midterm 1 Flashcards
1
Q
age trends and projections in Canada (1921-2046)
A
as years keep going up the age population of older people is also increasing
2
Q
what places have the highest senior population
A
- newfoundland and labrador
- new brunswick
- nova scotia
- qubec
- PEI
- BC
- ON
3
Q
what places have the lowest senior population
A
- nunavut
- northwest territories
- alberta
- yukon
4
Q
does the individual life expectance continue to increase?
A
yes as the year continue the life expectancy does too
5
Q
what are the life span predictions
A
- decreases in infant mortality rate (advances in medicence)
- advances in public health
- plateau of expectancy
- adding “life to years” instead of “years to life”
6
Q
aging and quality of life
A
- living longer doesn’t always mean living better
- decreased quality of life
- decrease in physical, cognitive, mental, social health
- increase in common mordibities and comorbidities
7
Q
desire to live longer is associated with:
A
- positive psychological wellbeing
- increased happiness, life satisfaction, purpose in life
- decreased risk of all-cause mortality (mediated by lifestyle behaviours)
- decreased mortality from cancer or suicide (mediated by lifestyle behaviours
8
Q
what are the types of aging
A
- chronological age
- biological age
- psychological age
- functional age
- social psychological/subjective age
- social age (social roles)
9
Q
chronological age
A
the number of years a person has lived
10
Q
biological age
A
a description of individuals development based on biomedical markers that are determined by molecular or cellular event
11
Q
psychological age
A
description of ones own experiences using nonphysical features such as experience, logic and emotional
12
Q
social psychological/subjective age
A
the personal subjective age of a person based on how old the individual feels and how they feel towards age
13
Q
social age
A
the social roles that an individual has placed on them by society that determines their age
14
Q
functional age
A
a combination of chronological, biological, and psychological age.
- considered to be the wholistic picture of a person described age
15
Q
types of functional aging
A
1st age- childhood (not describe by chronocial order)
2nd age- working and partetning
3rd age- ‘young old’ age between 65-84 years
4th age - above 85years
not everyone reaches all the ages or some skip because of health conditions and etc..*
16
Q
what is healthy aging
A
“continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course”
17
Q
what is included in healthy aging defintion
A
- meet their basic needs
- learn, grow, and make decisions
- be mobile
- build and maintain relationships
- contribute to society
18
Q
biopsychosocial model
A
biological- often associated with relationship of disease and bodily health
social- interpersonal factors such as social interactions and community activities
psychological- the aspects of mental and emotional wellness that also relate to behaviour
19
Q
fries (1980)
A
compression of morbidity
- burden of illness is compressed and more relative later in life, if it is not effecting you for a long time you have a better quality of life
20
Q
rowe and hahn (1987)
A
human aging: usual and successful
- widely cited in geriatrics, gerontology, aging research literature
- avoiding disease and disability
- high cognitive and physical function
- engagement with life
21
Q
MacArthur foundation study on successful aging
A
- led by john W. rowe
- American gerontology perceived to be in a crisis
- interdisciplinary cooperation
22
Q
strawbrdige et al (2002)
A
- need to include the effect of chronic conditions and functional difficulties with successful aging-higher rates of successful aging
23
Q
reichstadt et al (2010)
A
- qualitative interviews on successful aging in older adult perspectives
24
Q
what are the 2 broad categories of aging theory
A
- stochastic theories of aging
- programmed theories
25
stochastic theories of aging
- most prevalent theory is free radical theory of aging
- anti-oxidant vitamins
- age spots
26
free radical theory
- metabolic reactions occurring continuously in the body produce unstable molecules called free radicals
27
nonstochastic theories of aging
- programmed theories
- evolved from work by Hayflick and moorehead
- biological clock
28
neuroendocrine-immunological theory
tied to BOTH programmed and free radical theory
- immunity theory of aging
29
general physical changes with aging
- increased risk of chronic disease
- decline in lean body mass & bone density
- increased risk of fractures
- increased risk of falls
- impaired oral, eye, ear health
- changes in skin, taste, smell
- geriatric syndromes
30
geriatric syndromes
- depression
- function disability
- falling
- malnutrition
- urinary incontinence
- cognitive impairment
31
changes during aging
- skeletal
- musculature
- vision
- hearing
- vestibular
- joint proprioception
- balance
32
what is the skeletal system essential for
calcium storage, movement, reduce frailty
33
at what age does progression of various issue with skeletal system start
30
34
what are the changes in skeletal system that happen at 30+
- density or mass of bones being to dimmish
- bones more fragile and more likely to break
- development of osteoporosis or osteoarthritis
- stiffer/ less flexible joints
- limited range of motion
- collapse of vertebrae
35
what is the musculature system essential for
- prevention weakness and fatigue
- improve ability to perform activities of daily living
- reduce risk of falls and injury
36
when does peak muscle strength occur at
age 20-30
37
when does the musculature system start to change
after 30
38
changes to musculature system
- muscle fibers start to shrink
- muscle atrophy= the thinning or loss of muscle tissues (muscle "wastes away")
- sarcopenia = loss of muscle
- muscles fibers not able to contract as quickly
- presence of lipofuscin
39
what can cause changes
- by 50 changes occur due to environment, genes, illness/diseases, and socioeconomic factors
40
common visual changes
- glaucoma
- dry eyes
- macular degeneration
- cataracts
- diabetic retinopathy
41
presbycusis
progressive, multifaceted, age-related hearing loss
- influenced by factors like genetics, environment, trauma, ototoxic medicines
42
forms of hearing loss
sensorineural, conductive, and mixed hearing lss
- can impact one or both years
43
vestibular changes
- balance and where tou are in space
- causes people to be more cautious because balance is off and cause more falls
44
mechanoreceptors changes
located in the joints, capsules, ligament, muscles, tendons, and skins
- impaired/deterioration of proprioception leading to less accurate detection of body position
- can result in increased risk for falls degenerative joint disease
45
three fundamental properties of balance
- steadiness
- symmetry
- dynamic stability
46
balance and aging
balance disorders result from steady reduction of several systems functions, including musculoskeletal system, CNS& sensory system
47
what does good balance require
- reliable sensory input from an individuals vision, vestibular system & proprioceptors
- as you age, these system can deteriorate
- many falls are related to balance issues
48
what is number one leading health concerns for older adults
FALLING
49
how many people have a chronic disease
73% of individuals aged 65+ years old have at least 1 of 10 common chronic diseases
50
how many have ischemic heart disease
27%
51
what percent have diabetes
26.8%
52
what percentage has hypertension
65.7%
53
what percentage has periodontal disease
52.0%
54
what percentage has osteoarthritis
38%
55
what percentage has asthma
10.7%
56
what percentage has mood and anxiety disorders
10.5%
57
what percentage has osteoporosis
25.1%
58
what percentage has cancer
21.5%
59
what percentage has COPD
20.2%
60
aging risk factors
alcohol and tobacco use
nutrition
physical activity
sleep
61
alcohol and tobacco use
9.5% report daily or occasional tobacco use and 8.3% exceed low risk drinking guidelines
62
nutrition
77.3% of sample consume fruits and vegetables less than 5x a day
63
physical activity
60.6% of sample dont meet PA guidelines
64
sleep
46.8% of sample report trouble falling asleep
65
what is one of the most important risk factors for chronic disease
aging
66
what is multimorbidity
defined as the co-occurrence in the same individual of two or more of ten common chronic disease, including heart disease, stroke, cancer, asthma, COPD, diabetes, arthritis, Alzheimer disease or other dementia, mood and anxiety disorders
67
what is multimorbidity associated with
impaired quality of life, increased use of health care resources, institutionalization, adverse health effects, disability and premature death
68
does the proportion of seniors with multimorbidity increase with age?
yes
69
diabetes & risk factors
- diabetes is a growing public health burden in older adults
- aging increases the risk of diabetes
- management of diabetes for older adults is more complicated
- coexisting medical conditions
- cognitive issues
- diabetes self-management is more difficult due to lack of knowledge and access to resources
70
does cardiovascular disease increase with age with or without risk factors
yes. risk factors increase rate of lifetime risk %
71
high blood pressure
- most common in older adults
- due to changes in the vascular system as one ages
- reduction of elastic tissue, resulting in stiff arteries
72
falls
- most common cause of injury
- one of the leading causes of death
- 1/5 falls cause a serious injury
- large cost to healthcare system result from falls
73
post fall syndrome
- creates a cycle of increasing weakness and instability through joint mobility reductions, physical deconditioning, and poor balance
74
what is part of post fall syndrome
- dependence
- loss of autonomy
- loss of self-confidence
- depression
- confusion
- immobilization
- restriction to daily activities
75
fall cycle in seniors steps:
1. fall
2. loss of balance confidence
3. fear of falling again
4. self restriction of physical activities
5. reduced muscle strength, impaired balance
4. abnormal gait, more unstable on feet
5. increased risk of falling
then they fall again and cycle continues
76
compensatory mechanisms
cautious gait
frozen gait
77
cautious gait
excessive degree of age-related changes in walking and fear of falling
78
frozen gait
abnormal gate pattern in which there are sudden, short and temporary episodes of an inability to move the feet forward despite the intention to walk
79
what does AVOID stand for
Activity
Vaccinate
Optimize medications
Interact
Diet & nutrition
80
what are the 7 behaviours of a healthy lifestyle
1. exercising
2. eating a diet with vegetables
3. not smoking
4. drinking in moderation
5. getting adequate rest
6. coping with stress
7. having a positive outlook
81
what is the 7 behaviours missing
social interaction
82
what are basic activities of daily living
- dressing
- locomotion
- continence (bathroom)
- eating
- transferring
- walking and moving around
83
instrumental activities of daily living
- using a telephone
- traveling
- shopping
- preparing meals
- house work
- taking medicine
84
what are the maintaining "performance" a good thing for
good way to monitor their independence
85
what are the types of PA
aerobic (endurance)
strength
flexibility
balance
functional
86
aerobic (endurance)
- supplies o2 to brain
- walking, jogging, swimming
- 20-30min a day moderate intensity
87
strength
- muscle work more than daily living activities
- weight training, resistance bands, body weight
88
flexibility
- flexibility and stretching for increased freedom of movement for everyday activities and other excercise
- yoga, leg raises, swimming, tai chi
89
balance
- strengthens muscles that keep you upright
- improve stability and prevent falls
- very important to have good balance for older individuals
90
functional
- trains muscle to work together
- prepares for daily tasks by reproducing common movements
- various muscles in upper and lower body used at same time
91
what are benefits of PA
- can make a substantial difference in a persons life
- decrease BP
- increase strength and CV endurance
- increase balance
- increase lung and breathing function
- improve immune function
- reduce depression and anxiety
- control obesity
92
frailty and exercise
- everyone benefits
- adults at risk of frailty or living with frailty
- individuals in long term care
- hospitalized individuals
- can help improve physical function, help minimize and delay age-related declines
- aerobic, muscle-strengthening, and multi-component physical activity programs all demonstrate benefits
93
benefits related to frailty and PA
- improves ability to perform tasks
- prevents weak bones and muscle loss
- improves joint mobility
- improves sleep quality
- reduces risk of chronic conditions
- extends years of activity and independent living
- lowers risk of dementia
- reduces likelihood of falls
94
what are barriers to activity
- intrinsic barriers
- extrinsic barriers
95
intrinsic barriers
- related to the beliefs, motives and experiences of the individual
96
examples of intrinsic barriers
- previous experiences at school, concerns about over-exertion, or perceptions of physical activity
97
extrinsic barriers
- related to the broader physical activity environment
98
examples of extrinsic barriers
- such as skills and attitudes of others, the type of opportunities available, access and safety
99
1. main avenues for overcoming barriers
reassurance in relation to concerns about safety, frequency and intensity
100
second main avenue for overcoming barriers
education of individuals as to what is appropriate physical activity
101
changing up PA
strength
flexibility
balance and agility
co-ordination and dexterity
speed
muscular endurance
102
what are master athletes
starting as early as 25-35+
- activity dependent
- later-life leisure
- increasing in popularity and participation
103
are master athletes seen as role models or social comparison
- they are seen as both.
- modelling for some people and shows that anyone can do it
- or creates comparison making people think they arent good enough
104
what is cognition
- emcompasses all mental abilities, memory knowlesge, promblem sovling, attention, reasoning, language
105
what is cognitive health
CDC defines cognitive health as a brain that can perform all the mental processes that are collectively known as cognition, including the ability to learn new thing, intuition, judgment, language, and remembering
106
what are cognitive non-linear changes occurring during aging
- memory
- attention
- language
- intelligence
- brain changes
- everyday functioning in familiar environments"
107
brain reserve (BR)
"passive" form of capacity that is thought to depend on the structural properties of the brain
- the brains physical or structural components (size of neurons and connections)
108
less brain reserve
lower threshold for the expression of functional impairments
- more vulnerable
109
cognitive reserve (CR)
describes an "active" mechanism for coping with brain pathology
- the brain ability to cope with damage or changes, such as aging or disease, by utilizing pre-existing cognitive processes and neural networks more efficiently
- helps maintain cognitive function
110
what is the factor that decrease the least when aging
vocabulary
111
aging and long term memory
as you age might experience slower processing speed and difficulty retrieving memories, but not all memory decline is related to diseases like Alzheimer's
112
neuroplasticity
engaging in mentally stimulating activities can help maintain long-term memory function
113
what are the types of long term memory
episodic memory
semantic memory
114
episodic memory
(personal experiences) tends to decline with age
115
semantic memory
(facts and knowledge) usually remains stable longer
116
what plats a crucial role within the neural systems for long term memory
the hippocampus
- a reduction in hippocampal volume may contribute to age related cognitive decline
117
fluid intelligence
tasks that involve quick thinking, info manipulation, activities involving allocation and reallocation of attention
118
crystallized intelligence
tasks that tap well-learned stills, language, and retrieval of well-learned material rely more on this
119
examples of fluid intelligence
tests of memory
spatial relations
abstract and inductive reasoning
free recall
mental calculation
how fast you can solve a math problem
120
examples of crystallized intelligence
verbal meaning
word association
social judgement
number skills
know capitals of cities
121
over time as you age when declines fast fluid or crystallized
fluid intelligence
122
factors affecting cognitive needs
- blood pressure great than 140/90
- genetic predisposition to Alzheimer's disease
- elevated cholesterol levels
- inflammation
- myocardial infarction
- diabetes
- stroke
- depression
- alcohol consumption
- poor quality of sleep
- low physical activity
- social isolation
- social determinate of health such as education and income
123
dementia
- umbrella term
- describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life
- cognitive and psychological changes
124
what is dementia caused by
damage to or loss of nerve cells and their connection in the brain
125
dementia and comorbidities
individuals with dementia are more likely to have comorbidities
126
causes of dementia
- neurodegeneration, which is the damage and death of brain neurons
- dependent on types of neurons and brain regions affected and type of dementia
127
dementia statistics
- it is increasing each year in canada
- life tractroy is increasing/ living longer therefore more people are getting diagnosed
128
what are the 8 A's of dementia
- anosognosia
- agnosia
- aphasia
- apraxia
- altered perception
- amnesia
- apathy
- attention deficits
129
anosognosia
- ignorance of the presence of disease
130
agnosia
inability to recognize objects by using the senses
131
aphasia
loss of ability to speak or understand spoken, written or sign language
132
apraxia
inability to perform purposeful movements
133
altered perception
misinterpretation of information from senses
134
amnesia
memory loss
135
apathy
lack of interest; inability to begin activities
136
attention deficits
cant sustain/shift attention; easily distracted
137
risk factors that cannot be changed
- age
- sex
- genetics
138
risk factors that can be changes in early life
(up to 45)
- less education is associated with greater risk of dementia
139
risk factors that can be changes in midlife
(age 45-65)
- hypertension
- high alcohol intake
- obesity
- hearing loss
- traumatic brain injury
140
risk factors that can be changes in later life
(65+)
- smoking
- depression
- social isolation
- physical inactivity
- air pollution
- diabetes
141
Alzheimer's disease
- most common cause of a progressive dementia in older adults
142
how does alzheimer occur
when proteins (called plaques) and fibers (tangles) build up in the brain
143
signs & symptoms of early alzheimers
- beginning of memory loss that disrupts daily life
- coming up with the right word or name
- remembering names when introduced to new people
- having difficulty performing tasks in social or work settings
- forgetting material that was just read
- misplacing things and losing the ability to retrace steps
- changes in mood and personality
- experiencing increased trouble with risk factors that can be changes in early life and organizing
144
signs and symptoms of moderate Alzheimer's disease
- being forgetful of events/personal history
- moody or withdrawn, especially in socially or mentally challenging situations
- being unable to recall info about themselves like their address or telephone number
- experiencing confusion about what day it is
- troubles controlling bladder and bowels
- changes in sleep pattern
- showing an increased tendency to wander and become lost
- demonstrating personality and behaviour changes
145
signs and symptoms of server Alzheimer's disease
- require around the clock assistance with daily personal care
- lose awareness or recent experiences as well as of their surroundings
- experience changes in physical abilities, includign walking, sitting, eventually swallowing
- troubles with communication or none
- become vulnerable to infection, pneumonia
146
diagnosis for dementia
- medical history
- physcial exam and diagnostic exam for other conditions
- neuro exam
- mental cognitive status exam
- mini mental state exam
- brain imaging
- protein analysis of cerebrospinal fluid
- blood samples
147
how much of worldwide dementia could be preventable?
40%
148
what are the 12 changeable risk factors
- education
- hearing loss
- traumatic brain injury
- hypertension
- alcohol
- obesity
- smoking
- depression
- social isolation
- physical inactivity
- air pollution
- diabetes
149
mental health
- cognitive function
- mental disorders
150
cognitive function
changes in memory, attention, and processing speed
151
mental disorders
depression, anxiety , cognitive impairments
152
well-being
- coping mechanisms
- resilience
153
coping mechanisms
strategies used to manage stress and life changes
154
resilience
ability to adapt positively to adversity or significant life event
155
quality of life
- life satisfaction
- purpose and meaning
156
life satisfaction
overall contentment and fulfillment with life experiences
157
purpose and meaning
a sense of contribution and meaning engagement in daily activities and relationships
158
social connection
social support
social isolation
159
social support
relationships with family, friends, and communities
160
social isolation
The degree to which an individual lacks a sense of engagement with others
161
cultural influences
cultural identity
cultural competence
162
cultural identity
the preservation and influence of ones cultural background
163
cultural competence
the ability to interact effectively with people from diverse cultural backgrounds
164
life transitions
retirement
bereavement
165
retirement
adjusting to a new phase of life with changes to ones routine, responsibilities, and identity
166
bereavement
coping with loss and the associated grief process
167
self-identity and autonomy
self-esteem
autonomy
168
self esteem
maintaining a positive self-image and self-worth
169
autonomy
maintaining independence and control over ones life decisions
170
what is mental illness
characterized by alteration in thinking, mood, or behaviour, or any combinations thereof assocatied with some significant distress and impaired functioning.
- mental illness take many forms, including mood disorders, schizophrenia, anxiety, personality, eating disorders, addicitons
171
mental illness vs. mental health
a dual continuum of how they interact
- someone can have low mental illness and high mental health
172
what does the prevlaence of mental health problems range from
in adults over 65 ranges from 20-30%
173
what is the most common mental health condition among older adults
depression
174
what raises estimated of mental health issues to 40% for older adults
sub-clinical depression
175
how many death are from suicide in older adults
25% in people over 60
(highest for older males)
176
what effects mental health
- external factors (housing, income, transportation, mobility, services)
- internal factors (emotional factors, spiritual, social, physical)
177
why are mental illnesses missed?
- signs and symptoms often differ from those in younger people
- adults less likely to self-identify problems
- mental illness can accompany or stem from serious physical illnesses and disorders
- environmental, social, cultural factors can affect a persons signs and symptoms of mental illnesses and willingness to seek treatment
- care giver stress and burnout
178
older adults, dignity and mental illness
loneliness, lack of policy provisions, increased frailty, lesser focus on functional recovery, neurocognitive disorders, institutionalization, healthcare inequalities, social stigma and discrimination, ageism and elder abuse ALL compromised DIGNITY IN OLDER PEOPLE
179
neurotransmitter and healthy aging
- dopamine, serotonin, norephinephrine all decreased with age
180
dopamine
- reward-motivation system
- motor control, decision-making and teaching, motivation, pleasure
181
serotonin
boost when you feel significant and important
- mood, memory, sleep, cognition
182
norepinephrine
- regulates blood pressure
- memory formation and retrieval
- stress and sleep regulation
183
common mental health disorders in older adults
- depression
- suicide
- anxiety disorders
- dementia
- loneliness and isolation
- delusional disorders
- delirium
- paraphrenia
- concurrent disorders
184
depression
- not normal part of aging
- distinct type in late life (reactive with long-term care?)
- depressive symptoms are very similar to dementia, so person is often labeled as having dementia
185
late onset depression
often has a cognitive component, some memory impairment, which may be related to decreased blood flows or TIAs (stroke)
186
why is hard to tell if someone has depression
because depressive symptoms are very similar to dementia, so the person is often mislabed as having dementia
187
symptoms of depression
sleep
interest
guilt
concentration
energy
appetite
psychomotor
suicide
188
depression- sleep
- change in patterns
- day time napping
- unable to sleep
- feeling tired
189
depression- interest
- lack of interest or pleasure in life daily activities, anhedonia, physical limitations and pain limiting activities that they once enjoyed
190
depression-guilt
feeling like a burden, worthlessness, grift and loss, compounding life stressors, changes in roles, and responsibilities, and feeling sad without a reason
191
depression- concentration
- fears about cognitive decline and memory loss, and acute stress
- medical conditions that may occur independent of depression can contribute to issues with concentration and memory
192
depression- energy
- changes in energy, increase in angry, aggressive, agitated, irritable
193
depression- appetite
- changes to appetite, unintended weight gain or loss, increased or decreased sense of hunger
- change in eating patterns
- or change in foods
194
depression-psychomotor
reduced activity, like energy, feeling that they have slowed down, or a sense of restlessness
195
depression- suicide
- feeling hoplessness, helplessness, and sadness
- thoughts of death
196
late-life depression
- developed at the beginning of old age
- affects every 1 in 5 individuals
- characterized by an atypical cluster of symptoms
- less likely to be characterized by sadness
- underdiagnosed and inadequately treated
- becomes challenging to distinguish from dementia
197
what is delirium
acute change in mental status causing shift in cognitive functioning, reduced environmental awareness, altered attention, and behaviour changes
198
types of delirium
1. hypoactive
2. hyperactivity
3. mixed
199
hypoactive
withdrawn, reduced speech and activity, apathy, unawarenss
200
hyperactivity
increased activity, irritability, restlessness, combativeness
201
mixed
fluctuations in psychomotor activty
202
what are short term delirium outcomes
fall
pressure injuries
aspiration pneumonia
distress
prolonged hospital stay
long-term care admission
increased risk of mortality
203
long term delurium outcomes
functional and cognitive impairment
dementia
post-traumatic stress symptoms
sleep disturbances
increased risk of mortality
204
risk factors of delirium
-age
- comorbidity
- illness severity
- history of delirium
- dementia
- depression
- history of transient ischemia or stroke
- unmanaged pain
- hearing and visual impairment
- sleep deprivation
205
what is a common issue with delirum
it gets throw under and just called dementia but it shouldn't be because it is different and could be prevent if take right approaches
206
factors reduction risk of delirium
1, cognitive reserve
2. social support and interactions
3. environment influences
4. pain management
207
reducing risk of delirium-cognitive reserve
- the capacity of the mature adult brain can buffer the effects of neurological disease or injury
208
social support and interactions- reducing risk of delirium
regular visits from care partners help to reduce the burden of cognitive impairment and provide comfort with frequent reorientation
209
environmental influences- reducing risk of delirium
exposure to natural daylight can support the promotion of regular circadian rhythms and healthy sleep cycles
210
pain management- reducing risk of delirium
- appropriate and consistent pain assessments should be conducted to ensure pain is adequately controlled and severity is monitored, especially if communication becomes difficult with delirium
211
the intersection of delirium and mental health conditions
- unfortunately, some of the population most vulnerable to delirium are older adults who have dementia, depression, and acute psychiatric syndrome
- each of these syndromes can co-occur with delirium
212
what is it called when when an individual with pre-existing dementia develops delirium
it is called delirium superimposed on dementia
213
loneliness
- more of a state of mind
- the perception of being alone and isolated that matters most
- subjective, negative feeling related to the deficient social relations
- reported to be more dangerous than smoking
214
symptoms of loneliness/things that could occur
- suicidal ideation
- para-suicide
- Alzheimer's disease
- dementia
- negative effects on immune system
- effects of cardio-vascular system
- increased risk of hospitalization
- increase risk of LTC facility placement
215
types of loneliness
- development loneliness
- internal loneliness
- situational loneliness
216
developmental loneliness
lack of balance between individualisms and innate desire to relate to others
217
internal loneliness
the perception of being alone. Associated with low self-esteem and worth
218
situational loneliness
socio-economic and cultural milieu.
effected by the environment
219
interventions for loneliness
- activity involvement
- volunteer roles
- developing and keeping quality relationships
- pharmacological management of physical ailments
- staying contact with family and friends
220
what is social isolation
a state in which the individual lack a sense of belonging socially, lacks engagement with others, has a minimal numbers of social contacts and they are deficient in fulfilling and quality relationships
221
about social isolation
is a major and prevalent health problem among community-dwelling older adults, leading to detrimental health conditions
- prevalence of social isolation in community-dwelling older adults indicate that it as high as 43%
222
health effects of social isolation include;
- increased risk for all-cause mortality
- dementia
- increased risk for rehospitalization
- increased risk of falls
- these effect can be avoided through prevention efforts if detected early
223
impacts of social isolation
- health behaviour
- psychological
- physiological
- other outcomes
224
health behavioral
- less likely uptake addition behaviour
- no positive reinforcement for health check or say no to bad behaviours
225
psychological
- depression
- suicide
- cognitive decline
226
physiological
- preditor of mortality from heart disease and stroke
- decreased infection resistance
227
other outcomes
- all cause mortality
- risk of falls
- rehospilatzation and insitiualization
228
interventions for social isolation
- there is no one size fits all approach
- social prescribing programs(support groups, social activities..)
- patient-centered approach is essential (social facilitation, exercise, psychological therapies, social services more holistic approach asking what they need and what they think
229
principals for a comprehensive approach to aging and mental health
1. older adults must have access to mental health treatment
2. should receive the care and supports needed to live safely
3. equity, diversity, and inclusion must be embedded in all mental health treatment, care and supports
4. policy, programs and practices should support mentally healthy aging
5. governments at all levels must prioritize and invest in seniors mental health
230
what was WHO definition of health
a state of complete physical, mental, and social well-being and not merely the absense of disease
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what are key dimension that should be included in that WHO defintions
of social well-being, presence and quality of social relationships, social networks, social participation, social isolation, sexuality, social support, social strain and social environment
232
social ecological model contents
individual
interpersonal
institutional
community
policy
233
individual- social ecological model
knowledge, attitudes, skills, and behaviours
234
interpersonal- social ecological model
friends, family, social networks
235
institutional-social ecological model
organizations, schools, workplaces
236
community-social ecological model
cities, neighborhoods, resources, and norms
237
policy-social ecological model
federal, state, and local legislation
238
about social ecological model- individual and interpersonal factors
(mirco)
- immediate family, friends and community significantly shape the aging processes and health
- supportive social connections and positive interactions with family and friends are imperative
- need for belonging and reciprocity with others
- loneliness is influenced by social network size, social interaction frequency, and number of relationships
- family context experiences during early life
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about social ecological model- insitiuonal and commintiy
- neighborhood and built environments, healthcare, organizations, and educational system factors exert influence on older adults health
- the physical environment, housing, transport, healthy food, exercise, affect persons healthy
- improved through collaborative leadership, cooperation across sectors, age-friendly, communities and top down approaches
240
about social ecological model- policy, cultural, structural factors
- cultural health beliefs, policies, environmental characteristics of a region have profound influence over the aging experience and health of older adults
- political factors shape socioeconomic determinants of health and can reduce health disparities for older adults
- the decisions people make about their health, their capacity to cope with the progression of a disease and the effects of medical intervention are all significantly influenced by societal cultural values and norms
241
social ties in later life
older adults tend to have fewer social partners than younger ppl
242
the socioemotional selectivity theory
- explains progression of social network while aging
- older adults have greater emotional response
- they have less social relationships bc they want to spend time with people they love
- see themselves as having less time to waste and are more risk-adverse
- dont want painful social interactions
243
disengagement theory
- normal aging is a mutual withdrawal or disengagement between the aging person and other in the social system
- mutual withdrawal between older adult and society takes place in anticipation of death
- older ppl decrease activity levels and interact less frequently
- at the same time, society frees older adults from employment and family responsibilities
244
social issues of aging and psychological health
- social connection is essential for human health
- strong social improves physical health, outcomes (BMI, blood sugar) and mental health, decreases depression, PTSD
- social isolation negative effect increasing depressive symptoms
- conusleing on social connection can add year to life and enhance life
- social engagement GOOD
- positive link between social identity and health behaviour, suggesting more research is needed
245
retirement and aging
- shown to be both positivity and negatively related to mental health
- variation in the outcomes of retirement highlight to complexity of this issue
- involuntary retirement overall increases the possibility of loneliness, isolation, mental health
246
naturally occurring retirement communities (NORCs)
- unplanned communities that have a high proportion of older residents, and may be critical to finding housing solutions for aging
247
NORC buildings
apartments, condons, co-ops with 30% or more older adults
248
multiple social roles
= self-efficacy and life satisfaction
249
social worth
= improved overall health and survival
250
strong social roles
= reduced rates of death, social isolation, and loneliness
251
family and friends
- more likely to retain independence, a sense of meaning and purpose in life & effective physical and psychological functioning longer
252
marriage and social aging
- older adults are faced with various challenges and changes in later life impacting social networks and relationships like changes in family dynamics, illness, deaths, income changes
253
how do older adults respond to bereavement
- ppl who experienced marital loss have lower positive self-perception of aging than those who remained married
254
spouses specifically face unique caregiving demand whihc increase their risk of health issue, these include:
- financial hardships, organizing LTC placement for their spouse, navigating familial tensions
- changes in social and intimate spousal relationships can increase the risk of loneliness and depression
- maintaining physical and emotional contact is imperative for LTC residents and their spouses relationship
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violence against older adults
- elder abuse
- often perpetrated by family members (older ppl victimized by family member)
- includes physical, sexual, emotional and financial abuse
256
who is most abused
male victims from non-family violence
257
healthy aging =?
maintaining social relationships
258
social media and technology
ageist messages on social media associated with negative health outcomes including poorer mental health for older adults
- older ppl using it is growing
259
barriers of social media
- lack of instructions/knowledge
- confidence
- financial
- health abilities
- trust
260
what are the barrier of social media motivated by:
- social (and medical) support
- enjoyment and fun
- personal empowerment
- advocacy
- bridging generational gaps
261
what are intergenerational programs for
support social health, but also combat ageism
262
delirium distress
people need to be aware of the distressing outcomes experienced during and after delirium
263
components of delirium distress
- fear
- anger
- frustration
- hopelessness
- loss of control
- embarrassment
- guilt
