Chapter 19 Life’s Transitions: The Aging Process Objectives

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Chapter 19


  • Define aging, and explain the related concepts of biological, psychological, social, legal, and functional age.
  • Explain how the growing population of older adults will impact society, including considerations of economics, health care, living arrangements, and ethical and moral issues.
  • Discuss the biological and psychosocial theories of aging, and summarize major physiological changes that occur as a result of the normal aging process.

Objectives (cont.)

  • Discuss unique health challenges faced by older adults, and describe strategies for successful and healthy aging that can begin during young adulthood.
  • Discuss death, the stages of the grieving process, and strategies for coping with death.
  • Explain the ethical concerns that arise from the concepts of the right to die and rational suicide.
  • Review the decisions that need to be made when someone is dying or has died, including hospice care, funeral arrangements, wills, and organ donation.

Growing Old

  • Aging is a pattern of life changes that occurs as one grows older.
  • Gerontology is the study of individual and collective aging processes.
    • Biological age
    • Psychological age
    • Social age
    • Legal age
    • Functional age

Successful Aging

  • Avoid serious, debilitating diseases and disability.
  • Engage independently in most normal activities of daily living.
  • Maintain cognitive function.
  • Able to cope with physical, social, and emotional changes
  • Sense of control of their lives

ABC News Video: Seniors Say No to Retirement

  • Discussion Questions
  • What effects do having a purpose and being active have on attitudes toward life, wellness, and aging?
  • Do your parents intend to retire? Do you think they should?
  • Should older people be forced to stop working when they reach a certain age?
  • | Seniors Say No to Retirement

Older Adults

  • A growing population
    • Today, there are 37 million people age 65 or older in the United States.
    • That number is expected to increase as baby boomers age.
    • New programs are targeting baby boomers that promote health and prevent premature disease and disability.

Number of Americans Age 65 and Older (in millions), Years 1900–2000, and Projected 2010–2050

  • Copyright © 2010 Pearson Education, Inc.

Health Issues for an Aging Society

  • As the number of older Americans increases, their financial and medical needs become issues.
  • More people will be drawing from Social Security while less people contribute to the system.
  • Health care costs to the individual will rise as Medicare coverage becomes less adequate.
  • Housing and living arrangements will be a problem for low-income elderly.
  • A shortage of donor organs will present difficult ethical questions.

Living Arrangements of Americans Age 65 and Older

  • Copyright © 2010 Pearson Education, Inc.
  • Copyright © 2010 Pearson Education, Inc.

Theories on Aging

  • Biological theories
    • Wear-and-tear
    • Cellular
    • Autoimmune
    • Genetic mutation
  • Psychosocial theories of aging

Normal Effects of Aging on the Body

  • Copyright © 2010 Pearson Education, Inc.

Changes in the Body and Mind

  • Typical physical changes
    • Skin
    • Bones and joints
    • Head
    • Urinary tract
    • Heart and lungs
    • Eyesight
      • Glaucoma
      • Macular degeneration
    • Hearing
    • Sexual changes
    • Body comfort

Changes in the Body and Mind (cont.)

  • Typical mental changes
    • Intelligence
    • Memory
    • Adaptability
    • Depression
    • Senility

Alzheimer’s Disease

  • Progressive brain impairment that interferes with memory and normal intellectual functioning
  • Most common form of dementia
  • Affects an estimated one in ten persons over the age of 65 and nearly half of those over age 85

Alzheimer’s Disease (cont.)

  • Progresses in stages
    • First stage involves forgetfulness and memory loss.
    • Second stage sees accelerated first-stage symptoms and agitation, restlessness, and repetitive actions.
    • In the final stage, disorientation is complete, control of body functions are lost, and dependence on others is complete.

Health Challenges of Older Adults

  • Alcohol use and abuse
  • Prescription drug use
  • Over-the-counter remedies

Strategies for Healthy Aging

Caring for Older Adults

  • Older adults often experience comorbidity, or multiple chronic health problems.
  • Respite care is care that is given by someone who relieves the primary caregiver.

ABC News Video: Caring for Elderly Parents

  • Discussion Questions
  • The number-one tip for families currently caring for elderly parents is to choose a primary caregiver. Do you agree with this tip? What would rank second in importance?
  • How can family and friends support the primary caregiver?
  • Offer some suggestions on what to do if your elderly parent(s) are (is) not accepting your help.
  • | Caring for Elderly Parents

Understanding Death

  • Dying is the process of decline in body functions, resulting in death.
  • Death is the final cessation of vital functions.
  • Uniform Determination of Death Act, 1981
  • Brain death is the irreversible cessation of all functions of the entire brain stem.

Denying Death

  • Denying death is an effort to limit our own discomfort
  • Those who deny death tend to
    • avoid people who are grieving.
    • fail to acknowledge a dying person’s situation.
    • use euphemisms for the word death.
    • give false reassurances to people who are dying.
    • avoid touching people who are dying.

The Process of Dying

  • Complex process that includes physical, intellectual, social, spiritual, and emotional dimensions
  • Kübler-Ross and the stages of dying
    • Denial, anger, bargaining, depression, acceptance

The Process of Dying (cont.)

  • Social death denies a person normal social interaction.
    • Referring to the dying person as if they were already dead
    • Inadvertently excluding the dying person from conversations
    • Moving dying patients to terminal wards
    • Avoiding bereaved family members
    • Making degrading comments about patients in their presence

Kübler-Ross’s Stages of Dying

  • Copyright © 2010 Pearson Education, Inc.

Coping with Loss

  • Bereavement is the loss or deprivation experienced by a survivor when a loved one dies.
  • Grief is a state of mental distress that occurs in reaction to significant loss.
  • In disenfranchised grief, a person experiences a loss that cannot be openly acknowledged, publicly mourned, or socially supported.
  • Mourning refers to culturally prescribed and accepted time periods and behavior patterns for the expression of grief.

What Is Normal Grief?

  • Acute grief syndrome often includes
    • periodic waves of physical distress lasting 20 minutes to an hour.
    • a feeling of tightness in the throat.
    • choking and shortness of breath.
    • a frequent need to sigh.
    • a feeling of emptiness in the abdomen.
    • a sensation of muscular weakness.
    • intense anxiety.

Worden’s Model of Grieving Tasks

  • William Worden developed a more active grieving model that defined four tasks necessary for the individual to complete in the grief-work process.
    • Accept the reality of the loss.
    • Work through to the pain of grief.
    • Adjust to an environment in which the deceased is missing.
    • Emotionally relocate the deceased and move on with life.

When an Infant or Child Dies

  • The grief experienced when a child dies may be overwhelming.
  • The entire family feels pain, but it may be especially hard for siblings.
  • A child’s response to death may be longer grieving periods.

Quasi-Death Experiences

  • Losses that resemble death and that may involve a heavy burden of grief: a child running away, an abduction or kidnapping, a divorce, a retirement, or ending an athletic career

Life-and-Death Decision Making

  • The right to die: Some states legally allow certain life support techniques to be refused by competent patients.
    • Electrical or mechanical heart resuscitation
    • Mechanical respiration
    • Nasogastric feeding tube
    • Intravenous nutrition
    • Gastrostomy
    • Medication

Living Will

  • If a person is in a coma or otherwise incapable of speaking on his or her own behalf, medical personnel and administrative policy will dictate treatment.
  • A living will contains the person’s desire not to receive artificial life support.
  • Legal steps
    • Be specific.
    • Get an agent.
    • Discuss your wishes.
    • Deliver the directive.

Organ Donor Card

  • Copyright © 2010 Pearson Education, Inc.

Rational Suicide

  • The concept of rational suicide is a reasoned, coherent process in which a person chooses death as a preferable alternative to unbearable pain.
  • Euthanasia involves ending the life of a person who is suffering greatly and has no chance of recovery.
  • Passive euthanasia is the intentional withholding of treatment that would prolong life.
  • Dr. Jack Kevorkian started a one-person campaign to force the medical profession to review its position regarding physician-assisted suicide.

Making Final Arrangements

  • Hospice care has the primary purpose of relieving the dying person’s pain, offering emotional support to the dying person and loved ones, and restoring a sense of control to the dying person, family, and friends.
  • Funeral arrangements
    • Wake or viewing
    • Burial
    • Cremation
    • Anatomical donation

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