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Developmental PSYC213 > Lecture 11: physical and cognitive development in late adulthood > Flashcards

Lecture 11: physical and cognitive development in late adulthood Flashcards

1
Q

Ageing and Ageism

A

Ageism
• Treatment, stereotyping, discrimination because of someones age

• More stereotypes about old people than any other age group

  • Older people also have ageist views
  • See themselves more positively than their peers

• May impact on treatment recommendations and expected outcomes

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2
Q

Life Expectancy

A
  • Maximum lifespan is about 120 years
  • Increased life expectancy means that more people are approaching that limit
  • Centenarians = .02% of population

• Super centenarians

  • People 110 years+
  • Average lifespan not expected to exceed 85

• Biological limitations

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3
Q

Theories of Ageing

Senescence

Programming theories

A

Senescence (deterioration with age) explained by:

Cellular theories:

  • Wear and tear
  • Genetic errors

Programming theories:

  • Hayflick limit – 50 replications
  • Death built-in
  • Nothing can extend the lifespan
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4
Q

Physical Functioning

Primary ageing

Secondary ageing

A

Primary ageing – universal changes
Secondary ageing – effects of illness and disease
• Motor, sensory, intellectual slowing

  • Primary ageing of CNS and PNS
  • Can improve with training
  • Skin, bone, and muscle changes
  • Cardiovascular, respiratory and sensory systems change
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5
Q

Sensory Change

A

men lose their hearing more than women because they are exposed to more environmental hazards

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6
Q

Improving Health Behaviours in Late Adulthood

A
  • sleeping an average of 7-8 hours nightly
  • eating breakfast almost every day
  • seldom, if ever, eating snacks
  • controlling weight
  • exercising regularly
  • limiting alcohol consumption
  • being a nonsmoker for life
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7
Q

Current Research: Australian Longitudinal Study of Ageing (ALSA)

A
  • Australian Longitudinal Study of Ageing (Flinders University)
  • Began 1992 with 2087 participants aged 70+ years in South Australia
  • Aim: gain an understanding of how social, biomedical, and environmental factors are associated with age-related changes in health and wellbeing of elderly individuals
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8
Q

Chronic Illnesses: Cardiovascular Disease

Risk factors

A

Coronary heart disease, heart failure, stroke and peripheral vascular disease

Risk factors:
• Family history
• Smoking, poor diet, lack of exercise

  • Personality type
  • Stress
  • Gender
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9
Q

Chronic Illnesses: Hypertension

Risk factors

A

• High blood pressure

  • Systolic BP > 140
  • Diastolic BP > 90
  • Deterioration of arterial walls (continued high blood pressure)
  • Arteriosclerosis
  • Risks of heart attack, kidney damage, stroke

Risk factors

• Gender, genetics, obesity, poor diet, stress, personality characteristics

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10
Q

Chronic Illnesses: Cancer

Risk factors

A

• Uncontrolled cellular growth, dysfunction of DNA

  • Malignant tumours
  • Spread through metastasis

Risk factors:

  • SES, genetics, gender, lifestyle, diet
  • Life events, negative affect, personality, social support, isolation, stress
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11
Q

Chronic Illnesses: Arthritis

A
  • Inflammation of joints and connective tissue
  • Pain, stiffness, sometimes swelling
  • Osteoarthritis
  • Degenerative joint disease
  • Rheumatoid arthritis
  • Autoimmune reaction
  • Affects whole body
  • Stress makes condition worse
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12
Q

Mental Health Issues: Depression

Associates of depression

A

• Mental disorders underestimated and undertreated in older adults

  • Stoicism limits reporting
  • Most common disorder is depression
  • May be mistaken for normal ageing
  • Symptoms may mimic dementia
  • Associates of depression
  • Chronic health issues, functional impairment, social deprivation, medication
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13
Q

The Ageing Brain

Pseudodementia

Acute and Chronic brain syndromes

A
  • Neuronal loss and growth
    • Axon sprouting, dendrite branching, synaptogenesis (growth)
    • neurofibrillary tangles, granulovacuolar degeneration (loss)
  • Pseudodementia: mimic symptoms of dementia (depression etc)
  • Brain syndromes:
    • Acute: caused by e.g., diabetes, liver failure
    • Chronic: e.g., multi-infarct dementia and Alzheimer’s disease
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14
Q

Multi-infarct Dementia

A
  • Caused by vascular disease
  • Risk factors include hypertension, diabetes mellitus, advanced age, being male and smoking
  • Blockage of oxygen to brain causes tiny strokes
  • Sudden rather than gradual onset

• May have periods of lucidity

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15
Q

Alzheimer’s Disease (AD)

A
  • 50-60% of organic brain syndrome patients over 65 have AD
  • Degeneration of brain cells affecting memory, learning, and judgement
  • Symptoms worsen with disease progression
  • Care in controlled environment
  • Causes and cures not understood
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16
Q

Symptoms of Alzheimers Disease

A
  • Memory impairment
  • Deterioration of language
  • Deficits in visual and spatial processing
  • Repeating of questions
  • Everyday tasks unfinished or forgotten
  • Personality change (rigidity, egocentricity)
  • Irritability or anxiety
  • Lack of concentration
17
Q

Risk Factors for Alzheimers Disease

A
  • Chronological age
  • Gender
  • Vascular conditions
  • Low education
  • Head injury
  • Biological susceptibility
18
Q

Memory Changes

A
  • Anticipatory dementia
  • Gradient of vulnerability

• Some memory processes change more than others

Memory changes:

  • Working memory – age deficits
  • Episodic memory – steady decline
  • Semantic memory – largely intact
  • Procedural memory – least change
19
Q

Erikson: Ego-integrity vs. Despair

A
  • 8th and final critical stage of psychosocial development
  • People in late adulthood either achieve a sense of integrity of the self by accepting the life they have lived, and thus accept death, or yield to despair that their life cannot be re- lived
20
Q

Erikson: Ego-integrity vs. Despair

Life Review

A

Life Review: Reminiscence about one’s life in order to see its significance

  • Writing or taping autobiography
  • Constructing a family tree
  • Looking over scrapbooks and old letters
  • Trips to childhood locations
  • Reunions with friends and family
21
Q

Attitudes Towards Death

Death awareness movement

A
  • Death most likely to be in institutions
  • Often removed from everyday life
  • The dying may experience social death

• Language about death often full of euphemisms

Death awareness movement (70s)

  • New meanings for death and dying
  • Cultural analysis of attitudes
  • Promoted the notion of the good death
22
Q

Defining Death

A
  • Previously absence of respiration and heartbeat
  • Now criteria focus on brain death
  • Irreversible coma
  • Definition critical for issues of organ transplant
  • Conflicting views in Japan and North America
  • Reflection of cultural views on death
23
Q

Accepting One’s Own Death

A

• Death becomes more salient with age

Earlier death experiences

  • Death of sibling in childhood
  • Death of friends or peers in adolescence

• Death of cultural icons

Death acceptance (Wong, Reker, & Gresser, 1994):

  • Neutral acceptance
  • Approach-avoidance acceptance

• Escape-avoidance acceptance

24
Q

Death Anxiety

Terror Management Theory

A

Terror Management Theory
• Defensive reactions are a key human motive

• Adherence to own cultural worldview increases as death becomes more salient

25
Q

Differences in Death Anxiety

Age

Gender

Religiosity

A

Age differences
• Some evidence of decline with age

Gender differences

• Conflicting results

Religiosity differences
• Strong and low religiosity relates to lower anxiety than medium religiosity
• Specific religious beliefs about death important

26
Q

Kübler-Ross’ Five Stages in Coping with Death

A
27
Q

Quality of Death

Seven domains of experience of death (Hales, Zimmerman, & Rodin, 2008)

A

Seven domains of experience of death (Hales, Zimmerman, & Rodin, 2008):

  • Physical
  • Psychological
  • Social
  • Spiritual or existential
  • Nature of health care
  • Life closure and death preparation

• Circumstances of death

28
Q

Experience of Death

western good death

A
  • Western attributes of a good death
    • Control, comfort, closure, values and beliefs honoured, trusting in care providers, recognising impending death, minimising burden, and optimising relationships
  • Death awareness movement
    • Open rather than closed awareness
  • “Respecting Choices”
    • Advanced care planning
29
Q

Caring for the Dying

A

• Importance of the hospice movement

Difficulties with home death:

  • Intensive care needs of dying person
  • Hard to arrange round the clock care
  • Family conflict, unresolved anger
  • Cognitive impairment

Home care appropriate when person:

  • Is alert
  • Can benefit from familiar surroundings
30
Q

Hastening Death

Euthenasia, Passive and Active

A

Euthanasia: intentional ending of life

  • Unendurable, crippling, final, terminal
  • Voluntary or involuntary

Passive or active:

• Passive: withholding or discontinuing treatment to end suffering or allow death with dignity

• Active: deliberate action taken directly to shorten life of terminally ill person to allow death with dignity (mercy killing)

Concerns about slippery slope

31
Q

Advantages and Disadvantages of Legalising Euthanasia

A
32
Q

Advantages and Disadvantages of Legalising Euthanasia 2

A

more negatives than positives

33
Q

Bereavement and Grief

A

Bereavement
• The process of adjusting to the loss of someone close
• Change in status, role, and social and economic circumstances

Grief
• Emotional response experienced in early phase of bereavement

  • Loss of primary relationships
  • Relationships of attachment
  • Relationships of community

Losses are not equivalent
• Girls impacted more by death of siblings

• Boys impacted more by death of parents

34
Q

Stages of Grief

A

Stages of grief:
• Shock, disbelief, denial

  • Intense mourning
  • Period of restitution

Kübler-Ross’s five stages of coping with death also suggested to apply to grieving

• However, not a predictable, linear process Grief is culture-bound

Individual or collective experience?

35
Q

Anticipatory Grief

A

• Death process can be prolonged and debilitating

  • Many experience intense sadness and grief during caregiving period
  • Anticipatory grief more likely when
  • Illness is over a long period
  • Dying person not cognitively intact

• Resilience associated with pre-loss death acceptance

36
Q

Mourning

A
  • Mourning the social experience of grief
  • Series of restricted behaviours and obligations
  • Few prescriptions as to how to interact with someone who is mourning
  • Different expectations for expressions of grief depending on whether it is an on- or off-time loss
  • Cultural differences
37
Q

Recovery

A

Is recovery the appropriate term?
• Maybe resilience, adaptation, reintegration, resolution

Arguments against the term:

  • Does not allow for transformative outcomes
  • Leads to the view of bereavement as a disorganised state
  • Outcome depends on meaning of the loss and survivor’s coping resources
38
Q
A

Developmental PSYC213 (11 decks)

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