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Working with Older Person (I) (Physical health (Statistics (women :arrow…
Working with Older Person (I)
Theories of ageing
Social (kart 1990)
Elderly Adaptation Process (intrinsic)
Role theory (Cottrell, 1942)
role: foundation of self concept
ability of an individual to adapt changing over roles
successful ageing: replace old roles with new roles
Active theory (Havighurst, 1953)
social engagement and productive ageing
successful ageing: continued activity
Disengagement theory (Commung & henry,1961)
slowly withdrawn from former roles and activities
society disengage elderly by retirement
2 types: social and psychological
Continuity Theory (Rosow, 1963)
human development occurs throughout the whole lifespan
attempt to maintain existing internal and external structures by continuity
Societal Influence Process (Extrinsic)
Aged Subculture Theory (Rose, 1965)
elderly groups with the same generation will tend to share same enjoyable activities or culture, eg, morning exercise and morning tea
subculture is the group of ppl within both distinct or hidden culture
Modernization Theory (Cowgill and Holmes, 1972)
primary cause of elderly losing power
generation changes and modernized
Age Stratification Theory (Riley, JOhnson, Foner, 1972)
They were expected to "act like their age"
members are stratified by age, serve as social control, diff age groups have diff norms and expectations from others
Social Construction Theory (Walker & Phillipson, 1986)
image of elderly was constructed by culture
culture by culture
negative image if the elderly stems from the growing population and inablility
Biological (Programmed ageing)
Genetic lifespan theory (eg, family diseases)
due to age, the body parts will deteriorate and weakened
genetic clock/times
occur due to intrnsic timing mechanisms and signals
Random events (Wear & Tear theory)
due to change and accidents
the ability of immune system to distinguish between intrinsic and foreign materials is weakened
immune cells will then attach and damage body's strructure
Developmental / psychological
Erik Erikson, 1963
series of the developmental stages
predetermined order of development and specific task to across life span
Ego integrity vs despair, resolution of virtue: wisdom
ninth stage: the life cycle completed
successful in gerotranscendence
resolved "despair" and confronted daily
Abraham Maslow
hierarchy of needs
Definitions
an attempt to explain a phenomena
systemize what is known and explain rationales behind data /research
Micro
describe relationships
focus on small events, sickness
study the change of ppl, ie, memory, intelligence
Macr
how social institution, systems and society affect ageing
focus on large scale events, historical changes in health care polocies
examines how institutions affect behavior
Physical health
Genetic and environmental factors
environmental factors
common diseases
High cholesterol
Diabetes
Eye disease
Arthritis關節炎
High blood pressure
Statistics
women :arrow_right:menopause :arrow_right:low estrogen level :arrow_right:1 out of 5 develops osteoporosis
Men shrink, skin sags (50-60YO)
Incontinence, sleeplessness, weakened immune system; declined in cognitive abilities, loss in coordination (60-100YO)
Alzheimer's disease doubles every 5 years after 65YO, almost 50% of >90YO suffer from dementia
60% of >65YO with cancer
30% >60YO lost teeth
water consistency from 80% to 50%
normal ageing
skin: cell loss, body fluid decrease
eyes: dry, presbyopia, color vision, cataract
ears: dry canal, hearing ability, dizziness
brain and nervous system: decrease in brain weight, less sensitive, reactive time decline, altered sleep-wake cycle
Mental Health
Statistics
25% of elderly has mental problem
more in residential homes than in the community
46% of hospital beds used by elderly
hk elderly suicide rate is the 2nd/3rd highest among worldwide, even higher than teenagers
Functional mental disorder
behavioral problems not due to physical disease, eg depression
Organic mental disorder
associated with identified disease in the brain and body, eg, dementia
Common diseases
dementia
Statistics: 6-7% >65YO, its age related disease
symptoms
memory loss
judgement difficulties
personality change
intellectual decline
types
Alzheimer's 60%
Multi-infarct 30%
Others 10%
Assessment tools
MMSE mini-mental state examination
MoCA The Montreal Cognitive Assessment
AmIC Abbreviated memory inventory for Chinese
Clock drawing test
Treatment
medications
behavioral
cognitive stimulation therapy
Reality orientation
depression
lost appetite
sadness
inattractive behavior
lost interest
tired and guilty
thoughts of suicide
physical illness lead to depression
coronary artery disease
hyoertention
myocardial infarction心肌梗塞
neurological disorder
cerebrovascular腦血管, alzheimer's diseases, parkinson's
Metabolic disturbances
Diabetes mellitus (DM), hypothyroidism
cancer
Chronic obstructive pulmonary disease (COPD)慢性阻塞性肺病
Rheumatoid arthritis類風濕關節炎
Ref to "depression & stressful life event scale for older adults (adapted from strokes, gordon stress scale, 1988)
Assessment tools
GDS Geriatric Depression Scale
HADS Hospital anxiety and depression scale
delirium昏亂
Short-term, curable , reversible
Usually happens when sudden change and incidents occur
causes
medical conditions, substance abuse, substance withdraw, multiple etiologies
sleep disturbance
10% of >65YO
stress/ psychosomatic/ depression/ dementia
psychotic disorder
schizophrenia
anxiety disorder
somatoform disorder
Conversion disorder
Hypochondriasis