IMRE SEMSEI PhD Faculty of Health

University of Debrecen

Hungary

GERONTOLOGY

Gerontopsychology

APPROACHES OF COMPLEX VIEW OF THE ATTITUDES CONNECTED TO OLD

PEOPLE Constructive alternativism

Experts of health should be educated in interdisciplinary programs about the new relevant results. This is a newly forming part of gerontology, i.e. it is really a new view point and (not) only a new branch of discipline. Its importance is highly visible.

Aging is an organic part of the development of our personality. It is the closing but completing part, but for sure it is a new part in respect of quality. Therefore, it would be a mistake to consider this part solely as involution.

It is about the phase of life witch has a problem to solve and it is of new quality. It is about to accept that life has an end and it could either to be accepted or one can have a fear of falling into nothing. It could cause despair, hopelessness and existential anxiety.

One needs a sophisticated stereo view to understand and interpret the attitudes, which are often painful and dysfunctional. One has to understand his/her own view of aging and other opinions that concern his/her aging or others’ (they could be either young or old) aging processes.

„The life we lived is mirrored on our faces” Changes of our face can bee seen in our viscera as well, i.e. we can see the changes due to

our life not only on our face but our autonomous nerve system mirrors that as well. It adds important new point of views to the interpretation of several psychosomatic/psycho-neuro-immunological diseases that appears in old age.

Knowing this calls our attention to the basically non-functional purpose of plastic surgery or chemical modification of our old face.

Evolutionary duality Erik Erikson ‘s overarching life theory indicates that we have an evolutionary duality that

starts in the interactive processes that develop during and after birth. Since it was discovered that the newborn baby perceives his/her mother’s emotions and responds to it even after the first few minutes (9 min).

Two kinds of aging There are two kinds of aging process from point of view of psychology: one that is

accompanied by disease narrations and the other that lacks these ones. We can acquire new virtue, new attributes by reaching old age: stoicism, new kind of role

playing, transcendental readiness, capabilities of awareness and acceptance of transience, non-demandingness, freedom of our intellect, capability to accept help (even psychotherapy) could be on our list.

Scott Maxwell: „I would like to tell everyone who is approaching his/her old age and perhaps has a fear of it that this time period is the time for discoveries.” If they ask: „What kind of discoveries?” – I could answer: „Everybody has to find his/her own one otherwise it would not be a discovery.”

APPROACHES OF COMPLEX VIEW OF THE ATTITUDES CONNECTED TO OLD

PEOPLE

POSITIVE MODELS OF THE APPROACHING OF LIFE

The subjective or psychological age as a sum of biological chronological and sociological age According to WHO age grading: middle ages 45-59, starting to age 60-74, aged

75-90 and antediluvian (oldsters) are above 90. The public opinion is related to the chronological age of a person and it is

connected to their sociological age as well. There are unwritten rules , norms and attitudes regarding what is appropriate to do by an elderly and what kind of behavior could be expected from them.

In subjective living of aging there are biological, psychological sings, sings that refer to diseases or health, interpretation and experiences of these sings and cognitive representations connected to these sings.

The subjective age is formed in a psychological experience field where the dimensions of chronological, sociological and biological age appear and its way is influenced by the feeling if we consider our life successful or not.

The role of social clock We can not evaluate the process of aging unless we are not agreed in an age

limit that could be coupled to it. In case of old age the mile stone could be coupled to the beginning of the economical inactivity. The retirement is for almost all people is a basic change in way of life, style of life, therefore, the beginning of the aging process could be coupled to this turning point and period.

Different ways of lives One life is a more balanced, more successful and lived in good economical

situation where the prosperous social situation and good quality of life is accompanied by good physical and mental health.

The other life is just the opposite of the previous one where the gaining can not compensate the losses. The social and economical situation is not suitable. The objective quality of life is weakened by chronic diseases , social support is of low level, loneliness is frequent that is accompanied by solitude and social isolation.

Biases against the elderly In our postmodern society one can sense the high activity and mobility, quick

responsiveness, high level of consumption ant their presence in the electronic and printed media.

Negative stereotypes could easily be coupled to an ill elderly by certain layers of the society, i.e. by people in healing and care facilities at different levels of the health care system

One can, however, sense positive tendencies in the Hungarian society as well, it seems that „ageism” is moderated.

POSITIVE MODELS OF THE APPROACHING OF LIFE

New positive models of aging The „selective optimization and compensation model” can be well fitted to

dimensions of health psychology. This model concentrate on the up keeping of the functional capabilities. The elderly can cope with the decrease or cessation of functional capacities by using this strategy.

The „active aging” described by the WHO in 2002 emphasizes that the elderly are embedded in the society as active participants and they are not only people who need support, presenting a burden, and they should not be handled as a passive and marginalized group.

The „successful aging” depends mainly on such factors that the person can influence and govern by him/herself . There are factors that belong to these, i.e. healthy and active way of life, physical exercise and healthy diet. A few factors of the successful life: Smoking habit Appropriate level of physical activity Body Mass Index (BMI) Dietary habits Alcohol consumption Exercises for disease prevention Positive attitude to the aging process Etc.

POSITIVE MODELS OF THE APPROACHING OF LIFE

PSYCHIATRY OF OLD AGE

The natural process of aging results in changes in biological and psychological fields as well.

Psychological alterations as a function of age: Changes of the personality: decrease in flexibility, adaptation is

weaker and certain features of personality become more pronounced.

Changes of cognitive functions: negative: thinking slows dawn, short memory is impaired, learning is less successful; positive: consciousness, capability for synthesis, wisdom.

Mental decline is not a part of the normal aging process!

Ratio of psychiatric diseases in the old population is about 13%. Most frequent organic mental diseases are: delirium, demencia and amnestic syndrome. Depression of old age is also high among the elderly and this decreases the functional capacities of the old people.

Delirium It belongs to the organic psycho-syndromes that is developed on the ground of

brain diseases and/or general diseases of the body, therefore its treatment should be according to the treatment of the basic diseases. Its frequency among people treated in hospitals is about 10-30% above the age of 65.

Demencia Chronic organic mental syndrome and its frequency is 10% among people aged

over 65. The frequencies of different demencia are very similar all over the world.

Alzheimer’s demencia (AD) is 40-60 %, a vascular demencia (VD) 20-30 %, and the mixed type is about 20 % and the potentially mixed form is about 10 %.

Diagnostic symptoms of demencia Memory problems (disturbances of learning of new things or recognition of old

ones) one (or more) of the followings: aphasia (disturbances of phrasing) apraxia (disturbances of motor functions although there are not problems with fundamental

motor functions) agnosia (disturbances in recognition of objects, symbols, although the sensory functions are

intact) Disturbances of executive functions (planning, organizing, ordering, abstraction)

Schizoform and paranoid symptoms Psychosis is a pathological state that is characterized by loss of reality that is

accompanied by hallucination and/or delusions. Psychosis developed in old age could be of symptoms of organic disease, affective disease, schizophrenia, schyzoform or paranoid disturbance. Frequency of paranoid disturbances is about 0.2-0.3% above the age of 65.

PSYCHIATRY OF OLD AGE