Question

1. Summarize the growth and development in late adulthood

Define the age group and name at least 2 theorists that study that age group

mention of specific tasks, milestones, growth patterns, social development,

cognitive development patterns, play, exercise, etc.

2. Summarize the growth and development in advanced old age and geriatrics

Define the age group and name at least 2 theorists that study that age group

mention of specific tasks, milestones, growth patterns, social development,

cognitive development patterns, play, exercise, etc.

3. How would a nurse help a patient plan for end of life care?

4. Discuss how a patient deals with loss, grief, and bereavement

Answer 1

Question no 1

Late adulthood (old age) is generally considered to begin at about age 65. Erik Erikson suggests that at this time it is important to find meaning and satisfaction in life rather than to become bitter and disillusioned, that is, to resolve the conflict of integrity vs. despair. It has been estimated that by the year 2030,

People typically reach the peak of their physical strength and endurance during their twenties and then gradually decline. In later adulthood, a variety of physiological changes may occur, including some degree of atrophy of the brain and a decrease in the rate of neural processes. The respiratory and circulatory systems are less efficient, and changes in the gastrointestinal tract may lead to increased constipation. Bone mass diminishes, especially among women, leading to bone density disorders such as osteoporosis. Muscles become weaker unless exercise programs are followed. The skin dries and becomes less flexible. Hair loss occurs in both sexes. There is also decreased sensitivity in all of the sensory modalities, including olfaction, taste, touch, hearing, and vision.

Cognitive changes. The study of cognitive changes in the older population is complex. Response speeds (neural and motor) have been reported to decline; some researchers believe that age‐related decrease in working memory is the crucial factor underlying poorer performance by the elderly on cognitive tasks.

Intellectual changes in late adulthood do not always result in reduction of ability. While fluid intelligence (the ability to see and to use patterns and relationships to solve problems) does decline in later years, crystallized intelligence (the ability to use accumulated information to solve problems and make decisions) has been shown to rise slightly over the entire life span. K. Warner Schaie and Sherry Willis reported that a decline in cognitive performance could be reversed in 40% to 60% of elderly people who were given remedial training.

Dementias are usually responsible for cognitive defects seen in older people. These disorders, however, occur only in about 15% of people over 65. The leading cause of dementia in the United States is Alzheimer's disease, a progressive, eventually fatal disease that begins with confusion and memory lapses and ends with the loss of ability to care for oneself.

Retirement. Retirement at age 65 is the conventional choice for many people, although some work until much later. People have been found to be happier in retirement if they are not forced to retire before they are ready and if they have enough income to maintain an adequate living standard. Chronic health problems such as arthritis, rheumatism, and hypertension increasingly interfere with the quality of life of most individuals as they age.

Widowhood. Women tend to marry men older than they are and, on average, live 5 to 7 years longer than men. One study found ten times as many widows as widowers. Widowhood is particularly stressful if the death of the spouse occurs early in life; close support of friends, particularly other widows, can be very helpful.

Death and dying. Death and dying has been studied extensively by Elisabeth Kübler‐Ross, who suggested that terminally ill patients display the following five basic reactions.

Denial, an attempt to deny the reality and to isolate oneself from the event, is frequently the first reaction.

Anger frequently follows, as the person envies the living and asks, “Why should I be the one to die?”

Bargaining may occur; the person pleads to God or others for more time.

As the end nears, recognition that death is inevitable and that separation from family will occur leads to feelings of exhaustion, futility, and deep depression.

Acceptance often follows if death is not sudden, and the person finds peace with the inevitable.

Question no 2

Theories of successful aging. Theories of successful aging include the following:

The disengagement theory states that as people age, their withdrawal from society is normal and desirable as it relieves them of responsibilities and roles that have become difficult. This process also opens up opportunities for younger people; society benefits as more‐energetic young people fill the vacated positions.

The activity theory contends that activity is necessary to maintain a “life of quality,” that is, that one must “use it or lose it” no matter what one's age and that people who remain active in all respects—physically, mentally, and socially—adjust better to the aging process. Proponents of this theory believe that activities of earlier years should be maintained as long as possible.

Ageism. Ageism may be defined as the prejudice or discrimination that occurs on the basis of age. Although it can be used against people of all ages, older people are most frequently its target and it may often result in forced retirement. Stereotyping of the elderly is also an aspect of ageism, as seen in such a statement as “He drives like a little old lady.”