Old Age and Death and Dying

Where We End Up…

Old Age• The single greatest fear of old age was

once considered the fear of DEATH.

Old Age• Realistically, though, the greatest fear is

the fear of failure.

Old Age

• Decremental Model of Aging—Progressive physical and mental decline is inevitable with old age.

• Ageism—discrimination based on a person’s age. Try and do away with the stereotypes that older folks are irrelevant or unable to do things for themselves.

Myths and Ageism

Changes in Health

• Four major Diseases that affect the elderly– Heart Disease

– Hypertension

– Diabetes

– Arthritis

Heart Disease

Arthritis

Health

• Three major causes of death– Heart Disease

– Cancer

– Strokes

Stroke

Health Care For The Elderly

• Rising health care means that many people are unable to afford quality health care in their later years.

• Prescription drug costs and hospital stays, as well as permanent care facilities; often drain people of their income.

Health Care For The Elderly

Life Situations for the Elderly

• 50% of women and 20% of men are widowed by the age of 65.

• By the age of 80, 33% of men and 70% of women are alone.

Widowhood

Depression and the Elderly

• Loss of a spouse

• Genetic Pre-Disposition

• Stress

• Lifestyle

• Unhealthy eating

• Loneliness

• Lack of exercise

Changes in Sexual Activity

• Healthy Partners enjoy an active sex life well into their 70s and 80s.

• Some choose not to because of societal pressure that they are “not supposed to act” that way.

Changes in Sexual Activity

Changes in Sexual Activity

Adjusting to Old Age

• Society is slowly changing its attitudes toward the elderly, influenced in large part by organizations such as AARP.

Changes in Mental Functioning

• Crystallized intelligence refers to the ability to use accumulated knowledge and learning in appropriate situations. This ability increases with age and experience.

• Fluid intelligence is the ability to solve abstract relational problems and generate new hypotheses. This ability generally declines with age.

Crystallized and Fluid

Changes in Mental Functioning

• Two forms of loss of mental functioning are senile dementia and Alzheimer’s disease.

Changes in Mental Functioning

• Senile dementia is a condition where people lose their memory, forget, don’t know where they are or what time it is, find it harder to think for themselves, have short attention, personality gets altered and have difficulty relating to others.

Senile Dementia

Alzheimer’s Disease

• Alzheimer’s Disease is the fourth leading cause of death among US adults and is an incurable disease that destroys a person’s ability to think, remember and relate to others.

Alzheimer’s and Senile Dementia

• The difference between senile dementia and Alzheimer’s is that Alzheimer’s is a form of senile dementia that is incurable. Some of senile dementia is curable, some not.

Death and Dying

Elizabeth Kubler-Ross Theory

• Kubler-Ross felt terminally ill patients go through the following five stages:

• Denial• Anger• Bargaining• Depression• Acceptance

Elizabeth Kubler-Ross

Denial

• Used by almost all patients in some form. It is a usually temporary shock response to bad news. Isolation arises from people, even family members, avoiding the dying person. People can slip back into this stage when there are new developments or the person feels they can no longer cope.

Denial

Anger

• -Anger at God: "Why me?" Feeling that others are more deserving.

• -Envy of others: Other people don't seem to care, they are enjoying life while the dying person experiences pain. Others aren't dying.

• -Projected on environment: Anger towards doctors, nurses, and families.

Anger

Bargaining

• A brief stage, hard to study because it is often between patient and God.

• -If God didn't respond to anger, maybe being "good" will work.

• -Attempts to postpone: "If only I could live to see . . ."

Bargaining

Depression

• Mourning for losses

• -Reactive depression (past losses): loss of job, hobbies, mobility.

• -Preparatory depression (losses yet to come): dependence on family

Depression

Acceptance

• This is not a "happy" stage, it is usually void of feelings. It takes a while to reach this stage and a person who fights until the end will not reach it. It consists of basically giving up and realizing that death is inevitable.

• Hope is an important aspect of all stages. A person's hope can help them through difficult times.

Acceptance

In Conclusion (pun intended)…

• The theme does not change. A positive life as a child through adolescence, through adulthood, will indicate the best chance of a happy elderly age and a more philosophical view of life and its conclusion: death. A negative or stressful life, will lead more to feelings of despair.