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Lecture

HSM330 Lec 2 notes

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Department
Health Services Management
Course
HSM 330
Professor
Daolun Chen
Semester
Fall

Description
--Lec 2-- Optimal Aging-Successful Aging? • In recent decades, research on the health and function of aging persons has tended to focus on the prediction of negative outcomes such as disability, dependency, morbidity, and mortality or to be based on samples limited to frail individuals. Aging has sometimes been defined as a progressive functional decline or a gradual deterioration of physiological function with age associated with inevitable, and irreversible age-related process of loss of viability and increase in vulnerability. • In striking contrast, a different view of old age can be traced back more than 2,000 years to Cicero’s (Roman) famous essay “De Senectute” (Cicero, 44 B.C./1992) in which he expressed the stoical opinion that in old age, free of the demands of bodily needs and pleasures, it is finally possible to focus on the further development and enjoyment of the mind. In the 20th century, this optimistic perspective has found a new expression in the term successful aging. Different psychological definitions of successful aging have focused on cognitive function, perceived control, and life satisfaction. • There is more than one way to age successfully. • Erickson had argued that every stage of development was ongoing and therefore he had cautioned again attributing success to his stages of psychosocial development. It is a process that continuously occurs and is somewhat affected by the choices that individuals make. • Most models of optimal or successful aging are multidirectional, there is no specific way to define optimal aging. • Some models of optimal aging are also teleological- they are based on a telos reflecting the assumptions of the dominant group as well as cultural beliefs. It is therefore necessary to specifically outline what these underlying assumptions are and to recognize their limitations. • In 1998, Rowe and Kahn identified 3 components of successful aging that included the absence of disease, maintenance of high cognitive and physical function and an active engagement with life. The model is hierarchical in that having good health would enable having the other two. The ability to maintain one's cognitive and physical function would in fact lead to the ability to engage in life. Active engagement was defined as maintaining relationships with other people and demonstrating productive behavior. Avoiding Disease • etiology = the derivation or cause of an illness/disease. The Maintenance of High Cognitive and Physical Function • The ability to predict the maintenance of good cognitive function in later life is still unclear. There are however good habits that could promote better health. 1 The ability for older adults that maintain active mental lines such as engaging in crossword puzzles or bridge will also likely maintain good cognitive function. • Rehabilitation after an injury or cerebral vascular injury can also improve the function of the musculoskeletal system. For example physical, speech and occupational therapy can improve the sequelae of stroke and cancer treatment. Active Engagement with Life • Rowe and Kahn define "active engagement with life" as a high level of social support as well as productive work. • Dysfunctional autonomy-in old old dyad, one member could deny the existence of any problems in order to prevent institutionalization. Many older adults provide unpaid caregiving, i.e. looking after grandchildren etc. Many older adults also provide volunteer work. Vaillant's Model of Aging Well There are six criteria to aging well that include: • No physical disability at age 75 • Good physical health (no problems with instrumental activities of daily living) • Length of undisabled life. • Good mental health. • Objective social support-marriage, play, religious attendance, children, social network, siblings, confidants. • Self rated life satisfaction in 8 domains: marriage, income producing work, children, friendships and social contacts, hobbies, community service activities, religion and recreation/sports. Ancestral longevity was a predictor of mortality before age 60 but not thereafter. Variables that can be used to predict morbidity and mortality in midlife may not remain predictors in later life. Mature defenses = coping defenses • coping mechanisms may be useful to diminish anxiety and facilitate coping beh
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