Question

1. Summarize the growth and development in late adulthood as regards to milestones, growth pattern, cognitive development, specific task, play and exercise and name the 2 theorist inrespectively.

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

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

Answer 1

Late adulthood is the stage of life from the 60s onward; it constitutes the last stage of physical change

Physical Development in Late Adulthood

The aging process often results in a loss of memory, deteriorated intellectual function, decreased mobility, and higher rates of disease.

• During late adulthood the skin continues to lose elasticity, reaction time slows further, muscle strength and mobility diminishes, hearing and vision decline, and the immune system weakens.
• The aging process generally results in changes and lower functioning in the brain, leading to problems like decreased intellectual function and neurodegenerative diseases such as Alzheimer’s.
• Many of the changes in the bodies and minds of older adults are due in part to a reduction in the size of the brain as well as loss of brain plasticity.
• Memory degenerates in old age, so older adults have a harder time remembering and attending to information. In general, an older person’s procedural memory tends to remain stable, while working memory declines.

Cognitive Development in Late Adulthood

Cognitive abilities such as memory may see a decline in late adulthood.

• During old age, a general decline in memory is very common, due to the decrease in speed of encoding, storage, and retrieval of memory.
• Neurocognitive disorder, formerly called dementia, is a broad category of brain diseases that cause a gradual long-term decrease in the ability to think and remember.
• There is no cure for neurocognitive disorder, but there are many strategies to improve quality of life for people with this disorder, such as daily exercise programs and cognitive or behavioral therapies.

Socioemotional Development in Late Adulthood

Growing older means confronting many psychological, emotional, and social issues that come with entering the last phase of life.

• As people age, they become more dependent on others. Older adults may struggle with feelings of guilt, shame, or depression because of their increased dependency, especially in societies where the elderly are viewed as a burden.
• Many older adults contend with feelings of loneliness and isolation as their loved ones pass away, which can negatively impact their health and well-being. Staying active and involved in life can help to counteract these challenges.

Cognitive change as a normal process of aging has been well documented in the scientific literature. Some cognitive abilities, such as vocabulary, are resilient to brain aging and may even improve with age. Other abilities, such as conceptual reasoning, memory, and processing speed, decline gradually over time.

What Are the Signs of Cognitive Disorder?

• Confusion.
• Poor motor coordination.
• Loss of short-term or long-term memory.
• Identity confusion.
• Impaired judgment.

About half of the physical decline associated with ageing may be due to a lack of physical activity. Without regular exercise, people over the age of 50 years can experience a range of health problems including: Reduced muscle mass, strength and physical endurance. Reduced coordination and balance.

2) End of life care

End-of-life care is the term used to describe the support and medical care given during the time surrounding death. Such care does not happen only in the moments before breathing ceases and the heart stops beating. Older people often live with one or more chronic illnesses and need a lot of care for days, weeks, and even months before death.

There are ways to make a person who is dying more comfortable. Discomfort can come from a variety of problems. Like

• Pain
• Breathing problems
• Skin irritation
• Digestive problems
• Temperature sensitivity
• Fatigue

Pain ....Experts believe that care for someone who is dying should focus on relieving pain without worrying about possible long-term problems of drug dependence or abuse.Don't be afraid of giving as much pain medicine as is prescribed by the doctor. Pain is easier to prevent than to relieve, and severe pain is hard to manage. Try to make sure that the level of pain does not get ahead of pain-relieving medicines. Tell the doctor or nurse if the pain is not controlled. Medicines can be increased or changed. If this doesn't help, then ask for consultation with a palliative medical specialist who has experience in pain management for seriously ill patients

Breathing problems. Shortness of breath or the feeling that breathing is difficult is a common experience at the end of life. The doctor might call this dyspnea (disp-NEE-uh). Worrying about the next breath can make it hard for important conversations or connections. Try raising the head of the bed, opening a window, using a humidifier, or having a fan circulating air in the room. Sometimes, morphine or other pain medications can help relieve the sense of breathlessness.

Skin irritation. Skin problems can be very uncomfortable. With age, skin naturally becomes drier and more fragile, so it is important to take extra care with an older person's skin. Gently applying alcohol-free lotion can relieve dry skin and be soothingTurning the person from side to back and to the other side every few hours may help prevent bed sores. Try putting a foam pad under an area like a heel or elbow to raise it off the bed and reduce pressure. Ask if a special mattress or chair cushion might also help. Keeping the skin clean and moisturized is always important

Digestive problems. Nausea, vomiting, constipation, and loss of appetite are common issues at the end of life. The causes and treatments for these symptoms are varied, so talk to a doctor or nurse right away. There are medicines that can control nausea or vomiting or relieve constipation, a common side effect of strong pain medications.

Temperature sensitivity. People who are dying may not be able to tell you that they are too hot or too cold, so watch for clues. For example, someone who is too warm might repeatedly try to remove a blanket. You can take off the blanket and try a cool cloth on his or her head.

If a person is hunching his or her shoulders, pulling the covers up, or even shivering—those could be signs of cold. Make sure there is no draft, raise the heat, and add another blanket. Avoid electric blankets because they can get too hot.

Fatigue. It is common for people nearing the end of life to feel tired and have little or no energy. Keep activities simple. For example, a bedside commode can be used instead of walking to the bathroom. A shower stool can save a person's energy, as can switching to sponging off in bed

Encouraging conversations about feelings might help. You might want to contact a counselor, possibly one familiar with end-of-life issues. If the depression or anxiety is severe, medicine may help.

Mental and emotional needs

A dying person may also have some specific fears and concerns. He or she may fear the unknown or worry about those left behind. Some people are afraid of being alone at the very end. This feeling can be made worse by the understandable reactions of family, friends, and even the medical team.

Spiritual needs

People nearing the end of life may have spiritual needs as important as their physical concerns. Spiritual needs include finding meaning in one's life and ending disagreements with others, if possible. The dying person might find peace by resolving unsettled issues with friends or family. Visits from a social worker or a counselor may also help.

Many practical jobs need to be done at the end of life—both to relieve the person who is dying and to support the caregiver. Everyday tasks can be a source of worry for someone who is dying, and they can overwhelm a caregiver.