2. Chapter 12 Older Adulthood: Age 66 Plus

3. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Objectives Analyze physical changes that occur in older adults. Analyze cognitive changes that occur in older adults. Analyze socio-emotional changes that occur in older adults. Summarize how older adults might express integrity rather than despair. continued

4. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Objectives Identify how supportive relationships impact physical, cognitive, and socio-emotional well-being in older adulthood. Compare and contrast the stages of dying and the stages of grief.

5. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Older adulthood typically refers to the stage of life when people are age 66 and above Centenarian is a person age 100 or older Changes in physical appearance and functioning are common for many older adults People become more wrinkled as they age and harmless age spots, or liver spots, occur continued

6. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Muscle loss affects range of motion, and movements become slower –Physical activities can slow this process Internal body organs age and lose some efficiency of their function Incontinence may occur as health problems increase continued

7. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Sensory changes from middle adulthood continue throughout older adulthood Presbyopia progressively worsens Other vision conditions often develop Eye doctors recommend scheduling visits at least every 1–2 years, but sooner if changes in visual acuity are noted continued

8. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes The most common vision conditions in older adulthood are –cataracts (causes cloudy or distorted vision) –glaucoma (involves damage to the optic nerve) –macular degeneration (causes difficulty seeing objects in the center of the field of vision, while objects in the periphery are clearly visible) continued

9. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Diabetic retinopathy is an eye disease that involves damage to the blood vessels in the retina continued ©rob3000/Shutterstock.com

10. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Hearing loss associated with age is called presbycusis Many older adults complain of hearing a ringing sound in their ears, called tinnitus Hearing aids can help older adults cope with hearing loss continued

11. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Other sensory changes that typically occur in older adulthood include –a decrease in the sense of taste and smell –less sensitivity to pain and touch Both of these sensory changes can affect quality of life continued

12. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Sarcopenia, the loss of muscle mass and strength, continues to increase through older adulthood Many adults feel more stiffness in their bones along with muscle aches and pains Conditions affecting the bones, such as osteoporosis, continue to cause brittle, less dense bones continued

13. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes As in any other stage of life, proper nutrition is vital to maintain health Older adults may need to take dietary supplements to ensure they are meeting nutritional needs Physical activity recommendations for older adults vary depending on ability and health continued

14. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Older adults need 7 to 9 hours of sleep Frequent waking can disrupt sleep, and as a result, older adults may take frequent naps Changes in sleep patterns, such as those caused by sleep apnea, often result in a poor sleep quality continued

15. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes For healthy older adults, doctors continue to recommend regular health exams Dentists recommend scheduling annual exams and cleanings every six months For older adults who lose some or all of their natural teeth, dentures can help them comfortably eat, speak, and smile continued

16. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes There is a high incidence of chronic disease in older adults, especially those over age 85 –Cardiovascular disease –Cancer –Diabetes –Arthritis –Hypertension Older adults are more likely to catch common colds and flu continued

17. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Concerns of older adults include –increasing the quality and years of healthy life –eliminating health disparities Many diseases can be prevented or at least symptoms can be relieved with –proper nutrition, physical activity, food availability, and weight management –regular oral health, vision, and hearing care continued

18. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Physical Qualities and Changes Medicare, a government health insurance program, helps older adults pay for medical costs Social Security, a government retirement fund, provides supplemental income to Americans who –are at least 62 years of age –have met employment contribution eligibility standards

19. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 1.What age range does older adulthood typically include? What is a centenarian? ages 66 and above, a person age 100 or older 2.List three common changes older adults may experience in body composition and strength. (List three:) muscle mass and strength decline, fatty tissue increases, joints often ache, bones become brittle and less dense continued

20. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 3.Describe common sensory changes in older adulthood. Hearing and vision loss occur, resulting in vision problems such as cataracts, glaucoma, macular degeneration, and diabetic retinopathy; and hearing problems such as presbycusis and tinnitus. Decreases in the senses of taste, smell, and touch occur as well. continued

21. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 4.Explain the increase for nutritional needs in older adults. The body’s ability to absorb certain nutrients decreases in older adulthood. Medications and state of health can have an effect on nutritional needs as well. 5.Describe sleep apnea. condition in which the airway collapses or becomes blocked and causes a person to have pauses in breathing while sleeping continued

22. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 6.Compare and contrast Medicare and Social Security. Both are government programs that have been offered to older Americans for many decades. Medicare is a health insurance program that helps older adults pay for medical costs. Social Security is a retirement fund that provides supplemental income to Americans who are at least 62 years old.

23. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Cognitive Change In older adulthood, cognitive abilities may decline and adults may have more trouble –processing new information –recalling memories –concentrating Two theories help explain memory loss –Data overload (because the brain can only hold so much information) –Decrease in brain functioning continued

24. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Cognitive Change Verbal ability remains stable and may actually increase slightly during older adulthood Older adults remain in Kohlberg’s postconventional morality stage of moral development Traits of this stage include –valuing society as a whole –contributing to the well-being of others

25. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 1.How do older adult cognitive skills change? Cognitive abilities decline in the form of impaired brain processing and memory loss. continued

26. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 2.Compare and contrast two theories that explain memory loss in older adults. One theory states that memory loss occurs as a result of too much information being compiled over time and that the brain can only hold so much information. The second theory states that memory decline occurs as a result of declining brain functioning. continued

27. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 3.How do long-term memories influence older adult’s language abilities? Verbal ability is built on long-term memory. 4.Older adults are in which stage of Kohlberg’s moral development theory? postconventional morality

28. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Socio-emotional Change The need to be connected with others does not diminish in older adulthood, although social roles may change Erikson theorized that older adults experience a period of reviewing their life and accepting or struggling with experiences and decisions This stage is called integrity versus despair continued

29. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Socio-emotional Change Family relationships remain important Social roles change as new relationships develop and new bonds form Older adults may require more help and support from their adult children continued

30. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Socio-emotional Change Many older adult siblings face the passing of their parents and other siblings These transition periods are significant as remaining siblings take on new roles A woman may become the matriarch or a man may become the patriarch of the family continued

31. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Socio-emotional Change Maintaining relationships that include friends and community members helps fulfill societal and social needs continued ©Monkey Business Images/Shutterstock.com

32. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Socio-emotional Change The decision to retire is a major life decision that affects not only the worker, but also his or her spouse Options available after retirement may include –traveling –participating in hobbies –spending more time with family and friends –getting a part-time job –volunteering continued

33. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Socio-emotional Change Depression is common in older adulthood as work and family roles change and physical abilities decrease Loss of friends and family members increase these feelings Many medications also have side effects that cause depression continued

34. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Signs of Socio-emotional Change Myths on aging come from societal sharing of false or inaccurate beliefs Bias against, or unfair treatment of, older adults is termed ageism Although people often remain true to their temperament or personality, most tend to mellow with age

35. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 1.According to Erikson, what is the primary socio-emotional task of older adulthood? integrity versus despair 2.List three examples of how social roles change during older adulthood. adults move out of parenting roles, take care of grandchild or great-grandchildren, and retire continued

36. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 3.Why is social interaction important in older adulthood? fulfills the need for love, acceptance, and companionship; helps reduce feelings of depression, sadness, or loneliness; provides help and support when needed continued

37. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 4.Why may older adults view retiring as challenging? They have come to be defined by their profession and must find a new self-identity. 5.Describe ageism and give an example. bias against, or unfair treatment of, older adults (Examples will vary.)

38. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Special Needs Special needs in older adulthood vary Many special needs are related to physical ailments, as the body is declining in ability In addition to medications, adults may need to make other lifestyle adjustments to accommodate for changes continued

39. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Special Needs In older adulthood, dementia is common Memory loss for those with dementia differs from normal forgetfulness Dementia does not have a cure, but with some medications, symptoms may significantly improve continued

40. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Special Needs Alzheimer’s disease is a progressive brain disorder that includes memory loss and progressively severe confusion With decreasing physical abilities, many older adults have difficulty caring for themselves They may need alternative living arrangements continued

41. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Special Needs Many older adults want to stay in their homes Some older adults are not able to live independently because of poor health Moving from independence to increasing dependence is a major family-life transition Some older adults may move into new living communities continued

42. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Special Needs New living arrangements can be an option to provide more care as needed Three main types of living communities offer different levels of support –Independent living communities –Assisted living housing –Retirement homes continued

43. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Special Needs Caring for a loved one who is terminally ill is beyond what many people can do Hospice care is a form of care given by trained medical professionals It focuses on making a person comfortable in his or her last days and hours of life Care can be provided either in the patient’s home or in a hospice living center

44. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 1.What is dementia? How does dementia differ from normal memory loss? Dementia describes cognitive decline and memory loss caused by damage to the brain. A person with normal forgetfulness may simply need a prompt to remember. A person with dementia may ask the same questions repeatedly and not realize they asked the questions. Dementia can also affect language ability and personality. continued

45. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 2.Define Alzheimer’s disease. What are treatment options available for Alzheimer’s disease? Alzheimer’s is a progressive brain disorder that includes not only memory loss, but also progressively severe confusion. Treatment options include therapy, medications, help from a caregiver, and adjustments to housing. continued

46. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 3.Why may living arrangements need to change as an adult ages? With declining physical abilities, older adults may have difficulty caring for themselves and may need to live with family or in a living community. 4.What are three main types of living communities available for older adults? independent living communities, assisted living housing, and retirement homes continued

47. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 5.Explain hospice care and the needs it serves. Hospice care focuses on making a person comfortable in his or her last days and hours of life by controlling pain and serving emotional and sometimes spiritual needs. Hospice caregivers also focus on the needs of the family and loved ones as well.

48. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Death and Grief Older adults will often plan for their inevitable passing in a rational and organized way A Last Will and Testament gives directions on how to divide financial assets Those who receive the financial assets are called beneficiaries continued

49. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Death and Grief Many people have a living will that indicates medical preferences in the event they are unable to make decisions themselves Dying intestate means to die without a will When there is no will, state laws determine the division of assets continued

50. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Death and Grief Stages people experience when coping with their own death or grieving for another are –denial –anger –bargaining –depression –acceptance Each person is different and will not experience these stages in the same way continued

51. Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. Death and Grief One of the most difficult losses for older adults is losing a spouse and becoming a widow or widower Different cultures may have different customs involved with bereavement, grief, and mourning Friends and family can help individuals cope with the natural grieving process

52. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 1.Compare and contrast the difference between a Last Will and Testament and a living will. Both are legal documents concerning actions that need to be taken regarding a person’s death. A Last Will and Testament gives directions on how to divide financial assets, while a living will gives directions on whether to keep the person alive by artificial means or to let them pass, when there is no chance of recovery. continued

53. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 2.List and explain the five stages of dying. denial—individuals reject the idea of dying and ignore the concept of their own death; anger— individuals experience feelings of negativity and resentment; bargaining—individuals propose deals or exchanges in order to preserve their own life; depression— individuals struggle with the loss of life and become sad and withdrawn; acceptance— individuals understand and accept that the reality of their own death is near continued

54. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 3.Differentiate between the terms bereavement, grief, and mourning. Bereavement is the state of losing a loved one through death. Grief is the mental anguish or sadness that accompanies bereavement. Mourning is the period when family members and friends remember and grieve for the loss of a beloved one. continued

55. Checkpoint Permission granted to reproduce for educational use only.© Goodheart-Willcox Co., Inc. 4.How do the five stages of dying differ from the five stages of grieving? The five stages of grieving typically occur after an individual’s death, and involve loved ones coming to terms with the individual’s death and moving forward with their own lives.