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Midlife Crisis

July 31, 2012 by · Leave a Comment 

Trying to reinvent ourselves

Let’s quit our jobs, sell the house and move to the country!

Right in the middle of life, you get hit by a midlife crisis. At least some do; not as many as you’d think. But many people get hit by divorce, burnout, unemployment and economic downturns.

Here’s what is included in this lesson:

  • Delayed gratification
  • Changing careers
  • Divorce
  • Burnout
  • Self concept
  • Midlife crisis

Read chapter 16 of Berk’s Development Thru The Lifespan

Here are the resources you need:

CLUSTER

SLIDES

TERMS

[dropdown_box expand_text=” Terms To Know” show_more=”More” show_less=”Less” start=”hide”]

  • abstract thinking
  • active distraction
  • Baby Boomers
  • basic needs of love
  • Big Five personality traits = Costa & McCrae; based on factor analysis, proposes 5 dimensions: (OCEAN) openness, conscientiousness, extroversion, agreeableness and neuroticism
  • burnout
  • burnout prevention
  • compliance
  • compulsion to prove self phase
  • congruence
  • contempt (disgust)
  • create shared meaning principle
  • criticism of other’s personality
  • cynicism-involvement dimension
  • defensiveness
  • delayed gratification
  • denial of emerging problems phase
  • depersonalization phase
  • depression phase
  • displacement of conflicts phase
  • distract from reward
  • divorce
  • enhance your love maps principle
  • exhaustion-energy dimension
  • feminization of poverty
  • generativity vs stagnation = Erikson’s 7th stage of development; virtue is care
  • glass ceiling
  • humanism
  • inefficacy-efficacy dimension
  • inner emptiness phase
  • job outlook
  • judgment
  • kinkeeper = usually mother, act as hub of family info, care and interaction
  • let partner influence you principle
  • life changes
  • marital stability
  • Marshmallow Study
  • Maslach Burnout Inventory
  • midlife crisis
  • midlife transition
  • more fondness & admiration principle
  • neglecting personal needs phase
  • obvious behavioral changes phase
  • overcome gridlock principle
  • parental imperative theory = Gutmann’s theory, parents push gender roles when children are young but later reclaim a broad perspective
  • phases of burnout
  • phenomenological field
  • physically collapse phase
  • positive regard by others
  • positive regard by self
  • possible selves = part of self-concept; what you might become
  • predictors of divorce
  • principles of marital stability
  • reaction
  • real self
  • reassess achievements
  • reconnections
  • revision of values phase
  • reward-delaying strategies
  • sandwich generation
  • self
  • self as perceived
  • self control
  • self-concept
  • self-esteem
  • self-observation
  • self-regulation
  • self-response
  • self-talk
  • skipped-generation family
  • solve the solvable problems principle
  • stonewalling (withdrawal)
  • strategic thinking
  • subconscious
  • turn toward each other principle
  • unemployed
  • withdrawal phase
  • work environment
  • working harder phase

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NOTES

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  • Changing Jobs
    • Age 18-42
      • Most change jobs 10+x
    • Over life
      • 7 careers?
    • Definition problem
  • Why change careers
    • Money
      • Job outlook (market dwindling)
      • Economy downturn
      • Want more money
      • Better offer
    • Work environment
      • Co-workers & Boss
      • Boring-challenge
      • Stress
      • Glass Ceiling
        • Socio-Political term
        • Less women & minorities at highest levels of corporations
        • Glass = unbendable
    • Life Changes
      • Have a baby
      • Sandwiched generation
        • Care for your parents
        • Care for your kids
      • Skipped-generation family
        • Grandparents raising children
    • Unemployed
      • Older you are, longer not hired
      • Baby Boomers
        • 40% of work force
        • Born 1946-1964
  • Burnout
    • Psychological issue?
      • Not in DSM
    • 40% of workforce?
    • Symptoms
      • Less interested in work
      • Less pleasure in accomplishments
      • Exhaustion
    • Maslach Burnout Inventory
      • 3 dimensions
      • Exhaustion (energy)
      • Cynicism (involvement)
      • Inefficacy (efficacy)
    • 12 phases, not necessarily sequential (Freudenberger & North)
      • 1. Compulsion to Prove Self
      • 2. Working Harder
      • 3. Neglecting Personal Needs
      • 4. Displacement of Conflicts
      • 5. Revision of Values
      • 6. Denial of Emerging Problems
      • 7. Withdrawal
      • 8. Obvious Behavioral Changes
      • 9. Depersonalization
      • 10. Inner Emptiness
      • 11. Depression
      • 12. Physically collapse
    • Burnout Prevention
      • Organization
        • Healthier work life
        • Workload, control, reward,
        • Community, fairness & values
      • Individual coping
        • Resting
        • Temporary less work hours
  • Midlife Crisis
    • Midlife transition
      • Reassessment related to age
      • Life halfway over or more
    • Triggered by:
      • Andropause or Menopause
      • Death of parent
      • Unemployment
      • Underemployment
      • Never wanted to be a lawyer
      • Reassess achievements
      • Reconsider dreams
      • Want to make significant changes
    • Midlife Crisis occurs in about 10%
      • Many people reassess
      • Not based on age
  • Divorce
    • John Gottman
      • Marital Stability
      • Reconnections
        • How fight
        • How make up
      • Happy couples
        • have unresolved conflicts
        • 69% have “very same” ones 10 years later
      • 4 predictors of divorce; 4 major behaviors not to do
        • Criticism of other’s personality
        • Stonewalling (withdrawal)
        • Contempt (disgust)
        • Defensiveness
      • 7 Principles of what to do
        • 1. Enhance Your Love Maps
          • store info about partner (dreams, hopes)
        • 2. More Fondness & Admiration
          • Respect & appreciate diff.
        • 3. Turn Toward Each Other
        • 4. Let Partner Influence You
        • 5. Solve The Solvable Problems
        • 6. Overcome Gridlock
        • 7. Create Shared Meaning
  • CARL ROGERS (1902 – 1987)
    • Self
      • Self gradually emerges
      • From interaction w/ sig. others
    • Self-concept
      • Part of phenomenological field
        • gradually become differentiated
      • Object of perception
      • Real self vs self as perceived
        • Experiences are symbolized, ignored, dined or distorted
        • Become subconscious
      • Shouldn’t threaten integrity of child’s self-concept
        • Accept child’s feeling
    • Congruence
      • Symbolized experiences reflect all actual experiences
      • When congruent, person is free from inner tension
    • 2 basic needs
      • positive regard by others
      • positive regard by self
    • Self-regulation
      • 3 steps to control own behavior
      • 1. Self-observation
        • Track own behavior
      • 2. Judgment
        • Compare what see w/ standard
        • Rules of etiquette
        • Personal rules
      • 3. Self-response
        • Reward self
        • Punish self
    • For some
      • Self-regulation is self-concept
      • Self-regulation is self-esteem
  • Humanism
    • Reaction to behaviorism
      • Which was a reaction to Freud
    • Focus on:
      • Growth & fulfillment of individual
        • genuineness
        • acceptance
        • empathy
  • Self Control
    • Compliance = do what told
    • Respect
  • Walter Mischel
    • Delayed Gratification
    • Marshmallow Study
      • 1 small reward now or 2 small rewards if wait 15 min.
      • Little kids can’t wait
        • Can wait longer as get older
        • Can wait longer for preferred items
      • 4 yr olds (600 children)
        • Few ate immediately
        • Most delayed 3-5 min, then age
        • 1/3 delayed 15 min & got 2nd marshmallow
      • By 5
        • Use active distraction
        • Use self-talk (tell self rule)
      • By 12
        • Use abstract thinking
        • Distract from reward
    • Elderly
      • Less self-regulation
      • Less impulse control
      • Decline in reward-delaying strategies
    • Self control or strategic thinking

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QUIZ

[dropdown_box expand_text=” For You” show_more=”Quiz” show_less=”Less” start=”hide”]

  • 1. For Gottman which is a predictor of divorce:
    • a.           delayed gratification
    • b.           self-observation
    • c.           stonewalling
    • d.           efficacy
  • 2. Humanism a reaction to:
    • a.           cognitive therapy
    • b.           psychoanalysis
    • c.           existentialism
    • d.           behaviorism
  • 3. For some theorists self-esteem is the same as:
    • a.           self regulation
    • b.           self criticism
    • c.           self analysis
    • d.           all of the above
  • 4. What percentage of people have a mid-life crisis:
    • a.           10%
    • b.           20%
    • c.           45%
    • d.           67%
  • 5. Which studied delayed gratification:
    • a.           Maslach Burnout Inventory
    • b.           Boston Children’s Program
    • c.           marshmallow study
    • d.           rouge test

For the answers: Click Here

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DISCUSSION ITEM

  • Is divorce good or bad?

 

 

 

Retirement Planning

July 30, 2012 by · Leave a Comment 

  • Off to see the world.

Hit the road Jack.

Depression, Parkinson’s and hardiness are a surprisingly big part of retirement but a very small part of retirement planning. People don’t plan on getting sick. Yet most people don’t retire unless they are sick.

Historically, there was no such thing as retirement. People worked until they died. The trend is back. Many people who retire return to work. Some limit their hours, others work full time.

Retirement planning is easy: most people don’t do it. They don’t plan. And they don’t retire. In general, healthy people don’t retire or stay retired but disabled people do.

Here’s what is included in this lesson:

  • Retirement
  • Depression
  • Elder suicide
  • Parkinson’s
  • Hardiness

Read chapter 17 of Berk’s Development Thru The Lifespan

Here’s a good description of a person’s experience with depression and bipolar II disorder: New York Times

Here are the resources you need:

CLUSTER

SLIDES

TERMS

[dropdown_box expand_text=” Terms To Know” show_more=”More” show_less=”Less” start=”hide”]

  • activities of daily living (ADLs)
  • Alzheimer’s disease
  • amyloid plaques
  • assisted living
  • assistive technology
  • associative memory deficit
  • autoimmune response
  • average healthy life expectancy
  • average life expectancy
  • cataracts (p. 567)
  • cerebrovascular dementia
  • compression of morbidity
  • dementia
  • frailty
  • functional age
  • implicit memory
  • instrumental activities of daily living (IADLs)
  • macular degeneration
  • maximum lifespan
  • neurofibrillary tangles
  • osteoarthritis
  • primary aging
  • prospective memory
  • remote memory
  • rheumatoid arthritis
  • secondary aging
  • selective optimization with compensation
  • sleep apnea
  • terminal decline
  • wisdom

[/dropdown_box]

NOTES

[dropdown_box expand_text=” For You” show_more=”Notes” show_less=”Less” start=”hide”]

Retirement

  • Stop employment completely
  • Semi-retirement = reduce hours
  • Recent idea
    • Not historically common
    • Right of the worker?
  • History
    • 1881, William the First, German Emperor
      • Bismarck’s urging
    • 1889, Bismarck implemented it
      • Bismarck was 74
      • Set the age at 70
    • 1916, German lowered to 65
    • 1934, US Railroad Retire System
      • passed by Congress
      • Age 65
    • 1935, Social Security
      • Age 65
  • Why retire?
    • Pension
    • Disabled
    • Legal limits
    • Spouse
      • If wife retires, husband does
    • Wealth?
      • Inheritance only slightly more likely to retire
      • Don’t need to; lots of vacations
    • Health
      • Good health, work
      • Poor health, retire
    • People retire as early as the can
      • Even if working longer has higher benefits
    • Early Retirement
      • Lots of money
    • Can’t find a job
  • How spend time
    • Volunteer
    • Travel
    • Grey nomads & Snow birds
    • Grandchildren
    • Hobby
    • Sports
  • 6 lifestyle choices
    • Work full-time
    • Work part-time
    • Leisure activity
    • Variety of leisure activities
    • Return to part-time work
    • Return to full-time work
  • Concerns
    • Rising cost, flat income
    • Health
    • Location
    • Where live
      • Retirement community
      • Retirement home
      • Care home
      • Convalescent home
      • Rest home
      • Intermediate care
        • Send back home
      • Skilled nursing facility
      • Nursing home
        • Doctor & nurses

Depression

  • Major Depressive Disorder
    • Lasts for weeks at a time
    • Episodic
  • Symptoms
    • Lack energy & pleasure
    • Helpless
    • Sad
    • Little pleasure from sex or food
    • Trouble concentrating
    • Trouble sleeping
    • Suicidal thoughts
    • Thoughts of suicide or death
    • Don’t enjoy usual activities
    • Feel worthless, sad, guilty
    • Pull away from friends
  • Findings
    • React normally to sad images
    • React normally to fearful images
    • Rarely smile are happy images
    • Rarely laugh at jokes
    • Decreased response to likely reward
  • Range
    • Long-term depression
      • More common to have episodes
    • Periods of normal mood
    • First episode longest
      • More intense first episode
      • Easier to start another
  • Causes
    • 1. Genetics
      • Early-onset (before age 30)
      • More relatives with depression
      • Bulimia, irritable bowel syndrome
      • Alcohol or marijuana abuse
      • Anxiety & migraines
      • ADHD & OCD
      • Late onset (after 45 to 50)
      • Relatives have circulatory problems
    • 2. Infections
      • Viral infections in farm animals?
      • Borna disease; 1/3 have it
      • Infectious neurotropic virus
    • 3. Estrogen
      • More women than men
      • Postpartum depression
      • 20% of mothers
      • Recover quickly
    • 4. Brain Abnormalities
      • Hemisphere Dominance
      • Decreased activity in left hemisphere
      • Increased activity in right prefrontal cortex
  • Treatments
    • Untreated
    • Recover within few months
    • Episodes
  • Suicide
    • Elderly

Parkinson’s Disease

  • Symptoms
    • First symptom is loss of smell
    • Slow movements
    • Resting tremor
    • Rigidity
    • Difficulty initiating movement
    • Cognitive deficits
    • Depression (no outbursts)
  • But can follow visual cues
    • Follow parade
    • Climb stairs
    • “Step on the cracks” (sidewalk)
  • Incidence
    • 1–2% of those over 65
    • 50% more men than women
  • Progression
    • Gradual progressive death of neurons
    • Especially in substantia nigra
  • Substantia nigra
    • When over 45
    • Neuron loss of 1% per year
    • Most have enough to spare
    • When reach 20-30% of normal, Parkinsonian symptoms begin
  • Early onset
    • Probably genetic
  • Late onset
    • More common
    • Not genetic
  • Chances decrease if
    • Drink coffee
    • Smoke
    • Decaffeinated coffee & nicotine free cigarettes work just as well
      • Reduce damage to mitochondria?
  • Progressive death of neurons
    • Gradual
    • Decrease in dopamine
    • Decreased neural activity
    • Atrophy
    • Cell death
  • Treatment
    • L-Dopa Treatment
    • Precursor to dopamine
      • Crosses BBB
      • Hope it converts to dopamine
      • Not prevent continued loss
        • may contribute to neuron death
      • Harmful side effects
      • Effective in early stages?
      • Could do harm?
      • Doesn’t stop the disease
    • Other Therapies
      • Antioxidant drugs
      • Dopamine agonists
      • Glutamate antagonists

Hardiness

  • Suzanne C. Kobasa
  • Personality style
  • Pattern of characteristics
  • Healthy vs. ill under stress
  • 3 related general dispositions
  • Help resist stress
    • Commitment disposition
      • Involved in life
      • Curious about world
      • Interested in other people
    • Challenge disposition
      • Believe change in normal
      • Stability is rare
      • Look for personal growth opportunities
    • Control disposition
      • Believe you an influence world
      • Similar to Rotter’s internal locus of control
  • Generalized mode of functioning?
  • Sympathetic nervous system?
  • Change in motivation?
  • Cognitive reframing?
  • Coping style?
  • Self-efficacy?

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QUIZ

[dropdown_box expand_text=” For You” show_more=”Quiz” show_less=”Less” start=”hide”]

  • 1. Depressed people react normally to pictures that are:
    • a.           contented
    • b.           fearful
    • c.           happy
    • d.           all of the above
  • 2. Which is a dimensions of hardiness:
    • a.           contentment
    • b.           challenge
    • c.           restraint
    • d.           rigidity
  • 3. First symptom of Parkinson’s is:
    • a.           emotional outbursts
    • b.           action tremors
    • c.           loss of smell
    • d.           fluidity
  • 4. Parkinson’s patients are able to:
    • a.           hold a glass steady
    • b.           dance fluidly
    • c.           climb stairs
    • d.           all of the above
  • 5. People who summer in the north and winter in the south are called:
    • a.           retired roadsters
    • b.           elderly explorers
    • c.           commuters
    • d.           snowbirds

For the answers: Click Here

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DISCUSSION ITEM

  • What will you do when you retire?

 

 

 

 

Aging & Memory

July 29, 2012 by · Leave a Comment 

Aging and Memory

I remember what it’s like to be young.

There are 3 major concerns in aging and memory: what is memory, what happens in a stroke, and how does Alzheimer’s disease change memory.

As people age, they become quite concerned about their memories. Often they blame normal memory lapses on aging. But healthy people retain their memory capabilities. It is important to understand memory systems and how they work.

Two major conditions that impact memory, stroke and Alzheimer’s disease, are also covered.

Here’s what is included in this lesson:

  • Memory systems
  • Prospective memory
  • Practical memory
  • STM & LRM
  • Types of strokes
  • Symptoms of Alzheimer’s
  • Causes of Alzheimer’s

Read chapter 18 of Berk’s Development Thru The Lifespan

Video clip: Elizabeth Loftus on false memories.

Here are the resources you need:

CLUSTER

SLIDES

TERMS

[dropdown_box expand_text=” Terms To Know” show_more=”More” show_less=”Less” start=”hide”]

  • absentminded professor effect
  • active memory
  • activity theory = implicit or normal theory of aging; assumes staying active delays aging.
  • affect optimization = part of Labouvie-Vief’s aging theory; older you get, aim for optimal happiness
  • aging in place = live in own home & community as age
  • Alzheimer’s
  • aneurysms
  • arteriovenous malformations (AVMs)
  • buffers
  • cerebral embolism
  • chunks
  • congregate housing = private bedroom & bath but share dining room, activities, etc.
  • continuity theory = when old continue same beliefs and activities from youth
  • cueing effect
  • declarative memory
  • dependency–support script = dependent behaviors of institutionalized are attended to; rewarded
  • disengagement theory = older you get, more socially isolated you become
  • Down’s syndrome
  • early onset Alzheimer’s
  • echoic memory
  • ego integrity versus despair = Erikson’s 8th stage of development; wisdom is the virtue.
  • episodic memory
  • everyday memory
  • gerotranscendence = become more transcendent when old, less materialistic
  • hemorrhagic stroke
  • high blood pressure
  • iconic memory
  • independence–ignore script = independent behaviors of institutionalized are ignored; extinguished
  • ischemic stroke
  • late onset Alzheimer’s
  • life-care communities = multistage retirement community, shift to more assisted care as needed
  • long-term memory
  • memory
  • memory systems
  • neuron tangles
  • optimal aging = successful aging; elderly who are healthy and cognitively fit
  • practical memory
  • primary memory
  • procedural memory
  • progressive disease
  • prospective memory
  • protein plaque (clumps)
  • pulses
  • recall
  • reminiscence = life review as a tool for successful aging
  • secondary friends = as age lose primary friends, must establish new relationships
  • semantic memory
  • sensory memory
  • short-term memory (STM)
  • social convoy = network of friends “travel” through life together
  • socioemotional selectivity theory = more careful how spend time & money as age
  • steps
  • stroke
  • Third Age = over 45; last trimester of life
  • thrombotic stroke
  • transient ischemic attack
  • when memory
  • working memory
  • Yoruba people of Nigeria

[/dropdown_box]

NOTES

[dropdown_box expand_text=” For You” show_more=”Notes” show_less=”Less” start=”hide”]

  • Memory Systems
    • Sensory Memory
      • Buffers for vision & audition
      • Simplest kind of memory
      • Iconic memory ½ second
      • Echoic memory 3-4 sec
        • Replay tape
    •  Procedural Memory
      • What you do
    • Practical Memory
      • Everyday Memory
      • Do chestnut trees or oak trees lose leaves earlier in autumn?
      • Do horses in fields stand with head or tail to the wind?
      • In what direction do the seeds of an apple point?
      • What’s on penny; recall 3 of 8 critical features
    • Prospective Memory
      • Remember what going to do
      • Sensitive to elderly
      • Characteristics
        • Structure of normal day
        • Cueing effect (read story, remind to do)
        • Embarrassed when system fails
        • Social importance
      • “When” memory
        • do this at that time
      • Low information content
        • not a great deal of detail
      • One of most sensitive memory parts to aging
      • Easier to remember appointment with others
      • Harder to do object tasks
        • Collect a document
    • Wilkins & Baddeley
      • Simulate taking pills 4x a day
      • press button on little box
      • 2 groups:
        • Good free recall of lists
        • Bad free recall of lists
      • Good verbal memory group was less accurate = “absentminded professor effect”
    • 2 types of memory demands (Ellis, 1988)
      • Steps = anytime by end of day
        • Recall periodically over day
      • Pulses = do at specific time
        • Either remember it once or aware of all day
        • More likely to write down
        • Judged more important
        • Easier to remember
    • Short-Term Memory
      • STM
      • Working memory
      • Primary memory
      • Active memory
      • Capacity
        • 7 plus or minus 2 items
        • 7 plus or minus 2 chunks
        • Varies with type of info to recall
    • Long-Term Memory
    • Two types
      • 1. Declarative Memory
        • Conscious memories
        • A. Episodic memory (events)
        • B. Semantic memory (dictionary)
      • 2. Procedural Memory
        • Playing sports
        • Using tools
        • Dancing
        • Doing
  • Stroke
    • Transient Ischemic Attack
      • Less than 24 hours
      • Stroke symptoms
      • Unless you die = stroke
    • What is a stroke
      • Blood flow disruption
      • Brain’s version of a heart attack
      • Cells die
      • Brain attack
    • 1. Ischemic Stroke
      • Blocked-Clogged Arteries
      • A. Thrombotic stroke
        • Blocking narrow arteries
      • B. Cerebral embolism (stroke
        • Clot breaks off & travel to brain
    • 2. Hemorrhagic stroke
      • Weak blood vessel in brain burst
      • Blood leaks into brain
      • Two types
        • Aneurysms = ballooning region
        • Arteriovenous malformations (AVMs
          • bleeding from cluster of abnormally formed blood vessel
    • Risk Factor
      • High blood pressure
        • Biggest risk facto
      • Family history of stroke
      • Diabetes
      • Artial fibrillation
        • Irregular, rapid heart rate
      • Narrow arteries in other parts of body
        • Legs
        • Heart
      • Too much
        • Food, alcohol, smoking, drugs
        • Birth control pills, in women over 35
    • Symptoms
      • Depends which part of brain
      • Symptoms appear rapidly (usual)
      • Can get gradually worse, gradually better or on and off
        • Difficult to diagnose
      • Coma, unconscious, sleepy
      • Confused
      • Clumsy
      • Headache
        • Starts suddenly
        • Hurts most when lying flat
        • Hurts when you cough or move
      • Changes in sensory input (vision, hearing, taste, pain)
      • Changes in output (writing, speaking, walking)
    • After the stroke
      • Most people need rehab
      • 50% have arm or hand problems
  • Alzheimer’s
    • Progressive disease
    • Symptoms get worse with time
    • Symptoms
      • Inappropriate emotional response
      • Decline in intellect
      • Confused thinking
      • Memory loss
      • Repeated questioning
      • Inappropriate emotional response
      • Violence
    • Memory
      • Better procedural vs declarative
      • Better implicit vs explicit
        • Acquire new skills but not remember learning them
    • Age related
      • Likelihood increases with age
      • Strikes 50% of those over 85
    • Genetic components
      • Person with Down’s syndrome
        • (3 copies of chromosome 21)
        • Always acquire Alzheimer’s in middle age
      • Early onset
        • chromosome 1 & 14
      • Late onset
        • chromosome 10 & 19
    • Environmental component
      • 50% no relatives with disease
    • Yoruba people of Nigeria
      • high-risk genes
      • low incidence
      • maybe due to diet?
      • low-calorie, low fat, low salt diet
    • Brain proteins fold abnormally
      • Clump together
      • Interfere with neuronal activity
      • Amyloid protein
        • Cause plaque between neurons
      • Apolipoprotein E
        • Causes cell loss
        • Prevents plague removal
      • Tau protein
    • Tangles in cell bodies
    • Treatment to improve memory
      • Increase glucose & insulin
      • Acetylcholine activator drugs
      • Diet rich in antioxidants?
      • Block Aß42 production, inoculate with small amounts of Aß42

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QUIZ

[dropdown_box expand_text=” For You” show_more=”Quiz” show_less=”Less” start=”hide”]

  • 1. Which is the biggest risk factor for stroke:
    • a.         rigid blood-brain barrier
    • b.         high blood pressure
    • c.         low blood pressure
    • d.         neural tangles
  • 2. A ballooning blood vessel is called:
    • a.         ischemic stroke
    • b.         aneurysm
    • c.          plague
    • d.          hodos
  • 3. A headache that starts suddenly and hurts most when you lie flat might indicate:
    • a.         gerotranscendence
    • b.         neural tangles
    • c.         brain plaque
    • d.         a stroke
  • 4. How many items can you store in Short-Term Memory:
    • a.         depends if they are chunked
    • b.         depends on the content
    • c.         typically 5 to 9
    • d.         all of the above
  • 5. Which is a symptom Alzheimer’s disease:
    • a.         absent-minded professor effect
    • b.         neural tangles
    • c.         cueing effect
    • d.         all of the above

For the answers: Click Here

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DISCUSSION ITEM

  • How will you decide when to put your loved one in a nursing home?

 

Stages of Death and Dying

July 28, 2012 by · Leave a Comment 

Death and Dying

Into the dark; into the light. Into the unknown.

What happens when we die is easier to explain than deciding if we are dead. There are certain stages our bodies go through once the heart stops beating. But is a non-beating heart is not always considered death.

It was difficult to decide when life begins. We looked at several options. As it happens, it is no less difficult to figure out when life ends.

Here’s what is included in this lesson:

  • What is death?
  • How they tested for life 100 years ago
  • Stages of death and dying
  • Rigor & other mortis-es
  • Clinical death
  • Brain dead

Read chapter 19 of Berk’s Development Thru The Lifespan

Here are the resources you need. Click for a link for a pdf or scroll down).

CLUSTER

SLIDES

TERMS

[dropdown_box expand_text=” To Know” show_more=”Terms” show_less=”Less” start=”hide”]

  • appropriate death = good death; free of distress
  • acceptance
  • accident death
  • advance medical directive = general term for living will, health-care proxy & power of attorney
  • agonal phase
  • algor mortis
  • anger
  • anticipatory grieving = feeling loss before death of person with long illness
  • Balfour’s test
  • bargaining
  • bereavement = feelings of grief, desolation and loss
  • bloating
  • brain death
  • burial options
  • burial rituals
  • clinical dead
  • cloudy eyes
  • comfort care (palliative care) = reducing pain in terminal patients by medication dosage
  • compressed capillaries
  • CPR
  • cremation
  • death anxiety = persistent neurotic belief that you’re about to die
  • death certificate
  • death chill
  • death rattle
  • decomposition
  • denial
  • depression
  • died of old age
  • disarticulated bones
  • discoloration
  • dual-process model of coping = grief theory that people dynamically switch between loss & restoration
  • durable power of attorney = legal document to assign another to make decisions for you
  • electrical stimulation
  • embalming
  • euthanasia = ending a life to avoid pain; considered murder or suicide
  • forensic pathology
  • freeze-dried bodies
  • glassy pupils
  • grief
  • homicide
  • hospice
  • irreversible
  • Kubler-Ross, Elizabeth
  • lifespan development
  • liquefaction
  • lividity
  • living will
  • livor mortis
  • manners of death
  • mortality
  • mourning
  • natural death
  • odds of dying
  • palliative care (comfort care) = typically pain medication for terminal patients
  • pallor mortis
  • passive euthanasia = withholding or refusing food & medicine
  • permanent vegetative state
  • persistent vegetative state
  • postslaughter meat
  • primary flaccidity
  • putrefaction
  • resuscitation
  • rigor mortis
  • skeletonization
  • stages of grief
  • stethoscope
  • suicide
  • thanatology = scientific study of death
  • undetermined cause of death
  • vegetative state
  • voluntary active euthanasia = a type of assisted suicide; means provided, patient controls it
  • wake

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NOTES

[dropdown_box expand_text=” For You” show_more=”Notes” show_less=”Less” start=”hide”]

What is death?

  • How Know Dead
    • Old family member dies at home
    • Call priest
    • Check with no stethoscope
    • Hold mirror to mouth
    • Feather above nose
    • Balfour’s test
      • Stick heart with flag-needle
      • Watch needle for movement
  • When are you dead?
    • No personality
  • Legally Alive but…
    • Vegetative state (1-3 weeks)
    • Severe brain damage
    • Partial arousal
    • Persistent vegetative state (4+ wk)
    • Permanent vegetative state (1 yr)
  • Clinically Dead
    • No heart beat = oxygen delivery
    • No breathing = oxygen supply
    • Reversible?
  • Resuscitation
    • 4-6 minutes
    • CPR, ventilator
    • Heart-lung machine
  • No heartbeat
    • Unconsciousness 15-20 sec
    • Brain (full recovery) 3 minutes
    • Loses ability to work together
    • Hippocampus neurons 10 min
    • 30 minutes for rest of body, except spinal cord
    • Skin 24 hours
    • Bone & tendons 8-12 hours
    • Limbs 6 hours
    • Can be reattached
  • Brain Dead
    • Irreversible
    • No brain activity
    • Voluntary
    • Involuntary
    • Can take body parts
  • Before you bury
    • Wake
    • Just in case
    • Viewing
    • Sitting with
    • Party for
    • In remembrance
    • Life celebration
  • Process of Dying
  • Pre-Dying
    • As you die sleep more
    • Less desire for food
    • Less desire for water
    • Muscles don’t work well
    • Swallowing
    • Dry mouth
    • Choking
    • Bladder & bowel
    • Difficulty breathing
    • Muscles spasms
    • Convulsions
    • Pain
  • Agonal Phase
    • Right before death
    • Ears get cold (less circulation)
    • Can’t get comfortable
    • Disoriented
    • Labored breathing
    • Death rattle = fluid in lungs
    • Lose cough reflex
    • Mucus builds up; congestion
    • Doesn’t seem painful
    • Sense of peace
  • What triggers death?
    • Lack of oxygen
    • Brain stops getting oxygen
    • As brain stops working, systems shut down
    • Different cells die at different rate
    • Which cells deprived of oxygen
    • Kidney & liver = 24-36 (transplant)
    • Heart = 4-6 hours (transplant)
    • Brain = 3-7 minutes
  • Pallor mortis
    • 15 minutes after death
    • No blood flow
    • Capillaries close to skin
    • Lose flesh tone
    • Pale
    • No help calculating time of death
    • Occurs too quickly
    • People with heart failure are alive but look gray & blue lips
  • Livor mortis
    • Indicates no need to start CPR
    • 20 minutes
    • AKA, lividity
    • Discoloration
    • Black & blue
    • Green then purple then black
    • Settling of blood discolors body
      • congealed capillaries 4-6 hrs
      • maximum lividity 6–12 hrs
    • Blood pools
    • Interstitial tissue (between cells)
    • Color from reduced hemoglobin
    • No discoloration if body in contact with ground or object
    • Compressed capillaries
  • Algor Mortis
    • Death chill
    • Loss of body heat
    • 1.5 degrees per hour
    • Drops til room temp
    • 98.6 to 70 =19 hours
    • Pupils glassy
  • Pre-Rigor mortis
    • Within minutes of death
    • Muscles relax
    • No acetylcholine
    • Bowels & bladder empty
    • Eyeballs flatten (no blood pressure)
    • Pupils get cloudy
    • Good predictor of Time Of Death
    • Red blood cell; potassium breaks down
  • Rigor mortis
    • 3-4 hours
    • Stiffening of body
    • Completely stiff at 12 hours
    • Dissipates by 48 hours
    • Process
      • No ATP
      • Calcium ions diffuse
      • Myosin & actin bind
    • Steps
      • Contraction, can’t reset
      • No unbinding
      • AKA, primary flaccidity
      • Begins with eyelids, neck & jaw
      • lactic acid levels
      • Spreads to other muscles
  • Postslaughter meat
    • Chill to59°F
    • Cold shortening
    • Electrical stim. (deplete ATP)
    • Alternating current
    • Contract & relax
  • Forensic Pathology
    • Time of death
    • Holds its position after rigor sets
    • If body moved after death but before rigor, look at lividity
  • Putrefaction
    • Decomposition of proteins
    • Direct chemical process
    • Assisted by bacteria in body
    • Produce gasses & smells
    • Bloating – gasses into veins
    • Tongue swells-protrudes
    • Eyes bulge
    • Liquefaction of most organs
    • Bacteria break down tissue
    • Pancreas – “digests itself”
    • 2-3 days stomach discolor-swells
    • 3-4 days veins discolored
    • 5-6 days skin blisters; falls if touch
    • 14 days stomach fully extended
    • 21 days nails fall off; soft tissues
    • 28 days no face; liquefied organs
    • 30 Days hair, nails & teeth fall out
    • Look larger compared to dried out skin
    • Liquefaction complete
    • Body bursts open
    • Only skeleton remains
  • Skeletonization
    • Skeleton is exposed
    • 3 wks to 3 years
    • Ends with disarticulated bones
  • Death Certificate
    • Who
    • Where
    • How
    • Died of old age
    • Common until 1950s
    • No longer allowed
    • 5 Manners of Death
      • Natural (cancer, etc.)
      • Accident (fall of ladder)
      • Homicide
      • Suicide
      • Undetermined
  • Best Guess
    • Just on odds, most likely die from:
      • Heart disease
      • Stroke (all 4 types)
      • Pneumonia
    • Odds of dying
      • War 1 in 217,231
      • Lightning 1 in 83,930
      • Hot tap-water 1 in 64,788
      • Airplane crash 1 in 4,023
      • Car accident 1 in 247
  • Burial Options
    • Freeze-dry (liquid nitrogen)
    • Leave body out for vultures (Zoroastrians in India)
    • Cremation
    • Embalming
  • Burial Rituals
    • Bury with favorite things
    • Favorite people
    • Servants standing up to serve
    • Queen Victoria
    • buried with husband’s (Prince Albert) bathrobe
    • & plaster cast of his hand
  • Cultures
    • Cannibalistic rituals?
    • Leave exposed to elements
    • Donate body to science
    • Burial at sea
  • Elizabeth Kubler-Ross
    • Psychiatrist
    • Theoretical progression
    • Denial
    • Anger
    • Bargaining
    • Depression
    • Acceptance

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QUIZ

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  • 1. Which is a major cause of death (top 3)?
    • a.         car accidents
    • b.         plane crashes
    • c.         HIV/AIDS
    • d.         stroke
  •  2. No voluntary brain activity is required for:
    • a.         clinically dead
    • b.         Balfour death
    • c.         brain dead
    • d.         mostly dead
  •  3. Sticking a flagged-needle into the heart is part of:
    • a.         Kuber-Ross’s test
    • b.         Morgan’s test
    • c.         Balfour’s test
    • d.         CPR test
  • 4. In Algor Mortis, the body loses heat at a rate of:
    • a.         .5 degrees per hour
    • b.         1.5 degrees per hour
    • c.         2 degrees per hour
    • d.         2.5 degrees per hour
  •  5. Which do labored breathing, loss of cough reflex and congestion cause:
    • a.         kidney failure
    • b.         rigor mortis
    • c.         death rattle
    • d.         lividity

For the answers: Click Here

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DISCUSSION ITEM

  • What are your favorite quotes about death?

 

Day 20 Notes: Death & Dying

July 24, 2012 by · Leave a Comment 

Death and Dying

Death & Dying

Includes a discussion of when life ends, how to measure life-death, cultural rituals and stages of death and dying. Read more

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