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HTH 471 Exam 1

by: Lamourcj

HTH 471 Exam 1 HTH 471

GPA 2.8

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Chapters 1-5 notes for study guide
Study Guide
theories, aging, Gerontology
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This 10 page Study Guide was uploaded by Lamourcj on Sunday September 18, 2016. The Study Guide belongs to HTH 471 at James Madison University taught by Blosser in Fall 2016. Since its upload, it has received 5 views. For similar materials see Gerontology in Health and Human Services at James Madison University.

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Date Created: 09/18/16
Study Guide: HTH 471 Blosser Gerontology Chapters 1­5; 11 The Aging experience: IS:  Different for each of us  Defined by our history and current status  Can be modified How Old is Old?  Relative  Traditionally ages: o 62-65, for SS in United States o 50 for AARP o 65 for Medicare o Senior discount-varies  Young Old  Middle Old  Old Old or Oldest Old (85 +) Definitions of Ages:  Chronological age: numerical or number of years lived  Biological age- physiological capabilities and changes  Functional age- ability to carry out activities of daily living and live independently, often related to biological age Psychological Age: emotional maturity, personality, adaptive capacity, sensory and perceptual processes, mental processes Social age: involvement with community Ageism: The assumption that personal traits of older individuals and their situations are due to age, not other factors Who are our Nation's Elders?  Elders are defined as 65 and older  In a survey by the National Council or Aging: o Most saw themselves as "young or middle-aged" o 90% agreed that "as I look back on my life I am fairly well satisfied" o 70% agreed that " as I grow older things seem better that I thought they would be" o Half agreed that " these are the best years of my life"  Demographics of elders is very heterogeneous  Demography is the study of the size, geographical distribution and vital statistics of a particular group o Information largely gathered via surveys Number and Growth of Older Population:  Older population is growing rapidly and will continue to grow o 2009 - 1 in 8 people were 65 and over o 2030 - 1 in 5 people may be 65 and over  Why? o Baby boomers are "coming of age" o More people survive, birth rate is constant Life expectancy  Life expectancy in the US continues to increase o 2003-77.6 years o 2009- 78.2 years  Many factors influence life expectancy: o Gender o Ethnicity o Race o Reduced death of infants and children through control of infectious disease Housing and Geographic Distribution:  In 2009, 4 of 5 elders owned their own homes  4 of 5 elders live in metropolitan areas  States with the highest elder population o California (4.1 million) o Florida (3.2 million) o New York (2.6 million) o Texas (2.5 million) Marital status and living arrangements:  Because of life expectancies o 8.9 million women are widows o 2.1 million men are widowers  Marriage is beneficial to elders o Companionship, help with daily activities, higher household income  Elders who divorce is increasing  2/3 of elders live in a family setting  Only a small proportion of elders reside in nursing homes Education:  Older people have completed fewer years of formal education than younger adults  Baby boomers are the most educated cohorts in history  Educational attainment differs by race and ethnic origin  Elders are lifelong learners Income  Medicare and social security make elders less financially vulnerable  Elders living in a family setting are less financially vulnerable  Disparity of income level with race and ethnicity  Elder men have higher income levels than elder women  Social security o Began in 1935 o Financed by working adults o Earn credits in your working career o In 2005 the average SS income for a man was almost $350 over the poverty level, and even less for a woman  Supplemental security income o Established in 1974 to assist aged, blind and disabled o SSI is not tied to participation in the workforce o In 2004, SSI helped 7 million people, 40% were elders  Personals assets o Savings o Home equity  Pensions o From employers  Individual retirement accounts (IRA) o Money set aside  More than half of elders have at least one chronic condition which o Limits activities o Lengthens hospital stays o Results in more physician visits o Results in more medications prescribed o Raises out of pocket expenses  Foreign-born population o More likely than natives to:  Live with families  To be poor  To be uneducated and may be unable to speak English Racial and Ethnic Diversity  In general, minority elders are more likely to have to: o Have lower education levels o Live in sub standardized housing o Have less money o Have worse health  African American/Black elders o Women outnumber men o Most men are married, most women are widowed o 20% were living in poverty (2009) o More apt to suffer from chronic health problems than white elders o Health care concerns:  Low income can postpone seeking help  Tuskegee experiment  Racism/alienation o Professionals should:  Treat them with respect  Establish rapport  Put them at ease  Hispanic American/ Latino elders o Fastest growing minority of US o Subgroups are highly diverse o Many do not speak English o 45% live in poverty o Many live with their families  Native American elders: o Diversity 560 tribes o Higher death rates o Shorter life expectancy o Poorest minority o Most live on reservations o Low education level o Strong family network o Lack of access o Difficult to communicate o Asking permission and explaining what you are going to do  Asian and Pacific Islander American elders o Diverse subgroups including Chinese, Japanese, and Filipino o Uniting influence of Confucianism o Most live in metropolitan areas in the west o Many worked as seasonal workers and will not have social security benefits o Similar health status as white elders o Higher incidence of suicide rather than their white counterparts  Working with minority elders o Obstacles and opportunities. How to improve? Life span- theoretical limit on the length of life  1125 -120 years Life expectancy- the number of years and individual can expect to live  Improvements in public health education  Variations o Within and among countries  Morbidity o Period of reduced function, disability and illness o Compression morbidity Factors influencing longevity  Actuarial data- characteristics with years associated  Animal studies- highly controlled environment  Longitudinal studies (best method) - over time  Centenarian studies- ask old people (live more than 100 years)  "life is not a matter of getting good cards, but of playing a poor hand well" - Robert Louis Stevenson  Heredity  Parenting styles  Diet, activity level, stress management  Centenarians often have very old first-degree relatives  Human genome  Group of genes on chromosome 4 may be related o Gender  Females live longer than males  Average life expectancy in the U.S.  Males: 75.4  Females: 80.4  Males participate in riskier behavior  X chromosome  Hormonal influences o Race and ethnicity  Difficult to research in America  Socio-economic factor o Cigarette smoking  Leading cause of preventable death in the U.S.  Men lose 13.2 years. Women lose 14.5 years  In older people smoking  Reduces bone density in postmenopausal women  Increases risk of hip fractures  Increases risk of cataracts  Older people who quit gain 2 years o Genetic and acquired disease  Down's syndrome  Huntington's disease  Cancer o Body weight and height  Obesity is correlated with and increased risk of premature death and disability  Increased likelihood of diseases that negatively affect mortality rate  Shorter people live longer due to less use of heart o Physical activity  High levels of physical activity are associated with low death rates form all causes of mortality  Exercise strengthens the heart, decreases the likelihood of obesity, increases the good cholesterol in the blood, and reduces blood clot formation  No study has conclusively documented the effect of physical activity, the type, frequency or duration which promote long life. o Alcohol use  Light consumption (1-2 glasses a day) may be associated with cardiovascular benefits  Heavy drinking (3+ daily) is associated with reduced life expectancy o Marital status  People married at the time of their deaths lived longer than those widowed or divorced  Marriage may help promote longevity because:  You have a friend for help and reduction of stress  Marriage promotes healthful habits  Sex is more frequent in a married relationships o Psychological factors  Personality traits may influence longevity  A negative personality is comparable to high blood pressure  A negative person may also choose life-shortening behaviors  A calm person may live longer  Personality may effect hormones, immune function, cholesterol level, etc. o Cultural factors  People from developed countries have higher life expectancy than those from less-developed countries  Sanitation, prevalence of disease, accessibility to food/diet, access to health care o The physical environment  Radiation can impair cell function and accelerate the aging process  Air pollution is inversely related to longevity  Our environment will be more polluted in the future and have a greater effect on longevity Biological Aging Theories and Longevity Overview of cell reproduction and repair  Cells are the basic building blocks of all life  Each cell is somewhat self-contained and self-maintained  There are more than 200 types of cells in the human body  Mutations: any alterations to the genetic code o Can be insignificant or lethal  Can be caused by outside influence  There are two phenomena in aging: o Random theory of aging  Cross linking and wear and tear  The environment causes mutations in cells leading to errors and damage to the cells that weaken the ability to function and divide thus causing cross linking of DNA (making chromosome function less effectively) o Free Radical Theory  Damage from the highly reactive molecules within the cell causes aging  Free radicals are the toxic bio product of cell metabolism  Also created through our diet or environment  The body produces enzymes to inactivate free radicals o Rate of Living  Do we have finite amount of life? Can we use it all up?  Animal studies show that slower metabolisms increase longevity o Accumulation of errors  Eventually we wear out Programmed theory of aging o Born to die (biological clock theory)  Pacemaker theory suggests we are programmed from birth to shut down at a specific time  Hypothalamus  Immune system  Cells may have a finite life  Example: menopause o Telomere Shortening  Protective caps on our DNA fragments  May protect the genetic information during cell revision  Each division shortens  When the telomere is too short the cell cannot divide  Are telomeres our biological clock? Theories of Aging-  Any single theory of aging is insufficient  Genetic theorists acknowledge the external influences, and vice versa  It is difficult to determine what causes aging and what is a result of aging Chapters 3 and 5 How do we know when we are aging? Studying the physiological process  The Gold standard: Randomized Controlled Trial  Age changes must be: o Universal- occurs in all members o Intrinsic- caused by age not environment o Progressive- o Irreversible o Deleterious  As health care professionals, it is important to understand what changes are age-associated and what might be treatable The Integumentary System  Watch video Age associated changes in the integumentary system  Most changes are due to sun exposure  Cigarette smoking can alter texture of skin  Facial expressions create laugh lines  The skin does become more fragile, thinner, easier to tear, and rough to the touch  Less blood circulates making elders feel cold, bruise more easily  Less subcutaneous fat makes skin sag  Finger and toe nails grow more slowly  Graying of hair is caused by loss of pigment  Hair loss and change in texture and thickness of hair Sun exposure  Suns changes on our skin is called photoaging  UVB and UVA radiation is damaging  Stay out of the sun or use protective clothing like hats and long sleeves  Sunscreen = 1/2 hour before exposure, reapply, spf 30 or higher  Sunscreen may not protect against melanoma Skin Conditions: Senile Puritis  Literally means itching in older persons  Usually caused by dry skin  Treatment is lukewarm baths and lotion  Underlying causes for dry skin may be lice or mites, fungus, allergies or a chronic disease such as diabetes, kidney disease liver disease or cancer.  Elders may have stasis dermatitis around the ankles make the area more susceptible to injury and poor healing  Skin cancer is the most common type of cancer  Basal cell cancer and squamous cell cancer is usually located on face forearms or shoulders. Both grow slowly and are usually treatable  Melanoma- is serious. Should be brought forward to doctor  Asymmetry, irregular Border, uneven Color, Diameter greater than 6mm  Most common on ears Musculoskeletal System  Bones store calcium and share it with other parts of the body  Bone marrow produces white and red blood cells  Strength of bones depends on health, genetics and physical activity  Skeletal muscles produce voluntary actions  Smooth muscles help in the stomach, cardiac muscles are in the heart o Sarcopenia is the loss of skeletal muscle mass o Sarcopenia may be due to age or other factors such as decreased activity o Muscle strength diminishes but exercise can help o Less calories are needed, basal metabolic rate slows o Loss of muscles means greater proportion of fat o Joints become less flexible o Reduction in bone strength and mass make bones more susceptible to fractures o Women lose more bone mass and need to build sufficient amount before maturity  Increase mass with exercise, calcium, vitamin D, and medications o We become shorter with age, poor posture Skeletal Disorders  Most frequent complaint  Disorders are painful and restrict movement  Usually appear in midlife and get progressively worse  Arthritis and osteoporosis are most common disorders  Treatment focuses on preventing further degeneration, controlling pain and encouraging independence Osteoarthritis  Most common type of arthritis in the world  The cartilage between joints breaks down and bone spurs grow causing joint pain  Treatment includes aspirin, hot/cold compresses, weight loss. Supplements may be recommended  Splints or braces can help reduce pain  Hip or knee replacement surgery is used Rheumatoid Arthritis  Affects more than joints; can affect eyes, lungs, heart and nerves  2 to 3 times more common in women than men  Caused by inflammation in the tissue lining joints. Mostly affects hands and feet.  Anti-inflammatory drugs can help, but doctors recommended too Osteoporosis  Age related disorder that reduces bone mass and increases chances of fractures  Osteopenia is a lesser degree of bone loss  Most serious effect is hip fracture, also affects spine and can cause deformities  Calcium, vitamin D, physical activity and estrogen can help slow osteoporosis Low Back Pain  Low back pain is the most often caused by straining the muscles, usually while lifting  Spinal stenosis is common among elders and is caused by osteoarthritis  Difficult to determine the direct cause of back pain  Treatment includes exercise, ice, pain killers, and possibly surgery  Learn how to lift and bend properly and good posture Foot Problems  Foot problems increase with age, skin is thinner and drier, toenails are more brittle  Calluses and corns are caused by friction- ill fitting shoes or bones out of place  Bunions usually occur on the big toe and can cause a lot of pain  Most foot problems are caused by ill-fitting shoes  Orthopedists and Podiatrists are foot specialists Endocrine Disorders  Diabetes and thyroid are the most common disorders  Hypothyroidism is a deficiency in thyroid hormone.  Lack of energy, weight gain, swelling, depression  Hyperthyroidism is an excess of thyroid hormone. The increase heart rate and strain may cause a heart attack The Cardiovascular System  Circulation  Age associated changes  Hardening of the arteries  Exercise does help  Most alterations affect only peak performance and not daily activities  Claudication is caused when leg arteries become narrowed by the atherosclerosis  Valicose veins are distended, ropey blood vessels Lymphatic System  Systems work to return fluid to the bloodstream and protect by showing infection in swollen lymph nodes.  Also involved: the thymus and spleen  The immune system identifies and destroys foreign invaders  Immune function declines with age  Antibodies do not respond as vigorously to foreign antigens  Cancers and autoimmune diseases are more likely to occur in the middle years


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