Chronic conditions -- % with chronic conditions, most common?Chronic conditions- 80% of older Americans have at least one- 50% have at least 2Most common- Heart disease, cancer and strokeDementia, Alzheimer’s Dementia- Deterioration in cognitive and behavioral functioning due to physiological causes- Most irreversible, 10% can be reversed- Most caused by Alzheimer’s diseaseAlzheimer’s disease- Progressive, irreversible, degenerative brain disorder characterized by cognitive deterioration, and loss of control of bodily functions, leading to death- Degenerative brain disorderMemory – short and long term- Reserve capacityShort term- Gradually shrinks in capacity with age- Also called working memoryLong term- 3 categories: episodic, semantic, procedural- Episodic: specific experiences or events, linked to time and placeo Most likely to deteriorate with age- Semantic: general factual knowledge, social customs, and languageo Does not depend on where or when something was learnedo Little decline with age- Procedural: motor skills, habits, and ways of doing things, which can be recalled without conscious effort (implicit memory)o Unaffected by ageWisdom -culmination of a lifetime of personal growth and ego development- “exceptional breadth and depth of knowledge about the conditions of life and human affairs and reflective judgment about the application of this knowledge”-Studied by BaltesChapter 18Erickson -Achievement of late adulthood is a sense of ego integrityEgo integrity versus despair- 8th and final stage of life span- People in late adulthood either achieve a sense of integrity of the self by accepting the lives they have lived, and thus accept death, or yield to despair that their lives cannot be relived- Some despair is inevitable- Ego integrity does not come from just reflecting on the past but also form continued stimulation and challenge Coping -Adaptive thinking or behavior aimed at reducing or relieving stress that arises from harmful, threatening, or challenging conditionsAdaptive defenses- Change people’s perceptions of realities they are powerless to change- May be unconscious or intuitive- Humor, altruism, anticipation, suppression, etc.Cognitive-appraisal model- Model of coping- On the basis of continuous appraisal of their relationship with the environment, people choose appropriate coping strategies to deal with situations that tax their normal resources- Problem-focused coping: directed toward eliminating, managing, or improving a stressful situation- Emotion- focused coping: directed toward managing the emotional response to a stressful situation so as to lessen its physical or psychological impactRetirement – family focused- Volunteer workFamily-focused lifestyle- Pattern of retirement that revolves around family, home and companions- Conversation, watching tv, playing with cards, etc.Volunteer work- Tied to well-being during retirement- Protects against identity loss and mental health declineLiving arrangements-what do people want?- Aging in place-Most older adults live with a spouse, more women live alone with increasing age because of death of a spouseAging in place- Remaining in one’s own home, with or without assistance- What most adults preferMarital relationships Long-term marriage- Higher satisfaction- Healthier- Reduce anxiety and increase self-esteemWidowhood- Women more likely to be widowedDivorce and remarriage- 11% divorce rate later in life- Men more satisfied in late-life marriages- Less likely than unmarried couples to need support from the communityNonmarital relationships Single life- More likely than divorced or widowed people to prefer single life and less likely to be lonely- Least amount of social support - “single strain”- practical and emotional stressors attributed to the lack of an intimate partnerCohabitation- Very likely for older adults- Disadvantage for women, especially Gay and Lesbian relationships- Strong, supportive and diverse- Friendship networks substitute for families- No benefits such as partners social securityFriendships- Active circle of friends makes person happier and healthier- Deal better with changes of aging- Enjoy time with friends more than time with familiesNonmarital Kinship ties Relationships with adult children- Good relationships linked with less depression and loneliness - Close mother-daughter relationship- Children provide a greater share of supportRelationships with siblings -siblings provide both companionship and emotional support- rivalry decreases by old age- sisters vital in maintaining family relationships and well-beingGreat-grandparents -less involved than grandparents- most find the role fulfilling and a mark of longevity- source of wisdom, links to the pastChapter 19Care of the dying- Hospice, palliative careHospice- Personal, patient-and-family centered care for a person with a terminal illness- Focused of palliative carePalliative care- Care aimed at relieving pain and suffering and allowing the terminally ill to die in peace, comfort, and dignity- Also called comfort care- Leads to a higher quality of life, better emotional statem and longer surivial timeKubler Ross stages 5 stages in coming to terms with death1. Denial2. Anger3. Bargaining4. Depression5. AcceptancePatterns of grieving Bereavement- Loss, due to death, of someone to whom one feels close and the process of adjustment to the lossClassic grief work model1. Shock and disbelief2. Preoccupation with the memory of the deadperson3. ResolutionSuicide -Rate in the US much lower than other countries-native American men have highest rates for race- white men over 75 have highest rates in generalEuthanasia Passive euthanasia- Deliberate withholding or discontinuation of life-prolonging treatment of a terminally ill person in order to end suffering or allow death in dignityActive euthanasia- Deliberate action taken to shorten the life of a terminally ill person in order to end suffering or to allow death with dignity- Also called mercy killingAdvance directives -“living will”-document specifying the type of care wanted by the maker in the event of an incapacitating or terminal illnessEnd of life options -Different cultures see the path towards death in different ways-need for better palliative
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