Fluent Essays

Step 1: Using the information from your textbook, power point presentations, and the Internet; write a one to two page paper on the following topic: A community’s response to the physical and mental health needs of its aging population has become a highly publicized topic within recent years.   Taking into account your communitys elderly residential facilities, apply the following: Discuss what policies might a residential facility develop to minimize the chances that its residences will develop institutionalism  Include whether or not such polices are common or uncommon Determine which stage of Eriksons psychosocial development an aging adult may be in if they are suffering from institutionalism  Explain how understanding of the: social, emotional, cognitive, and physical development of the Aging Adult can be helpful in a clinical setting LIFE-SPAN DEVELOPMENT 17e John W. Santrock © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® Chapter 19 Socioemotional Development in Late Adulthood © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® Chapter Outline Theories of Socioemotional Development Personality, the Self, and Society Families and Social Relationships Ethnicity, Gender, and Culture Successful Aging 3 © McGraw-Hill Education Theories of Socioemotional Development 1 Erikson’s theory Activity theory Socioemotional selectivity theory Selective optimization with compensation theory 4 © McGraw-Hill Education Theories of Socioemotional Development 2 Erikson’s theory Integrity versus despair: involves reflecting on the past and either piecing together a positive review or concluding that one’s life has not been well spent. Life review: looking back at one’s life experiences, evaluating them, and interpreting/reinterpreting them. Reminiscence therapy: discussing past activities and experiences with another individual or group. ©PeopleImages/Getty Images 5 © McGraw-Hill Education Theories of Socioemotional Development 3 Activity theory: the more active and involved older adults are, the more likely they are to be satisfied with their lives. Socioemotional selectivity theory: older adults become more selective about their social networks. Spend more time with individuals with whom they have had rewarding relationships. Classes of goals. Knowledge-related. Emotional. Trajectory for each type of goal is different, as it involves the perception of time. Courtesy of Dr.Laura Carstensen 6 © McGraw-Hill Education 6 Theories of Socioemotional Development 4 Selective optimization with compensation theory: successful aging is related to the following: Selection: older adults have reduced capacity and loss of functioning, reducing performance in most life domains. Optimization: maintain performance in some areas through continued practice and use of new technologies. Compensation: older adults need to compensate when life tasks require higher level of capacity. 7 © McGraw-Hill Education Positive Resolution of Erikson’s Eight Stages of the Human Life Span Conflict and Resolution Culmination in Old Age Old age Integrity versus despair: wisdom Existential identity; a sense of integrity strong enough to withstand physical disintegration. Middle adulthood Generativity versus stagnation: care Caring for others, and empathy and concern. Early adulthood Intimacy versus isolation: love Sense of complexity of relationships; value of tenderness and loving freely. Adolescence Identity versus confusion: fidelity Sense of complexity of life; merger of sensory, logical, and aesthetic perception. School age Industry versus inferiority: competence Humility; acceptance of the course of ones life and unfulfilled hopes. Early childhood Initiative versus guilt: purpose Humor; empathy; resilience. Toddlerhood Autonomy versus shame: will Acceptance of the cycle of life, from integration to disintegration. Infancy Basic trust versus mistrust: hope Appreciation of interdependence and relatedness. 8 © McGraw-Hill Education Idealized Model of Socioemotional Selectivity Through the Life Span Access the text alternative for slide images. 9 © McGraw-Hill Education Personality, the Self, and Society 1 Personality The self and society Older adults in society 10 © McGraw-Hill Education Personality, the Self, and Society 2 Personality Conscientiousness predicts lower mortality risk from childhood through late adulthood. High neuroticism linked to negative emotions, predicted higher frailty. Higher conscientiousness linked to a longer life and reduced risk of developing Alzheimer disease. Higher level of agreeableness and lower level of neuroticism less likely to develop dementia. Higher levels of conscientiousness, openness to experience, agreeableness, and extraversion linked to positive emotions. 11 © McGraw-Hill Education Personality, the Self, and Society 3 Self and society Self-esteem Tends to decline significantly in the 70s and 80s because of. Being widowed, institutionalized, or physically impaired. Having a low religious commitment. Declining health. 12 © McGraw-Hill Education Personality, the Self, and Society 4 Self-control Most older adults still effectively maintain a sense of self-control. Plays an important role in older adults’ engagement in healthy activities. Study of 65- to 92-year-olds found self-control linked to better outcomes for well-being and depression following 6-week yoga program. 13 © McGraw-Hill Education Personality, the Self, and Society 5 Older adults in society Stereotyping older adults Ageism: prejudice against others because of their age. Policy issues in an aging society Status of the economy: concern U.S. economy cannot bear the burden of older persons who are generally consumers. Health care: older adults increase health care cost considerably; many suffer from a chronic disease. Eldercare: physical and emotional caretaking of older family members. 14 © McGraw-Hill Education Personality, the Self, and Society 6 Generational inequity: view that aging society is unfair to its younger members. By receiving large allocations of resources. Income: poverty is linked to an increase in physical and mental health problems. Living arrangements: older adults who can sustain themselves living alone often have good health and few disabilities. 15 © McGraw-Hill Education Personality, the Self, and Society 7 Technology—Pros and Cons Reduces likelihood of being depressed by one-third. Adults 75 and older who connect with family, friends, and neighbors using smartphones and the Internet have a higher level of psychological well-being than their counterparts who do not. Adults 65 and older watch an average of 51 hours, 32 minutes of television per week, contributing to sedentary behavior and less social and physical behavior. ©Peter Dazeley/Photographer’s Choice/Getty Images 16 © McGraw-Hill Education Degree of Personal Life Investment at Different Points in Life Access the text alternative for slide images. 17 © McGraw-Hill Education Priorities for age groups change over time. Priorities include independence, work, friends, family, health, cognitive fitness and thinking about life. 17 Self-Esteem Across the Life Span 18 © McGraw-Hill Education 18 Families and Social Relationships Lifestyle diversity Attachment Older adult parents and their adult children Great-grandparenting Friendship Social support and social integration Altruism and volunteering 19 © McGraw-Hill Education Lifestyle Diversity 1 Married older adults In 2012, 58 percent of U.S. adults over 65 years were married. Marital satisfaction is greater in older adults than in middle-aged adults. Retirement alters a couple’s lifestyle. Older adults married or partnered are usually happier and live longer than those who are single. Married L G B T individuals 50 years and over report better quality of life and more economic and social resources than unmarried partnered counterparts. 20 © McGraw-Hill Education Lifestyle Diversity 2 Divorced and separated older adults In 2015, 13 percent of women and 11 percent of men 65 years and older in the United States were divorced or separated. Divorce has social, financial, and physical consequences. Remarriage is increasing due to. Rising divorce rates. Increased longevity. Better health. 21 © McGraw-Hill Education Lifestyle Diversity 3 Cohabiting older adults In 2010, 3 percent of older adults were cohabiting. More for companionship than for love. Psychological well-being for men seems to increase more than for women. ©Thinkstock/Getty Images 22 © McGraw-Hill Education Attachment Older adults have fewer attachment relationships than younger adults. With increasing age, attachment anxiety decreases. In late adulthood, attachment security is associated with greater psychological and physical well-being than attachment anxiety. Insecure attachment is linked to more perceived negative caregiver burden in caring for patients with Alzheimer’s disease. 23 © McGraw-Hill Education Older Adult Parents and Their Adult Children Eighty percent of older adults have living children, many of whom are middle-aged. Adult daughters are more likely to be involved in the lives of aging parents. Adult children often coordinate and monitor services for aging, disabled parents. 24 © McGraw-Hill Education Great-Grandparenting Four-generation families are more common. Great-grandparents can transmit family history. An area of little research: your future career path? Courtesy of John Santrock 25 © McGraw-Hill Education Friendship In late adulthood, new friendships less likely to be forged, and close friends chosen over new friends Friendships are less problematic and negative than in younger years. Friendships are more important than family in predicting mental health. Individuals with close ties to friends less likely to die across a 7-year age span 26 © McGraw-Hill Education Social Support Convoy model of social relations: individuals go through life embedded in a personal network of individuals to whom they give and from whom they receive social support ©Terry Vine/Getty Images 27 © McGraw-Hill Education Social Integration Older adults have fewer peripheral social contacts and more emotionally positive contacts with friends and family. Low level of social integration is linked with coronary heart disease in older adults. Loneliness 18 percent of older adults reported often or frequently lonely. Loneliness and social isolation associated with decreases in cognitive functioning. Loneliness linked to earlier death. 28 © McGraw-Hill Education Altruism and Volunteering Older adults with persistently low or declining feelings of usefulness to others at increased risk of earlier death Volunteering associated with multiple positive outcomes Constructive activities and productive roles. Social integration. Enhanced meaningfulness. Lower risk of cognitive impairment. 29 © McGraw-Hill Education Ethnicity, Gender, and Culture Ethnicity Gender Culture 30 © McGraw-Hill Education Ethnicity Elderly ethnic minority individuals face both ageism and racism. African Americans and Latinos overrepresented in poverty statistics. More likely to become ill, but less likely to receive treatment. Many never reach eligible age for Social Security and Medicare benefits. Despite stress and discrimination, many ethnic minority individuals develop coping mechanisms for survival. “Happiness paradox”. Extended family networks. Churches. 31 © McGraw-Hill Education Gender May be decreasing femininity in women and decreasing masculinity in men during late adulthood Older men may become more feminine (that is, nurturing or sensitive), but women do not necessarily become more masculine (that is, assertive or dominant). Age differences and androgyny traits. Older adult females face ageism and sexism. “Triple jeopardy”: female ethnic minority older adults face three levels of discrimination. 32 © McGraw-Hill Education Culture 1 Factors that are important in living the good life as an older adult Health. Security. Kinship/support. 33 © McGraw-Hill Education Culture 2 Factors that are likely to predict high status for older adults Valuable knowledge. Control key family/community resources. Engage in useful/valued functions as long as possible. Role continuity throughout the life span. Age-related role changes that give greater responsibility, authority, and advisory capacity. Extended family. Respect for older adults. 34 © McGraw-Hill Education Culture 3 ©Alison Wright/Corbis/Getty Images 35 © McGraw-Hill Education Successful Aging 1 Many abilities can be maintained and/or improved in older adults due to Proper diet. Active lifestyle. Mental stimulation and flexibility. Positive coping skills. Good social relationships and support. Absence of disease. 36 © McGraw-Hill Education Successful Aging 2 Four factors best characterize successful aging Proactive engagement. Wellness resources. Positive spirit. Valued relationships. ©Dallas Morning News, photographer Jim Mahoney 37 © McGraw-Hill Education End of Main Content © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® www.mheducation.com Accessibility Content: Text Alternatives for Images 39 © McGraw-Hill Education Idealized Model of Socioemotional Selectivity Through the Life Span – Text Alternative The motivation for knowledge-related goals starts pretty high in one’s early years, peaks in adolescence and early adulthood, and then declines during middle and late adulthood. The emotional trajectory is high during infancy and early childhood, declines from middle childhood through early adulthood, and increases in middle and late adulthood. Return to parent-slide containing images. 40 © McGraw-Hill Education Degree of Personal Life Investment at Different Points in Life – Text Alternative From ages 25 to 34, priorities are ranked as work, friends, family, independence. From ages 35 to 54, priorities are ranked as family, work, friends, cognitive fitness. From ages 55 to 65, priorities are ranked as family, health, friends, cognitive fitness. From ages 70 to 84, priorities are ranked as family, health, cognitive fitness, friends. From ages 85 to 105, priorities are ranked as family, thinking about life, cognitive fitness. Return to parent-slide containing images. 41 © McGraw-Hill Education LIFE-SPAN DEVELOPMENT 17e John W. Santrock © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® Chapter 18 Cognitive Development in Late Adulthood © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® Chapter Outline Cognitive Functioning in Older Adults Language Development Work and Retirement Mental Health Religion and Spirituality Courtesy of Helen Small 3 © McGraw-Hill Education Cognitive Functioning in Older Adults 1 Multidimensionality and multidirectionality Education, work, and health Use it or lose it Training cognitive skills Cognitive neuroscience and aging 4 © McGraw-Hill Education Cognitive Functioning in Older Adults 2 Multidimensionality and multidirectionality Cognitive mechanics: hardware of the mind, reflecting the neurophysiological architecture of the brain Involve speed and accuracy of the processes. Cognitive pragmatics: culture-based software programs of the mind Include reading and writing skills, language comprehension, educational qualifications, professional skills, and types of knowledge that help to master or cope with life. 5 © McGraw-Hill Education Cognitive Functioning in Older Adults 3 Speed of processing Considerable individual variation due to decline in brain functioning and central nervous system. Linked to increased rate of falls for older adults. Impaired visual processing speed linked to vehicle accidents. 6 © McGraw-Hill Education 6 Cognitive Functioning in Older Adults 4 Attention Older adults are less able to ignore distracting information. Yoga and meditation may improve goal-directed attention. Selective attention: focusing on a specific aspect of experience that is relevant while ignoring others Divided attention: concentrating on more than one activity simultaneously Sustained attention: focused and extended engagement with an aspect of the environment Executive attention: aspects of thinking that include planning actions, allocating attention to goals, detecting and compensating for errors, monitoring progress on tasks, and dealing with novel or difficult circumstances 7 © McGraw-Hill Education Cognitive Functioning in Older Adults 5 Memory Explicit memory: facts and experiences that individuals consciously know and can state Declines as person ages. Episodic memory: retention of information about the where and when of life’s happenings. Semantic memory: person’s knowledge about the world. ©Clarissa Leahy/The Image Bank/Getty Images 8 © McGraw-Hill Education Cognitive Functioning in Older Adults 6 Implicit memory: memory without conscious recollection that involves skills and routine procedures that are automatically performed Less likely to be adversely affected by aging. Working memory and perceptual speed: cognitive resource mechanisms that decline as person ages. Source memory: ability to remember where one learned something. Prospective memory: remembering to do something in the future. Noncognitive factors: health, education, and socioeconomic status influence an older adult’s performance on memory tasks. 9 © McGraw-Hill Education Cognitive Functioning in Older Adults 7 Executive functioning: aspects of working memory that decline in older adults involve Updating memory representations that are relevant for the task at hand. Replacing old, no longer relevant information. Decision making: preserved rather well in older adults 10 © McGraw-Hill Education Cognitive Functioning in Older Adults 8 Metacognition Adults have accumulated a great deal of metacognitive knowledge by middle age to draw on to help counteract decline in memory skills. Mindfulness Involves being alert, mentally present, and cognitively flexible while going through life’s everyday activities and tasks. Can improve memory and inhibitory control. 11 © McGraw-Hill Education Cognitive Functioning in Older Adults 9 Wisdom: expert knowledge about the practical aspects of life that permits excellent judgment about important matters High levels of wisdom are rare. Late adolescence to early adulthood is the main age window for wisdom to emerge. Factors other than age are critical for wisdom to develop to a high level. Personality-related factors are better predictors of wisdom than cognitive factors. ©Elizabeth Crews 12 © McGraw-Hill Education Cognitive Functioning in Older Adults 10 Education, work, and health Education Successive generations in America’s twentieth century were better educated, a continuing trend. Work Successive generations have placed a stronger emphasis on cognitively oriented labor, linked with cognitive advantages post-retirement. Health Successive generations have been healthier in late adulthood. Terminal decline: best described as slow and steady. 13 © McGraw-Hill Education Cognitive Functioning in Older Adults 11 Use it or lose it Mental activities can benefit the maintenance of cognitive skills. Reading books, doing crossword puzzles, going to lectures and concerts. Research suggests that mental exercise may Delay/reduce cognitive decline. Lower the likelihood of developing Alzheimer’s disease. (Top) ©Silverstock/Getty Images; (middle) ©Kurt Paulus/Getty Images; (bottom) ©Tom Grill/Corbis 14 © McGraw-Hill Education Cognitive Functioning in Older Adults 12 Training cognitive skills Improve the cognitive skills of older adults. Some loss in plasticity in late adulthood, especially in those who are 85 years and older. Cognitive vitality of older adults can be improved through cognitive and physical fitness training and nutritional interventions. Ginkgo biloba. Omega-3 polyunsaturated fatty acids or fish oil. 15 © McGraw-Hill Education Cognitive Functioning in Older Adults 13 Cognitive neuroscience and aging Cognitive neuroscience: discipline that studies links between brain and cognitive functioning. Changes in the brain can influence cognitive functioning, and changes in cognitive functioning can influence the brain. 16 © McGraw-Hill Education Theorized Age Changes in Cognitive Mechanics and Cognitive Pragmatics 17 © McGraw-Hill Education The Relation of Age to Reaction Time 18 © McGraw-Hill Education Language Development 1 Decrements in language may appear in late adulthood Tip-of-the-tongue phenomenon. Difficulty understanding speech in certain contexts. Speech of older adults is lower in volume, slower, less precisely articulated, and less fluent. 19 © McGraw-Hill Education 19 Language Development 2 Change in phonological skills leads to Slower information processing speed. Decline in working memory. Changes in discourse Some individuals’ language becomes more elaborate, some less varied. Bilingualism may delay onset of Alzheimer’s 20 © McGraw-Hill Education 20 Work and Retirement 1 Work Retirement in the United States and in other countries Adjustment to retirement ©Greg Sailor 21 © McGraw-Hill Education Work and Retirement 2 Work Labor force includes men and women 75 and over. Women up 87 percent since 2000. Men up 45 percent since 2000. Working beyond retirement age. Primarily financial needs, health, knowledge, and purpose in life. Cognitive ability is one of the best predictors of job performance in older adults. Older workers have lower rates of absenteeism, fewer accidents, and higher job satisfaction than younger counterparts. 22 © McGraw-Hill Education Work and Retirement 3 Retirement in the United States On average, workers will spend 10 to 15 percent of their lives in retirement. In the United States in 2017, average retirement age for men was 64 and for women was 62. Life paths for individuals in their 60s are less clear (for example, some do volunteer work, some change careers, some are laid off and not retired). Seven million retired Americans return to work after they retire. 23 © McGraw-Hill Education Work and Retirement 4 Work and retirement in other countries 33 percent of those in their 60s and 11 percent in their 70s are still working. Increasing number of adults are beginning to reject the early retirement option. ©Ronnie Kaufman/Blend Images LLC 24 © McGraw-Hill Education Work and Retirement 5 Adjustment to retirement Older adults who adjust best to retirement are. Healthy. Active and have adequate income. Better educated. Connected with extended social networks and family. Satisfied with their lives before retiring. Flexible and plan key factors. U.S. attitudes toward money and retirement—2017 survey. 18 percent are very confident they will have enough money. 60 percent are confident they will have enough money. 30 percent felt preparing for retirement causes emotional distress. 25 © McGraw-Hill Education Mental Health 1 Depression Dementia, Alzheimer disease, and other afflictions 26 © McGraw-Hill Education Mental Health 2 Major depression: mood disorder in which the individual is deeply unhappy, demoralized, self-derogatory, and bored Depression not more common among older adults compared to younger adults. Common predictors: Earlier depressive symptoms. Poor health or disability. Loss events. Low social support. Treatment: medications, psychotherapy, consistent exercise. Risk for suicidal ideation. 27 © McGraw-Hill Education Mental Health 3 Dementia: neurological disorder in which primary symptoms involve deterioration of mental functioning 23 percent of women and 17 percent of men 85 years and older are at risk. Reducing risks may be possible through diet, exercise, cognitive training, and vascular risk monitoring to maintain cognitive functioning. 28 © McGraw-Hill Education Mental Health 4 Alzheimer’s disease: gradual deterioration of memory, reasoning, language, and eventually, physical function Women are more likely to develop Alzheimer’s disease because they live longer than men. Alzheimer’s involves deficiency in the brain of messenger chemical acetylcholine. Formation of amyloid plaques and neurofibrillary tangles Linked to the ApoE4 gene. 29 © McGraw-Hill Education Mental Health 5 Early detection and drug treatment Mild Cognitive Impairment (M C I) represents transitional state between cognitive changes of normal aging and very early disease. F M R I shows smaller brain regions involved in memory for individuals with M C I. 30 © McGraw-Hill Education Mental Health 6 Drug treatment of Alzheimer’s disease Cholinesterase inhibitors and other drugs slow downward progression. Caring for individuals with Alzheimer’s disease Support often emotionally and physically draining for family. Respite care: services that provide temporary relief for those caring for individuals with disabilities and illnesses or the elderly. ©Bettmann/Getty Images 31 © McGraw-Hill Education Mental Health 8 Parkinson’s disease: chronic, progressive disease characterized by muscle tremors, slowing of movement, and partial facial paralysis Triggered by degeneration of dopamine-producing brain neurons. Several treatments available. ©AP Images 32 © McGraw-Hill Education Two Brains: Normal Aging and Alzheimer Disease ©Alfred Pasieka/Science Source 33 © McGraw-Hill Education Comparing images of a non-diseased and Alzheimer’s brain shows a distinct difference in shape and size. The Alzheimer’s brain is smaller. 33 Religion and Spirituality Older adults are spiritual leaders in many societies around the world. Older adults have higher levels of life satisfaction, self-esteem, and optimism. Religion can provide some important psychological needs in older adults. Higher resilience and less depression symptoms among those who attend religious services. ©ozgurdonmaz/Getty Images 34 © McGraw-Hill Education End of Main Content © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® www.mheducation.com LIFE-SPAN DEVELOPMENT 17e John W. Santrock © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® Chapter 20 Death, Dying, and Grieving © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® Chapter Outline The Death System and Cultural Contexts Defining Death and Life/Death Issues A Developmental Perspective on Death Facing One’s Own Death Coping with the Death of Someone Else 3 © McGraw-Hill Education The Death System and Cultural Contexts The death system and its cultural variations Changing historical circumstances Components comprising the death system: People. Places or contexts. Times. Objects. Symbols. 4 © McGraw-Hill Education The Death System and Its Cultural Variations Cultural variations in the death system Ancient Greeks: live a full life and die with glory. Most societies have a ritual that deals with death. In most societies, death is not viewed as the end of existence because the spiritual body is believed to live on. ©Ahn Young-joon/AP Images 5 © McGraw-Hill Education Changing Historical Circumstances Life expectancy increased from 47 years for a person born in 1900 to 78 years for someone born today. Location of death: over 80 percent of deaths in the United States occur in institutions or hospitals. 6 © McGraw-Hill Education Issues in Determining Death 1 Issues in determining death Decisions regarding life, death, and health care 7 © McGraw-Hill Education Issues in Determining Death 2 Brain death: when all electrical activity of the brain has ceased for a specified period of time Flat EEG reading for a specified period of time is one criterion of brain death. Includes both higher cortical functions and lower brain stem functions. ©Stringer/Getty Images 8 © McGraw-Hill Education Decisions Regarding Life, Death, and Health Care 1 Advanced care planning: process of patients thinking about and communicating their preferences about end-of-life care Choice in Dying: create a living will. Living will: legal document reflects the patient’s advance care planning. Advance directive: indicates whether life-sustaining procedures should or should not be used to prolong an individual’s life when death is imminent. 9 © McGraw-Hill Education Decisions Regarding Life, Death, and Health Care 2 Euthanasia: the act of painlessly ending the lives of individuals suffering from incurable diseases or severe disabilities Passive euthanasia: treatment is withheld. Active euthanasia: death deliberately induced. Terri Schiavo. Assisted suicide: patient self-administers lethal medication and determines when and where to do this. Jack Kevorkian. 10 © McGraw-Hill Education Decisions Regarding Life, Death, and Health Care 3 Needed better care for dying individuals Death in America is lonely, prolonged, and painful. A good death involves physical comfort, support from loved ones, acceptance, and appropriate medical care. Hospice: a program committed to making end of life as free from pain, anxiety, and depression as possible. Palliative care: reducing pain and suffering, helping individuals die with dignity. ©Comstock Images/PictureQuest 11 © McGraw-Hill Education A Developmental Perspective on Death Causes of death Attitudes toward death at different points in the life span 12 © McGraw-Hill Education Causes of Death 1 Prenatal death through miscarriage Birth defects Sudden infant death syndrome (SIDS) leading cause of infant death in the United States Accidents or illness cause most childhood deaths 13 © McGraw-Hill Education Causes of Death 2 Most adolescent and young adult deaths result from suicide, homicide, or motor vehicle accidents. Middle-age and older adult deaths usually result from chronic diseases. 14 © McGraw-Hill Education Attitudes Toward Death at Different Points in the Life Span 1 Childhood Some young children believe the dead can be brought back to life through medicine or magic. Children as young as 4 to 5 years of age can understand the irreversibility of death and the cessation of functions. 15 © McGraw-Hill Education Attitudes Toward Death at Different Points in the Life Span 2 At some point in the middle and late childhood years, many children develop more realistic and accurate perceptions of death. Honesty is the best strategy in discussing death with children. Support programs for parentally bereaved children and their caregivers can be beneficial. ©Per-Anders Pettersson/Getty Images 16 © McGraw-Hill Education Attitudes Toward Death at Different Points in the Life Span 3 Adolescence Death regarded as remote and may be avoided, glossed over, or kidded about. Deaths of friends, siblings, parents, or grandparents bring death to the forefront of adolescents’ lives. Develop more abstract conceptions about death than children. 17 © McGraw-Hill Education Attitudes Toward Death at Different Points in the Life Span 4 Adulthood Middle-aged adults fear death more than young adults do. Older adults are forced to examine the meanings of life and death more frequently than younger adults. ©Ned Frisk Photography/Corbis 18 © McGraw-Hill Education Facing One’s Own Death 1 Kübler-Ross’ stages of dying Perceived control and denial The contexts in which people die ©Science Photo Library/Getty Images 19 © McGraw-Hill Education Facing One’s Own Death 2 Knowledge of death’s inevitability permits us to establish priorities and structure our time. Three areas of concern Privacy and autonomy in regard to their families. Inadequate information about physical changes and medication as death approached. Motivation to shorten their life. 20 © McGraw-Hill Education Facing One’s Own Death 3 Kübler-Ross’ stages of dying Denial and isolation: dying person denies she or he is really going to die. Anger: dying person’s denial gives way to anger, resentment, rage, envy. Bargaining: dying person develops hope that death can be postponed. Depression: withdrawal, crying, and grieving. Dying person comes to accept the certainty of death. Acceptance: sense of peace. 21 © McGraw-Hill Education Perceived Control and Denial Perceived control may be an adaptive strategy for remaining alert and cheerful. Denial insulates and allows one to avoid coping with intense feelings of anger and hurt. Can be maladaptive depending on extent. 22 © McGraw-Hill Education The Contexts in Which People Die More than 50 percent of Americans die in hospitals. Nearly 20 percent of Americans die in nursing homes. Hospitals offer many important advantages. Professional staff members. Technology helps prolong life. 23 © McGraw-Hill Education Communicating with a Dying Person Open communication with dying people is important because they can Close their lives in accord with their own ideas about proper dying. May be able to complete plans and projects and make arrangements and decisions. Have the opportunity to reminisce and converse with others. Have better understanding of what is happening to them. 24 © McGraw-Hill Education Grieving 1 Dimensions of Grieving Grief: emotional numbness, disbelief, separation anxiety, despair, sadness, and loneliness accompanying the loss of someone loved. Pining or yearning reflects an intermittent, recurrent wish or need to recover the lost person. Cognitive factors are involved in the severity of grief. Prolonged grief disorder. 25 © McGraw-Hill Education Grieving 2 Disenfranchised grief: an individual’s grief involving a deceased person that is a socially ambiguous loss and cannot be openly mourned or supported Examples: spouse, abortion, stigmatized death such as a death due to AIDS Dual-process model: model of coping with bereavement that emphasizes oscillation between Loss-oriented stressors and Restoration-oriented stressors Oscillation model: oscillation between coping with loss and coping with restoration 26 © McGraw-Hill Education 26 Coping and Type of Death Death’s impact on survivors strongly influenced by the death’s circumstances Sudden deaths likely have more intense and prolonged effects on survivors Survivors may develop Post-Traumatic Stress Disorder. 27 © McGraw-Hill Education Cultural Diversity in Healthy Grieving Some cultures emphasize importance of breaking bonds with the deceased and returning quickly to autonomous lifestyles. Non-Western cultures suggest beliefs about continuing bonds with the deceased vary extensively. There is no one right, ideal way to grieve. 28 © McGraw-Hill Education Making Sense of the World Grieving stimulates individuals to try to make sense of their world. Reliving events leading to the death is common. When death is caused by an accident or a disaster, the effort to make sense of it is often more vigorous. ©Thomas Hinton/Splash News/Newscom 29 © McGraw-Hill Education Losing a Life Partner 1 The death of an intimate partner brings profound grief. Widows outnumber widowers because women live longer than men. Age groups and percent of widows 14 percent of 65 to 74 years old. 31 percent of 75 to 84 years old. 59 percent of those 85 years old and over. 30 © McGraw-Hill Education Losing a Life Partner 2 Widowed women are probably the poorest group in America. Many widows are lonely and benefit considerably from social support. Cross-cultural study of widowed men and women Study in the United States, England, Europe, Korea, and China: depression peaked in the first year of widowhood for men and women Widowed women recovered to levels compared to married individuals in all countries. Widowed men continued to have high levels of depression 6 to 10 years post-widowed everywhere except in Europe. Becoming widowed is associated with a 48 percent increase in having an earlier death. 31 © McGraw-Hill Education Forms of Mourning 1 Funerals are an important aspect of mourning. Cultures vary in how they practice mourning. In the United States, funerals are conducted privately and are followed by a memorial ceremony. ©Xinhua/eyevine/Redux 32 © McGraw-Hill Education Forms of Mourning 2 In some cultures, a ceremonial meal is shared after a death, while in others a black armband is worn by bereaved family members for 1 year following a death. Amish culture: community handles virtually all aspects of the funeral Traditional Judaism: 7-day period of shivah is especially important Designed to promote personal growth and to reintegrate bereaved individuals into the community. ©Russel Underwood/Corbis/Getty Images, ©Paul Almasy/Corbis/VCG/Getty Images 33 © McGraw-Hill Education End of Main Content © 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education. Because learning changes everything.® www.mheducation.com