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Psyche. Late Adulthood


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T/F the mind is a great instrument of thinking?
Define Mental illness?
some form of diagnosed mental behavior
Define psychopathology?
The study of disease of can also be an overall refcerence to the disease.
Whar are the 4 D' to psychiatric Abnormalties/ abnormal behavior?
1-Deviance: from socail norms
2-Distress: individual stress/ family
3-Dysfunction (behavior): negative
4-Danger:to themselves/ others
5 points of mental health!
1-Absent of psychopatholgy
2-Adequate life satisfaction
3-Self acceptence 4- sense of mastery
5-ability to work/love/play
2 points of Mental illness
1- inadequate adjustment
2- Maladptive behavior
T/F aa person xcan be diagnosed differently at age 65 than at 25 although symtoms are similar?
Define Schizophrenia? 3 points
1-break with reality
2-psychosis= loss of contact with reality
3-becomes apparent by age 30
2 positve symptoms of schizophrenia?
1- halucinations
2- delusions
2 negative signs of schizophrenia?
2- disorganized speech
3 points of anxiety based disorders?
1-panic attacks
3-show in young adults
T/F personality disorders increase as people age?
False- decrease
T/F females experience more depression then males at an earlier on set?
T/F Males have more disorders related to drugs, alcohol, and agressive behavior
T/F the differences don't level off after mid-adulthood?
T/F cultural variations effect mood disorders
What did Martin Seligman say about learned helplessness? 2pts
1- cause of events is internal- effecting self esteem
2- see more global problems then none helpless
Define "Just world" theory?
Abused child takes blame to secure immature notion of a just world- to keep their world making sense
Hall mark of depression and suicisde?
Other symtoms of depression/suicide?
Sadness/ lack of interest in life/ interactivity/ pessimism/ indescisive/ physical symtoms/ neurovegative symtoms
define neurovegatative symtoms
Loss of appetite/ sleeplessness/ fatigue
Name 2 types/causes of depression?
1- exogenous- reaction to external
2- endogenous- comes from within
( will usually see both elements)
T/F all people do depression the same?
What are 2 neurotransmitters associated with the biochemical Imbalnces of depression?

serotonin works with___________?
Norepinenphrine works with__________?
2 pts of depressive equilvalents?
1- masks the depression
2-more prevalent in younger population
3 types of depressive equivalents?
2-Somaticizing-channeling psych- body
3-Agression- seen in low IQ and children
Define Anhedonia?
loss of pleasure of life
2 parts needed to diagnos depression
Low mood/ anhedonia
how do you treat for depression?
Medications and pych therapy and rest
T/F Medications treat the symtoms not the cause?
T/F females attemt sucide more often then males?
T/F Females are more succesful than males in accomplishing the suicide attempt?
T/F Native americans have the highest suicide rate?
T/F years ago people over 65 had higher rates then they do now
True/ rates have been cutr in half
T/F men outnumber females 4-1 in suicide completion
Name 3 elements in assessing suicide risk?
3- Plan
Define ORGANICITY in terms of brain disorders
problem with the structur of the brain
T/F people with mental illness never self medicate with alcohol and drugs?
T/F older people have much lower rates of substance abuse
2 parts of substance abuse?
1- Emotional component
2- negative consequence
3 parts of substance dependency?
1-has physical component
2-compulsive usage
3- has detox/ withdrawal syntoms
2 obstacles TO mental health
2-older generations have low awareness of mental health
2 reasons older generation has low awareness of mental
1- unsure what mental illness is
2- seen as an inevitable part of aging
define gerontology?
study of the aging process
define geriatrics?
branch of medicine that deals with the elderly and the aging process
T/F late adulthood is the fastes growing population segment
Define senecence?
Growing old/aging/experencing the body declining at a gradual rate
define senility?
something that is characterized or associated with growing old
progressive abnormally accelerated deteroation of the mental facilities and emotional stability
6 factors of Longevity?
1-social and family support2-medical tech.3-diet+nutrition4-personality charcteristics-sense of humor-ability to relax5 exercise6-genes
Acronym AGING for genetic factors=
A=attitude G= genetics
I= interests
N= nutrition
G=give up smoking
Why do males live shorter lives than females?
-Exposed to harsh occupational stresses
-lifesyle=males abuse substances
-m's more driven to suppress feel.
-f's have estrogen= resists disease
Define Hayflick limit
DNA & RNA stop producing in the body/ body can't convey message to create new cells limiting replication/ 115=point were cells can no longer replcate
T/F The immune system losses it's effieciency to fight disease?
Why does the immune system lose it's effieciencyt while we age?
The thymus gland shrinks and can't produce lymphocytes which become T-cells which attack disease and infections
2 elements of hypochondriasis?
1-consistent across lifespan
2- is a personality manifestation
T/F elderly gain ability to taste better?
T/F Sweets and salts decline more than bitter and sour?
T/F decrease in sensitivity during aging is a mixed blessing ? why/why not?
True can't feel the accumulating injuries
Define and 3 points of arthritus?
- Immflamation of a joint
1-100 types of arthritus
2-can be painful/cause swelling
3-some types are sudden/ gradual
2 major forms of arthritus

osteo arthritus
What is the most common form of arthritus?
Osteo arthritus
3 pts on osteo arthritus
1-40 million affected
2- effects specific area's of body
3-common in knees/hips/ wt bearing joints
What does rheumatoid arthritus effect?
effects the connective tissue/ comes from scar tissue
5 pts on rheumetoid arthritus?
1-very generalized
2-slow to develope
3-hinders mobility
4- causes fatigue and fever-5
What does cva mean?
Cerebro Vascular Accident

CVA can cause 3 things...?
2-speech impediment
3-memory loss
what physiologically causes CVA?
an interuption in the arterial blood flow to the brain that results ion death or loss in functioning
T/F 80% of CVA victims are over 65 years old
What is the major cause of CVA?
hypertension-narrowing arteries- anyerism- migrating clot
Name the 2 areas of the brain that are effected by CVA?
1-cerebral cortex
2-Limbic system
What comprises the Limbic part of the brain?
1- amygdala
3-brain stem
If hippocampus is effected what can be lost?
Amygdala is in charge of ...?
fight or flight
if CVA effect the brain stem what is effected?
vital fuctions which are most important
What is the worst part of the brain to be afeected by a CVA?
the brain stem because it handles the vital functions
What does TIA stand for?
Transient Ischemic Attack
What is a TIA?
series of minor low grade strokes
What does Contralateral Efffects of stroke mean?
if person has stroke on lefts side of brain the right side of body will be effected

Define selective attention?
Focusing only on relavent info but has presence of distracting stimuli
ie. reading paper with the radio on
define divided attention?
processing several relevant pieces of info simultaneoulsy
ie. driving/ ability to focus
Of selected and divided attention which one is affected the most as we age?
what % of weight does the brain lose as we age?
5% weight
What % of size does are brain lose as we age?
15% size
Why do we process info slower as we age?
decreased number of brain cells
At what age is there a major decline in brain changes?
What is the part of the brain effected first?
cerbral cortex
T/F primitive areas stay intact as we age?
T/F neurons cannot regenerate?
T/F drugs and alcohol have no effect of brain changes?
false- they speed neuron death
T/F Alzhiemers is a normal part of aging?
T/F Alzheimers is related to poor oxygen utilization in the brain?
Define dementia?
a progressive brain disorder that is characterized by loss of memory and reasoning.
define pseudodementia?
false dementia related to major depression
T/F 75% of those with dememntia Alzheimers are over 65 years old?
T/F dementia alzheimers is linked to genetics and shows up with age?
Define Alzheimers?
cronic brain disorder characterized by memory loss, loss of reasoning, lossof voluntary and involuntary muscle control, ultimately ends in death
T/F dementia effects 1 out 10 people over 65?
T/F Dimentia effects 1 out of 2 people after age 85?
T/F people over 80= 25% will have alzhiemers
T/F people over 85= 30% will have alzhiemers
T/F people are living longer thus creating more opportunity for disease to happen?
What are the 2 areas of the brain effected by alzhiemers?
1-cerebral cortex
2-Limbic system
Alzhiemers tends to focus on the------?
T/F alzhiemers can only be formally diagnosed after death?
During autopsy what 3 things show up?
1-Neuro-fibrillary tangles
3-Amyloid bodies
What are neurofibrillary tangles?
diseased neurons that get emeshed rapidly together
What are plaques?
brain areas that are in decal/ alzhiemers prduces more plaque tham any other disease
what are Amyloid bodies?
degenerated bodies in the brain
T/F an alzheimers brain is smaller than normal?
_____% greater chance of getting alzheimers with family history
_____% greater chance of getting alzheimers with a parent having the disease?
Someone with Alzheimers has low levels of______________?
Acetylcholine is resposible for? and found in?
memory/ hippocampus
What is the enzyme that breaks down Acetylcholine?
Choline acetyltransferase
T/F high levels of Choline Acetyltransferase are found in patients with alzhiemers.
4 other potential causes of Alzheimers?
1-brain toxins-Al. + salt
2-viral infection
3-decreased blood and O2 to brain<30%
4-can't synthasize protiens
what is the main med for alz.?
4 stages of Alzheimers?
2 pt on forgetfulness stage?
1-memory loss
2- affected person is usually unaware
5 points of confusion stage?
1-usally been diagnosed
2-shrt term memory is impaired
3-promblems communicating
4-depressed 5-PARANOID
4 pis of incontinence stage?
1-family effected most
2-unable to care for hygene
3-longterm memry effected
4-loss of language skills
What is Erikson's stage of later adulthood?
Integrity vs. despair
-people would reflect back on lifes and see how they did
T/F -Someone who is ego systonic(integrity) would appreciate their accomplishments- usually has wisdom
T/F -Someone who has ego-dystonic (despair) has problems solving life choices
what does ego systonic mean?
acceptable to a person
what does ego dystonic mean?
unacceptable to a person- despair
Anorexia is Ego-____________?
Bulemia is ego-______________?
What is the crisis to be solved in tyhe integrity or depair stage of developement?
4 pnts of stability & successful aging?
1-socio-economic status
2-healthy self concept
3-self-esteem/satisfied with life
4-physical health and autonomy
T/F psychological maladjustment can be caused by th stress of aging?
define functional disorder?
-are caused by a psychological not physiological
- no known organic cause
-mood disorder
T/F functional disorders are caused by psych. factors as well as interpersonal factors
T/F A very disorganized personality can be seen as a fuctional disorder
elderly are suseptible to mood disorders because.....
-Tend to have a lot of sadness and hopelessness usually because they have multiple loses, declining health, they lose purposefulness in life
depression, bipolar, szchetzphrenia are...........?
functional disorders
T/F suicide rate is 50% higher in men over the age of 65 then it is for teens
T/F Depression peaks 40-50 years old
_____% of elderly folks in some type of care experience depression
Out of the 30-60% of elderly that experience some depression, _____%=major depression
Organic brain Syndromes 3 points?
1-Usually refered to syndromes
2-There is a direct origon(Etiology)
3-5-10% of people 65-75 have organic disorder
T/F 20% ages 90-100 have organic disorder
dementia 3pts?
1- not anormal part of aging
2- Fatal disease and progressive
3- irreversible= NO CURE***
Delerium 6 pts?
1--often confused with dimentia
2-is a reversable conditione***
3-caused by the toxic side effects of medication
4- caused by malnutrition(caused by fixed income)
5- poor oxygenation in the brain
6- cardivascular disease causes por oxygenation of brain
Delerium 3pts?
1-caused by infection
2- substance abuse
3- restless and agitated
Define Apoplexy?
1- a severe impairment in neurological functioning
2- Related to a stroke
3- Also known as a fit of anger or rage
Define Multi-infarct Dementia/ vascular dementia? 5pts
1-changes in the brains blood vessles that cause the death of brain tissues
2-confusion-dizziness- unsteadiness
3-can be confused with TIA’s
4-paralysis-memory loss-then coma
5- it is irreversable/ dygenerative
Define Pick's disease?5pts
-Rare form of demtia
-effects women more then males
1-disoriented=person,place, time, situation, object
2- easily fatigued
3-caused by atrophy of the frontal lobe
4-Huge changes in personality
5-degenerative and irreversible
Define Ageism? 3 pts
1- prejudism and discrimination based on peoples age
2-can play a major role in the care the lederly recieves at a SNF- robs elderly of making own decisions
3-generally a western phenomonon
Define Disengagement Theory? 4 pts
1- older people slow down and gradually withdraw from society 2- self-imposed isolation 3- very reciprocal= person withdraws and society withdraws 4- people are seen as incapable
Define Activity theory?
the more active and involved they are the less likely they are to show the signs of aging and they will have life satisfaction=use it or lose it/ people who exercise their mind= the less likely to have alzhiemers
What is sublimation(coping)
use of a different method to stimulate the inner world ie. the teach can't teach but could tutor.
Define Social Breakdown Theory?
Aging is effected by negative social and psychological functioning/ older people get negative feed back from society, they’re made to feel less attractive and less competent
T/F In terms of Social breakdown theory, at work the opposite is true?
True-Older people are more reliable and better workers then younger people
T/F People who support the Social Breakdown Theory want to see social systems changed to accomodate the elderly more
Who coined "Character armor?
Wilhelm Reich
2points on family situation during late adulthood?
2 reasons people rely on grandparents more?
1-worker mobility
2- high divorce rate
During the 20th century what % number of grandchildren live with or in close proximity grandparents ?
60%(in 1900); now it is 15%
T/F Only 20% of peole need assisted living (activities of daily living)
define institutionalized care?
anyone in a long relationship with care
What % LIVE IN NURSING HOMES over age 65?
Why are more females are in nursing homes than males?
female’s longer life expectency
3 types of Institutionalized care?
1-skilled nursing facility
2-intermediate/residential commun.
3=Adult day care
Define Institutionalism?
is a psychological state brought on by a depersonalized environment
traits of institutionalism? 7pts
1-behaviors become automatic
2-person becomes expressionless
3-generalized apathy
4-sense of pride/ hygene
5-low sense of moral
6-quality of life is poor
7-social relationships become cease
T/F elderly can feel alienated from society but it depends on kin relations
what % of middle adult are caught in sandwich generation?
Define Kinkeeper?
-person who maintains contact between generations/ maintains the cohesion between all family members
T/F Caregivers tend to experience a lot of stress/ need to work hard to balance social interactions and keep people happy
What can the Model of Caregiving and Coping(comes from Cognitive Behavioral Therapy)?
Can give power to change thoughts so outcome can be changed= resources, social support, coping skills= having these things can reframe the situation
3 elements of Model of caregiving?
2-Caregivers thoughts
3- consequences/ out come
-can be positve or negative
Inthe Model of caregiving why are the Caregivers thoughts so important?
Directly impacts the outcome/ reframing can change neg to positive outcome
3 element of healthy elders?
1-more contact with non-family friends
2-financial stability
3- reciprocal exchange in relationships
in healthy elders what does financial stability render
creates opportunity to move to a retirement community; gives them options
In healyhy elders what does non familial relations demonstrate?
shows that people can adjust better/flexibility which is deemed very healthy
in healthy elders what does reciprocal exchange mean?
exchange favors/ srevices/ goods/ recipes; gives them social interaction
T/F studies show people are married in late adulthood are happier because they nolonger have to put energy into finding a mate
Marriages in Late adult tend to be more satifying why?
emptynest/ usually retired no longer have to worry about job stresses
What are the Reasons for enhanced marriages?
they better understand the partners likes/ dislikes/ knows each others tendencies and blend into one entity/ personal ambitions tend to be satisfied there fore the partners can devote more time to each other ie. compassion+ loving
T/F esearch shows that are married are better off physically, psychologically, and financially then peopl who never got married, divorced, widowed
T/F 10x more widows then widowers(male)
false 5x
T/F women cope much better than males over a lose of a spouse because in a traditiuonal marriage most males have their emotional needs taken care by the wifes of and men are socialized not to show emotions
T/F widowers have a higher remarriage rate
T/F Remarriages tend to be unhappier because no children and more flexibility
T/F Need for affiliation is greater then need for achievement
Name 5 styles of grandparenting?
4-Resevoir to family
5-Distant figure
Define Formal GP?
boundaries/ roles are clearly outlined, Grandparents don’t indulge grandchildren/ may do minor babysitting upon convenience
Define Funseekers GP?
tend to be very informal, playful, grand children see grandparents as a source of pleasure and fun, problem is they have very poor authority
Define surrogate GP?
increasing in our society/ gp’s have primary role of raising grandchildren, can leave folks overburdened
Define Resevoir to family GP?
GP”s show alot of wisdom, tend to be authoritarian(rules and regulation), tend to have skills and resources, tend view children as being subordinate, GC’s have alot of anger towards GP’s
Define distant figure GP?
tend to be remote, infrequent contact around holidays
Define social security?
in 1935(depression) FDR for our nations wanted to find a basic way to provide income to people who are retired or disabled
Define Medicare?
is health ins. for people who are 65 years older/ person has to pay into it
Define Medicade?
Title 19= medical assistance based on the need for service, developed in 1966, paid by the government(SAGA= State assisted government aided)
Define retirement?
a formal end to working and a beginning of a new life
Elements of retirement?
-hav to redefine themselves
-normal transition
-in 2000 about 33million people over the age of 65 are retired
2 types of retirement?
Involuntary-the golden handshake
Why is retirement a very difficult adjustment?
loss of commarderie and needfulness
-1st year is most difficult
T/F Gerontologists suggest that a gradual retirement works better then and abrupt transition
6 stages of retirement?
2-honeymoon phase
3- disenchantment
4- reorientation
Define pre-retirement?
-remote- when retirement is off in the distance-near- 1-2 years retirement will happen soon/ transition to retirement is very close/people worry about financial
Define honeymoon phase?
person find new freedom/ can last a while or short lived depending when novelty wears off/ opportunity to try things they never had before
Define disenchantment?
Emotional letdown, can accompany depression, caused by loneliness, problems with health and finances
Define reorientation?
person gets very realistic, check out alternatives and options
Define stability?
person masters their strengths, develope a routine, and become more of their weaknesses
Define termination?
Can becaused by going back to work, person realizes they have less autonomy, role of retirement is canceled by illness disability or death
Define Thanatology?
the field of study of death and dying
T/F Children see death as a reversible process
T/F by age of 5-7 kids realize that death is not reversible
T/F adolescents accept death but see themselves as mortal
false/ immortal
T/F Teenagers proximity to death, the closer to death they have come in the family corresponds to a better sense of death/ depends on where they live
Western culture=
dying denying culture= imbedded in our language which takes the edge of the pain of death
Death Anxiety= 4pts ages?peaks?why?...
1-Peaks in middle adulthood
2-prepares people for death
3-Experienced at 40-50 years old
4-Elderly tend to except mortality
Define Harvard Criteria (death Defined)? 5pts
In 1986 Harvard said:
1-No respitory function
2-No blood flow/ circulation
3-No brain Activity/ through an EEG
4-No consciousness or responsiveness
5-No reflexes/ pupil dialation
T/F technology has deepened the death denying culture
T/F The only times we become metaphysical when death is emminent/ sickness/ depression
T/F Psychologists have found it better to NOT inform people of terminal illness/ gives a chance to finalize plans, make amends, closure
false/ do inform
2 types of euthanasia?
Passive and active
Define euthanasia?
the act of painlessly putting to death an animal or person who is afflected with an incurable disease or a severe disability
Define active euthanasia?
a direct/ deliberate effort to terminate life- Through themselves or assisted by others (ie. Dr. Kevorkian)
Define passive euthanasia?
-withdrawing essential life support systems and letting nature take it’s course/ Life saving treatment is not given/ Karen Anne Quinlan (1976- 1985)
Define -Bereavement?
the actual loss of the other person through death
T/F -Emotional element varys during bereavement and it gets better with time
Define grief?
the emotional reaction to the loss (depression always follows loss)
T/F we all grieve the same?
name 3 ways we deal with greif?
define affected depression?
-depression/ Anhedonia= loss of pleasure in things you previously liked/ Survivors guilt(Lofton)
T/F In affected greif usually happens in sudden unexpected death-
T/F the underlying peice is that the person wants to be reunited with the dead person in affected greif?
Define behavior coping for grief? 5pts
1-person may feel fatigue
2-will cry
3-may become agitated
5-often has somatic complaints
Define cognitive coping through grief?4pts
1-mental process slows down
2-may seem preoccupied
3-increase in memories
4-may have flashbacks
Define mourning?
the set of behaviors that express/ demonstrate the grief and loss/
Mourning is determined by__________?
culture and religion
T/F Loss of a child is most difficult because it goes against nature
T/F When death is anticipated then it gives people a chance to detach
T/F When preparing for someones death six months is not enough but if it is longer than 13 months a strain in coping is developed
What are the two most common ways to die?
Coronary heart disease and cancer
Define Lingering deah trajectory?
-death is expected but not eminent/ descicions are possible but risk long term and cronic pain
Define quick death trajectory?
-A matter of weeks or months until death happens
name 2 types of medical care for dying?
Curiative and palliative
actively treat the symptoms
Palliative care=
treat the pain to provide comfort/ typically down with narcotics/ Usually done in a hospice
Define Hospice?
Residential care that allows to die humanely and with dignity/ tries to personalize the care/
Name 3 Components of Death
(Functional, Cellular,Brain)
no heartbeat or respirations/ brain will die 5-8 minutes after

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