Later Adulthood

1. Later Adulthood Brainstorm: 60-74 And 75 plus?

2. Generativity results

3. Generativity results – Summer, ‘10

4. Brainstorming Free associate to old age, seniors, elderly. What are your expectations of your later adulthood, i.e. 60-74? What factors contribute to a healthy vs. an unhealthy older adulthood?

5. Developmental Tasks Accepting one’s life Promoting intellectual vigor Redirecting energy toward new goals Developing a point of view about death The Psychosocial Crisis: Integrity vs. Despair

6. Defining Healthy and Unhealthy Aging Healthy Active Disease-free Independent Unhealthy Fatigue Sick Inactive Loss of ADLs Successful Aging Avoiding illness Engagement with life High cognitive and physical functioning

7. Age related changes Some examples Physical changes Sensory changes Stamina, dexterity and balance Illness Cognitive changes…yes, but Neural plasticity continues throughout the lifespan Physical exercise==blood flow==neural nourishment Learning new things keeps the brain healthy and growing Psychosocial Role gain and role loss Increase in losses Ageism

8. Do we live in an ageist society? “deep and profound prejudice against the elderly” (Robert N. Butler, M.D.) "any attitude, action, or institutional structure which subordinates a person or group because of age or any assignment of roles in society purely on the basis of age" (Linda M. Wolfe, Ph.D website) http://www.oldwomensproject.org/index.htm- skits demonstrating an ageist comment with helpful responses.

9. Contributors to Unhealthy Aging Personality-neuroticism* Inadequate nutrition* Disinterest Limited resources Physical limitations, e.g. teeth problems No appetite Lack of exercise: 60%+ (CDC) of older adults don’t get adequate exercise Early family adversity *Linked with fatigue

10. Contributors to healthy aging • Nutrition • Antioxidants improve cognitive function Blueberries, avocadoes, fish, dark chocolate, nuts • 5 fruits/vegies a day; even 2 shows a positive effect on cognitive function. • Exercise - physical, psychological, cognitive benefits • Tai Chi 1/week=fewer falls through better balance • Aerobic exercise (150 minutes moderate intensity/week) reduces risk of heart disease, stroke, high bp, etc. • Strength training increases stamina and independence – 2 days/week • Balance exercises decrease rate of falls • Activity decreases depression, colon cancer, diabetes, osteoporosis

11. Healthy Aging, continued • Personality • Extroversion • Conscientiousness • Optimism • Sense of control • Social connections • Help with stress management • Meaningful roles • Vaillant’s findings

12. Vulnerability-Stress Model Individual vulnerability + Stress = Low quality aging

13. Adaptation to Change and Healthy Aging-the SOC Model Selection—Optimization--Compensation Small groups: Eating, Exercise or Cognitive Activity How might you encourage older adults to select your topic as a priority? How can the individual’s internal resources be best used? What limitations exist and what are detours around them?

14. Very Old Age-75+ Coping with physical changes of aging Developing a psychohistorical perspective Traveling unchartered territory The Crisis: Immortality vs. Extinction

15. What is a psychohistorical perspective? Integration of personal and societal experiences in the past with the present situation and future expectations/possibilities. For 80 year olds (born in 1931) what are some significant historical events? Consider your time on earth so far. Significant personal events/experiences? Significant social events/changes? Imagine how these might impact you over time.

16. http://www.theelders.org/elders How might the psychohistorical perspective of the elders have contributed to their choice to focus on equality of women and girls? What other connections can you make between their histories and their work? Consider the basic concepts of psychosocial theory…how are they relevant to the development of the Elders?

17. Demographic Trends (“Social Work in Health Care…”) Increase in number of older adults 12.7% now, 20% in 2050 Worker:Social Security recipient=3.1:1; will be 2:1 Chronic Illness and Conditions Growing diversity Chronic illnesses differ across groups Elders of color and low income have had less access to healthcare Belief about end of life care differ across groups

18. Trends, continued Intergenerational Families and Care-giving 70% of seniors who live in the community and need assistance rely entirely on family 25% of households are involved in caring for a relative over 50 Elders are providing care to grandchildren Changes in Health Care world Community based care Consumer Centered/Consumer Directed Care

19. Social Work Knowledge and Skills Knowledge about health and emerging health care world Rapid evolution of skills Cultural competence Clinical case management Advocacy and empowerment skills Research and evidence-based practice Skills for ethical practice

20. In small groups Identify & prioritize Ms. Sophie’s major needs/problems. Discuss the major influences on her aging process. What would you say are the three strongest influences? Consider information from class and discuss: Specific issues that affect the helping process How you might effectively work with Ms. Sophie and her family to attain the highest quality of life possible.

21. Panel discussion questions What have your experiences with grandparents been like? This could be your own, your children’s, or other people’s. Are your experiences reflected in the descriptions of grandparent types in the text? What meaningful roles have you observed older adults to fill? What made them meaningful? What other ideas do you have for creating meaningful roles for older adults? Think about your life from a psychohistorical perspective. What major events or contextual characteristics do you think have affected you such that you will reflect on them in your very old age? What major events or contextual characteristics do you believe will influence your generation (cohort)?

22. Early Family Adversity-long term effects Adversity defined as: parental loss abuse or inadequate parenting high level of conflict and/or violence Multiple pathways for this connection Adversity … psychosocial characteristics and unhealthy behaviors… physiological changes. Adversity … increased physical and psychological problems linked with cognitive impairment. Adversity … highly stressful events … cognitive decline.

23. Specific outcomes linked with early family adversity Heightened dysregulation of physiological responses Exaggerated or flattened response to stress Increased risk of heart failure, stroke, diabetes…all linked with cognitive decline Poor coping strategies Increased stress over lifespan Major depression and PTSD

24. For Panel on Wednesday… Read “Intergenerational Relationships in Various Ethnic Groups” on page 508. Consider how this matches up with your own experience or others you know. Imagine yourself as a grandparent. What would you like your role to be? What values, in addition to individualism and collectivism, underlie your perspective?