Camila Vangh-egas

Study Guide Exam 5 (Final)

Chap. 15
What is the age-related hearing condition known as?
Presbycusis, hearing impairment beginning around age 50.
As we age, how does the epidermis and dermis change?
The epidermis is less tightly held to the dermis. Some fibers within the dermis decline. (Fat cells)
Looser skin, less elastic and wrinkled. More in women than in men.
As we age, where does fat tend to accumulate?
It tends to accumulate in the torso. Men tend to accumulate in upper abdomen and back, and
women around the waist and upper arms.
What circumstances tend to lead to earlier menopause in women?
Women who smoke or have not borne children tend to lead earlier into menopause.
What happens during menopause?
End of menstruation, and women’s reproductive capacity. Physical and emotional symptoms,
including hot flashes, and depressive episodes.
What are the benefits and risks of using hormone replacement therapy?
Benefits:
Hormone replacement therapy contracts hot flashes, and vaginal dryness. It offers protection
against bone deterioration.
Risks:
Increase heart attack, strokes, blood clots, breast cancer, gallbladder disease, lung cancer, ERT.
(Women with hystorectomys) HRT everyone else. Alzheimer and dementia.
What role does reduced testosterone play in the male’s ability to attain an erection?
It diminishes blood flow to and changes in connective tissue in the penis. It may be harder to
maintain an erection and more stimulation is required.
What are the leading causes of death in middle age?
Cancer, Heart Disease, Unintentional injury.
Are men or women more vulnerable to health problems and why?
Men are more vulnerable to have health problems, it may be due to genetic makeup, exposition
to cancer causing agents as a result of lifestyle or occupation, and the delay of going to the
doctors.
What variables contribute to cancer death rates?
- Poorer medical care, reduced ability to fight the disease
- High life stress
- Inadequate diet
- Co-occurrence with other illnesses
- Smoking, environmental situations
- Heredity
- Socio-economic status
What is atherosclerosis, angina pectoris and osteoporosis?
Atherosclerosis: a buildup of plaque in his coronary arteries, which encircle the indicators of
cardiovascular disease.

Heart attack: blockage of normal blood supply to an area of the heart, usually brought on by a
blood clot in one or more plaque-filled coronary arteries.
Arrhythmia: irregular heartbeat

Angina pectoris: reveals an oxygen-deprived heart.

Males are naturally more prone to cardiovascular diseases.
List and describe key features in the Type A behavior pattern.
Type A's- pre-occupied with commitment deadlines eager to compete: driven.
Time urgency, hostility, competitiveness.
They are more likely to develop heart disease.
List and describe the three Cs of hardiness.
Control- This is the belief that you can influence what happens in your life and is linked to the
concept of an internal locus of control.
Commitment- This involves a sense of purpose and involvement in the world around you,
family, community, work etc. Hardy people have a range of interests and support networks to
turn to in time of stress.
Challenge- Life changes are seen as challenges to overcome or opportunities rather than
problems, threats and stressors. Hardy people welcome change and personal growth.
Understand fluid and crystallized intelligence, when they decline and how adults
compensate for those declines.
Crystallized Intelligence: refers to skills that depend on accumulated knowledge and experience,
good judgment, and mastery of social conventions - abilities acquired because they are valued by
the individual's culture.
Fluid Intelligence: depends more heavily on basic information-processing skills - ability to detect
relationships among visual stimuli, speed of analyzing information, and capacity of working
memory.
Many cross-sectional studies show that crystallized intelligence increases steadily through
middle-childhood, whereas fluid intelligence begins to decline in the 20's
Keeping active, keep the memory working better.
What type of working memory suffers more? Less?
Working memory diminishes steadily, however verbal memory suffers less than spatial memory.
Spatial diminishes at double the rate than verbal.
What is expertise?
Acquisition of intensive knowledge on a field.

Chap. 16
What is generativity? What factors contribute to preserve generative commitments?
Generativity is reaching out to others in ways that give to and guide the next generation.
Extending commitment beyond self and partner, may be realized through parenting or other
family, work and mentoring relationships, volunteering. giving back to the community
Know the four developmental tasks proposed by Levinson.
Young-old: we must forget some youthful activities and find joy and happiness in aging.
Destruction-creation: we look back on all the wrong we have done and try to make up for it by
giving charitable gifts, creative products, volunteer service, and mentoring young people.
Masculinity-femininity: we try to balance both the male a female characteristics within us.
Engagement-separateness: there must be a balance between being separated and connected to
the external world.
According to Vaillant, what becomes a major preoccupation to midlifers?
According to Vaillant, the most-successful and best-adjusted middle-aged adults enter a calmer,
quieter time of life in which passing the torch becomes a major preoccupation.

Know the big 5 personality traits and how they evolve. Give examples.
Neuroticism: Individuals who are high on this trait are worrying, temperamental, self-pitying,
self-conscious, emotional, and vulnerable. Those who are low are calm, even-tempered, self-
content, comfortable, unemotional, and hardy.
Extroversion: High- affectionate, talkative, active, fun-loving, and passionate. Low- reserved,
quiet, passive, sober, and emotionally unreactive.
Openness to experience: High- imaginative, creative, original, curious, and liberal. Low- down
to earth, uncreative, conventional, uncurious, and conservative.
Agreeableness: high- soft-hearted, trusting, generous, acquiescent, lenient, and good-natured.
Low- ruthless, suspicious, stingy, antagonistic, critical, and irritable.
Conscientiousness: high- hard-working, well-organized, punctual, ambitious, and preserving.
Low- negligent, lazy, disorganized, late, aimless, and non-persistent.
According to MIDUS participants, what do negative turning points lead to?
They lead to a positive change in one’s life. Fulfilling a dreaming, doing something good, rarely
associated to life crisis.
What are possible selves? How do they evolve in both quantity and quality throughout
adulthood?
Possible selves: future oriented representations of what one hopes to become and what one is
afraid of becoming. They are the temporal dimension of self-concept - what the individual is
striving for and attempting to avoid. This is just as important as explaining behavior, but as we
age, we rely less on social comparisons in judging our self-worth and more on temporal
comparisons.
Preserve mental health by adjusting hopes and fears.
Which gender identity is associated with cognitive flexibility, psychosocial maturity and
other benefits?
Androgyny, people who integrate both male and female sides live happier, more able to adapt to
life’s challenges.
How does being “off-time” in development affect the parent-child relationship?
Most middle-aged parents adjust well to launching their children, especially if they have positive
relationships. Adult children who are "off-time" in development can prompt parental strain. As
children marry, middle aged parents, especially mothers become "KINKEEPERS".(Parents try to
maintain a family together).
What factors impact the closeness of grandparent-grandchild ties?
Valued elder: being perceived as a wise, helpful person.
Immortality through descendants: leaving behind not just one but two generations after death.
Reinvolvement with personal pass: being able to pass family history and values to a new
generation.
Indulgence: having fun with children without major child-rearing responsibilities.
What is the sandwich generation?
Middle- age adults who must care for multiple generations, above and below at the same time.
How does job satisfaction change at midlife?
They feel as if they have lost something of greater value. They show a sharper decline in
physical and mental health, and those over 40 usually stay jobless longer, suffering substantial
income loss. Increase satisfaction, know what their doing.
What is burnout, glass ceiling and when is it most likely to happen?
Glass ceiling is a metaphor used to represent an invisible barrier to advancement in a profession,
especially affecting women and members of minorities. Glass cliff is a situation in which a
women's leadership position is precarious.
Burnout is most common among people that are police, teachers, nurses or those that work in the
military. a condition in which long-term job stress leads to a mental exhaustion, a sense of loss of
personal control, and feelings of reduced accomplishment.
What does an extreme career shift at midlife typically signal?
An extreme career shift usually signals a personal crisis. Less educated workers with a physical
disability face greatly reduced chances of remaining in the labor force.

Chap. 17
What is functional age? Give examples.
Functional age- actual competence and performance. People age biologically at
different rates, some 80-year old’s appear younger that many 65-year old’s. Ruth
became infirm physically but remained active mentally, whereas Ida, to physically fit
for her age, to found it hard to converse with others, keeping appointments, or
complete familiar tasks.
What factors have contributed to gains in average life expectancy?
Factors that can contribute include improved nutrition, medical treatment, sanitation, and safety.
- Heart disease, the leading cause of overall adult heath in the United states had
dropped by nearly 70% in the past four decades) declines in risk factors “blood
pressure and cigarette smoking”) and advances in medical treatment.
What are the differences in life span for men/women and various races?
- women out live men, by an average of five years. The protective value of females’ extra
X chromosome along with their reduced risk taking and physical aggression, are believed
to be responsible.
- Because men are at higher risk for disease and early death, they reap somewhat larger
generational gains from positive lifestyle changes and new medical discoveries.
Life expectancy varies substantially with SES as education and income increase, so does
length of life. The gap in life expectancy at birth between the wealthiest and the poorest
individuals is 14 ½ years for men and 10 years for women. SES also accounts for the 2 to
3 year advantage in life expectancy for European-American over African American
adults age 65 and older. Stressful life event, wide-ranging unhealthy behavior, jobs with
healthy risks, and weak social supports area associated with low SES.
How does the sense of smell change with age?
Besides enhancing food enjoyment, smell has a self-protective function. An aging
person who has difficulty detecting rancid good gas fumes, or smoke may be in a life-
threatening situations. A decrease in the number of smell receptors, along with loss of
neurons in brain regions involved in processing odors, contributes to declines in odor
sensitivity after age 60, with ¼ of people over age 70 affected.
With age, how does the heart muscle change?
Aging of the cardiovascular and respiratory system proceeds gradually and usually
unnoticed in early and middle adulthood. In late adulthood, changes become more
apparent. As the years pass, the heart muscles become more rigid, and some of its
cells die while others enlarge, leading the walls of the left ventricle to thicken.
Artery walls stiffen and accumulate some plaque (cholesterol and fats) due to normal
aging. The heart muscle become less responsive to signals from pacemaker cells
within the heart, which initiate each contraction. The heart pumps with less force,
maximum heart rate decreases, and blood flow throughout the circulatory system
slows. (not enough oxygen is getting delivered to the body tissues during physical
activity.)
List and describe guidelines of healthy sleep habits.
Establishing a consistent bedtime and waking time. Exercising regularly and using the
bedroom only for sleep (not for early, reading, or watching TV). Prescriptions
sedatives relieve temporary insomnia. But long-term medication can make matters
worse by inducing drug dependence, daytime sleepiness and rebound insomnia after
the drug is discontinued.
How does SES affect willingness to pursue medical treatment? Why?
Low-SES and ethnic minority older adults are more likely than their higher SES and
ethnic minority older adults are more likely than their higher-SES and white
counterparts to delay or forgo medical treatment, particularly taking prescriptions
medication and undergoing complex surgical procedures. One reason is cost: on
average US Medicare beneficiaries devote 18 percent of their income to out- of-
pocket heath care expenses. Another reason is perceived discriminatory treatment by
health-care providers, which undermines ethnic minority patients’ trust. Low SES and
minority older people often do not comply with doctors’ directions because they feel
less in control of their health and less optimistic that treatment will work. Their low
self-efficacy further impairs their physical condition.
How do men and women compare in their physical health after age 85?
Men are more prone to fatal diseases, women to non-life-threatening disabling conditions-
especially, mobility limitations due to osteoporosis and arthritis. At very old age and beyond,
women are more impaired than men because only the sturdiest men have survived. With few
physical limitations, older men are better able to remain independent and to engage in exercise.
Leisure and counter pursuits, and social activities, all with promote better health.
What is emphysema? How does it develop?
Emphysema is caused by extreme loss of elasticity in the lung tissue, which results in
serious breathing difficulty. Although a few cases of emphysema are inherited, most
result from ling-term cigarette smoking.
What is a stroke? How does it develop?
Are more prevalent among women, largely because women live longer. Stroke occurs
when a blood clot blocks a blood vessel or a blood vessel hemorrhage in the brain,
causing damage to brain tissue. It is a major cause of late-life disability and, after
age75, death.
What is the difference between Parkinson’s disease, Alzheimer’s & Vascular dementia?
Parkinson’s: involve deterioration in subcortical brain regions (primitive structures below the
cortex) that often extends to the cerebral cortex and, in many instances, result in brain
abnormalities resembling Alzheimer’s disease. Neurons In the part of the brain that controls
muscle movements deteriorate. Symptoms include tremors, shuffling gait, loss of facial
expression, rigidity of limbs, difficulty maintaining balance, and stooped posture, overtime, the
disease often results in dementia.
Alzheimer’s: chances increase if you have diabetes. Alzheimer’s disease is the most common
form of dementia, in which structural and chemical brain deterioration is associated with gradual
loss of many aspects of thought and behavior. Slowly
Vascular dementia: a series of stokes leafing areas of dead brain cells, producing step-by-step
degeneration of mental ability, with each step occurring abruptly after a stroke. Vascular
dementia is the combined result of genetic and environmental influences. The effects of
predatory are indirect, through high blood pressure, cardiovascular disease, and diabetes, each of
which increase the risk of stroke. And environmental factors include cigarette smoking, heavy
alcohol use, high salt intake, very low dietary protein, obesity, inactivity, and psychological
stress which also heighten stroke risk. Abruptly
Create a simple timeline articulating the course of Alzheimer’s disease.
The earliest symptoms are often progressively worsening memory problems
(forgetting names, dates, appointments, familiar routes of travel, or need to turn off
the kitchen stove.) What is serious deterioration sets in, recall of destiny events in
such basic facts as time, date, in place evaporates. Faulty judgment puts the person in
danger. Personality changes occur loss of spontaneity and sparkle, anxiety in response
to uncertainties created by mental problems, aggressive outburst, reduced initiative,
and social withdrawal. Depression often occurs in the early phases of Alzheimer’s and
other forms of dementia and seems to be part of the disease process. However,
depression may worsen as the older adult reacts to disturbing mental changes.
- as the disease progresses, skilled and purposeful movements disintegrate. The course
of Alzheimer’s varies greatly, from a year two as long as 20 years, with those
diagnosed in their 60s and early 70s typically survive longer than those diagnosed at
later ages.
How can we support the caregivers of dementia patients (Hint..hint…Social Issues box)?
Increase knowledge about the disease, caregiving challenges and available community resources.
Many interventions teach caregivers everyday problem- solving strategies for managing the
dependent persons behavior. Along with techniques for dealing with their own negative thought
and feelings, such as resentment about having to provide constant care. Modes of delivery
include support groups, individual therapy, and classes pricing coaching in effective coping
strategies. All yield improvements in caregivers’ adjustment and in patients disturbing
behaviors, both immediately and in follow-ups more than a year later.
- Caregivers usually say that respite- time away from pricing care- is the assistance they more
desire. But they may be reluctant to accept friends’ and relatives’ help because of guilt. Respite
at least twice a week for several hours improve physical and mental healthy for most caregivers
by enabling them to maintain friendships, engage in enjoyable activities and sustain a balanced
life.
- For respite to be most effective, caregivers must start using services before they become
overwhelmed.
How does problem solving for older adults differ from problem solving in younger adults?
Selective optimization with compensation: narrowing their goals, they select
personally values activities to optimize (or maximize) returns from their diminishing
energy. They also find new ways to compensate for losses.
- Older adults take in less about a stimulus and its context, their recall is reduced in
relation to that of younger people.
- Older adults memory limitations make it hard to keep all relevant facts in mind when
dealing with a complex hypothetical problems. For similar reasons, financial decision
making—evaluating loan and investment options—tend to be less effective than it
was in midlife.
- Older adults extend the adaptive problem solving of midlife period as long as they
perceive problems as under their control and as important, they are active and
effective in solving them. Older adults generate a smaller number of strategies
compared to young and middle-aged adults, perhaps because they include only
strategies, they have previously found helpful, based on their long-life experience. At
the same time, older adults are particularly good at adapting strategies to fit problem
conditions home, relative’s, and friends. And because they have especially concerned
with maintaining Positive relationships, they usually do what they can to avoid
interpersonal conflicts.
- Older adults make faster decisions about whether they are ill, seek medical care
sooner, and select treatments more quickly. In contrast young and middle-aged adults
or more likely to adopt A wait and see approach in favor of gathering more facts even
when a health problem is serious. older adults report that they often consult others
generally spouses and adult children but also friends neighbors and members of their
religious congregation for advice about everyday problems. in contrast to younger
married couples, Older couples more often collaborate in solving problems. Their jointly
generated strategies is highly effective. even on demanding tasks that require
complex memory and reasoning.
What is wisdom?
When researchers asked people to describe wisdom, most mentioned breadth and
depth of practical knowledge, ability to reflect on and apply that knowledge in ways
that make life more bearable and worthwhile; emotional maturity, including the
ability to listen patiently and empathetically and give sound advice; and the altruistic
form of creativity that involves contributing to humanity enriching others’ lives. One
group of researchers summed up the multiple cognitive and personality traits that
make up wisdom as “expertise in the conduct and meaning of life”.

- Wisdom whether applied to personal problems or to community, and national, an

international concern requires the “pinnacle of insight into human condition.”
What is terminal decline?
Terminal decline refers to acceleration in deterioration of cognitive functioning prior
to death.
What are the benefits of continuing education at late life?
Benefits: understanding new ideas in many disciplines, learning new skills that enrich
their lives, making new friends, and developing a broader perspective on one world.
Participants come to see themselves differently. Many abandoned their own ingrained
negative stereotype of aging when they realize that adults late life include themselves
can still engage in complex learning.
Provide a positive learning environment - Many older adults have internalized
negative stereotypes of their own abilities and come to the learning environment
with low self-efficacy. a supportive group atmosphere helps convince them that
they can learn.
- allow ample time to learn new information- rate of learning varies widely among
older adults. Presenting information over multiple sessions or allowing for self-
paced instructions aid mastery.
- present information in a well-organized fashion- older adults do not organize
information as affectively as younger adults. Material that is outlined presented and
then summarized enhances memory and understanding.
- relate information to older adults’ knowledge and experiences- relating new
material to older adults have already learned, by drawing on their extensive
knowledge and experiences an given many vivid examples enhances recall.
- adapt the learning environment to fit changes in sensory systems- adequate lighting
availability of large print reading materials, appropriate amplification, produce
background noise comma and clear, well organized visual aids to supplement
verbal teaching these information processing.

Chap. 18
Explain the negative outcome of Erikson’s final psychological conflict.
Despair: the negative outcome of this stage, despair, occurs when aging adults feel
they have made many wrong decisions, yet time is too short to find an alternative
route to integrity. Without another chance, the despairing person finds it hard to
accept that death is near and is overwhelmed with bitterness, defeat, and
hopelessness. These attitudes are often expressed as anger and contempt for others,
which disguised contempt for oneself.
Define the different types of reminiscence: self-focused, other-focused, and
knowledge-based.
Self-focused: engaged in to reduce boredom and revive bitter events—adjustment
problems-people are often anxious and depressed from dwelling on painful pas
experiences.
- Other- focused: extroverted- directed at social goals, such as solidifying family and
friendship ties and reliving relationships with lose loved ones.
- Knowledge based: drawing on their past for effective problem-solving strategies and
for teaching younger people.
When considering self-concept, do adults express more positive or more negative self-
evaluations? Why?
Adults in both age groups expressed more positive than negative self-evaluations.
Positive, multifaceted self-definitions predicted psychological well-being. Engaging
in co-related activities, in turn, is associated with gains in life satisfaction and with
longer life.
What are sex & SES differences in religious involvement in late adulthood?
Religious activity is especially high among low-SES ethnic minority older people, including
African-American, Hispanic, and native-American groups. In African American communities,
churches not only provide context for deriving meaning from life but also are centers 4
education, health, social welfare comma and political activities aimed at improving life
conditions. Aging African Americans look to religion as a powerful source for social support
beyond the family and for the inner strength to withstand daily stresses and physical
impairments. Compared with their European American age mates, more African American older
adults report feeling closer to God an engaging in prayer as a meaning of overcoming life’s
problems.
Women are more likely than men those at that religion is very important to them, to participate in
religious activities, and to engage in a personal quest for connectedness with higher power.
Understand the scripts in control vs. dependency.
Dependency-support script, dependent behaviors are attended to immediately. Independence-
ignore script, independent behaviors are mostly ignored. Notice how these sequences reinforce
dependent behaviors at the expense of independent behaviors, regardless of the old person’s
competencies.
What are the strongest risk factors for late life depression?
Physical declines and chronic disease are among the strongest risk factors for late-life
depression. Although few older than young and middle-aged adults are depress, profound
feelings of hopelessness rise with age as physical disability leads to diminished personal control
and increased social isolation.
What differences do we see in adolescent suicide vs. elder suicide?
Elder suicide- suicide increases over the lifespan, has risen about 15% - white men.
Failed suicides are rare in old age. The ratio of attempts to completions for
adolescents and young adults is as high as 200 to 1; for aging adults, it is 4 to 1 or
lower. When older people decide to die, they are especially sterned to succeed.
- Underreporting of suicides probably occurs at all ages, but it is more common in old
age. Many older adults, like Abe, engage in indirect self-destructive acts rarely
classified as suicide—deciding not to go to a doctor when ill or refusing to eat or take
prescribed medications. Among institutionalized older adults, these efforts to hasten
death is widespread Consequently, suicide in late life is a larger problem than
statistics indicate.
- Dementia is also linked to suicide.
- The chances of suicide are further elevated when a sick older person is socially
isolated—living alone or in a nursing home with high staff turnover, minimal
caregiver support, and little opportunity for personal control over daily life.
How can social support (and what kinds of support) help an elder manage their aging?
Overall, for social support to foster well-being, older adults must take personal
control of it. Help that is not wanted or needed or that exaggerates weaknesses results
in poor person–environment fit, undermines mental health, and—if existing skills fall into
disuse—accelerates physical disability. In contrast, help that increases
autonomy—that frees up energy for endeavors that are personally satisfying and that
lead to growth—enhances quality of life. These findings clarify why perceived social
support (older adults’ sense of being able to count on family or friends in times of
need) is associated with a positive outlook in older adults with disabilities, whereas
sheer amount of help family and friends provide has little impact
- Finally, besides various types of assistance, older adults benefit from social support
that offers affection, affirmation of their self-worth, and sense of belonging.
Extroverted older people are more likely to take advantage of opportunities to engage
with others, thereby reducing loneliness and depression and fostering self-esteem and
life satisfaction. But as we will see in the next section, gratifying social ties in old age
have little to do with quantity of contact. Instead, high-quality relationships, involving
expressions of kindness, encouragement, respect, and emotional closeness, have the
greatest impact on mental health in late life.
Be able to explain disengagement theory, activity theory, continuity theory and
socioemotional selectivity theory.
disengagement theory, older people decrease their activity levels and interact less
frequently, becoming more preoccupied with their inner lives in anticipation of death
-  activity theory proposes that social barriers to engagement, not the desires of older
adults, cause declining rates of interaction. Older people who lose certain roles and
relationships (for example, through retirement or widowhood) try to find others in an
effort to stay active—conditions that promote life satisfaction. However, when health
status is controlled, older people who have larger social networks and engage in more
activities are not necessarily happier. Recall that quality, not quantity, of relationships
predicts psychological well-being in old age.
- According to continuity theory, most aging adults strive to maintain a personal
system—an identity and a set of personality dispositions, interests, roles, and
skills—that promotes life satisfaction by ensuring consistency between their past and
anticipated future. This striving for continuity does not mean that older people’s lives
are static. To the contrary, aging produces inevitable change, but older adults try to
minimize stress and disruptiveness by integrating those changes into a coherent,
consistent life path, drawing on well-practiced strategies acquired over a lifetime. As
much as possible, they choose to use familiar skills and engage in familiar activities
with familiar people—preferences that provide a secure sense of routine and direction
in life.-- For example, a retired manager of a children’s bookstore collaborated with
friends to build a children’s library and donate it to an overseas orphanage.
- According to socioemotional selectivity theory, social interaction in late life extends
lifelong selection processes. In middle adulthood, marital relationships deepen,
siblings feel closer, and number of friendships declines. As people age, contacts with
family and friends are sustained until the eighties, when they diminish gradually in
favor of a few very close relationships. In contrast, relationships with people to whom
one feels less close decline steeply from middle through late adulthood
Compare and contrast independent living communities, Green House nursing homes and
life care communities.
As we look at housing arrangements for older adults, we will see that the more a setting deviate
from home life, the harder it is for older people to adjust.
- Smaller communities have features that foster gratifying relationships—stability of
residents, shared values and lifestyles, willingness to exchange social support, and
frequent social visits as country people “drop in” on one another. And many suburban
and rural communities have responded to aging residents’ needs by developing
transportation programs (such as special buses and vans) to take them to health and
social services, senior centers, and shopping centers.
- Green house- Each is limited to 10 or fewer residents, who live in private
bedroom–bathroom suites that surround a family-style communal space. Besides
providing personal care, a stable staff of nursing assistants fosters aging adults’
control and independence. Residents determine their own daily schedules and are
invited to join in both recreational and household activities, including planning and
preparing meals, cleaning, gardening, and caring for pets.  A professional support
team—including licensed nurses, therapists, social workers, physicians, and
pharmacists—visits regularly to serve residents’ health needs. In comparisons of
Green House residents with traditional nursing home residents, Green House older
adults reported substantially better quality of life, and they also showed less decline
over time in ability to carry out activities of daily living.
- Life care communities: About 12 percent of U.S. adults age 65 and older live in
residential communities, a proportion that rises with age as functional limitations
increase. Among people age 85 and older, 27 percent live in these communities,
which come in great variety. Housing developments for aging adults, either single-
dwelling or apartment complexes, differ from ordinary homes only in that they have
been modified to suit older adults’ capacities (featuring, for example, single-level
living space and grab bars in bathrooms). Some are federally subsidized units for low-
income residents, but most are privately developed retirement villages with adjoining
recreational facilities.
- Nursing home- About 3 percent of Americans age 65 and older live in nursing
homes, nearly half of whom are 85 and older. They experience the most extreme
restriction of autonomy and social integration.
Explain some of the challenges of widowhood and how to resolve them.
-Profound loneliness.
- Aging adults have fewer lasting problems than younger individuals who are widowed,
probably because death in later life is viewed as less unfair. And most widowed older
people especially those with outgoing personalities and high self-esteem, are resilient
in the face of loneliness period to sustain continuity with their past, they tried to
preserve social relationships that were important before the spouse’s death. social
support is vital for favorable adjustment greater ease of contact with family and
friend’s, and satisfaction with the support they provide, are associated with reduction
in symptoms of grief and depression a higher sense of self efficacy in handling tasks
What is key to never-married women’s lives?
Same-sex friendships are key in never-married older women’s lives. These rend to be
unusually close and often involve joint travel, periods of co-residence, and
associations with each other’s extended families.
What are never-married, childless men prone to?
never-married, childless men are prone to loneliness and depression. And Without
pressure from a partner to maintain a healthy lifestyle, these men engage in more
unhealthy behaviors. Hence, their physical and mental health tends to be less
favorable than their married counterparts. Overall, never married older people report
a level of social connectedness and psychological well-being equivalent to that of
married aging adults.
Which grandparent-adult grandchild bond is the closest?
Degree of grandparent involvement during childhood strongly predicts current
relationship quality. Often that I was one grandchild is special characterized by more
frequent contact, affection comma and enjoyable times together factors that enhance
older adult’s psychological well-being. Relationships with grandmothers tend to be
closer, with maternal grandmother and granddaughter bonds the closest. As was
so, when children were young.
Identify the various types of elder abuse and give examples of each.
Physical abuse- intentional infliction of pain, discomfort, or injury, through hidden,
cutting, burning, physical force, restraint, or other physical aggressive attacks.
- physical neglect- intentional or unintentional failure to fulfill caregiving obligations,
resulting in lack of food, medication, or health services or in the other persons being
left alone or isolated.
- emotional abuse - verbal assaults such as name calling, humiliation being treated as a
child comma and intimidation threats of isolation or placement in a nursing home.
- sexual abuse- unwanted sexual contact of any kind.
- financial abuse- illegal or improper exploitation of the aging persons property or
financial resources, through theft or use without consent.
** Emotional abuse, financial abuse, and neglect are the most frequent reported types.
Often several forms occur in combination. The perpetrator is usually a person the
adult trust and depends on for care and assistance.
What are the risk factors of elder abuse?
Dependency of Victims:
- Dependency pf perpetrators: With in late life parent- child relationships especially,
abusers are often dependent, financially or emotionally, on their victims. this
dependency experienced as powerlessness, can lead to aggressive, exploitative
behavior.
- Psychological disturbance and other traits of perpetrators: salient factors
underlying the dependency of abusive adult children are mental illness and alcohol or
other drug addictions. after these perpetrators are socially isolated, have difficulties at
work, or are unemployed, with resulting financial worries.
- history of family violence- elder abuse by family members is often part of a long
history of family violence. Adults who were abused as children are increase risk of
abusing older adults.
- Institutional conditions- elder maltreatment is more likely to occur in nursing homes
that are rundown and overcrowded and that have staff shortages, minimal staff
supervision, at high staff turnover comma and few visitors. highly stressful work
conditions combined with minimal oversight of caregiving quality set the stage for
abuse and neglect.
How is retirement described today?
Retirement is described as a positive think but many people want to continue to work.

Chap. 19
Give examples of the agonal phase of dying and brain death.
Brain Death: Irreversible cessation of all activity of the brain, and brain stem.
Agonal Phase: The phase of dying in which gasps and muscle spasms occur during the first
moments in which the regular heart beat disintegrates.
Clinical Death: Phase when heartbeat, circulation, breathing, and brain function stop but
resuscitation is still possible.
Mortality: Phase of permanent death.
With regard to death, define the following: non-functionality, finality, universality,
applicability, causation
non-functionality
-all living functions cease at death
finality
-cannot be brought back
universality
-all living things die
applicability
-only living things die
causation
-death is caused by the breakdown of body functions; internal & external
Which are the most challenging death sub concepts for young children to understand?
1.Permanence: Once a living thing dies, i cannot be brought back to life.
2. Inevitability: All living things die eventually.
3. Cessation: All living functions, including thought, feeling, movement, and bodily processes,
cease at death.
4. Applicability: Death applies to living things.
5. Causation: Death is caused by a breakdown of bodily functioning
Know the guidelines for discussing concerns about death with children and adolescents.
Define death anxiety. Who feels most/least anxious about death?
-Take the lead
-Listen perceptively
-Acknowledge feelings
-Provides facts candidly, with cultural sensitivity
-Solve problems jointly
Death anxiety:
Cultural variations
-influenced by religious teachings
-westerners= spirituality, meaning of life more important than religious commitment
Individual variations
-women more anxious than men
-low among adults with deep faith in higher being
-reduced by sense of symbolic immortality
Know Kubler-Ross’s responses to death.
Denial
-refusal to acceptance diagnosis & discussions
Anger
-resentment & fury at unaccomplished goals or unfairness
Bargaining
-for extra time
Depression
-due to inevitability
Acceptance
-peace & disengagement
*evaluation
-stages are not a fixed sequence/universal
-does not allow for context
-may lead to caregiver insensitivity
-best seen as coping strategies
Where do most Americans want to die?
home
-most preferred option; intimacy & loving care
-only about 25% of elders
-need for adequate caregiver support
Articulate the differences between ending life-sustaining treatment, medical aid-in-dying,
voluntary euthanasia and involuntary euthanasia including how commonly they are
utilized.
ENDING LIFE SUSTAINING TREATMENT
-doctor withholds or withdraws treatment
-permits natural death
MEDICAL AID IN DYING
-at an incurably ill patient's request, a doctor prescribes a lethal dose of medication that patient
self-administers to end life
-legal is US; must have <6mons to live
-other countries, do not have to be terminally ill, but requires unbearable suffering
-most are 65+; died in hospice or home
VOLUNTARY EUTHANASIA
-at suffering patient's request, a doctor ends the patient’s life painlessly [administering lethal
dose of medication]
INVOLUNTARY EUTHANASIA
-doctor ends a suffering patients life by some medical means without patient consent
What is the difference of bereavement, grief, and mourning?
Bereavement: Is the experience of losing a loved one by death.
Grief: Intense physical and psychological distress.
Mourning: Is the culturally specified expression of the bereaved person's thoughts and feelings.
What is disenfranchised grief?
the result of loss for which one does not have a socially recognized right, role, or capacity
to grieve. cannot be openly mourned or socially supported.
What is anticipatory grief?
The unconscious process of disengaging before the actual loss or death occurs, especially in
situations of prolonged or predicted loss. Disenfranchised grief. Loss that is experienced and
cannot be openly acknowledged.
Cite some examples cultural variations in mourning behavior.
Jewish mourning, found that the influence of religion, immigrant culture, and the history of oppression
via slavery produced unique local variations in grief and mourning in Jamaica, Trinidad, Grenada, and
Barbados. Sitting Shiva anicut, avelut, sheloshim 30 day period following burial including Shiva.