Midterm flashcards
By the year 2050, what percentage of the US will be occupied with elderly people?
30% or more
What is the fastest growing age group?
85+
By the Year 2040….
60+ yo – ??? Million
85+ yo – ??? Million
Year 2040
60+ yo – 12.5 Million
85+ yo – 1.7 Million
Regarding diversity, what groups are increasing/decreasing by 2050?
Increasing: black, hispanic, asian
Decreasing: white
How healthy do you believe older adults are currently in comparison to 10 years ago?
Health span (decreasing) vs lifespan (increasing) Getting better about reducing disability, but end of life is a struggle
What might account for decreases in disabling effects of certain diseases in older adults?
- Better vision technology (cataracts)
- Target chronic conditions earlier
- Not doing great with arthritis (more computer work; lifestyle changes; wear and tear OA) and diabetes
- Mental status
- Medication management
Among those aged 65+ years, what percent have chronic diseases and are on medications?
92% have ≥1 and 50% ≥2 chronic diseases
80% take ≥1 medication; majority take 2-3
40% of older adults in nursing home facilities take 9+ meds
59% take unnecessary meds
Recent Mortality Trends: U.S. vs Global ….
What are we doing well/not well at treating?
Better in breast cancer, ischemic heart disease
Not doing well with alzheimer’s and lung cancer and diabetes
Gerontology:
study of ageing
Frailty:
age-related pathological state of loss of physiologic reserve that leads to physical impairments and functional limitations and disability. Loss of strength (weakness), usually related to muscles, fatigue (exhaustion), loss of weight (10lbs within last year that was unintentional), ambulation (slow walking speed), low physical activity
Age-related changes:
changes occurring in older adulthood; diff from pathological processes but may interact reciprocally with illness and disease prevention.
Active aging:
successful multidimensional aging process which includes physical, psychosocial (in class notes)
Active ageing is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. It applies to both individuals and population groups.
Geriatrics:
medical services for older people
Aging:
growing older (universal)
Health promotion:
approach to intervention focused on maintaining health and avoiding disease
Definitions of ageing: biological, psychological, chronological, social
Biological: decline and deterioration of function
Psychological: Changes that occur in capabilities related to mental and cognitive functioning, self-esteem/efficacy
Name all the Age Groups and Terms :
Senior: 55+ Older adult: 65+ Young-old: 55-75 Old old: 76+ Oldest old: 85+ octogenarian (80-89) Nonagenarian: 90-99 Centenarian: 100-109, supercentenarian (110+)
Factors Influencing the Aging Experience
social supports, gender, SES, location, nationality, view of oneself, roles in life, current laws and practices
Gender and ageing
Access Pensions Widowhood Poverty Life satisfaction Research Women had less access: Rights; reproductive rights Access to education Men lose their social network Men remarry; life satisfaction goes up, stays the same for women Men ignored when it comes to prostate cancer, breast cancer, osteoporosis
Cohort Effects : definition
how history effects/impacts a generation of people or older adults; influences behaviors and experiences of aging
the particular impact of a group bonded by time or common life experience
Name the cohorts
Today’s elder cohort (~1901-1924)
Upcoming cohorts:
Baby Boomers (~1946-1964)
Generation X (1965 – 1981)
Generation Y / Millennials (1982 – 2004?)
Generation Z / iGeneration (2005? – 2015?)
name Public Policy & Social Factors of ageing
Older Americans Act (OAA)
Social Security
Family responsibilities
Intergenerational conflict?
OAA: Adult day care, older adult rights
Ratio changing; workforce financial burden of paying into SS, older people aren’t dying as quickly
Socioeconomic Status & Ageing factors include
Education
Income
How Residence affects ageing…
Environment Location Rural, suburban, urban Migration Aging in place Institutionalization
Less smog, stress, more intimate relationships, more physical activity (rural) More hospitals (suburban) Urban: fewer financial resources, more ethnically diverse
How Experiences/ Personal Characteristics affect ageing
Genetics Personality traits Personal attitudes Self-esteem Protective Factors
How Roles affect ageing
Expectations
“Appropriate” functions
Value of the individual
How social attitudes affect ageing
Current attitudes
Can views be changed?
How Community-Living US and UK Older Adults (60+yo) Spend their Time (hrs/day)
UK: more time volunteering, less time working and slightly less sleeping, more self-care/grooming
US: less time volunteering, more time working and slightly more sleeping, less self-care/grooming
Define Occupational Deprivation
Definition: unable to do what is necessary/meaningful in his/her life due to external restrictions
For what reasons may older adults be vulnerable to occupational deprivation?
Lack of opportunities to engage in occupation have negative consequences
Life and Role Transitions
What types of events/situations might trigger life transitions and role changes?
What are some examples of life and role transitions that late middle-aged and older adults may experience?
Retirement, loss of spouse, loss of job, role as grandparent, caregiver to spouse, late life relocation, health issues (chronic or acute)
Work and Retirement
Does current society value older workers?
What are characteristics of older workers?
Why might older adults experience retirement differently?
Losing meaningful occupations; lack of resources in retirement
Might have caregiving roles
Establish routine when they retire, plan for retirement; successful transition to retirement; positive outlook
Factors of Widowhood
Gender Grief Health repercussions Social participation Practice implications
50% woman experience loss of a spouse; experience it more often over the age of 80
Grief: 10-20% chronic experience with grief; other health repercussions; further lack of social participation
Informal social participation; fiends, family, neighbors; buffers them from negative outcomes of grief and widowhood
Higher informal participation more common in widows rather than those not widows also compared to widowed men
Helping clients who have recently suffered a loss to regain social participation
Late-life Relocation factors to consider
Process differs from relocations in earlier life
Health repercussions
Control
Practice implications
More family involvement as compared to early life re-location
Making sure to anticipate these conversations that involve relocation, instead of springing it all of a sudden
Societal Norms–> Community based services –> Informal Support Systems –>Physical Environment –> Individual Characteristics –> Residential Move Decision
Empowerment issues to consider
Definition: giving them a say in their health needs; being recognized and promoting people’s abilities to meet their own needs, solve their own problems, mobilize the necessary resources to in control of their life
Older adults are one of the most disempowered groups
Care model vs. Empowerment model
Contributing factors to disempowerment
Empowerment model; giving them the control of their care needs
Why they might be disempowered 1) Poverty; health needs; 2)not one single heterogeneous group; not all the same, 3) health costs are affected that service providers know that population of older adults is rising, 4) negative stereotypes that society has about older adults
OT and Aging
What role does OT play in assisting with life and role transitions and empowerment of older adults?
Given the assigned LR chapter, what are possible strategies/activities to use to achieve the goal of, “Describe occupation and make explicit the relationship of occupation to health”?
Making sure they are able to maintain heir occupations; how does aging affect occupation; how is their current occupation compared to how their aging and how it influences them
What are the 5 age-related theories:
wear and tear theory (including free radical theory)
lifespan development theory
selective optimization with compensation theory
life course perspective
continuity theory
Theories of Ageing: Biological
Biological: Wear and Tear Stochastic Developmental-Genetic Cellular Aging Evolutionary Neuropsychological
Theories of Ageing: Psychological
Psychological Life-Span Development Selective Optimization w/Compensation Socioemotional Selectivity Cognition and Aging Personality and Aging
Theories of Ageing: Sociological
Sociological Life Course Continuity Theory of Aging Social Exchange Social Constructionist Feminist Political Economy of Aging Critical Perspectives of Aging
Biological Theories of Aging : Wear and Tear Theory
Address aging processes at the organism, molecular, and cellular levels
There is not measureable indictor that someone is aging!!
Free Radical Theory
when cells and tissues wear down
Free radical theory: how cell damage occurs by free radicals; trying to illustrate that damage accumulates over time; eventually leads to cells stop functioning; antioxidants
Use fireplace analogy; embers/sparks are free radicals and carpet is the tissue that gets worn down
Wear and Tear Theory factors
Pollution Metabolism Inflammation Smoking Ionizing Radiation UV light
Psychological Theories of Aging
Seek to explain the multiple changes in the individual behavior in the middle and later years of the life span; boundaries addressed are amorphous
Psychological Theories of Aging: Life-Span Development Theory
Ontogenetic development is biologically and socio-culturally constructed
Potential for development is present from infancy»_space; old age
No age or stage is supreme
Events at each stage affect future development
Development becomes less plastic and opportunities for change are more limited
Ontogeny: dev. of embryo to adulthood: birth to death
Socially and culturally impacted from birth to death
Very distinctly differences; no indiv the same
Interrelated lifespan trends contribute to human development:
Evolutionary selection benefits decrease
Need for cultural resources increases
Efficacy of cultural resources decreases
The older the person gets, the less natural selection will help them
With age, the protective benefits of aging is not as strong; the more we need culture based resources; more practice to maintain the same amount of learning
Resources may become les effective for them; increases with age; but also experiencing some other chronic condition
Ontogeny/Ontogenesis
the development of an individual organism or anatomical or behavioral feature from the earliest stage to maturity.
Psychological Theories of Aging: Selective Optimization w/ Compensation
Considered a Life-span Development Theory
Fundamental mechanisms:
Selection
Optimization
Compensation
Manage the dynamics between gains and losses as one grows older in order to successfully age
As one gets older, there are more restrictions in older adults lives, can no longer do what they used to be able to do or prioritize; avoid certain activities due to health status
Selection; Loss of hearing may restrict their activity selection
Optimization: how to allocate resources for the activities they choose, how do you invest add’l resources? Plan more activities etc; keeping in mind age-related changes in the body: ex: church, but they can no longer drive
Compensation: use of alternative methods to be able to achieve the activities they want to achieve; choosing a goal; assistive devices or tech; ex: losing their eyesight but they love the choir, cannot read music; compensate to use ones with braille on it
Sociological Theories of Aging
Consider the context in which aging occurs and the demands of the activities and the environments
Sociological Theories of Aging: Life Course Perspective
To understand older people now, you need to know their past
Emphasizes social and cultural factors (at macro»micro levels) that might influence the aging experience over time
Pathways between life phases and circumstances in early life affect later life health
Cohort effects, contextual factors that influence them
Life Course Perspective
Key concepts
Trajectories – stable patterns of behavior of health across time
Transition; changes in social roles or responsibilities; Retirement
Turning point; grad school; life takes a diff direction; changes in ongoing social role trajectories
Contextual influences: life history events; safety of neighborhood; health policies; race/gender/SES
(Spouse who has poor eating habits)
Timing in lives – The interaction between age or stage of the life course and timing of event or transition
Linked Lives - dependence of the development of one person on the presence, influence or development of another
Adaptive strategies: conscious decisions that people make to improve their health or well-being or social norms that frame the way in which decisions are made to adapt to external changes
Sociological Theories of Aging: Continuity Theory
Past experiences, decisions, and behaviors form the foundation for the present and future
Goal of adapting to changes is to maintain patterns of thought, activities, and habits
Strategies used for adaptation come from past experiences
(Teaching dance instead of participating in the occupation; diff means and strategy)
Name Physiological Systems
Nervous Cardiovascular Respiratory Endocrine Hematologic Immune Digestive Genitourinary Muskuloskeletal Integumentary Special senses
Nervous System - changes
Changes
Loss of neurons and myelin
Frontal lobe atrophy
Unbalanced neurotransmitters
Cognitive changes
Altered motor skills
Diminished sensory input
Loss of neurons; AD, PD Loss of myelin Frontal lobe atrophy Reduced executive functioning Unbalanced neurotransmitters
Nervous System - results
Results
Common diseases (e.g., Alzheimer’s)
Reduced exec function; slowed reaction and mental processing
Less stage 3 and 4 sleep
Motor skill changes; motor and postural, gait, shorter more hesitant gait
Diminished sensory input; body in space;
Slower fine motor and postural reflexes
Shorter, hesitant gait
Lower proprioception, vestibular sensation, and kinesthesia
Cardiovascular System - changes
Changes Increased adiposity Endocardium scarring Loss of autorhythmic cells Decreased cardiac output Decreased max heart rate Atherosclerosis Ulcerations
Less efficient nerve conduction
Fatty plaques around arteries
Postural hypotension; lightheaded standing up too fast
Aneurysms: arteries leak or rupture
Cardiovascular System - results
Results Hypertension Quickly tiring and SOB Postural/orthostatic hypotension Stroke, heart attack Aneurysms Peripheral vascular disease Thrombus
Respiratory System - changes
Changes Forced vital lung capacity decreases Lungs lose elastic recoil Loss of surface area of alveoli Stiffening rib cage Decrease O2 saturation
Respiratory System - results
Results
Decreased tolerance for PA
Difficulty expanding rib cage, especially during PA
Disease (COPD, emphysema, chronic bronchitis)
Pneumonia
Endocrine System - changes
Changes Decreased efficiency of hormone release Decreased thyroid activity Decreased aldosterone Elevated cortisol response to stress Decreased insulin production; insulin resistance
Endocrine System - results
Results
Decreased cognitive function, strength, sexual function
Reduced metabolic rate and mental alertness, subpar thermo-regulation, increased atherosclerosis
Increased BP
Hyperglycemia
Immunosuppression
Disease exacerbation (e.g., diabetes, HTN)
NIDDM
Hemotologic System - changes
Hemotologic Changes
Decreased erythropoiesis 2○ to disease
Hemotologic System - results
Results
Anemia (hypoproliferative; ineffective erythropoiesis)
Hypoproliferative: rate RBC is produced declines; possibly bleeding in digestive tracts
Erythropoiesis: Vit B12 deficiency, dietary intake result
Immune Systems - changes
Immune Changes Decreased # T-cells Altered immune surveillance of cancer cells Slow destruction of thymus Increased autoantibodies
Immune Systems - results
Results
Infectious diseases
Cancer
Autoimmune disease
