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Parenthood

  • Being childless is more accepted
  • People having fewer children
  • Decision to have children
  • Women with traditional role are more likely to have children
  • more thinking about financial implications of having children
  •  
  • Singlehood
  • Individuals not living with intimate partner
  • Men in bluecollar jobs and women in demanding careers overrepresented after age 30
  • Advantages (freedom/mobility)
  • Disadvantages
  • Loneliness, limited sexual/social life, reduced sense of security ,exclusion from world of married couples
  •  
  • Grandparenting
  • Grandmothers have more contact with gc than grandfathers
  • Role and functions vary in  family ethnic group, culture
  •  
  • Divorce
  • Disrupted relationships
  • Other:
  • Young age at marriage
  • Different religious beliefs
  • Previously divorced
  •  
  • Age and the brain
  • smaller/lighter with age
  • Space between skull and brain doubles from 20-70
  • Number of neurons decline in some parts of the brain, but not as much as previously thought
  •  
  • 75 year old heart pumps less than 75% of blood during early adulthood
  • Efficiency of respiratory system declines with age
  • Digestive system produces less digestive juice and less efficient in pushing food through the system (more constipation)
  •  
  • Alzheimer's symptoms
  • Gradual
  • Forgetfulness first
  • Affect recent memories first, then older memories fade
  • Causes confusion, inability to speak intelligibly or recognize closest family members
  • Loss of voluntary control of muscles occurs
  •  
  • Quality of life
  • Activities of Daily Living (ADLs)
  • Basic self-care tasks
  • Bathing, dressing, eating
  • Instrumental Activities of daily living (IADLs)
  • Conducting business of everyday life
  • Require cognitive competence
  • shopping, food preparation, housekeeping
  •  
  • Psych/mental disorders
  • Common
  • Depression
  • Drug-induced disorders
  • Not just alcohol
  •  
  • Chronic illness
  • Most older people have one+ chronic illness
  • Arthritis
  • Inflammation of one or more joins, common, 50% of older people
  • Hypertension
  • High blood pressure 33% of older people
  •  
  • Gender differences
  • Women experiene more non-life threatening illnesses, but men face more serious illness
  • Women smoke less, drink less alcohol, less dangerous jobs
  • Medical research has typically studied diseases of men with all male samples; the medical community only now beginning to study women's health issues
  •  
  • Deliberate vs automatic memory
  • Deliberate
  • Recall more difficult
  • Content helps retrieval, slower processing, smaller working memory make context harder to encode
  •  
  • Automatic
  • Recognition easier than recall
  • More environmental support
  • Implicit memory better than deliberate memory
  • without conscious awareness
  • Depends on familarity
  • (Freudian) Ego-integrity versus despair
  • Last stage of Erikson
  • Creates wisdom if successful
  •  
  • Despair
  • Occurs when people feel dissatisfied with their life, and experience gloom, unhappiness, depression, anger, or the feeling that they have failed
  • Can result in bitterness and unwillingness to accept aging and death
  •  
  • Integrity vs despair
  • Individual experiences sense or mortality
  • Manifests as a review of life and career
  • In response to retirement, death of spouse or close friends, or changing social roles
  • Reminiscence or introspection is most productive when experienced with significant others
  • Outcome of this life-career reminiscence can be either positive or negative
  •  
  • Peck: Three tasks of Ego Integrity
  • * Ego differentiation versus work-role preoccupation
  • People must redefine themselves in ways that do not relate to their work-roles or occupations
  • Why might it be difficult for one to find a new role in late adulthood?
  •  
  • * Body transcendence versus body preoccupation
  • Individuals 
  •  undergo changes in their physical identity as they age
  • Peck: we must learn to cope with and move beyond these physical changes (transcendence)
  • Why is this so difficult? loss of independence
  •  
  • * Ego transcendence versus ego preoccupation
  • People must come to grips with their coming death
  • If people in late adulthood see these contributions, they will experience ego transcendence
  • If not, they may become preoccupied with the question of whether their lives had value an worth to society
  •  
  • Levinson
  • People enter late adulthood by passing through transition stage
  • View themselves as "old" - not getting old
  • Recognize stereotypes and loss of power and respect
  • Not always looked at as resources to younger individuals
  • No longer center of work and family activities 
  •  
  • But...
  • One can serve as resource to younger individuals
  • Advice is sought and relied upon when viewed as wise older adult
  • Does this always happen in US?
  •  
  • Once can focus on new freedom to do things simply for fun
  •  
  • Bernice Neugarten
  • Four personality types for people in 70s
  • Disintegrated and idsorganized
  • - unable to accept aging, experience despair as they get older
  • - Often found in nursing homes or are hospitalized
  • Passive-dependent
  • - Become fearful with age - fear of falling ill, fear of the future, fear of their own inability to cope
  • Defended Personalities
  • - Try to stop aging, may attempt to act young, exercising vigorously, and engage in youthful activities
  • Integrated personalities
  • - most successful cope comfortably with aging
  • -they accept becoming older and maintain a sense of self dignity
  • -- majority of people studies fall into this category
  •  
  • The New Old Age
  • Third Age
  • Age 65-79+
  • Marked by personal fulfillment, self-realization
  • high life satisfaction
  • need more opportunities to stay active
  •  
  •  
  •  
  • Spirituality and religion in late adulthood
  • - About 3/4 us elders say religion is very important
  • - Half attend services weekly
  • - Many become more religious/spiritual with age
  • - cultural, SES, gender differences
  • -Psychological, social benefits
  •  
  • Factors in psychological well-being
  • Control versus dependency
  • - poor healthy, depression linked
  • - suicide risk
  • - negative life changes
  • - social support, interaction
  •  
  • Taking control
  • Rats and human research has shown absence of control over stressors is a predictor of health problems
  •  
  • Marriage in late adulthood
  • - Satisfaction peaks in late adulthood
  • - fewer stressful responsibilities
  • - fairness in household tasks
  • - joint leisure
  • - emotional understanding, regulation
  • - if dissatisfied, harder for women
  •  
  • Long-term gay and lesbian partnerships
  • - most happy, highly fulfilling
  • - healthier, happier than singles
  • - coping with oppression may strengthen skill at coping with physical aging
  • - face legal, health-care issues
  •  
  •  

 

Final Wednesday

Day 1

Chapter 19

  • US Societal changes
  • Early 1900s...
  •  "comfort"
  • die of infection
  • at home
  • family caregiver
  • death short and sudden 
  •  
  • Today...
  • "cure/delay"
  • die of chronic illness
  • at institutions
  • institution staff as caregiver, not always well-trained to do this (trained to cure)
  • death prolonged
  •  
  • What is death? (with medical advancements)
  • Brain death
  • All activity in brain/stem stopped
  • irreversible
  •  
  • Persistent vegetative state
  • Activity in cerebral cortex stopped
  • brain stem still active 
  •  
  • Concept of death
  • Permanence
  • Inevitability
  • Cessation
  • Applicability
  • Causation 
  •  
  • Early childhood
  • Don't completely understand permanence of death, universality, lack of functioning
  • Facts that affect understanding:
  • * Experience with death
  • * Religious teachings
  •  
  • Adolescence
  • More experienced with death and grief
  • More mature understanding of death
  • * Problems applying idea to their lives
  • - High-risk activities
  • - View as abstract state
  •  
  • Early adult
  • * Avoidance
  • * Death anxiety
  • * Death considered distant
  • Middle adulthood
  • * Begin to think of death
  • * Aware of limited time left to live
  • * Focus on tasks to be completed
  • Late adulthood
  • * Think and talk more of death
  • * Practical concern about how and when 
  •  
  • What results in less anxiety?
  • * Goals fulfilled
  • * Feel as if one has lived a long life
  • * Have come to terms with finality
  • * Prior experience with death
  •  
  • Kubler-Ross Theory DABDA
  • * Stages are not a fixed sequence
  • * May cause insensitivity by caregivers
  • * Best seen as coping strategies
  •  
  • Seven Stages
  • * Shock/disbelief
  • * Denial
  • * Anger
  • * Bargaining
  • * Guilt
  • * Depression
  • * Acceptance / hope 
  •  
  • Communicating with Dying People
  • Be truthful (diagnosis, course of disease)
  • Listen perceptively
  • Acknowledge feelings
  • Maintain realistic hope
  • Assist final transition 
  •  

Day 2

  • Factors that influence thoughts about dying
  • Cause of death (nature of disease)
  • Personality
  • Coping style
  • Family members' behavior
  • Health professionals' behavior
  • Spirituality and religion
  • Culture
  •  
  • Traditional places of death
  • Home
  • * most preferred
  • * Only 25% die at home
  • * Need adequate caregiver support
  • Hospital
  • * Intensive care unit can be depersonalizing
  • Nursing Home
  • * Focus usually not on terminal care
  •  
  • Hospice Approach
  • Comprehensive support for dying and their families
  • * family and patient as a unit
  • * team care
  • * palliative (comfort) care
  • * home or homelike
  • * bereavement help
  •  
  • Advance Medical Directives
  • * Written statement of desired medical treatment in case of incurable illness
  • * Living Will: specifies desired treatments
  • * Durable power of attorney
  • - authorizes another person to make healthcare decision on one's behalf
  • - more flexible than living will
  • - can ensure partner's role in decision making even in relationships not sanctioned by law
  •  
  • Difficult grief situations
  • * Parents losing child
  • * Children or adolescents losing a parent
  • * Adults losing an intimate partner
  • * Bereavement overload
  •  
  • Bowlby 4 stages of grief
  • *Numbness
  • *Yearning
  • *Disorganization and despair
  • *Reorganization
  •  
  • Resolving Grief
  • * Give yourself permission to feel the loss
  • * Accept social support
  • * Be realistic about course of grieving
  • * Remember the deceased
  • * When ready, engage in new activities and relationships. Master tasks of daily living.
  •  

Week 7

Jeff Pitner
Module by Jeff Pitner, updated more than 1 year ago
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