Ageism Flashcards
What are stereotypes about old people?
more stereotypes than any other group
older people see themselves more positively than their peers
may impact on treatment recommendations
What is projected age profile?
by 2051 those aged 85+ will make up largest population, followed by 40-44 year olds
What is maximuym lifespan?
120 y
What is percentage of centenarians?
.02% population
What is peak average lifespan expected to be?
85 - due to biological changes
What is senesence
Degenerative phase of ageing process that causes individual to be more vulnerable to disease and mortality as years go by
What are cellular theories of senescence?
Processes that take place within and between cells and lead to breakdown of cells, tissues and organs. Caused by wear and tear, and genetic errors [all people have cells with genetic errors; older people have greater number of cells with errors, and greater number of cells in with multiple errors]
What are programming theories of senescence?
Hayflick limit - humans cells in laboratory replicate only to a certain point- about 50 times. At this point genetic material runs out.
Death is programmed into complex organisms.
Anything less than ideal environmental conditions may shorten lifespan; nothing will extend it.
What is primary ageing of physical functioning?
universal changes that everyone experiences
What is secondary ageing of physical functioning?
effects of illness and disease
What happens to physical functioning in older age?
motor, sensory and intellectual slowing
primary ageing of CNS and PNS - can improve with training
skin, bone and muscle changes
cardiovascular, respiratory and sensory changes
What improves health behaviours in late adulthood?
sleeping 7-8 hours/night eating breakfast no snacks controlling weight exercise limit alcohol nonsmoker for life
What are risk factors for cardiovascular disease?
family history smoking, diet, lack of exercise personality type stress gender - men 3x more likely to experience cardiovascular event before 60; women display symptoms ten years later
What is hypertension?
HBP - >140/90
deterioration of arterial walls
risks of heart attack, kidney damage, stroke
What are risk factors for hypertension?
gender [higher in men < women; women more likely to be fatal] obesity genetics poor diet stress personality characteristics
What are risk factors for cancer?
SES, genetics, gender, lifestyle, diet [low SES - lung, stomach; high SES - breast, colon]
life events, stress, personality, social support, isolation
What is most common mental health issue for older adults?
depression
may be mistaken for normal ageing
may mimic dementia
has multiplicative affect [old age stigma + mental health]
What are associates of depression?
chronic health issues, functional impairment, social deprivation, medication
What happens in brain with ageing?
neuronal loss and growth - neural shrinkage more common than loss of neurons
density of synapses increases with age and with brain stimulating activity
Plasticity allows brain to take on new neural connections [axon sprouting; dendrite branching]
What are acute brain syndromes?
caused by metabolic issues - eg diabetes, liver failure - may be reversible; fluctuating periods of lucidity
What are chronic brain syndromes?
irreversible changes in brain - eg multiinfarct dementia; alzheimer’s disease
What is multi-infarct dementia?
tiny strokes - confusion or spotty memory may be symptoms
may be lessened if caught early
What is alzheimers?
50-60% of organic brain syndrome patients over 60
Degeneration of brain cells affecting memory, learning, judgement
Symptoms worsen with progression
Causes and cures not understood
What are symptoms of Alzheimer’s?
memory impairment deterioration of language deficits in visual and spatial processing repeating of questions every day tasks unfinished personality change irritability, anxiety lack of concentration
What are risk factors for AD?
chronological age gender [more women] vascular conditions low education head injury biological susceptibility
What is anticipatory dementia?
concern that normal age-associated memory changes are signs of AD
What is gradient of vulnerability?
memory processes that show greater age-related change than others. Holding info in STM is unaffected; age related deficiencies found if info has to be used while being held [working memory].
Episodic memory shows slow, steady decline
Semantic memory is factual knowledge - remains intact, speed of accessing info declines
Procedural memory shows least change
learning skills is still possible, just slower
What is Erikson’s crisis for older age?
Ego-integrity vs despair
People achieve sense of integrity by accepting the life they have lived, and tf death, or yield to despair that life can’t be relived [fear of death]
What are changes in memory with older age?
Working memory - age deficits
Episodic memory - steady decline
Semantic memory - largely intact, speed of accessing info declines
Procedural memory - least change
learning skills is still possible, just slower
What is death awareness movement?
promoting idea of ‘good death’ - surrounded by family and friends with minimal technological interference
How is death defined?
In technologically advanced countries, irreversible coma [brain death] [for organ donation]
- previously absence of respiration and heartbeat
What are three dimensions of death acceptance?
Neutral acceptance [death is reality that is neither welcomed nor feared]
Approach-oriented acceptance [death as a passage to a happy afterlife]
Escape oriented acceptance [death as escape from a painful existence]
What are children’s understandings of death
Death is temporary and reversible
What are adolescents’ understandings of death?
deny own mortality as cling to personal fable of invincibility
What are young adults’ understandings of death?
anger - frustrated dreams might go unfulfilled
What is terror management theory?
Anxiety associated with our awareness of mortality, and how it impacts on sense of self, social behaviour and worldview.
Defensive reactions against death are a primary human motive
Adherence to own cultural worldview increases as death becomes more salient - Turn to social-in groups to ensure values continue
What are differences in death anxiety?
Death anxiety is measured with self-report scale
- some evidence of decline in age
- Peak for m and f in 20s, again for f in 50s, then for both in sixties
- high and low religiosity lower rating than medium; specific religiosu beliefs are important
What are Kubler Ross five stages?
denial anger bargaining depression acceptance -
What are the seven domains of experience of death, that influence quality of death?
physical psychological social spiritual or existential nature of health care life closure and death preparation circumstances of death
What are western attributes of good death?
control, comfort, closure, values and beliesf honoured, recognising impending death, optimising relationships
What are difficulties with home deaths?
intensive care needs of dying person
family conflict, unresolved anger
cognitive impairment of patient
When is home care appropriate for a home death?
when person is alert
when person can benefit from familiar surroundigns
What is passive euthanasia?
withholding or discontinuing treatment to end suffering
What is active euthanasia?
Deliberate action taken to shorten life
What is bereavement?
Process of adjusting to loss of someone close
Change in status, role and social and economic circumstances
What is grief?
Emotional response experienced in early stage of bereavement
[loss of primary relationships; relationships of attachment; relationships of community]
What deaths impact girls more?
siblings
What deaths impact boys more?
parents
What are stages of grief?
shock, disbelief, denial
intense mourning
period of restitution
What is anticipatory grief?
sadness and grief during caregiving period
more likely when illness is over a long period; when dying person is not cognitively intact
Chronic grief - associated with dependence before death; resilience associated with pre-loss death acceptance
What is mourning?
Social experience of grief
What are different expectations for expressing grief with regards on-time and off-time deaths?
Recover quicker from on-time deaths
Off-time deaths expected to produce more expression of grief
What are more appropriate terms than ‘recovery’ from grief?
resilience, adaptation, reintegration, resolution
grief can lead to transformaion, emergence of new possibilities
indicators of recovery are ability to find energy in every day life, ability to feel pressure, freedom from psychological pain and distress
