OT 433 Late Adulthood

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1

What is the lifespan in the U.S.?

78.8 years old

2

In 2010, age 65+ was ___________ of the total population?

13%

3

In 2030, age 65+ is expected to be ____________ of the total population

20%

4

Ageism

  • Prejudice/discrimination towards older people (identical behavior perceived differently due to age)
  • Modern and Western phenomenon
  • Stereotypes can become self-fulfilling prophecies
  • Myths of Aging
5

Normative Aging

  • Expected changes
  • Severe disability is NOT a part of normal aging
  • Influenced by genetics, lifestyle, environment, attitude
6

Pathology

  • Not expected by increased prevalence w/ age
  • Alzheimer's, CVA, Parkinson's
  • Lifestyle can decrease risk of onset
7

Physical transitions

  • Primary aging/senescence - universal and irreversible changes due to genetic programming
  • Secondary aging - changes due to illness, health habits, and other individual differences but NOT due to age.
8

Primary Aging

  • Thinning and graying hair
  • Decreased elasticity and collagen leads to wrinkles
  • Shorter stature due to posture, decreased bone density and changes in cartilage
  • Brain becomes smaller and lighter BUT retains structure and function
  • Reduced circulation (blood flow) in brain
  • Reduced capacity of circulatory, respiratory, and digestive system
  • Muscle fibers decrease in size and amount
  • Slowing reaction time
9

Declines noted in:

  1. Vision
  2. Hearing
  3. Taste & smell
  4. Tactile discrimination and fine motor skills (buttoning, zipping becomes a challenge)
  5. Mobility
  6. information processing (fluid & crystallized)
10

Leading cause of death in the elderly?

  • Heart disease & cancer
11

Most have at one chronic condition: % of people with arthritis & diabetes?

  • Arthritis: 53% (65+ years old)
  • Diabetes: 22% (65+ years old)
12

Geriatric Syndromes

  • Problems with more than one cause (falls, urinary incontinence, dementia, depression (1:3 will have a fall)
  • Identification is crucial
  • Emphasis changes from diagnose and treat to one of risk factor assessment and reduction
13

Preventing falls from happening by educating and modifying focus on...

  1. Environmental modifications
  2. Strength & balance
  3. Vision
  4. Medications
14

Polypharmacy

  • Normative changes - metabolism
  • Drug induced disorders are not unusual
  • Sometimes not clinically necessary
15

Aging theories

  • Genetic programming
  • Wear-and-tear
  • Life expectancy
16

Who generally lives longer?

  • Women - typically 5 years longer
  • Hispanics have a higher life expectancy than African Americans
  • It's thought that people who are married live longer
17

Health and Wellness

  • During 2008-2010, 76% of people age 65+ rated their health as good, very good, and excellent.
  • Increased prevalence of disability w/age does not equate to inability to live independently
  • 30% community dwelling older adults age 65+ report difficulty in one or more ADL
  • Most common ADL deficits for community dwelling and long-term are residents are bathing, mobility in the home, and getting in and out of bed or their chair.
18

Living arrangements

  • skilled nursing facilities
  • assisted living facilities
  • adult day care
  • home health care
  • BUT most live out their lives in their homes
19

Psychological disorders

  • Depression is NOT a normal part of aging but is more common in those whose function become limited.
  • Dementia - 1/3 of those over 85 years old
20

Cognition

  • Cognition can improve in late adults, but in many cases, it has to be very specific/very specific skills
21

Schaie's Sequential Studies

  • different age groups at various points in time
  • Fluid intelligence declines and crystalized remains steady or improves.
  • Typically, minimal cognitive declines until 80s
  • Significant individual differences, 1/3 in their 70s scored higher than young adults
  • Environmental and cultural factors are significant
22

Memory

  • Short term memory declines become more pronounced after age 70 with most difficulty w/info presented quickly and verbally
  • Episodic memory: conscious recall. Did you brush your teeth this morning? Can be affected by age
  • Semantic memory: unconscious recall. General knowledge and facts. What is a toothbrush? Largely unaffected by age.
  • Implicit memory: unconscious recall. Handing a client a toothbrush and asking them to brush their teeth. Largely unaffected by age.
23

Psychosocial development

  • Remember the "big five" personality traits? if you are seeing significant changes, what might be some peoples reasons for these changes?
24

Neugarten: coping w/aging

  • Disintegrated disorganized
  • Passive dependent
  • Defended
  • Integrated
25

Successful aging

  • Continuity theory - individual desired levels of involvement are key
  • Selective optimization - focus on specific skills to compensate for losses in others
26

Elder abuse

  • Isolation and decreased health increases risk
  • Alzheimer's dementia more likely to be targets of abuse
  • Economic, psychological, and social pressures on caregivers who provide 24-hour care
  • many cases go undetected or unreported
  • Prevention is key