Later AdulthoodLater Adulthood

Brainstorm: 60-74Brainstorm: 60-74

And 75 plus?And 75 plus?

Generativity resultsGenerativity results

AGEAGE 19-2319-23 25-3425-34 35-6035-60 35-4535-45 46-6046-60

nn 44 77 88 44 44

RangeRange 31-4931-49 26-4726-47 28-5728-57 38-4738-47 43-5143-51

MedianMedian 42.542.5 3636 4646 3838 48.548.5

MeanMean 4141 34.734.7 42.642.6 39.239.2 4646

Generativity results – Summer, ‘10Generativity results – Summer, ‘10

AGEAGE 19-2419-24 25-3425-34 35-6035-60 35-4535-45 46-6046-60

nn 55 77 66 55 11

RangeRange 34-3834-38 18-5518-55 30-4530-45 30-4530-45 4444

MedianMedian 3636 4242 40.540.5 3838 4444

MeanMean 36.436.4 38.338.3 37.837.8 36.636.6 4444

BrainstormingBrainstorming

Free associate to Free associate to old age, seniors, elderly.old age, seniors, elderly. What are your expectations of your later What are your expectations of your later

adulthood, i.e. 60-74?adulthood, i.e. 60-74? What factors contribute to a healthy vs. an What factors contribute to a healthy vs. an

unhealthy older adulthood?unhealthy older adulthood?

Developmental TasksDevelopmental Tasks

Accepting one’s lifeAccepting one’s life Promoting intellectual vigorPromoting intellectual vigor Redirecting energy toward new goalsRedirecting energy toward new goals Developing a point of view about deathDeveloping a point of view about death

The Psychosocial Crisis: The Psychosocial Crisis:

Integrity vs. DespairIntegrity vs. Despair

Defining Healthy and Unhealthy Defining Healthy and Unhealthy AgingAgingHealthyHealthy

ActiveActive Disease-freeDisease-free Independent Independent

UnhealthyUnhealthyFatigueFatigue SickSick Inactive Inactive Loss of ADLsLoss of ADLs

Successful AgingSuccessful AgingAvoiding illnessAvoiding illness Engagement with lifeEngagement with life

High cognitive and physical functioningHigh cognitive and physical functioning

Age related changesAge related changes

Some examplesSome examples Physical changesPhysical changes

Sensory changesSensory changes Stamina, dexterity and balanceStamina, dexterity and balance IllnessIllness

Cognitive changes…yes, butCognitive changes…yes, but Neural plasticity continues throughout the lifespanNeural plasticity continues throughout the lifespan Physical exercise==blood flow==neural nourishmentPhysical exercise==blood flow==neural nourishment Learning new things keeps the brain healthy and growingLearning new things keeps the brain healthy and growing

PsychosocialPsychosocial Role gain and role lossRole gain and role loss Increase in lossesIncrease in losses AgeismAgeism

Do we live in an ageist society?Do we live in an ageist society?

““deep and profound prejudice against the elderly” deep and profound prejudice against the elderly” (Robert N. Butler, M.D.)(Robert N. Butler, M.D.)

"any attitude, action, or institutional structure which "any attitude, action, or institutional structure which subordinates a person or group because of age or subordinates a person or group because of age or any assignment of roles in society purely on the any assignment of roles in society purely on the basis of age" (Linda M. Wolfe, Ph.D website) basis of age" (Linda M. Wolfe, Ph.D website)

http://www.oldwomensproject.org/index.htm- skits http://www.oldwomensproject.org/index.htm- skits demonstrating an ageist comment with helpful demonstrating an ageist comment with helpful responses.responses.

Contributors to Unhealthy AgingContributors to Unhealthy Aging Personality-neuroticism*Personality-neuroticism* Inadequate nutrition*Inadequate nutrition*

DisinterestDisinterest Limited resourcesLimited resources Physical limitations, e.g. teeth problemsPhysical limitations, e.g. teeth problems No appetiteNo appetite

Lack of exercise: 60%+ (CDC) of older adults don’t Lack of exercise: 60%+ (CDC) of older adults don’t get adequate exerciseget adequate exercise

Early family adversityEarly family adversity

*Linked with fatigue*Linked with fatigue

Contributors to healthy agingContributors to healthy aging NutritionNutrition

Antioxidants improve cognitive functionAntioxidants improve cognitive functionBlueberries, avocadoes, fish, dark chocolate, nutsBlueberries, avocadoes, fish, dark chocolate, nuts

5 fruits/vegies a day; even 2 shows a positive effect on 5 fruits/vegies a day; even 2 shows a positive effect on cognitive function.cognitive function.

Exercise - physical, psychological, cognitive benefitsExercise - physical, psychological, cognitive benefits Tai Chi 1/week=fewer falls through better balanceTai Chi 1/week=fewer falls through better balance Aerobic exercise (150 minutes moderate intensity/week) Aerobic exercise (150 minutes moderate intensity/week)

reduces risk of heart disease, stroke, high bp, etc.reduces risk of heart disease, stroke, high bp, etc. Strength training increases stamina and independence – 2 Strength training increases stamina and independence – 2

days/weekdays/week Balance exercises decrease rate of fallsBalance exercises decrease rate of falls Activity decreases depression, colon cancer, diabetes, Activity decreases depression, colon cancer, diabetes,

osteoporosisosteoporosis

Healthy Aging, continuedHealthy Aging, continued PersonalityPersonality

ExtroversionExtroversion ConscientiousnessConscientiousness OptimismOptimism Sense of controlSense of control

Social connectionsSocial connections Help with stress managementHelp with stress management Meaningful rolesMeaningful roles

Vaillant’s findingsVaillant’s findings

Vulnerability-Stress ModelVulnerability-Stress Model

Individual vulnerability Individual vulnerability

+ +

Stress Stress

==

Low quality agingLow quality aging

Adaptation to Change and Healthy Adaptation to Change and Healthy Aging-the SOC ModelAging-the SOC Model

1.1. Selection—Optimization--CompensationSelection—Optimization--Compensation

2.2. Small groups: Eating, Exercise or Cognitive Small groups: Eating, Exercise or Cognitive ActivityActivity

• How might you encourage older adults to select How might you encourage older adults to select your topic as a priority?your topic as a priority?

• How can the individual’s internal resources be How can the individual’s internal resources be best used?best used?

• What limitations exist and what are detours What limitations exist and what are detours around them?around them?

Very Old Age-75+Very Old Age-75+

Coping with physical changes of agingCoping with physical changes of aging Developing a psychohistorical perspectiveDeveloping a psychohistorical perspective Traveling unchartered territoryTraveling unchartered territory

The Crisis: The Crisis: Immortality vs. ExtinctionImmortality vs. Extinction

1.1. What is a psychohistorical perspective? What is a psychohistorical perspective? Integration Integration of personal and societal experiences in the past of personal and societal experiences in the past with the present situation and future with the present situation and future expectations/possibilities.expectations/possibilities.

2.2. For 80 year olds (born in 1931) what are some For 80 year olds (born in 1931) what are some significant historical events?significant historical events?

3.3. Consider your time on earth so far.Consider your time on earth so far.• Significant personal events/experiences?Significant personal events/experiences?• Significant social events/changes?Significant social events/changes?

4.4. Imagine how these might impact you over time.Imagine how these might impact you over time.

http://www.theelders.org/eldershttp://www.theelders.org/elders

1.1. How might the psychohistorical perspective How might the psychohistorical perspective of the elders have contributed to their choice of the elders have contributed to their choice to focus on equality of women and girls?to focus on equality of women and girls?

2.2. What other connections can you make What other connections can you make between their histories and their work?between their histories and their work?

3.3. Consider the basic concepts of psychosocial Consider the basic concepts of psychosocial theory…how are they relevant to the theory…how are they relevant to the development of the Elders?development of the Elders?

Demographic Trends (“Social Work Demographic Trends (“Social Work in Health Care…”)in Health Care…”)

Increase in number of older adultsIncrease in number of older adults 12.7% now, 20% in 205012.7% now, 20% in 2050 Worker:Social Security recipient=3.1:1; will be 2:1Worker:Social Security recipient=3.1:1; will be 2:1

Chronic Illness and ConditionsChronic Illness and Conditions Growing diversityGrowing diversity

Chronic illnesses differ across groupsChronic illnesses differ across groups Elders of color and low income have had less access Elders of color and low income have had less access

to healthcareto healthcare Belief about end of life care differ across groupsBelief about end of life care differ across groups

Trends, continuedTrends, continued

Intergenerational Families and Care-givingIntergenerational Families and Care-giving 70% of seniors who live in the community and 70% of seniors who live in the community and

need assistance rely entirely on familyneed assistance rely entirely on family 25% of households are involved in caring for a 25% of households are involved in caring for a

relative over 50relative over 50 Elders are providing care to grandchildrenElders are providing care to grandchildren

Changes in Health Care worldChanges in Health Care world Community based careCommunity based care Consumer Centered/Consumer Directed CareConsumer Centered/Consumer Directed Care

Social Work Knowledge and SkillsSocial Work Knowledge and Skills

Knowledge about health and emerging health Knowledge about health and emerging health care worldcare world

Rapid evolution of skillsRapid evolution of skills Cultural competenceCultural competence Clinical case managementClinical case management Advocacy and empowerment skillsAdvocacy and empowerment skills Research and evidence-based practiceResearch and evidence-based practice Skills for ethical practiceSkills for ethical practice

In small groupsIn small groups

1.1. Identify & prioritize Ms. Sophie’s major Identify & prioritize Ms. Sophie’s major needs/problems.needs/problems.

2.2. Discuss the major influences on her aging process. Discuss the major influences on her aging process. What would you say are the three strongest What would you say are the three strongest influences?influences?

3.3. Consider information from class and discuss:Consider information from class and discuss:• Specific issues that affect the helping processSpecific issues that affect the helping process• How you might effectively work with Ms. Sophie and How you might effectively work with Ms. Sophie and

her family to attain the highest quality of life possible.her family to attain the highest quality of life possible.

Panel discussion questionsPanel discussion questions

1.1. What have your experiences with grandparents been like? This could be What have your experiences with grandparents been like? This could be your own, your children’s, or other people’s.your own, your children’s, or other people’s.

2.2. Are your experiences reflected in the descriptions of grandparent types Are your experiences reflected in the descriptions of grandparent types in the text?in the text?

3.3. What meaningful roles have you observed older adults to fill?What meaningful roles have you observed older adults to fill?4.4. What made them meaningful?What made them meaningful?5.5. What other ideas do you have for creating meaningful roles for older What other ideas do you have for creating meaningful roles for older

adults?adults?6.6. Think about your life from a psychohistorical perspective. What major Think about your life from a psychohistorical perspective. What major

events or contextual characteristics do you think have affected you such events or contextual characteristics do you think have affected you such that you will reflect on them in your very old age?that you will reflect on them in your very old age?

7.7. What major events or contextual characteristics do you believe will What major events or contextual characteristics do you believe will influence your generation (cohort)?influence your generation (cohort)?

Early Family Adversity-long term Early Family Adversity-long term effectseffects

Adversity defined as:Adversity defined as: parental lossparental loss abuse or inadequate parentingabuse or inadequate parenting high level of conflict and/or violencehigh level of conflict and/or violence

Multiple pathways for this connectionMultiple pathways for this connection Adversity … psychosocial characteristics and unhealthy Adversity … psychosocial characteristics and unhealthy

behaviors… physiological changes.behaviors… physiological changes. Adversity … increased physical and psychological Adversity … increased physical and psychological

problems linked with cognitive impairment.problems linked with cognitive impairment. Adversity … highly stressful events … cognitive decline.Adversity … highly stressful events … cognitive decline.

Specific outcomes linked with early Specific outcomes linked with early family adversityfamily adversity

1.1. Heightened dysregulation of physiological Heightened dysregulation of physiological responsesresponses

2.2. Exaggerated or flattened response to stressExaggerated or flattened response to stress

3.3. Increased risk of heart failure, stroke, Increased risk of heart failure, stroke, diabetes…all linked with cognitive declinediabetes…all linked with cognitive decline

4.4. Poor coping strategiesPoor coping strategies

5.5. Increased stress over lifespanIncreased stress over lifespan

6.6. Major depression and PTSDMajor depression and PTSD

For Panel on Wednesday…For Panel on Wednesday…

Read “Intergenerational Relationships in Read “Intergenerational Relationships in Various Ethnic Groups” on page 508.Various Ethnic Groups” on page 508.

Consider how this matches up with your own Consider how this matches up with your own experience or others you know.experience or others you know.

Imagine yourself as a grandparent. What Imagine yourself as a grandparent. What would you like your role to be?would you like your role to be?

What values, in addition to individualism and What values, in addition to individualism and collectivism, underlie your perspective?collectivism, underlie your perspective?