Каталог :: Психология

Реферат: Older adalthood

     Term Paper: Older Adulthood
     Developmental Psychology
Developmental theorist Eric Erickson found that psychological growth and
development can occur throughout the life span. He identified eight life
stages, each with a specific psychosocial problem that, if successfully
resolved, brings about growth and the potential to master the next stage. The
eighth and final life stage he called “maturity.” At this juncture, a person
comes to realize that his or her life cannot be relived. Successful
negotiation brings about ego integrity—a sense of peace with life as it was
lived. If integrity does not develop, the person experiences despair, and
regret about one’s life dominates. There is fear that death will come before
a meaningful life can be experienced. Alternatively, a sense of integrity
fosters wisdom. Erickson viewed the wise elder as contributing to society and
future generations through interactions with younger people.
Compared to studies of intelligence, little research has been conducted on
wisdom. Difficulty in defining and measuring this construct is likely the
reason. In many situations, wisdom may be as valuable as intelligence,
particularly in a rapidly changing technological world that requires personal
flexibility.
Knowledge is an aspect of wisdom and includes the ability to know the limits
of one’s knowledge. Wisdom also involves knowing what problems need solving
and what problems can be let go. It includes the desire to evaluate things in
depth. Those who possess wisdom have a tolerance for ambiguity and for things
that inevitably get in the way. Further, those who are wise are motivated to
understand and appreciate the impact of the context that surrounds a
situation.
     Importance of relationships
Social contact is an essential human element that has direct effects on
health and emotional well-being. Relationships also act as potential buffers
against stress. Numerous studies have shown that stress negatively affects
one’s immune system. This is of particular importance for the elderly because
immune functioning tends to diminish with age. New evidence is emerging that
strong social relationships also promote recovery from certain illnesses. A
recent study of 180 elderly men showed that those who experienced emotional
support and companionship were at lower risk for developing heart disease.
Another investigation found subjects who had strong relationships to be at
lower risk of dying after a myocardial infarction than those who lacked
supportive relations. Death rates are higher among people who are socially
isolated. The sheer number of relationships is not the important factor, but
the quality. For example, the presence of a family member does not
automatically imply a meaningful relationship. Extensive research on gender
differences suggests that the nature of relationships differs for men and
women. Women tend to have more intimate connections. They benefit from having
more positive feelings toward relationships. However, women also tend to
suffer more from relationships because investment in others’ concerns can
lead to increased conflict and stress. For this reason, relationships for men
sometimes can provide greater protection from stress.
Both fulfilling informal and formal human connections can be healthful.
Formal supports may include a member of the clergy, housekeeper, visiting
nurse or psychotherapist. Informal relations are family members and casual
contacts, perhaps the grocery store clerk. For some elderly, close neighbors
are a crucial source of informal support. Studies indicate that pets are a
source of relational support. Elderly pet owners have been shown to be less
depressed, better able to tolerate social isolation and be more active than
those without pets.
Relationship loss is common in late adulthood. Parents are deceased, and
siblings and contemporaries begin to die. The opportunity for expression of
sadness is critical for emotional healing; however, depression is not a
normal state for the elderly. Consider Jane, who at 92 lives in a retirement
home. She has no living siblings, has one remaining son of three children and
has outlived two husbands. Notwithstanding these losses, she has a handful of
meaningful friendships, is involved in her church and is well-liked by the
staff members.
Researchers who followed subjects from adolescence to old age in a large-
scale qualitative study of adult development discovered valuable information
about relationships and aging. Positive relationships at any age of the
person’s life were found to correlate to satisfaction in old age. A
satisfying marriage at age 50 predicted positive aging at 80. Contentment in
later life was the outcome for subjects who had the ability to express
gratitude and forgiveness in relationships. Overall, researchers determined
that loving relationships promote personal growth and emotional healing.
Successful aging also involves learning to play and be creative after
retirement. This ability to adapt to situational and physical changes helps
explain why some people age more successfully than others.
Cohort effects need to be taken into account in clinical situations as well
as research with the elderly. (Cohort refers to membership in a group as
defined by a person’s birth year.) Much of the difference between young and
older groups is due to cohort effects. Cohort groups are socialized into
certain beliefs, attitudes and abilities based on the time in history in
which they live. These factors remain stable as the cohort ages. Twenty years
from now, a cohort of elderly Americans will look different than the current
group because of different historical experiences. For instance, older people
20 years from now will have more formal education than today’s cohort of
elderly. The way health care providers interact with and conduct patient
teaching will need to be modified for each new cohort.
     Sexuality in later life
Elderly couples may have inaccurate assumptions about aging and sex. Health
care providers can sensitively present factual information to patients about
the effects of aging, illness and medications on sexual functioning.
The likelihood of sexual activity during later life is related to how
sexually active a person was during his or her younger years. Given an
available partner, a person who was sexually active in younger years is
likely to remain active into late adulthood.
Men who have been sexually active generally can engage in some sort of sexual
activity well into their 70s or 80s. About 90 percent of erectile problems
are physical rather than psychological. To have an erection, the man must be
in a responsive state of mind and have normal hormone functioning, including
adequate testosterone levels and penile blood supply. Possible impediments
include hypertension, elevated cholesterol, diabetes, coronary artery
disease, smoking, alcohol abuse and medications (especially those used to
treat hypertension and depression). Surgeries such as a radical prostatectomy
also may cause erectile problems. Aging itself is not to blame.
Reports indicate that about 52 percent of men aged 40 to 70 have some degree
of erectile dysfunction. About one out of four men aged 65 to 80 have serious
problems achieving and sustaining erections. In the group of men older than
80, one out of two have substantial erectile problems. Sildenafil citrate
(Viagra) works for more than half of men who use it. Perhaps due to
humiliation, shame or the belief that there is no help, few men seek medical
attention for sexual problems.
As a man enters late adulthood, it is normal for erections to occur less
frequently. More stimulation is needed for arousal. The ability to have
repeated ejaculations is lessened, but once achieved, an erection lasts
longer. Ejaculation also can be delayed. Volume of semen remains the same,
but sperm counts are lowered. This information will help the man and his
partner understand normal changes.
Physiologically, women are able to be sexually active as long as they live. A
woman who enjoyed sex in younger years is likely to want to continue. The
problem often, however, is the lack of a partner. In 1998, 46 percent of
women older than 65 were widowed while only 15 percent of men were. Women who
had orgasms in their younger years will likely be able to do so well into
their 80s or later. Sex, however, will be different later in life than it was
during earlier periods. Orgasms tend to be shorter, and muscle contractions
are fewer in number. With age, women may take longer to become sexually
aroused. Decreased ovarian estrogen production following menopause is likely
to create vaginal dryness, leading to painful intercourse. Older women may
need information about use of lubricants to ameliorate this problem. Some
aging women feel self-conscious about their appearance. As a woman ages,
weight gain is common, as are changes in body shape due to redistribution of
adipose tissue around the abdominal area. Counseling can provide an
opportunity for discussion about feelings related to normal body changes and
help a woman feel more comfortable with and knowledgeable about her physical
self. Non-intercourse avenues of sexual expression can be encouraged between
elder adults.
Sexual functioning in both sexes is likely to be enhanced by physical
fitness. Partners who are in good physical condition are more likely to enjoy
sex. They possess the energy requirements for intercourse. Pain, from
conditions such as arthritis or back ailments, also can make sex less
desirable.
     Cognitive changes
Cognition refers to the mental process by which knowledge is acquired. It
involves perception, reasoning, attention, memory and language. With age,
some cognitive abilities remain intact or may even improve while others
slowly decline. Overall, changes occur in a slow and gradual trajectory.
Information on cognitive changes presented here is based on studies of
averages from groups of elderly people. There is much variability among older
people with regard to the degree of decline and specific area of functioning.
A particular elderly person may function similarly to someone decade's
younger.
Cognitive decline is believed to be related to functional and structural
changes in the brain. As one ages, the brain shrinks (atrophy). The number of
neurons and the number of dendrites on each cell decreases. Cellular
demyelination also occurs. These changes slow message transmission between
cells. Dead nerve cells collect in brain tissue, causing plaques and tangles.
Additionally, a fatty brown pigment called lipofusin accumulates in brain
tissue. Despite this picture of a seemingly deteriorating brain, the majority
of cognitive ability is retained as we age.
Cognitive ability is commonly divided into two general areas, verbal and
performance. Performance skills involve manipulation of objects. They tend to
decline at a more rapid rate than verbal skills. Verbal abilities deal with
language and remain relatively intact with age.
The speed at which a person processes information gradually slows over the
life span. Comprehension and production of speech becomes slightly slower
over time. In some cases, diminished visual acuity and decreased auditory
sensitivity may account for slowed processing.
On tests that require complex functions, the elderly do not do as well as
younger people. The elderly perform better when they are dealing with
familiar tasks as compared to new ones. When their ability is measured in
everyday tasks, the elderly do better than in the laboratory. In some cases,
older adults outperform younger adults when assessed in terms of everyday,
real-world functioning.
Generally, attentional abilities decline with advancing age. Attention
involves the complex mental processes of focusing, selecting, dividing,
sustaining and inhibiting. Driving a motor vehicle is a task requiring
complex attention. Divided attention is required to drive the vehicle,
monitor the dashboard, look at the road and road signs and be aware of
changes in engine sounds. Intersections can be particularly taxing on
attentional abilities. Older adults show decreased ability when attentional
tasks are complex, in other words, when attention is required to more than
one source of information (e.g., driving). However, they continue to do well
on simple tasks requiring attention.
     Memory types
Memory is the ability to register, retain and recall a wide range of
information such as thoughts, sensations, experiences and knowledge. Some
aspects of memory remain relatively intact with age while others decline.
Short-term memory consists of two components called primary and working
memory. Primary memory involves holding small amounts of information for a
short amount of time, such as remembering a new phone number long enough to
write it down. Primary memory remains relatively intact with age. By
contrast, working memory, which requires briefly holding and manipulating
information, declines. For instance, this ability is required to repeat
digits in reverse (e.g., 4, 9, 7 backwards is 7, 9, 4).
Semantic memory is knowledge of facts and meanings of words. This type of
memory does not require a reference to time. Generally, decline in semantic
memory is negligible.
The type of memory that deals with remembering how to perform a motor skill
such as riding a bicycle is called procedural memory. Overall, decline in
this area is minimal.
Long-term, or episodic, memory is a unique form of recall because it deals
with acquiring and retrieving information from a particular place at a
certain time. Remembering what you had for breakfast today or what you did on
your 21st birthday are examples of episodic memory. Episodic memory peaks in
young adulthood, so it is not uncommon for the elderly to remember
information from that period of their lives. Long-term memory declines slowly
over time.
Memory problems associated with aging are likely due to difficulty with both
encoding (registering the message into memory) and retrieval. Older adults
are generally less precise in encoding new information, and retrieval is
slowed. Overall, cognitive decline in the elderly is subtle and more evident
in laboratory tests, in which the limits are tested beyond what is typically
required for everyday functioning. Humans are remarkable in their ability to
adapt and compensate for deficits. Further, evidence shows that cognitive
training can conserve and improve memory, concentration and problem solving.
In the largest study of its kind, independent adults aged 65 to 94 who had no
cognitive problems received training for two hours a week for five weeks on
tasks related to everyday living. The intervention resulted in improvement in
memory, concentration and problem-solving skills. These findings hold the
promise that training applied to specific tasks such as using medication and
managing finances may benefit older adults.
Gradual physical and cognitive decline is inevitable with age. The health
care provider must keep this in mind in order to accurately assess and
identify problems in each individual. Likewise, each elderly patient also
must be assessed for strengths that, when tapped, can promote health,
satisfaction and happiness in later years.
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