation of essential metabolites

9. Slide 9 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Theories of Aging Biological programming theory  Hereditary basis for aging o Evidenced by similarities in life expectancies in a particular family  Programmed genetic occurrence caused by specific aging gene  Progressive environmental damage to cells, interfering with normal cell functions  Aging attributed to o Accumulation of lipofuscin, lipids,a nd fat o Changes in collagen structure and degenerative changes in elastin make tissues stiffer, less pliable and less elastic and efficient

10. Slide 10 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Psychologic Theories Disengagement theory  Natural withdrawal, or disengagement, between individual and society  Withdrawal prevents older adults from experiencing frustration when they can no longer function adequately, while allowing younger member of society to fulfill now-empty role  Criticism of theory o Does not allow for may active, functional older adults o Process is not seen in all cultural groups and it is therefore not universal

11. Slide 11 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Psychologic Theories Activity theory  Older person who is more active socially is more likely to adjust well to aging  More social involvement have higher morale and better life satisfaction and personal adjustment  Meaningful activities involving close, personal contact are important

12. Slide 12 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Psychologic Theories Continuity theory  Critical factors in adjustment to old age are previously developed coping abilities and ability to maintain previous roles and activities  Never highly involved maintains same level of involvement in old age  Adjustment to aging process will be eased by maintaining roles and interests similar to those developed earlier

13. Slide 13 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Late Adulthood: 65 Years and Older  Physical Characteristics Slow increase in body weight until 45 to 50 y/o then gradual decline in weight Adipose tissue accumulation  Female: chest, waist, hips and thighs  Male: waist, chest, and lower abdomen Decrease in trunk length as a result of the increase in spinal curvature due to thinning of the disks Stages of Growth and Development

14. Slide 14 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Physical Characteristics Abnormal postures and contours  Kyphosis: exaggeration of thoraci curvature  Barrel chest: affect position of diaphragm and reduce effectiveness of respiration Postural changes affecting:  Body posture  Mobility  Gait  Respiratory efficiency Pg 182-183

15. Slide 15 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Late Adulthood: 65 Years and Older  Psychosocial Development Older years should be viewed as a time of satisfaction and pleasure. Erikson described challenge of late adulthood as ego integrity versus despair Evaluate one’s life and accomplishments and find satisfaction and meaning in life Mastering task of integrity: feel life is well spent and satisfied with decisions and achievements Conflict and despair: dissatisfied with accomplishments Retirement is a major adjustment. Stages of Growth and Development

16. Slide 16 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Figure 8-23 Many older people continue to work and learn after the traditional retirement age. (From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

17. Slide 17 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Late Adulthood: 65 Years and Older  Family Roles Change with Time Today’s grandparent may be working and highly active. Caring for grandchildren may be a full-time responsibility can lead to multiple stresses Factors contributing to grandparents raising grandchildren: divorce, abandonment, unemployment, death or illness of a child, and incarceration Couples may need to adjust to increased time together, companionship, and closeness. The impact of the death of a spouse is traumatic; being widowed is more common for women than for men. Stages of Growth and Development

18. Slide 18 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Figure 8-20 A loving relationship with a spouse is an example of a positive influence during older adulthood. (From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

19. Slide 19 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Figure 8-21 Beauty throughout the life span.

20. Slide 20 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Cognitive and Intellectual Development Older adults in good health and nurturing environments will have the capacity to maintain or increase their level of functioning. Factors important to continued cognitive functioning:  Level of education  Work roles  Personality  Health  Life style  Relevancy of tasks

21. Slide 21 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Memory Some older adults notice some changes; benign forgetfulness more common than Alzheimer’s disease There appears to be a greater loss of recent memory over remote memory. Older people are more slower than young people but are often more accurate  Sacrifice speed for accuracy

22. Slide 22 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 years and Older  Health Promotion Environment, social patterns, diet, exercise, and personal habits  Factors that determine state of health All ages benefit from living a healthy life style, even in later years Nutrition, activity, sleep, safety

23. Slide 23 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 years and Older  Nutrition Activities related to food and diet include transportation for food purchase, meal planning, and meal preparation Older adults should have a diet of foods higher in quality and lower in quantity while maintaining the basic nutrient content. Most frequently recommended are diets that are low in saturated fats and carbohydrates and high in fiber.

24. Slide 24 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 years and Older  Nutrition Psychosocial factors: economic factors, loneliness; inability to shop for and prepare meals Economic factors  Determine what foods are purchased and included in diet Loneliness  Contribute to inadequate diet Adequate fluid intake is important.  Minimum intake of 1500 mL/day  Avoidance of fluid due to fear of incontinence and lack of thirst

25. Slide 25 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Late Adulthood: 65 Years and Older  Activity Exercise is crucial to general well-being. Improves cardiovascular function, lowering BP while enhancing oxygen utilization and maintaining joint mobility Never to a point of exhaustion Followed by rest periods to recuperate and maintain the body to its maximum level of functioning  Sleep More rest but less actual sleep is required. More accidents when awakening at night Night lights and reduce excess furniture or clutter decreases risk of nighttime injury Stages of Growth and Development

26. Slide 26 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Late Adulthood: 65 Years and Older  Safety Most accidents are preventable. The key to prevention is knowledge and recognition of the contributory factors that place the person at greater risk. Diminished sight, with changes in posture or balance, can dispose to risk of falls Single fall produce injury requiring immobilization

27. Slide 27 Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Stages of Growth and Development Developmental Tasks of Late Adulthood  Accepts own life  Recognizes accomplishments  Finds satisfaction with new roles, relationships and leisure time  Maximizes independence and maintains high level of involvement  Accepts own mortality and prepares for death