1. AGING DEATH AND BEREAVEMENT

2. AGING AGING By 2020 15% of population of us will be above 65 yrs. By 2020 15% of population of us will be above 65 yrs. The fastest growing segment is people above 85. The fastest growing segment is people above 85. Average life expectancy in US is about 76 years. Average life expectancy in US is about 76 years. Gerontology—the study of aging and geriatrics –important new medical field. Geriatrics– care of elderly Gerontology—the study of aging and geriatrics –important new medical field. Geriatrics– care of elderly

3. SOMATIC AND NEUROLOGIC CHANGES SOMATIC AND NEUROLOGIC CHANGES Strength and physical health gradually decline Strength and physical health gradually decline Changes in the brain occur with aging Changes in the brain occur with aging -- decreased weight, enlarged ventricle, decreased cerebral blood flow. Senile plaques, neurofibrillary tangles==severe-- Alzheimers disease. -- decreased weight, enlarged ventricle, decreased cerebral blood flow. Senile plaques, neurofibrillary tangles==severe-- Alzheimers disease. Cognitive changes – memory loss. intelligence remains same Cognitive changes – memory loss. intelligence remains same

4. Ego integrity / despair Ego integrity / despair Psychopathology Psychopathology Depression Depression Suicidal tendencies Suicidal tendencies Change in sleep patterns Change in sleep patterns anxiety and fear. anxiety and fear. Alcohol related problems Alcohol related problems Longevity—continuation of physical, occupational activity. Advanced education. Longevity—continuation of physical, occupational activity. Advanced education. Social support systems Social support systems

5. Stages of dying and death Stages of dying and death Denial Denial Anger Anger Bargaining Bargaining Depression Depression Acceptance –I am ready to go. Acceptance –I am ready to go.

6. Bereavement versus depression Bereavement versus depression ---characteristics of bereavement ---characteristics of bereavement Shock and denial Shock and denial Illusion of existence Illusion of existence Subsides after 1-2 years Subsides after 1-2 years Mortality rate high for close relatives. Mortality rate high for close relatives. Widowed men– high risk Widowed men– high risk

7. ----depression ----depression Significant weight loss Significant weight loss Sleep disturbance Sleep disturbance Hallucinations Hallucinations Suicide attempts Suicide attempts

8. Physicians response Physicians response Support to patient & family Support to patient & family As per patients wish tell him/Her and relatives about the condition. As per patients wish tell him/Her and relatives about the condition. Sense of failure-- emotional detachment. Sense of failure-- emotional detachment.