SHDH2039 Fundamental

Psychology for Health

Studies

Lecture 5 Development II
Old Age, Death & Dying

Lecturer:
 Lesson Plan
(A) The study of Old Age

(B) Psychosocial Theories of Aging

(C) Stages of dying

(D) Loss

(E)Bereavement

(F) Euthanasia

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 (A) The study of Old Age
1) Gerontology vs.
Geriatrics the study of old age
vs. the medical specialty devoted
to old age

Hillary Clinton vs. Barack Obama

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 (A) Old Age
2) Demographers– study population
trends
– Changing shape of the population pyramid
– By 2030, the no. of those over 65 is
projected to outnumber the no. of people
in other age groups

• In HK
• Male life expectancy 81.2 years
• Female life expectancy 87.3yers
• By 2034, percentage of people 65 or over = 28%,
up from about 15% currently 4
 (A) Old Age

Life Expectancy at Birth (Male and Female), 1971 - 2015

The life expectancies at birth for both sexes have steadily increased
during the past 45 years, from 67.8 years for males and 75.3 years for
females in 1971 to 81.2 years and 87.3 years respectively in 2015.
Source: http://www.chp.gov.hk/en/data/4/10/27/111.html
CCN2039_1617_S1_L5_Old_Death 5
 (A) Old Age

Proportion of older adults aged 65 years and over by country.

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 Population
Pyramids

CCN2039_1617_S1_L5_Old_Death 7
CCN2039_1617_S1_L5_Old_Death
 (A) Old Age
4) Longevity Life expectancy – number of
years a person can expect to live
• Factors affecting longevity
heredity, health habits, environment, social class,
gender, ethnicity, medical technology
• Dependency ratio:
As the population ages, the numerator will
increase and the ratio will increase. Why is
this a big problem?

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 Lesson Plan
(A) Issues of Old Age

(B) Psychosocial Theories of Aging

(C) Stages of dying

(D) Loss

(E) Bereavement

(F) Euthanasia

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(B) Psychosocial Theories of Aging
1) Erikson – 8th stage: Ego integrity vs.
Despair
2) engage in _life review_____________ - an
evaluative process on one’s past behavior
– Ego integrity the sense that one has
lived a useful life
• resulted from right choices, a meaningful
& productive life
– Despair
• a sense of meaninglessness, blame
oneself or others for misfortunes,
greatly fear death
• a sense of hopelessness because of too
little time to make meaningful changes
before death
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(B) Psychosocial Theories of Aging
2) Activity Theory
• psychologically and physically healthiest response to old
age is to maintain the greatest possible level of
activity and involvement in the greatest number of roles.
• 3) Disengagement Theory
 the view that aging makes a
person’s social sphere
increasingly narrow, resulting in
role relinquishment, withdrawal,
and passivity.

– it is normal and healthy for older

adults to scale down their social
lives and to separate themselves
from others to a certain degree.

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 (B) Psychosocial Theories of Aging
4) Continuity Theory
– a positive way to adjust to aging is to
maintain consistency on one’s lifestyle, as
much as one’s physical conditions permit.

• ___roles_______ and relationships still

seem to be essential ingredients for
emotional balance for most older adults.
Li Ka Shing, aged 88

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 Lesson Plan
(A) Issues of Old Age

(B) Psychosocial Theories of Aging

(C) Stages of dying

(D) Loss

(E)Bereavement

(F) Euthanasia

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 (C) Stages of Death & Dying
• Thanatology– the scientific study of
death and dying
• Kübler-Ross’s 5-stage Theory
– suggested dying patients go
through stages as they
confront their own loss of life

– _denial__________: an initial reaction

(e.g., not me!), is a defense mechanism

– Anger: 2nd stage (why me?), may resent

anyone who is healthy

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(C) Stages of Death & Dying
– Bargaining: 3rd stage (if I do…then…), looking for
a way out, trading good behavior for good health

– Depression:4th stage, can no longer deny the

illness, a time for “anticipatory grief”, mourn the
prospect of own death

– __Acceptance_________: 5th stage, a tired,

peaceful calm may descend, may make
preparations & say “goodbye” to friends and
family members

• “Stages” can occur in varying, intermittent

order! 15
 Lesson Plan
(A) Issues of Old Age

(B) Psychosocial Theories of Aging

(C) Stages of dying

(D) Loss

(E) Bereavement

(F) Euthanasia

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 (D) Loss
• being deprived of or coming to be without
something that one has had before

• 4 types of losses
– possession (e.g. house, car, job)
– bodily function (e.g. limbs, organs, disease)
– self (e.g. esteem, identity, status, role)
– close relationship (e.g. spouse, parents, child)

• Loss is __dynamic__________
– e.g. loss of husband may lead to …

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 Lesson Plan
(A) Issues of Old Age

(B) Psychosocial Theories of Aging

(C) Stages of dying

(D) Loss

(E) Bereavement

(F) Euthanasia

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 (E) Bereavement
• the sense of loss following a
death of someone close

• Can have detrimental effects

upon physical & mental health
if the ability to cope with it is
inadequate

• ___grief_______: individual
emotional response to
Zinnia Flower, 2015
bereavement
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 (E) Bereavement
• Phases of grieving
1) Impact/Shock
-disbelief, emotional/physical numbness (adaptive?), especially intense if
death is sudden.

2) Confrontation
-sadness, despair, agony as the person must face the reality of loss
-may exhibit behavioural (e.g., crying) and cognitive (e.g., loss of
concentration) similar to depression.

3) Accommodation/Acceptance
- survivor re-engages with life and internalizes feelings caused by the loss.

• People go through the grieving process

(and these 3 phases) at varying paces. 20
 Lesson Plan
(A) Issues of Old Age

(B) Psychosocial Theories of Aging

(C) Stages of dying

(D) Loss

(E)Bereavement

(F) Euthanasia

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 (F) Euthanasia
Deciding how to die?
• Euthanasia
• Active euthanasia: a situation in which someone takes action to
bring about another person’s death, with the intention of ending
that person’s suffering.
• Passive euthanasia: a situation in which a seriously ill person is
allowed to die naturally via cessation of medical interventions

• 2 ways to make your intentions known

– ___living will_________________ : a document that
indicates what medical intervention should or should not occur
– Health care proxy: the person chosen to make medical
decisions if the person who chose becomes unable to make
his/her own decisions
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 Conclusion
• ** Assigned Readings: Ch 9, p. 425-427

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