Saturday, January 2, 2010

Chapter 14: The Physical Challenges of Old Age

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  1. Setting the Context

    * Socioeconomic status aging and longevity: highlights the lifespan impact of poverty and stress on aging rates by reminding students of the fetal programming research; but also surveys studies suggesting its mainly education that predicts the transition time to ADL impairments (Bottom line: I.Q and education are the main correlates of living longer healthier ).

    Race ethnicity and aging: Explores possible reasons for the Hispanic paradox (the fact that poverty level Latinos live longer than we might expect).

    MOST IMPORTANT: New section on cohort differences in aging, shows that--just as we might expect- due to the obesity epidemic,the baby boomers are traveling into their older years more ADL impaired (Also a new chart here, shows that obesity rates have quadrupled among college educated U.S adults, so the clear SES differences spelled out above may be eroding, with more middle class people becoming disabled at younger ages.)

    Interventions: 1) we need to adopt a lifespan approach--focusing on children (and especially reducing child poverty and promoting education)-- to really help foster health in later life.
    2) we need to focus on the wider obesogenic environment, building more user friendly walkable communities.

    3) But, as the label
    "disease free" aging only applies to a minority of older people (roughly one in ten U.S elderly), we also need to pay attention to making the world more user friendly for normally aging adults .....

    Therefore next section,sensory and motor changes:
    *Explores in more depth how people adapt to vision loss..
    * discusses interesting new interventions for hearing problems such as the hearing loop.
    * Targets strategies for warding off lower body impairments--the prime reason for late life ADL problems and entering a nursing home.

    Driving:
    Explores the most difficult driving situations for older adults in more depth.

    Dementia:
    Generally updates this research, and includes a photo showing the Alzheimer's plaques and tangles.

    Nursing homes:
    * spells out research suggesting that the number of alternate community settings (that is, loved ones willing to take the older person in) predicts the transition time to a nursing home.

    * Explores the trend to providing loving, person-centered nursing home care, but also reports on a 2010 poll showing half of industry experts rank U.S nursing homes as fair or poor. (Another depressing finding: In a Michigan survey 1 in 5 family members reported their relative had suffered from nursing home abuse.)

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