Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Human Behavior > Late Adulthood/Death and Dying > Flashcards

Late Adulthood/Death and Dying Flashcards

1
Q

Gerontology

A

The study of social, biological and psychological aspects of aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Geriatrics

A

Clinical physical issues related to aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Geriatric psychiatry

A

Mental health and aging

  1. Differentiating changes of normal aging from symptoms of psychiatric disorders
  2. Modifiability of illness in late life
  3. Distinguishing between changes in early-onset psychiatric disorders who have now aged, and disorders that began in later life
  4. Modifiability of normal aging to improve functioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Two groups of Geriatric Psychiatry

A
  1. Young-old (65-90)

2. Old-old (90 and beyond)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fastest growing segment of US population

A

85 and older

  • Projected 10 million by 2025
  • Projected 20 million by 2050
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why is there an increase in the older population?

A

Baby boom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

States with highest percentage of 65 and older population

A 
North Dakota
South Dakota
Iowa
Arkansas
Florida
West Virginia
Pennsylvania
Maine
Connecticut
Rhode Island
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Projected population growth in Wisconsin (65 and older)

A

2000: .70 million
2030: 1.36 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ratio of men to women in 65 and over population

A

More women than men

- Ratio favors women as we age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which racial group is the fastest growing in the 65+ population

A

Hispanic (White 65+ population is decreasing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Marital Status of 90+ (Males vs Females)

A

Males: 42.9% Married; 49.3% Widowed
Females: 6.3% Married; 84.2% Widowed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Centenarians: Proportion of total population

A

Increasing between 1980 and 2000s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Centenarians (Male/Female ratio)

A

Percent males decreases as approaching 100 years old

Percent females increases as approaching 100 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cognitive Changes of aging

A

1) Intellectual performance (peak in 30s, plateau through 60s, rapid decline in 70s)
2) Decrease in fine touch sensation
3) Decline in ability to rise from chair and preform ADLs
4) Mild Neuronal cell loss, blood flow decreases
5) Myelin decreases in white matter
6) Sensory losses (all senses)
7) Random cell loss except in hypothalamus, hippocampus, cerebellum, brainstem, and frontal lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Neurogenesis

A

1) Birth of new neurons (from neural stem cells)
2) New cells compete with old cells (losers die)
3) Occurs throughout life
4) Chronic Stress suppresses cell proliferation
5) Physical activity and exercise promote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Neurogenesis occurs in predominately what two regions of the brain?

A

Subventricular zone lining lateral ventricles
Subgranular zone - part of dentate gyrus of hippocampus
(May even occur in neocortex and cerebellum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fluid Intelligence

A

Decreases

  • One’s ability to think and react quickly
  • Mental flexibility and speed of information processing
  • Learn new information
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Crystallized Intelligence

A

Stable

- Knowledge or experience accumulated over time and verbal skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cognitive changes in Normal Aging

A
  • Memory: Remote memory preserved; recent memory takes longer
  • Attention: Simple focused attention is preserved; divided attention is more challenging
  • Language: Verbal abilities preserved; word retrieval more difficult
  • Executive function, Reasoning and Problem Solving: Maintained - use strategies developed in middle adulthood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Projected number of AD cases in Individuals above age 65

A

Currently: 5.3 million

By 2050: 13.5 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What disease has had the highest percentage change in causes of death

A

Alzheimer’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What increases in the brain with Alzheimer’s

A

Neurofibrillary tangles and Amyloid plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

First two structures to atrophy in Alzheimer’s

A

Hippocampus, then Frontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Erik Erikson Stage 8

A

Integrity vs. Despair

1) Integrity is a sense of satisfaction that life has been productive and worthwile
2) Despair is a loss of hope and a sense that life has no purpose or meaning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Common Life Changes in Aging

A
  1. Retirement
  2. Physical Changes: senses
  3. Health
  4. Mobility
  5. Memory
  6. Death of spouse, other family, and friends
  7. Home and personal possessions
  8. Income
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Older Adult Responses to Loss or Changes

A 
Denial
Guilt
Loneliness
Overly-Critical
Rigidity
Stubbornness
Selective Memory
Anger
Reminiscence
Depression/Anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How many people die in the US annually

A

2.5 million (60 million worldwide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Bereavement

A

4 Bereaved people for each death

10 million bereaved people in US (3% pop.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Complications to Bereavement (30%)

- 1-2 million individuals yearly

A 
Major Depression (15-30%)
PTSD (based on circumstances of death)
Complicated Grief (10-20%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Stages of Grief

A

1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Prevalence of Depression in the elderly (Most to Least)

A

Nursing Home Residents > Primary Care Outpatients > Community Residents

32
Q

Percent of Older adults > 60 who suffer from significant depressive symptoms

A

20%

33
Q

Suicide Rates

A

Increase as we age

White males 85+ complete suicide nearly 6x the general population

34
Q

Late Life Depression: Consequences

A
  • Premature Deaths from co-morbid cardiovascular and cerebrovascular diseases
  • Increases the risk of Dabetes, Cardiovascular disease and Alzheimer’s disease
  • Increased healthcare costs and utilization of resources
  • Increased suffering, functional impairment and poorer quality of life
  • Increased caregiver burden
35
Q

Modifiability of Illness in Later Life

A

1) Depression in the elderly respond robustly to antidepressants and psychotherapy
2) Alzheimer’s: Not much can be done

36
Q

Challenges Facing the Elderly

A 
Ageism
Barriers for Care
Socioeconomics
Living Situation
Elder Abuse and Neglect
37
Q

Ageism

A

Discrimination towards older people including negative stereotypes held by younger adults

38
Q

Maximum amount for moderate alcohol use in 65+

A

one drink/day

39
Q

Alcoholism and drug dependences

A

4% and 8% (Likely 10 to 15 percent)

40
Q

65+: Poverty

A

Roughly 9% Below poverty level

Older women had higher poverty rate than older men

41
Q

65+: Employment

A

17.2% older Americans were in the workforce

42
Q

65+: Education

A

High school or higher: 78.3%

Bachelor’s degree or higher: 21%

43
Q

Highest income source for population aged 90 and over

A

Social Security (47.9%)

44
Q

65+: Percentage living with spouse

A

Men: 72%
Women: 42%

45
Q

Top Source of Health Insurance for persons 65+

A

Government: Medicare

46
Q

Limitations in ADL (Activities of Daily Living)

A

Highest for those 85+ (mostly due to walking limitations)

47
Q

65+: Chronic Health conditions

A

Women > Men

48
Q

Types of Elder Abuse

A 
Physical Abuse
Sexual Abuse
Emotional Abuse
Financial Exploitation
Victimization
Undue Influence
Neglect/Abandonment
Self-Neglect
49
Q

Top three most common types of elder abuse

A

1) Neglect - depriving an elder of something needed for daily living
2) Physical Abuse
3) Financial exploitation

50
Q

Successful Aging

A

Low Risk of Disease and disability due to disease
High mental and physical functioning
Active engagement with life
Caveats: Can those with functional limitations or chronic health problems age successfully

51
Q

Wisdom

A

Extensive practical knowledge, ability to reflect on and apply that knowledge in ways that make life more bearable and worthwhile, emotional maturity, and creativity

52
Q

Cognitive Reserve

A

Capacity of an adult brain to cope with brain pathology in order to minimize symptomatology

53
Q

Classification of Brain Reserve:

A

1) Passive Model - Brain reserve

2) Active Model - Cognitive Reserve - Compensation

54
Q

A Good Death:

A

“Free from avoidable distress and suffering for patients, families and care givers and consistent with cultural and ethical standards” - Institute of Medicine

55
Q

Thanatology

A

Study of Death and Dying (Many physicians poorly trained in this area)

56
Q

Stages of Dying (Kubler-Ross)

A

1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance
* stages may not go in order and may go back and forth

57
Q

Physician Barriers to Treating Death

A
  • Death is something to be avoided rather than a natural part of life
  • Death is failure of our medical care
  • Death of a patient is a negative reflection on the doctor
58
Q

American View of a “Good Death”

A
  • Dying not prolonged
  • Pain and symptoms controlled
  • Not being burden to others
  • Control over decision-making
  • Strengthening Relationships
59
Q

Where do Americans Die (Want to Die vs. Where they actually die)

A

Want to Die

  • Home (60-70%)
  • Hospital (20-40%)
  • Nursing Home (0%)

Where they die

  • Hospital (50%)
  • Nursing Home (30%)
  • Home (20%)
60
Q

Circumstances of Death

A

Intentional - suicide
Unintentional - trauma
Sub-intentional - Substance abuse

61
Q

Advance Directives

A

A patient’s wish or choice about end of life care

- Includes living wills, health care proxy, and do not resuscitate orders

62
Q

Euthanasia

A

AMA - Physician-assisted suicide is a criminal act and is never appropriate
It is legal and ethical to provide medically needed analgesia to a terminally ill patient even if it coincidentally shortens the patient’s life

63
Q

Oregon Death with Dignity Law

A

Allows dying patients to take home lethal doses of prescription medication

  • Physicians tended to become more involved
  • No flood of people to Oregon to die (Must be 6 month resident)
  • Those who requested assistance include need for control and independence
  • 36% of those who filled prescription did not use them
64
Q

Palliative Care (NOT hospice care)

A
  • Providing relief from suffering as one nears death with complex medical conditions
  • Comfort measures from symptoms
  • Assistance with determination of goals
  • Can and Should co-exist with life prolonging interventions
65
Q

What is Hospice

A

Provides comfort and support to persons nearing the end of life (forgoes life prolonging goals in favor of quality of life goals)
Comfort is the primary goal

66
Q

Criteria for Hospice Admission

A
  • Recommendation of personal physician
  • Life expectancy of 6 months or less if the illness runs its normal course
  • No longer seeking cure
  • Desire to stay out of hospital
67
Q

Changes in Physiology Weeks and Days Before Death

A
  • Increased Sleep
  • May refuse food and drink
  • Decreased reserve for physical activity
  • Decrease in blood pressure and blood volume
  • Changes in cognition/memory/orientation
  • “The Last Hoorah”
68
Q

Changes in Social Interactions

A
  • Withdrawal from social interactions
  • Interactions with core group of loved ones
  • No longer care about previous interests
  • Complete any old business
  • Express gratitude and love
  • Ask and grant forgiveness
69
Q

Final Hours of Life

A
  • Unresponsive
  • Bluish discoloration
  • Decrease blood pressure
  • Decrease Breathing
70
Q

Death Rattle

A

Pharyngeal secretions in final hours

71
Q

Grief normally lasts:

A

Up to 12-24 months (usually less)

72
Q

Grief
Mourning
Bereavement

A

Grief: Subjective feeling of loss
Mourning: Process of resolving grief
Bereavement: State of mourning the death of a loved one (state of being deprived)

73
Q

Attachment Theory

A

It is because of our ability to make attachments that makes loss of a loved one so painful
- Grief is the price we pay for attachment or loss

74
Q

Grief as a normal process

A
  • Shock/Denial (2-3 months)
  • Intense concern/ Preoccupation with the deceased (6 months to 1 year)
  • Despair/Depression
  • Recovery - reorganize
75
Q

Phase 3 of Grief: Resolution

A
  • Can think about the past with pleasure
  • Regaining interests in activities
  • Forming new relationships
76
Q

Complicated Grief

A

Men (especially young men) > Women
Sibling deaths - more intense because of shared history
- Twin death = loss of identity
- Non-twins = loss of one of the most long term significant relationships

77
Q

2 Months Depression in Grief - Major predictor of prolonged grief disorder

A
  • Cardiac problems and impaired immune response
  • Increased suicide and accidents
  • Poor self care

Human Behavior (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions