Age Related Adjustments & Transitions

Question 1

• Role changes after retirement: -

Answer 1

• Division of labour & household roles may
change renegotiation of chores, leisure &
social activities
• The spouse may view retirement as a threat to
territory & authority
• One spouse may become the carer
• Death of spouse  social relationships may
change

Question 2

• Health care:

Answer 2

increase Community based & increased Preventative
Health
- People living longer with higher quality
of health with shorter time of debility
• Men seek health care less than women

Question 3

Depression

Answer 3

• losses: relationships, independence, work and
income, mobility and flexibility, self-worth
• social isolation
• chronic pain and illness
• side-effects from medications
• frustration with memory loss
significant changes in living arrangements e.g.
moving from living independently in the
community or with family to an aged care
home
• admission to hospital
• difficulties adapting to change
• particular anniversaries and the memories they
evoke.
• Fear of death

Question 4

Tom Kitwood’s 17 points of malignant

psychology

Answer 4

1. Treachery (deception to manipulate/force into compliance)
2. Disempowerment (not allowing person to use their abilities
   or not assisting them to complete actions they have
   initiated)
3. Infantilism (patronising, treating person as a young child)
4. Intimidation (instilling fear through threats or physical
   power)
5. Labelling (using a pattern of behaviour e.g., wanderer, or a
   category such as organic mental disorder as the main basis
   of interacting with a person)
   • 6. Stigmatisation (treating person as an outcast or diseased
   object)
   • 7. Outpacing (providing information, choices at a such a
   pace that the person can’t understand them or putting
   them under pressure to do things faster than they can
   manage)
   • 8. Invalidation (not acknowledging the subjective reality of a person’s experience, and especially what they are
   feeling)
   • 9. Banishment (sending person away, excluding them
   either physically or psychologically.
   • 10. Objectification (treating the person like an object that can be pushed, lifted, filled and so on instead of a human being)
   11 Ignoring (carrying on in conversation or action in front of
   the person as if they weren’t there)
   • 12 Imposition (forcing a person to do something, overriding
   their wishes or denying a choice on their part)
   • 13 Withholding (refusing to give attention, assistance to meet
   need/s)
   • 14 Accusation (blaming a person for actions or failure to take
   action that arise from a lack of ability or misunderstanding)
   • 15 Disruption (roughly intruding on a person’s action or
   inaction or breaking their frame of reference)
   • 16 Mockery (making fun of a person’s unusual action or
   remark, teasing, humiliating, making jokes at the person’s
   expense)
   • 17 Disparagement (telling a person that they are incompetent,
   useless, worthless and so on, giving them messages that
   damage their self esteem

Question 5

Telomerase Theory of Aging.

Answer 5

• it is understood that telomeres (the sequences of
nucleic acids extending from the ends of chromosomes),
shorten every time a cell divides

Question 6

The Neuroendocrine Theory

Answer 6

• As we grow older the hypothalamus loses its regulatory
ability and the receptors which uptake individual
hormones become less sensitive to them. Accordingly,
as we age the secretion of many hormones declines.

Question 7

Free Radical Theory

Answer 7

• Free radicals are known to attack the structure of cell membranes,
which then create metabolic waste products (see the Membrane Theory of Aging). Such toxic accumulations interfere with cell communication, disturb DNA, RNA and protein synthesis, lower energy levels and generally impede vital chemical processes.

Question 8

The Membrane Theory of Aging

Answer 8

• As we grow older the cell membrane becomes less lipid (less
watery and more solid). This impedes its efficiency to conduct
normal function and in particular there is a toxic accumulation

Question 9

age–related Medical Conditions

Answer 9

• Anxiety
• Arthritis, osteoarthritis
• Cardiac disease, angina
• COAD, hypoxia
• Continence (e.g., constipation, incontinence, urinary
retention)
• CVA
• Dementia, Alzheimer’s disease
• Depression
• Endocrine (e.g.. diabetes, thyroid dysfunction)
• Hypertension
• Infections (e.g., UTI, pneumonia)
• Parkinson’s disease
• Sleep disorders
• Vision (e.g., near or total blindness)

Question 10

Drugs commonly ordered include: -

Answer 10

• Cardiovascular (e.g., antiarrhythmics,
alpha & beta blockers & digitalis)
• Antihypertensives
• Analgesics
• Antiarthritics
• Sedatives
• Tranquilisers
• Laxatives
• Antacids

Question 11

Absorption of meds

Answer 11

• Change in quality & quantity of digestive
enzymes
• Increased gastric pH
• decreases number of absorbing cells
• decreases GI motility
• decreases intestinal blood flow
• decreases GI emptying

Question 12

Distribution of meds

Answer 12

• decreases cardiac output & reserve
• decreases blood flow to target tissues, liver & kidneys
•decreases lean body mass
decreases plasma protein (decreases protein binding drugs)
• decreases total body water
• increase adipose stores

Question 13

Metabolism of meds

Answer 13

decreases microsomal metabolism of drugs

• decreases hepatic biotransformation

Question 14

4. Elimination of meds

Answer 14

• decreases renal excretion
• decreases respiratory & vital capacity with increase co2 retention
• decreases number of receptors
• variability in receptor sensitivity

Question 15

Identifying polypharmacy

Answer 15

• A number of medications for no obvious
reason (e.g., 10 or more)
• Duplicate drugs (e.g., diuretics,
sedatives, tranquilisers)
• Inappropriate dosage
• Contraindicated medications
• Drugs to treat adverse reactions