OT 433 Late Adulthood
What is the lifespan in the U.S.?
78.8 years old
In 2010, age 65+ was ___________ of the total population?
In 2030, age 65+ is expected to be ____________ of the total population
- 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
- Expected changes
- Severe disability is NOT a part of normal aging
- Influenced by genetics, lifestyle, environment, attitude
- Not expected by increased prevalence w/ age
- Alzheimer's, CVA, Parkinson's
- Lifestyle can decrease risk of onset
- 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.
- 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
Declines noted in:
- Taste & smell
- Tactile discrimination and fine motor skills (buttoning, zipping becomes a challenge)
- information processing (fluid & crystallized)
Leading cause of death in the elderly?
- Heart disease & cancer
Most have at one chronic condition: % of people with arthritis & diabetes?
- Arthritis: 53% (65+ years old)
- Diabetes: 22% (65+ years old)
- 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
Preventing falls from happening by educating and modifying focus on...
- Environmental modifications
- Strength & balance
- Normative changes - metabolism
- Drug induced disorders are not unusual
- Sometimes not clinically necessary
- Genetic programming
- Life expectancy
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
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.
- skilled nursing facilities
- assisted living facilities
- adult day care
- home health care
- BUT most live out their lives in their homes
- 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
- Cognition can improve in late adults, but in many cases, it has to be very specific/very specific skills
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
- 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.
- Remember the "big five" personality traits? if you are seeing significant changes, what might be some peoples reasons for these changes?
Neugarten: coping w/aging
- Disintegrated disorganized
- Passive dependent
- Continuity theory - individual desired levels of involvement are key
- Selective optimization - focus on specific skills to compensate for losses in others
- 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