Lifespan FINAL

• Senescence


  the natural physical decline brought about by aging
• early-old age


  60-75
• middle-old age


  76-90
• late-old age


  90+
• immortality versus extinction


  old age erikson stage

  - reminiscing about the past - focus on activities that bring pleasure
• factors under study for aging


  genetics,diet,antioxidants
• free radicals or oxidative stress


  errors are a result of random damage from free radicals; they are unpaired unstable ions

  
• biological clock


  aka programmed cell death or apoptosis
• wear and tear theory


  human body wears down

  
• immune theory


  decline in function of immune system
• gene theory of aging


  longevity associated with a genetic trait
• vision in old age


  Decreased tear production

  Decreased visual acuity, color discrimination,

  pupil size

  Safety concerns—driving (esp night)

  Annual eye examinations needed

  Presbyopia: age-related loss of

  accommodation—need for reading glasses

  almost universal

  Glaucoma: intraocular pressure

  Cataracts: opacity and yellowing of lens
• presbyopia


  age-related loss of

  accommodation—need for reading glasses

  almost universal

  
• hearing in old age


  Inner-ear atrophy, cell degeneration

  • Loss of ear hair cells

  • Annual audiology testing

  • Tympanic membrane atrophy/sclerosis

  • Presbycusis: progressive sensorineural

  hearing loss associated with aging

  • Hearing loss results in decreased

  quality of life

  • Miscommunication, loss self-

  esteem, depression, falls, safety risk,

  cognitive decline
• presbycusis


  progressive sensorineural hearing loss associated with aging

  
• skin changes in old age

  thinner, wrinkled, fragile
• safety issues from decreased sensation in old age

  Burns from cooking, bathing; motor skill considerations
• taste/smell in old age


  Loss of taste buds

  Changes result in large amount of salt/sugar in food

  Dental health important—semiannual dental visits

  Loss of teeth, caries, periodontitis, gingivitis

  Decreased acuity of olfactory nerve

  Food safety issues with loss of smell
• Urinary Incontinence


  inability to control urination

  
• health strategies for elimination issues in old age


  Exercise

  • Increase fiber/fluid

  • Lifestyle modifications: weight loss,

  exercise, diet

  • Voiding schedules

  • Prompted voiding

  • Incontinence devices

  • Kegel exercises

  • Avoid caffeine (incontinence)
• malnutrition factors of old age


  - access to food

  • Decline in GI absorption, metabolism,

  elimination

  • Deterioration of senses

  • High frequency of dentition problems

  • Cultural food preferences

  • Living environment (e.g., institutions)

  • Anorexia resulting from disease

  • Medications
• High prevalence of sleep disorders in old age

  Decrease in total hours required

  • Increase in nocturnal awakenings,

  shorter periods of sleep, decrease

  in slow-wave activity
• multi-infarct dementia (MID)


  death of brain tissue

  
• Alzheimer's disease


  most common form of dementia - progressive memory loss
• treatment for dementia


  no cure - medications, encourage self-care, routines, and stimulation, safety

  interventions (falls, wandering)
• Symptoms of Alzheimer's


  forgetfulness, inattentiveness, disorganized thinking,

  altered level of consciousness, perceptual disturbances, sleep-

  wake disorders, psychomotor disturbances, and disorientation

  
• Stage 1 Alzheimer's


  Forget recent events

  Forget new information, particularly names of people and places

  
• stage 2 alzheimers


  Generalized confusion

  Deficits in concentration and short-

  term memory

  Speech becomes aimless and repetitive;

  vocabulary becomes limited and words

  get mixed up

  Personality traits become exaggerated

  as rational thought disappears
• stage 3 alzheimers


  Memory loss becomes

  dangerous, causing accidents

  or the person to go missing
• stage 4 alzheimers


  Full-time care is needed since sufferers cannot

  care for themselves

  Communication not clear; ultimately talking stops

  Unable to recognize their closest loved ones

  Blank staring at TV or into space
• stage 5 alzheimers


  Unresponsive

  Identity and personality gone

  Recognizes no one
• elder abuse


  Intentional or neglectful acts by a caregiver or "trusted" individual which, harm a vulnerable elder.
• caregiver strain


  a term used to describe the burdens in the caregivers' day to day lives that can be attributed to the need to provide care or assistance to someone else

  -

  offer resources eg support groups, education, respite care, senior day care
• depression in old age


  older adult at highest risk

  factors: isolation,loss, environmental change,low self esteem,medical conditions, medications

  help with counseling, social support, pleasurable activities
• modifications for old age homes

  Widened doorways

  •Door levers

  •Ramps

  •Lighting

  •Smart home devices

  •Bathtub with walk-in shower or bathtub w/bench or

  bath chair & safety bars
• values-beliefs pattern


  spirituality,religion, assessment tools that guide choices or decisions
• Medicaid expands


  services for low income elderly over and above medicare
• Medicare and Medicaid


  Great Society programs to have the government provide medical aid to the elderly (Medicare) and the poor (Medicaid).
• how has death changed


  Death occurs later.

  Dying takes longer.

  Death often occurs in

  hospitals.

  Causes of death have

  changed.

  And after death...it is

  unclear
• Kubler-Ross stages of dying/grief


  1. Denial

  2. Anger

  3. Bargaining

  4. Depression

  5. Acceptance