Aging and Death

Aging

• The study of aging is called gerontology.

• As people age, their bodies begin a process of decline in every major system.

• There are several theories in regards to the cause of aging.

▫ Decline of cell reproduction

▫ Nutrition, injury, disease, and the environment

▫ Aging viruses

▫ Free radicals

Skeletal System

• As early as age 40, the bone mass and density begin to diminish.

• People can lose some height as the cartilage disks between the vertebrae shrink.

• The shortening of the spinal column causes a shift in weight, which alters posture.

• Range of motion and flexibility decrease as joints lose water and start to fuse and ligaments and tendons harden.

Muscular System

• Atrophy is the wasting away of tissue.

• Regular exercise can do much to counteract the affects of aging on the muscular system.

Cardiovascular System

• Fibrous tissue begins to replace the muscle tissue of the heart. As a result: ▫ The heart becomes less adept at

contracting and expanding.

▫ The valves become thicker, making it more difficult to fully close.

• In general the heart becomes far less efficient at pumping blood. Therefore, the output of the heart decreases.

Nervous System

• The cerebral cortex portion of the brain slowly decreases in size, which causes impaired thinking, reasoning, and remembering.

• Neurons die at an increased rate and those that remain are degenerating, which results in:

▫ Slower nerve conduction

▫ Slower reaction times

▫ Decreases in motor and sensory abilities

Integumentary System

• Glands produce less lubrication to the skin’s surface, leaving the skin dry and fragile.

• Skin loses elasticity due to the shrinking of elastin fibers.

• The loss of subcutaneous fat produces sagging, wrinkles, and lines.

• The skin becomes more sensitive to UV rays from the sun.

Urinary System

• The kidneys shrink.

• A decrease in blood flow to the kidneys diminishes its ability to cleanse the blood stream of waste.

• People may experience a loss of muscle control in the bladder and sphincters.

• Problems with glucose control could lead to hyperglycemia.

Digestive System

• Peristalsis decreases, which can cause: ▫ Constipation

▫ Diverticulosis

▫ Difficulty swallowing and digesting food

• Ability to taste decreases with age.

• Less saliva is produced, and gum disease and loss of teeth can occur.

Endocrine System

• Both men and women experience a decline in adrenal gland production.

• Women also experience a reduction of estrogen and progesterone.

• For men, the prostate gland becomes larger while the production of testosterone from the testes diminishes.

Immune System

• The immune system becomes weaker, which leaves the elderly vulnerable to infectious diseases.

• Because of their weakened immune systems, the elderly are encouraged to get flu vaccinations prior to flu season.

Respiratory System

• The exchange of oxygen and carbon dioxide decreases.

• As a result:

▫ Irregular activity quickly leaves the elderly breathless.

▫ The elderly are at much greater risk of respiratory disease.

The Terminally Ill Patient

• The final stage of growth is death.

• For some people, life ends abruptly and unexpectedly. But for others, they are diagnosed with a terminal illness.

• A terminal illness is an incurable disease that results in death.

Stages of Grief

• Dr. Elizabeth Kubler-Ross has established five stages of grieving.

• Many terminally ill patients and their family members experience these stages of grief as they cope with a terminal illness.

• People may not experience all the stages, they may experience them out of order, or they may cycle through them or some of them several times.

Denial

• Denial is often the immediate reaction to being told of a terminal illness.

• A person in denial will reject the idea that they are dying, or insist that the doctor has made a mistake.

• Health care workers who deal with terminally ill patients who are in denial should allow the patient to speak and provide comfort without confirming or denying the situation.

Anger

• Anger often follows denial, specifically when the patient is no longer able to deny the truth.

• Patients can become hostile and direct it towards anyone with whom they come in contact.

• Health care workers must provide support and understanding during this time.

Bargaining

• Once patients accept death, they often desire more time to live.

• The will to live is strong and they set goals for themselves that they want to meet.

• To achieve these goals, many patients turn to religion and make bargains or promises in hopes of having more time to live.

• Health care workers should be sensitive and attentive to patients in this stage.

Depression

• Depression can occur when a patient realizes that death is imminent.

• Depression can take the form of quiet withdrawal, spoken regrets, or great sadness.

• Health care workers should be particularly sensitive during this time and allow patients to express their grief.

Acceptance

• The final stage of grief is acceptance. During this stage, patients accept the fact that they are going to die.

• They may spend the rest of their days settling unfinished business and helping family and friends cope.

• Health care workers should be sure to continue to provide emotional support and gentle touches of reassurance.

Mortuary Science

• After people die, their bodies must be cared for in a specific, scientific manner.

• Mortuary science is the scientific care of the body and the emotional and ceremonial needs of the remaining family members.

Funeral Directors

• Funeral directors run funeral homes.

• Funeral directors perform many jobs, such as:

▫ Mortician and undertaker

▫ Funeral planner

▫ Director of activities at a funeral home