Psyche. Late Adulthood
Terms
undefined, object
copy deck
- T/F the mind is a great instrument of thinking?
- True
- 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?
- True
- 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?
-
1-depression
2- disorganized speech - 3 points of anxiety based disorders?
-
1-panic attacks
2-phobia's
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?
- True
- T/F Males have more disorders related to drugs, alcohol, and agressive behavior
- True
- T/F the differences don't level off after mid-adulthood?
- False
- T/F cultural variations effect mood disorders
- True
- 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?
- Hopelessness
- 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?
- False
- What are 2 neurotransmitters associated with the biochemical Imbalnces of depression?
-
Serotonin
Norepenephrine - serotonin works with___________?
- Mood
- Norepinenphrine works with__________?
- Motivation
- 2 pts of depressive equilvalents?
-
1- masks the depression
2-more prevalent in younger population - 3 types of depressive equivalents?
-
1-Brooding-dwell
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?
- True
- T/F females attemt sucide more often then males?
- True
- T/F Females are more succesful than males in accomplishing the suicide attempt?
- False
- T/F Native americans have the highest suicide rate?
- True
- 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
- True
- Name 3 elements in assessing suicide risk?
-
1-intent
2-means
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?
- False
- T/F older people have much lower rates of substance abuse
- True
- 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
-
1-Expensive
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
- True
- Define senecence?
- Growing old/aging/experencing the body declining at a gradual rate
- define senility?
- something that is characterized or associated with growing old
- define SENILE DEMENTIA?
- 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?
- True
- 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?
- False
- T/F Sweets and salts decline more than bitter and sour?
- True
- 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
-
rheumetoid
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
stroke - CVA can cause 3 things...?
-
1-paralysis
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
- True
- 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
2-hippocampus
3-brain stem - If hippocampus is effected what can be lost?
- memory
- 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
"Contralateralization" - 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?
- Divided
- 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?
- 60
- What is the part of the brain effected first?
- cerbral cortex
- T/F primitive areas stay intact as we age?
- true
- T/F neurons cannot regenerate?
- true
- 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?
- false
- T/F Alzheimers is related to poor oxygen utilization in the brain?
- true
- 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?
- true
- T/F dementia alzheimers is linked to genetics and shows up with age?
- True
- 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?
- true
- T/F Dimentia effects 1 out of 2 people after age 85?
- true
- T/F people over 80= 25% will have alzhiemers
- true
- T/F people over 85= 30% will have alzhiemers
- true
- T/F people are living longer thus creating more opportunity for disease to happen?
- true
- What are the 2 areas of the brain effected by alzhiemers?
-
1-cerebral cortex
2-Limbic system - Alzhiemers tends to focus on the------?
- hippocampus=memory
- T/F alzhiemers can only be formally diagnosed after death?
- true
- During autopsy what 3 things show up?
-
1-Neuro-fibrillary tangles
2-plaques
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?
- true
- _____% greater chance of getting alzheimers with family history
- 15
- _____% greater chance of getting alzheimers with a parent having the disease?
- 50
- Someone with Alzheimers has low levels of______________?
- Acetylcholine
- 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.
- true
- 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.?
- Aricept
- 4 stages of Alzheimers?
-
1-forgetfulness
2-confusion
3-Incontinence
4-death - 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
- true
- T/F -Someone who has ego-dystonic (despair) has problems solving life choices
- true
- what does ego systonic mean?
- acceptable to a person
- what does ego dystonic mean?
- unacceptable to a person- despair
- Anorexia is Ego-____________?
- systonic
- Bulemia is ego-______________?
- dystonic
- What is the crisis to be solved in tyhe integrity or depair stage of developement?
- wisdom
- 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?
- true
- 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
- true
- T/F A very disorganized personality can be seen as a fuctional disorder
- true
- 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
- true
- T/F Depression peaks 40-50 years old
- true
- _____% of elderly folks in some type of care experience depression
- 30-60%
- Out of the 30-60% of elderly that experience some depression, _____%=major depression
- 10-15%
- 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
- true
- 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
-Disorganized
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
- True
- Who coined "Character armor?
- Wilhelm Reich
- 2points on family situation during late adulthood?
-
-CAN BE SOURCE OF GREAT SATISFACTION
- CAN ALSO BE ASSOCIATED WITH PAIN AND TURMOIL - 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)
- true
- define institutionalized care?
- anyone in a long relationship with care
- What % LIVE IN NURSING HOMES over age 65?
- 5%
- 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
- True
- what % of middle adult are caught in sandwich generation?
- 44$
- 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
- true
- 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?
-
1-situation/event
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
- true
- 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
- True
- 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
- True
- T/F widowers have a higher remarriage rate
- True
- T/F Remarriages tend to be unhappier because no children and more flexibility
- false
- T/F Need for affiliation is greater then need for achievement
- true
- Name 5 styles of grandparenting?
-
1-Formal
2-Funseekers
3-Surrogate
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?
- GPâ€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?
-
Voluntary
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
- true
- 6 stages of retirement?
-
1-pre-retirement
2-honeymoon phase
3- disenchantment
4- reorientation
5-stability
6-Termination - 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
- true
- T/F by age of 5-7 kids realize that death is not reversible
- true
- 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
- true
- 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
- true
- meta=
- beyond
- T/F The only times we become metaphysical when death is emminent/ sickness/ depression
- True
- 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
- true
- Define grief?
- the emotional reaction to the loss (depression always follows loss)
- T/F we all grieve the same?
- false
- name 3 ways we deal with greif?
-
1-Affected-depression
2-Behaviorally
3-Cognitively - 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-
- True
- T/F the underlying peice is that the person wants to be reunited with the dead person in affected greif?
- True
- Define behavior coping for grief? 5pts
-
1-person may feel fatigue
2-will cry
3-may become agitated
4-insomnia
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
- True
- T/F When death is anticipated then it gives people a chance to detach
- True
- 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
- True
- 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
- Curiative=
- 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)
- Functional=
- no heartbeat or respirations/ brain will die 5-8 minutes after