Chapter 25

Later adulthood (65+ years in often a stage in life that people look forward to in regards to retirement, financial security, family help and contact. It is a time in life whereby we avail of time to spend with our friends and family and take part in activities that we were unable to find time to do earlier in life. However this can be a time in life when physically our bodies physically deteriorate and the aging process takes its toll. Mobility, general physical health, bodily function and agility may start or have become compromised and less responsive and effective. We may experience pain or impairment in our physical wellbeing. As a result we may require assistance aids or appliances to assist us with physical care needs. We may require access to convenient health and leisure facilities, practical help and access to assessment of need.   

Our intellectual needs are just as important as we age. They are all the needs an adult requires to keep their brain working effectively. Intellectual needs change as we grow and develop.  By later adulthood our intellect has developed but we need to use, expand and maintain it.  As human beings we are always on a journey of learning and development and therefore we require our intellect to aid us and help us achieve.  In later adulthood  we require our intellect  which helps us not only with day to day decisions but for continuing education, mental activity motivation and stimulation. In later adulthood our brain may be subject to less functioning ability and may be effected by disease process. However this can also happen in Adulthood, but is rare. In later adulthood intellect can become impaired which may in turn compromise cognition/memory and mental functioning. This will require those in later adulthood to have access to specialist assessment and care provision provided by health and social care professionals.

Post 2

This chapter was very important to me because I learned a lot about elders that I did not know and some terms that I never heard before. An interesting aspect I found in this chapter was the section about grandparents and grandchildren. This was interesting to me because some of definitions actually relate to my life. In this chapter I learned about the different variations of grandparents and grandchildren which can be found on 710 of our textbook chapter 25. Here I learned about remote grandparents or in other words a grandparents who are emotionally distant to their grandchildren (Berger, 2011.) I have never heard this term, and this actually relates to my life. My grandmother was never really tied to me and my sister and always acted as if we were a burden or didn't know what to do with us. So I would label her a distant grandparent since she never really emotionally tied with me and my sister. The next term in this section is a companionate grandparent, who is a fun loving grandparent that spoils their grand kids (Berger, 2011). I would label this for my dad's side because his parents were always spoiling me and my sister. I never wanted to leave there because it was one big play house and it was some place where I felt at home. So my dads parents would be labeled as companionate grandparents for all that they have done for me and my sister. The next term on the list is involved grandparents or parents that live close to the grandchildren or live with them (Berger, 2011). I always lived a distance of about 45 minutes away from my grandparents so this definition does not apply to me but my best friend actually built on an addition for her grandmother and lived in an apartment attached to the house. The final term is Surrogate parents who raise their grandchild because their parents are unwilling to do so (Berger,2011). This relates to my life and my friends because my good friend Miranda's grandmother raised her her whole life because of the absence of her parents. This chapter was overall interesting to me because I learned so much that I always wanted to know about older people. In this chapter I learned names of grandparents and learned so much about the elderly which helped me understand them and their behaviors a lot more.

integrity vs. despair

            Integrity vs despair from Erik Erikson was something I had seen before from reading many books and also many situations I had been around in my life. I understood when I was younger watching my grandparents do something to better the community or remain a part of it you don’t want to be remembered as somebody who just gave up one day by not seeing your kids and family or not showing up to do something that was special to those in your community (all of this reminds me of “A Christmas Carol”.

            Unlike those who reach the level of despair I never really had seen that from within the family. However, I had my grandfather who took care of those who had been on the track to despair. So what my grandfather did was he would talk with the family members and make sure he could have them come in frequently to make sure that they could still feel that importance and love that was once there before they were put into an intensive care facility.

            Having been apart of a family of very independent people we never had the issues of being in a situation where we thought a loved one wasn’t getting the attention they believed they deserved from the younger family members. I see a lot of abuse and abandonment in society as of now due to situations of money and living of those who are next to receive either wealth or something in return.

CHapter 24: Aging

It may surprise people to know that there are a significant number of young people barely out of their teens who have become caregivers for their grandparents. Many of these young people were raised by their grandparents. In other instances, the grandchild becomes the primary caregiver because he or she lives closer to the elder than other family members. Sometimes, it's simply because a particular grandchild feels close to the grandparent and has the "caregiver personality." Whatever the reason that care giving begins, I hear from a number of young adults who are trying to care for one or more grandparents. Most of them love their grandparent dearly, but they often come up against obstacles that are quite overwhelming for people so young. One young woman recently wrote about the problem of getting health information about her grandfather, because the Health Insurance Portability and Accountability Act laws won't allow her to do so without the proper paperwork, and her grandfather doesn't see the need to have this youngster involved in his clinical care. The problem is that the grandfather doesn't understand that no other family member is available to help him. The granddaughter is working on the problem with the help of a mature mentor, but it can be frightening to be faced with the responsibility of an elder at such a young age.

I find the idea of calorie restriction as a means of extending life and delaying aging rather surprising. I'm with the majority of scientists in being skeptical that calorie restriction is beneficial and can extend human life. Just because it works for animals doesn't mean it will work for humans.

Over-nourishment as is commonly seen in the U.S. is definitely detrimental and contributes to diseases that can shorten the human lifespan. As a culture we've focused on the negative health effects of being over-weight and practically ignored the negative health impacts of being underweight.

Our text mentions that consuming fewer calories results in less frequent cell duplication. Makes sense as the body doesn't have enough macro-nutrients (measured in calories) to function properly so it has to allocate resources and make do with what it has. Michael Rae, one of the leaders of the Calorie Restriction Society, pictured in our textbook, looks rather thin and undernourished to me. My guess is he wouldn't have much endurance in a race, resistance to pathogenic organisms, or reserves to fall back on if injured or ill. Undernourishment shortens the lifespan of thousands of people in poorer countries, this is due in part to lower disease resistance.

When you don't get enough nutrition non-essential things such as bones suffer. With a slower metabolism, all of the body's processes slow down, including mineral and bone metabolism, which are essential for skeletal health. People who are underweight are at greater risk of bone fractures and osteoporosis.

Adequate nutrition, not too much and not too little is best for sustaining and supporting the health and longevity of the human body.

References

Alam, I., Larbi, A., & Pawelec, G. (2012). Nutritional status influences peripheral immune cell phenotypes in healthy men in rural Pakistan. Immunity & Aging, 916-25. doi:10.1186/1742-4933-9-16

Bialo, S. R., & Gordon, C. M. (2014). Underweight, overweight, and pediatric bone fragility: Impact and management. Current Osteoporosis Reports, (3), 319.

Rytter, M. H., Kolte, L., Briend, A., Friis, H., & Christensen, V. B. (2014). The immune system in children with malnutrition—A systematic review. Plos ONE, 9(8), 1-19. doi:10.1371/journal.pone.0105017

Aging Grandparents

Reading about aging in chapters 23 and 24 made me think a lot about my own grandparents. I have two surviving grandparents--my Grandad my mom's side and my Lola on my dad's. Seeing them over Thanksgiving brought about mixed feelings.

Ever since my Grandma passed away, my Grandad hasn't been the same. You can tell he misses her dearly. He also got a call from his best friend this week...his friend said it very well may be the last time they talk. Lola is also seeing her friends go. Her med school class has a reunion every year. Each year, less classmates show up. I can't currently imagine what it's like to lose the people closest to you, but I guess we are all bound to experience at some point in our lives.

Another thing that saddens me is seeing my grandparents gradually lose their independence. My Lola was always an independent, feisty woman who raised a family, worked, and ran a household without a husband for most of her life. After she had triple bypass surgery, she has significantly slowed down physically. We've had a complete role reversal from when I was a child. Now I'm the one who buckles her in when we go on a car ride. I also need to zipper her coat before we go out together. What pains me most is to remember that she was not always like this. And, she doesn't want it to be like this. She still wants to be able to live alone and take care of herself, but it just isn't practical anymore.

I think we often forget that older people were once our age. We forget that they understand love, loss, and going through transitions when really we should be asking them for advice. There are some things you can only learn through time.

Chapter 25

A lot of elder-care arrangements now are home care, aging in place, and NORCs since they are less costly and more individualized than nursing homes. One common form here in the United States is called assisted living. Assisted living is an arrangement that combines some of the privacy and independence of home life with some medical supervision of a nursing home. A patient who is in the residence of assisted living may have their own private room allowing pets and their own furnishings just like a traditional home. My grandmother is currently in this process. My grandmother was deciding to either go with a cottage which is independent living or go with an apartment where she would be closer to my grandfather when he got moved into memory support. She ended up choosing the cottage because she wanted a smoother transition since she has been used to living in large houses most of her life. Many assisted living facilities range from group homes of three or four elderly people to large apartment or townhouse. Usually, medical assistance is readily available just in case something would happen or the person needs daily supervision when taking a pill. They have doctors readily available and an ambulance is provided when necessary. The one where I live has assisted living and independent living. My grandmother loves her independence and not being awoken by others moving about. So the person she talked to about the cottage with definitely agreed that she should go with the cottage without exactly telling her. Since she has a bad back it would be better for her so she doesn't have to necessarily walk as far.

Many elders are abused in homes so sometimes making these kind of decisions. Elder abuse occurs when caregiving turns into resentment. We are all human but we should still treat our elderly with respect. I did a research assignment on elder abuse and it was so hard to see the mistreatment that they receive. It is terrible that people could treat such kind people with disrespect. Some provide excellent care but some people think that they are basically going there to die. The caregiver is exhausted from taking care of the care receiver and disagree often about schedules, menus, doctor visits and so on. I see it sometimes with my grandmother. She gets upset when my grandfather is staring off into no where while she is trying to talk to him. We have been trying to explain to her that it is the disease not him. She just doesn't understand that. She has been stuck in her ways for so long that she doesn't always see when she is doing something wrong. She feels like she has this large burden on her shoulders. My mom has been helping her by talking to my grandfather. She got help in there. She has someone sitting with him so she can get a break. She is stressed because of the decisions she has to make and she takes it out on him. I am looking forward to them moving up here because then they will be closer to us and we will be able to help. Reading in the book about late adulthood really opened my eyes to get some of an understanding what Alzheimer Disease is and how elder abuse and assisted living is described.

Alzheimer Disease- Chapter 24

When I saw that we were doing late adulthood, I immediately thought of my grandfather. The signs were there that he had the Alzheimer's but he wasn't diagnosed till 2013. Alzheimer Disease is the most feared and frequent type of dementia diagnosed in North America. It is also called senile dementia of the Alzheimer type. Alzheimer disease is characterized by the proliferation of plaques and tangles within the cerebral cortex of the brain. These types of abnormalities destroy the neurons ability to communicate with one another and eventually it will stop cortex function all together. When my grandfather was diagnosed we were looking down his bloodline to see who could have had it or dementia. We only found one. My grandfather is only 70. It is hard seeing the man I look up to have this disease. While reading this book though I saw the stages section. There is five identifiable stages of the disease. 

It all starts out with the person forgetting recent events or newly acquired information an example of this would be names of people and places. This first stage is not much worse than having a mild cognitive impairment so most people do know something is wrong. In stage 2, generalized confusion develops, with deficits in concentration and short-term memory. Speech becomes aimless and repetitive basically it seems like the are confused about what they are even saying. There vocabulary could also seem very limited. In stage 3, memory loss becomes dangerous. My grandfather forgets to shut things off like the stove or throws important papers away that my grandmother needs. He isn't one of the ones that doesn't know what a fork is. My grandmother is still taking care of him and they are over 1000 miles away in Texas. Right now, my grandfather is between the stages of 3 and 4. He can still be taken care of by my grandmother and we are hoping within the next few months we will get them moved up here. In stage 4, full-time care is needed. The suffers cannot care for themselves anymore, communicate clearly, even recognize their closest loved ones. The reason they can't recognize people is not because they forgotten who they are, just that part of the brain has deteriorated further. Speech is short and simple and by the end of stage 4 they stop talking. They can't basically do anything, reading is impossible and they stare blankly at the TV or space. In the final stage, people with Alzheimer Disease become unresponsive. Their identity and personality are gone and they recognize no one. Death normally comes 10-15 years after the first signs appear. 

Seeing my grandfather go through this disease is so hard. We get calls from my grandmother often. She is worried about money more than anything else because she is afraid of what will happen to them if they run out of money when he goes into memory support. Sometimes when I talk to him on the phone he doesn't remember me which I hate the most about this disease. My grandfather used to be funny and crack jokes on us all the time but now he is serious and it is difficult to listen to it all occur. Last Christmas, my mom told him to read my brothers and myself "The Night Before Christmas." At this time, it was the book that you could record so my brothers and I all have our own book and I listen to it from time to time to remember the jokes he would crack with us. A lot changes in a year with this disease. Always remember no matter what events happen in your life people are there for you and know that life is not always easy especially with the ones you love. He gave me tons of strength to get through my dads death and I am blessed of all the amazing memories I have with my grandfather! If you have a family member with Alzheimer Disease give them a hug because one day they will never remember you again. I am dreading that day but for now I am going to enjoy the time I have left. 

Chapter 24

Alzheimer disease is the most frequent type of dementia in North America and Western Europe. My one sister helps out at an elderly nursing home back at in my hometown. It's interesting and upsetting to witness this disease. There are people from all the stages from confusion to death. There are less people in the slightly confused stage since that is just the beginning. She knows this one lady who constantly tells her the same things. She always says "respect your body or nobody else will." then goes on a rant about young men nowadays. My sister finds it funny to listen to at first. She also has her mind set on people from certain areas and background as well as tattoos, tanning, and dying hair. It's cute that she tries to help her out and guide her in life. However, she will tell my sister these things every day, or just about. It comes up frequently. I'm not sure what stage this is, or if it is Alzheimer's at all. But I do know that she is set on it. She has her values and forgets that she tells my sister the same thing every day. She also tells her stories from her past. This is where it confuses me. I thought people with Alzheimer's disease have trouble putting together things from their past. Like in the Notebook, the main character Noah reads the story of his and this girl Allies love and how it started. In the beginning of the movie, she doesn't recognize who he is. She believes it is this man who is reading her a story. She also met her children and couldn't tell who they were. Throughout the movie, she realizes how familiar the story sounds to her. She recognizes her husband for a brief period of time, then it goes into panic and forgets everything that has happened. My sister said she hasn't dealt with extreme cases like this before but is interested to see if this is similar to how people with Alzheimer's act in real life.

Post 1 Chapter 24/25

Today I wanted to speak about chapter 25 because I learned a lot in this chapter and also found it the most interesting. I found this the most interesting because I do not really reflect on adulthood or the facts and psychological aspects of it it. I found one part especially very interesting and it is called Satisfaction with age which can be found on page 697 at the bottom of the textbook. I learned in this section about social deficit which is the lack of needed social experiences (Berger, 2011). With that said comes along the controversial version of age stratification which is the disengagement theory. In this theory "as people age, traditional roles become unavailable or unimportant, the social circle shrinks, coworkers stop asking for help, and adult children turn away to focus on their own children" (Berger, 2011). I found this interesting because I never knew this happened when you get older. However I did realize by observing others that I never see old adults with a huge social crowd or a big friend group and now I realize as they grow older their traditional roles change. Also, to go along with this topic "children want to be with other other children, adults want to be with other adults and other adults want to be with one another or by themselves" (Berger, 2011). I found this  interesting and humorous because I always wondered why I saw old people sitting alone or sometimes didn't want to be bothered and now I know that they want to be with their own group of people. That explains a lot for me because I am always curious as to why some older adults act a certain way or want to be alone. On the other hand, there is a different theory at place here and that is called the active theory. What the active theory explains is that older adults like to be more social and stick close to their family and friends (Berger, 2011). Here I also see in some cases especially close families like mine because we are always together and they are always social. However I do know families who's older adults do not want to come to family functions or be social. So for me it goes both ways, I just thought this section was very interesting because I learned a good portion about adults than I did not know before.

Elderly Cognition

As I have grown up I never really had the hands on experience seeing the elderly going through stages like cognitive decline. However, outside of my family I was able to see it more so because of my grandpa taking care of a former world war two pilot and seeing how his PTSD (post traumatic stress disorder) affected him with what was already going on like his inability to remember things and him missing a lot of what is being said to him.

            I had only the experience above and also the experience of my great grandmother. She was a holocaust survivor and about 97 years-old when I first met her. I was watched as a child by her and I found it odd that she would go about what she was doing in her own manner (due to my inability to realize people do things their own way). I know she was suffering from alzeimers which made me rather uncomfortable at times when she didn’t realize I was even over and a lot of times her calling me Bart (grandpas name).

            The amazing thing about her cognition regardless of the decline was that she still spoke German and English almost perfectly from what I could tell. As well as her ability to be a very caring and loving individual to somebody so much younger and remembering those things trapped in her mind from my grandpa being a child and replaying those things with me (even though it was unintentional).

Aging

Aging, and getting closer to death, is a unique example of something that we all experience if we're lucky enough to get to that point. With that being said, it's incredible to see how differently we each choose to handle this reality. I think that the book discussing the importance of maintaining at least one close companion is such valuable information, and something that I've thought about quite a bit, even now when I'm still in the younger part of my life. The book talks about grandchildren, and the relationship between older and younger generations. I feel that this is very important for the elderly; to maintain positive relationships with the younger generations, ideally with children and grandchildren. I hope that when I am aging, I have children and grandchildren who I can count on to be a part of my social network. It seems that as the elderly begin to lose their social networks, they struggle more and more with aging. Losing your partner, as an elderly couple, feels to me like one of the hardest things that someone could ever go through. This opinion further solidifies the importance that I place on maintaining close, healthy relationships with the younger generations in your life. Watching your grandchildren grow can be a very fulfilling experience in an otherwise trying time when you've lost your close friends and/or partner.

Age and Expertise

The relationship that is between expertise and age is not very straightforward. Time is an essential requirement for expertise. Not everyone becomes an expert on a certain subject as they older but everyone needs months, maybe even years of practice. Some researchers believe that practice is extensive. Several hours a day for at least 10 years but that only may be true in some areas. Surgeons have to have a lot of practice. I see an orthopedic surgeon for my shoulder and he had to do two surgeries. He had to pracptice the procedures I received. He isn't very old at all and he is a very good surgeon. Age doesn't necessarily determine if you are an expert on a subject but practice does. The longer you practice the more expertise you gain.

While I was reading about family skills it was interesting to see the discussion on expertise was focused on occupations such as surgeons, taxi drivers, and even pilots. They had many more male workers than female. Recently, we have seen two shifts occurred that changed this picture. The first shift was many more woman are working in occupations that were formally for men. A woman who was told she couldn't be a surgeon because she was a women became an anesthesiologist and developed a scale that has saved millions of newborns. Half the new medical doctors today in the United States are women. The second shift is the study of woman's work gained a new respect in today's society. In earlier generations, women would say they were either "just a housewife" or a "nonworking mom" but recently in today's society work at home has come to be important and both men and women do it. The reason this relates to expertise is because many wives and mothers aren't necessarily that great at that job and fathers had to take on the more domestic emotional roles. Nowadays the term "maternal instinct" is no longer assumed that every mother has it and are protective of every child. Many mothers experience postpartum depression, financial stress, or even bursts of anger and are unable to provide for the care that the child needs. I don't necessarily believe that the older a mother is the more patience they have. We all are human and we all go through experiences that cause us to grow up quickly and to act older than we should. When you lose a family member like a parent at a younger age like 14 and there is only one income you learn how to manage things like money and how to help your family whether it is to either get a job or help with siblings and maybe just around the house.

Developmentalists have not pinned down all the components of an expert in the emotional work of raising a family. I don't think anyone will be an expert in raising a family no matter if they find all the components of what makes an expert because every person is different and every person believes in what they want to believe. I know I am no expert at being a mom but I am learning more and more everyday.