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psych310 > Lecture 15: Ageing > Flashcards

Lecture 15: Ageing Flashcards

1
Q

Why treat older adults separately?

A
  • Anticipated response to interventions cannot be assumed to be the same as younger adults (efficacy for children treated separately)
  • The higher prevalence of organic disorders
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2
Q

When is old age?

A

The four ages of ageing:

1) Childhood & adolescence
2) Independence, earning & saving
3) Personal fulfilment (50-74)
4) Dependence, decrepitude & death (74+)

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3
Q

Demographics

A
  • For first time, more people in Britain over 45 than under 45
  • NZ >65:1951=9%, 2001=12%, 2051=26%
  • 98% aged 65-74 live independently, 70% aged 85+ live independently
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4
Q

NZ life expectancy (2014 data)

A
  • L.E at birth is 83.2 for females & 79.5 for males
  • Gap between Maori and non-Maori L.E at birth has reduced to 7.1 years
  • L.E at birth is 77.1 for Maori females & 73.0 for maori males, compared to 83.9 for non-maori females & 80.3 for non-maori males
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5
Q

An Ageing World

A
  • Older people now outnumber children <5 for first time
  • > 1 billion >65 by 2040
  • Projected that a 1/3 of people born now, in wealthy nations, could live to 100
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6
Q

Challenges of Ageing Population

A

Human organisation:

  • Structure of family
  • Patterns of work + retirement
  • Social services
  • Health sector
  • Pensions
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7
Q

Theories of ageing

A

Erickson’s theory:

  • Trust vs. mistrust = hope (0-2)
  • Autonomy vs. doubt = will (2-4)
  • Initiative vs. guilt = purpose (4-5)
  • Industry vs. inferiority = competence (5-12)
  • Identity vs. role diffusion = fidelity (13-19)
  • Intimacy vs. isolation = love (20-39)
  • Generativist vs. self absorption = care (40-64)
  • Integrity vs. despair = wisdom (65-death)
  • Transcendence = faith humility
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8
Q

Successful ageing

A
  • Contradiction in terms success & ageing
  • Criteria for success? = length of life, biological health, mental health, cognitive efficacy, social competence & productivity, personal control, life satisfaction
  • Subjective vs. objective indicators
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9
Q

What is successful ageing

A
  • R.J.Havighurst (1961) coined the phrase
  • Rowe & Khan (1998) = avoidance of disease & disability
    = maintenance of cognitive + physical functioning
    = sustained engagement with life
  • Usual vs. successful ageing (R&K, 1987) = extrinsic vs. intrinsic factors
    = example of diet
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10
Q

How do we know what makes up successful ageing?

A
  • Cross-sectional vs. longitudinal
  • Large scale longitudinal studies = MacArthur Study
    = Harvard Study
  • Examining groups that have lived to >100 - Blue Zones
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11
Q

Blue Study Results

A

1) Move naturally
2) Purpose - “why i wake up”
3) Down shift - stress reducing techniques
4) 80% Rule
5) Plant Slant
6) Wine@5 = 1-2 glasses
7) Belong - faithbased
8) Loved ones first = families first
9) Right Tribe = groups that support healthy behaviours
= 5 friends

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12
Q

Critique of successful ageing

A
  • ‘Success’ based on scientific ideas by theorists yet to reach old age, rather than real life experiences of elderly
  • Praises fortunate & privileged elders and labels others as ‘unsuccessful’
  • Fits into neo-liberal ideology-individual responsibility vs. social collective
  • Promotes white middle class values
  • Does not accommodate losses that are part of ageing
  • A health promotion model that does not speak to older adults
  • Fits a political system that is trying to make the aged less a social responsibility
  • Possibility that old age is a time of reflection?
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13
Q

Older adults concept of successful ageing

A
  • Respect
  • Worth
  • Wellbeing
  • Via: reciprocal roles with children, social support, social engagement, spirituality, independence
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14
Q

Physically successful ageing

A

Playgrounds for elderly

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15
Q

Psychological elements of successful ageing

A
  • Attitude = internalised (attitudes)
    = self stereotypes
    = determinants of longevity -> genes, will to live, +7.6yrs median with +ve ageing population
    -> factors in order: selfperception, gender, loneliness, functional health, SES
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16
Q

‘Only as Old as you feel’

A
  • Yannick Stephan (2015)
  • Younger subjective age related to risk of death, health, lower depression, increased wellbeing
  • Continuing to engage actively with life
  • Sexual identity
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17
Q

Social elements contributing to successful ageing

A
  • Productivity
  • Strong interpersonal relationships
  • Social support
  • Marriage
  • Socio-economic
18
Q

Kaumatua & Kuia

A
  • Leadership
  • Storehouse, transmission & imparting knowledge
  • Guardians of Tikanga
  • Nurterers of mokopuna
  • Dispute resolution
19
Q

Ageing in NZ

A
  • Life and Living in Advanced Age Cohort Study in NZ (LiLACS NZ)
  • Prof Ngaire Kerse examining how Maori & non >80 are ageing
20
Q

Functional disorders in old age

A
  • a general decrease in vulnerability to functional disorders while organic disorders means prevalence rates overall remains similar
  • Low rate seeking help, many mental illness goes undiagnosed & untreated
21
Q

Depression

A
  • Often under reported as seen as ‘normal’ part of ageing or illness
  • prevalence = 1.1% of those >65
  • Symptomology different to adults = loss of memory, changes in sleep + appetite
  • Complications in diagnosis: cross-over with dementia, physical illnesses, polypharmacy
22
Q

Late life depression

A
  • First episode past 60
  • Symptoms = cognitive dysfunction, increased co-morbidity, high rates of lethargy & fatigue, less likely to have a family history of depression, chronic & more resistant to treatment, possible different biological pathway, possible prodrome to dementia, suicide
23
Q

Anxiety

A
  • More common than depression in later life
  • Underreporting = mimic physical health issues
    = mimic side effects of medication
    = mimic some signs of dementia
    = institution
24
Q

Prevalence of anxiety

A
  • 4.5% of older adults >65
  • Phobias & GAD most common
  • OCD & PTSD least common
  • Most common females & with co-morbid medical disorder
  • Older adults symptoms are centred on: sleep + appetite, memory + attention, agitation
25
Q

Psychometrics

A
  • GAI, GDS, HONOS 65+, MMSE, Addenbrookes ACE-R, CAMCOG, MOCA, Clock drawing task
26
Q

Depression

A
  • Mental decline rapid
  • Knows time, date, where they are
  • difficulty concentrating
  • Language + motor skills slow but normal
  • Notices memory problems
27
Q

Dementia

A
  • Mental decline slowly
  • Confused + disoriented
  • Difficulty with ST memory
  • Writing, speaking + motor skills impaired
  • Doesn’t notice memory problems
28
Q

Delirium

A
  • Acute onset
  • Chest infection/UTI
  • Bloods/MSU
29
Q

Organic disorders of old age

A

memory and dementia

30
Q

Changes in cognitive processes with age

A
  • Complex attention decreases
  • ‘Lapses’ in memory
  • Semantic memory intact
  • Episodic memory impacted
  • Language intact
  • Wisdom increases
31
Q

Ageing & memory

A
  • Takes longer to recall
  • More difficulty recalling names
  • Putting a time to a memory
  • Age Associated Memory Impairment (AAMI)
32
Q

Dementia

A
  • Symptoms that occur when brain is affected by specific conditions
  • Syndrome
33
Q

Types of dementia

A
  • Alzheimer’s disease = 50-70%
  • Vascular dementia = 20%
  • Dementia with Lewy bodies = 10%
  • Mixed/other account for large proportions of cases
34
Q

Prevalence of dementia

A
  • 65-69 = 1.4%, 70-74 = 2.8%, 75-79 = 5.6%, 80-84 = 11.1%, 85+ = 23.6%
  • Rates double every 5 years
  • Women more likely Alzheimer’s and men vascular
  • Other factors = genetic, cardiovascular, env.
35
Q

Treatments of dementia

A
  • Lifestyle = exercise, stop smoking, diet, cognitive stimulation/socialisation
  • Medication = aspirin, aricept, exelon, reminyl
36
Q

Functional & cognitive changes with dementia

A
  • Forgetfulness, MCI, Early Dementia, Mild, Moderate, Severe, ‘Treatments in each area build on not move on’
37
Q

Working with memory problems

A
  • treatments = physical-body, social-the carer, env., psychological, medication
38
Q

Approaches to dementia care

A
  • Reality Orientation, reminiscence, validation therapy, stimulation (Snoozleen), person-centred care, working with care givers, reliance on care env. most important - env. driven behaviours, behaviour modification-ABC
39
Q

Approaches to dementia care - life story format

A

E.g. family, your friends, jobs…

40
Q

Approaches to dementia care - personhood theory

A
  • Stresses importance of a humanising person-centred approach in care of PWD
  • This conflicts with societal views of ageing which values youth, beauty, intelligence
  • Tom Kitwood (early 1990s)
  • Personhood is a ‘status that is bestowed on a human being by others in context of relationship + social being’
41
Q

Person-centred care

A
  • View dementia as a disability not a disease
  • Promoting positive wellbeing
  • Importance of life history + identity
  • Working with abilities
  • Recognising quality of carers…
42
Q

Five part model

A
  • Behaviour (centre)
  • Env
  • Person
  • Biology
  • The Carer

psych310 (23 decks)

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