Chapter 20 Elizabeth Lytle, MPH, BSN, RN Los Altos School District A Lifetime of Health.

Chapter 20

Elizabeth Lytle, MPH, BSN, RN Los Altos School District

A Lifetime of Health

Topics of Focus For This Chapter

Gender Longevity gender gap

Midlife Hormone changes

AgingChallengesPhysical Activity Benefits

DeathAdvance directives

Stages and emotions

75.7 years

80.6 years

The Difference In Life Expectancy

Men

Women

4.9 years

Why Do Women Live Longer Than Men?

Estrogen

Protects heart, brain, bone and blood vessels

Boosts immune function

May protect against metastases

X Chromosome

Extra dose of immune genetics

TestosteroneDepresses immune function

Increases risk of heart disease and stroke

Injury Men die more frequently of injury

Life Years Lost Due To Lifestyle Habits

Health HazardYears Lost

(man)

Years Lost

(woman)

Smoking 2.5 1.8

High Blood Pressure

1.5 1.6

High Blood Sugar

0.5 0.3

Obesity 1.3 1.3

Changes At Midlife For Women

PerimenopauseBegins 4 to10 years before last period

Hormone shifts begin causing night sweats and hot flashes FSH and LH increase; estrogen decreases

MenopauseComplete cessation of menstrual periods for 12 consecutive months

Average age for menopause is 51.5

Menopause Has Some Health Effects

Decreased estrogen causes:Dryness of skin and mouth

Increased effect of androgens

Increased risk of Urinary Tract Infections

Increased risk of other health conditionsObesity

Metabolic syndrome

Heart disease

Stroke

Breast cancer

Hormone Therapy During Menopause

Recommended for short-term symptom relief

Estrogen Only

Minimize hot flashes and night sweats

Protect from heart disease and osteoporosis

Combination Therapy

Increases breast cancer, heart disease, breast cancer and stroke

Men Experience Changes At Midlife Too

Decreased Testosterone

By 30-40% between ages 48-70

Effects: Decreased muscle Increased fat Loss of bone density Lowered fertility and virility Low energy

Prostate Change

Benign Prostatic Hypertrophy May affect urine flow

Sexuality and Aging

Better health translates into better sex life

Men

Sexually active men live longer

Need more time for erection or orgasm

Women

Those who enjoyed sexual activity lived longer

Produce less vaginal lubricant

Summary of Effects Of Aging On The Body

Brain shrinks

Senses fade

Immune system weakens

Osteoporosis and arthritis

Tissue degeneration

Digestion slows

Heart grows less efficient

Alzheimer’s Disease Is a Form of Dementia

Dementia Loss of previous mental capability

Alzheimer’s Disease

Progressive deterioration of brain cells and mental capacity

Early Signs

Insomnia Irritability Increased sensitivity to alcohol Decreased energy Decreased frustration tolerance

Alzheimer’s Disease Is a Form of Dementia

Still not sufficient evidence to prove that any preventative strategy can prevent Alzheimer’s

May Lower Risk

Regular exercise

Have a purpose in life

Weight management

Healthful diet

Cholesterol-lowering drugs

Treatment No known treatment

Osteoporosis Is a Chronic Disease

DefinedLosses in bone density become so severe that a bone will break with slight trauma or injury

Prevention

Eat enough calcium or take a supplement Drink alcohol moderately Don’t smoke Let the sunshine in Exercise regularly

The Aging Pill: Physical Activity

Older people receive additional benefits from exercise

Greater ability to live independently

Reduced risk of falling and bone fractures

Lower risk of dying from heart disease

Lower risk of developing high blood pressure, colon cancer and diabetes

Fewer symptoms of anxiety and depression

Improvements in mood and well-being

Mental Ability Does Not Decrease With Age

Older adults are wiser:

See multiple points of view

Search for compromise

Solve social conflicts

These skills remain about the same:

Understanding

Vocabulary

Ability to remember key information

Verbal Intelligence

Two Common Types of Advance Directives

Health-Care Proxy

Gives someone else power to make decisions on your behalf

Living WillIndicate whether you want or don’t want all medical treatment and technology used to prolong life

Additional Options

Do-Not-Resuscitate:

Advance directive component that specifies you do not want to be resuscitated if heart stops

Five Wishes

Holographic Will

Stages Of Death

Death Moment heart stops

Functional Death

End of all vital functions

Cellular Death

Gradual death of body cells after heart stops

Brain Death

Absence of electrical activity on EEG and lack of reflexes

Spiritual Death

Moment when soul leaves body

Kubler-Ross’ Emotional Response To Dying

Five Emotions Faced While Dying

1 Denial

2 Anger

3 Bargaining

4 Depression

5 Acceptance

Other Death Topics

Care-givingTypically daughter, wife or sister

may experience anxiety and depression

Hospice Home-health program helps dying

Near-Death Experience

Autoscopy—watching from above as resuscitated

Transcendence—passing into foreign region or dimension

Suicide Is Most Common In Those Above 65

‘Rational’ Suicide?

Person suffering without future positive outcome ends their life

Perhaps as a result of undiagnosed depression

Physician-Assisted Suicide

Authorized in Oregon and Netherlands

Debate about physician’s responsibility

Autopsies Examine Body After Death

MedicolegalCause of death

Gather information for evidence

Medical/

Educational

Increase knowledge

Determine more exact cause of death

Grief’s Effects On Health Are Numerous

Changes in respiratory, hormonal and central nervous system

Mood swings

Lose appetite, feel physically sick

Sleep poorly

Increased rates of depression, suicide, serious mental illness and premature death