The document discusses stress, anxiety, and depression among the elderly and various coping strategies. It describes how stress can lead to anxiety and depression. Common stressors for the elderly are discussed such as loss, health issues, and social roles. The effects of stress on the body and mind are summarized. Various theories on aging and the impacts of stress are introduced. Strategies for coping with stress are provided, including social support, relaxation, exercise, and seeking help from mental health professionals when needed.
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Stress and Coping Strategies Among the Aged
1. Stress among the aged and
coping strategies
Presented by : Sunita Sijwali
Dept of Extension and
Communication Management
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2. “Everyman desires to live long, but
no man would be old.”
Johnathan Swift, 1667-1745
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3. Aging
• Aging is a process of general, irreversible,
and progressive physical deterioration
that occurs over time.
• This process usually occurs after sexual
maturation and continues up to the time
of maximum longevity (life span) for
members of a species.
• Death is the final event.
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4. What is “Normal Aging”?
• Two groups:
▫ Those with disease
▫ Those with “normal” health
• Society has a widespread belief, however, that
physical and mental declines are inevitable as we
age.
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5. Stress, Anxiety and Depression
• Stress is an everyday part of our lives and a normal reaction to a
situation where you feel under pressure. It’s part of our primal “fight
or flight” response and is intended to keep us safe and alive
• Stress causes your body to release stress hormones, which stimulate
your brain and body. Over time, that type of stimulation can take a
negative toll on an older person.
• Anxiety, however, is still having those feelings of stress long after
the actual offending event has passed. This constant feeling of being
stressed, even though there no longer exists an imminent stressful
situation you have to deal with, is what is classed as anxiety.
• Depression is a common mental disorder, characterized by
sadness, loss of interest or pleasure, feelings of guilt or low self-
worth, disturbed sleep or appetite, feelings of tiredness and poor
concentration.
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6. Stress, Anxiety, and Depression –
• Stress is usually a precursor to anxiety, and
anxiety is usually a precursor to depression.
stress anxiety depression
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7. • Stressful life events often precede anxiety disorders
(Faravelli & Pallanti 1989, Finlay-Jones & Brown
1981).
• Interestingly, long-term follow-up studies have
shown that anxiety occurs more commonly before
depression (Angst &Vollrath 1991, Breslau et al.
1995).
• In fact, in prospective studies, patients with anxiety
are most likely to develop major depression after
stressful life events occur (Brown et al. 1986).
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8. SAD among the aged
• In older persons, stress is thought to play a
bigger role in triggering depression than in other
groups.
• Like childhood, old age brings special pressure,
unique upsets, and key biological changes
• The stresses of elderly people need not result in
psychological disorders, if treated early.
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9. Who is at risk
Elderly
Live alone
Are economically disadvantaged
no relatives or friends
experienced recent losses
Have been ill or have a progressive or
chronic illness
experienced a head injury
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10. Leading Causes of Stress
• Disintegrating family bond and
relationship
• Work Pressure and Financial Insecurity
• Health Hazards
• Poor Nutrition
• Lack of Rest
• Personal Relationship
• Social Environment and Panic of Terror
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11. Loss and Grief
Role Loss ( spouse , friends, work) and Acquisition
(Grandparenthood and great-grandparenthood) provide
both new demands and opportunities.
Social Status
Changes in social identity: due to role loss in retirement
Losses in physical capacity and reserve
Functional losses may place older persons in help-seeking
rather than help-providing roles
Examples OF STRESSORS
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12. How stress affects older adults
• Studies show that long-term stress can damage brain
cells, leading to depression. Depression is one of the
most dangerous effects of stress in older people.
• Fatigue
• Loss of memory and concentration
• Inability to fight off or recover from illness
• Increased risk of chronic diseases such as heart disease
and cancer
• Irritability or moodiness
• Consuming too much alcohol
• Symptoms of stress may include anxiety, sadness,
trouble eating and sleeping, aches and pains, and weight
loss.
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13. Anxiety Disorders in Later Life
• Anxiety is also common among the elderly
• At any given time, around 6% of elderly men and
11% of elderly women in the U.S. experience at
least one of the anxiety disorders
▫ GAD is particularly common, experienced by up to
7% of all elderly persons
▫ Anxiety in the elderly may be underreported
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14. Anxiety Disorders in Later Life
• There are many things about aging that may
heighten anxiety levels, including declining health
▫ Researchers have not, however, systematically tied
anxiety disorders among the elderly to specific events or
losses
• Older adults with anxiety disorders are often
treated with psychotherapy of various kinds,
particularly cognitive therapies
▫ Many also receive antianxiety medications
Again, all such drugs must be used cautiously with older people
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15. ▫ Excess or undue
worry or fear
▫ Fatigue
▫ Disturbed sleep
▫ Jumpiness,
jitteriness, trembling
▫ Muscle aches,
tension
▫ Dizziness,
lightheadedness
symptoms
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16. Anxiety
How it works… Our rest system shuts down
and stress response kicks on.
We are too relaxed
even tiered.
Our minds go
blank and we feel
helpless.
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17. Depression in Later Life
• Depression is one of the most common mental
health problems of older adults
• The features of depression are the same for
elderly people as for younger people
▫ As many as 20% of people experience this disorder at
some point during old age
The rate is highest in older women
• Several studies suggest that depression among
older people raises their chances of developing
significant medical problems
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18. Depression in Later Life
• Like younger adults, older people who are
depressed may be helped by cognitive therapy,
interpersonal therapy, antidepressant medications,
or a combination of these approaches
▫ More than half of older patients with depression
improve with these treatments
▫ It is sometimes difficult for elderly people to use
antidepressant drugs effectively and safely because
the body’s metabolism works differently in later life
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19. Depression Symptoms:
• Poor appetite or weight Loss
• Insomnia or hypersomnia
• Loss of energy or tiredness
• Psychomotor agitation or slowing
• Loss of pleasure in usual activities or
decrease in sexual drive
• Feelings of self-reproach or excessive
guilt
• Diminished ability to concentrate
• Suicidal ideas, wishes or attempts.
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21. Cellular clock theory
Stress, aging and telomeres
• Researchers recently confirmed that people subjected to
chronic stress tended to have shorter telomeres.
• Cells with long telomeres live longer. Short telomeres
have been linked to a wide range of human diseases,
including coronary heart disease, osteoporosis and HIV
infection. Shortening of telomeres is prevented or
reduced by telomerase, which has been shown to keep
immune cells young by preserving their length and
ability to continue to divide and reproduce accurate
replicas.
• Chronic stress results in increased secretion of cortisol
that causes a rise in blood sugar and blood pressure and
reduces inflammation and immune system resistance to
infection.
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22. • The stress theory of aging emphasizes that stressful environments cause cellular
damages, disruption of cellular functions, and eventual organismal aging.
• Loneliness and Shortened Telomeres
• An April 2014 study by scientists at the Vetmeduni Vienna in Austria examined the
telomere length of isolated “lonely” African grey parrots compared to parrots with a
partner. The researchers found that the telomere lengths of single parrots were
shorter than those housed with a companion parrot. African grey parrots are highly
social birds, but unfortunately in captivity they are often kept in isolation from
other parrots.
• Phobic Anxiety and Shortened Telomeres
• A July 2012 study from Brigham and Women’s Hospital (BWH) found that chronic
phobic anxiety shortened telomere length in middle-aged and older women. The
study suggests that untreated chronic phobic anxiety is a possible risk factor for
accelerated aging.
• Untreated Depression and Shortened TelomeresThe scientists discovered
that within the cells of the immune system, activity of telomerase is generally
greater in individuals with untreated major depression. Over time, untreated
depression can shorten telomeres and make people prone to diseases typically
associated with advanced age such as heart disease, diabetes, osteoporosis, and
stroke.
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23. Hormonal stress theory
• Hormonal stress theory is aging in body hormonal system can
lower resistance to stress and increase risks of diseases.
• Hormonal stress theory is a theory that attributes stress
responses to stressors (internal or external stimuli) that cause
a cascade of hormonal reactions involving multiple hormones,
especially the hypothalamic, pituitary, adrenal axis, cortisol,
and eventually norepinephrine and serotonin as well as
peptide y which is involved in resilience.
• In the long run, elevates blood glucose and lipids (cholesterol)
in the blood can lead to chronic illnesses such as diabetes and
cardiovascular disease, and the immune system can become
suppressed. This is why chronic stress may contribute more to
the development of chronic illnesses
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24. Erikson's Integrity vs. Despair
• Integrity versus despair is the eighth and final stage of Erik
Erikson's theory of psychosocial development. This stage occurs
during late adulthood from age 65 through the end of life.
• During this period of time, people reflect back on the life they have
lived and come away with either a sense of fulfillment from a life
well lived or a sense of regret and despair over a life misspent.
• A person caught up in old sadness, unable to forgive themselves or
others for perceived wrongs, and dissatisfied with the life they've
led, will easily drift into depression and despair.
• The ego quality that emerges from a positive resolution is
wisdom.Conversely, despair is the result of the negative resolution
or lack of resolution of the final life crisis. This negative resolution
manifests itself as a fear of death, a sense that life is too short, and
depression. Despair is the last dystonic element in Erikson's (1959,
1982) theory.
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25. Activity theory
The activity theory suggests that aging people
should remain as active as possible, expand their
activities beyond their daily routine, and to
develop friends their own age.
The act of staying social and seeking a particular
role in society during old age has proven to
dramatically decrease the likelihood of
depression and solitude.
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26. stress theory of aging
• stress theory of aging, a stochastic theory of
aging that hypothesizes that aging and death
result from the effects of environmental
stressors that cause wear and tear on cells and
disrupt their function.
• The generation of free radicals during oxidative
cell processes is sometimes cited as a specific
stressor that disrupts DNA and protein function
and so causes aging.
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28. Coping with stress
• The first step to coping with stress is learning to
recognize it. If you have suffered a loss, are
struggling with an illness or disability, or are having
trouble dealing with a major change in your life,
know that symptoms of stress are normal and not a
sign of weakness.
• But prolonged sadness, anxiety, loss of interest in
life, and giving up activities you once enjoyed are
not a normal part of getting older. They could be
signs of depression. If you are struggling to deal with
stress or depression, you need to ask for help from
your doctor or another member of your medical
team.
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29. …
• Long term stress increases the risk for heart disease,
high blood pressure, stroke, digestive problems, and
sleep disorders. An older person is already at greater
risk for these conditons.
• People respond to stress in different ways. These
may include crying, withdrawal, and depression. It
is important to allow an elderly person to maintain
as much independence as possible. However, if
stress interferes with a person's eating, health, or
normal daily activity, he or she should be referred to
an appropriate mental health provider.
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30. Strategies for coping with stress:
• Take care of yourself. When dealing with stress, it's important to
get plenty of sleep and maintain a healthy diet. Avoid caffeine and
alcohol.
• Get regular exercise. Exercise releases hormones that help you
fight off stress and depression. Exercise can improve your sense of
well-being.
• Participate in social activities. Find activities you enjoy that
will give you more social interaction. You could try to learn a new
language, mentor a child, or take up dancing.
• Talk about your feelings. Sharing your feelings with friends and
loved ones is the best way to get these emotions out in the open,
where you can start to deal with them.
• Learn relaxation techniques. Mind-body techniques such as
deep breathing, meditation, and yoga can be helpful. You might also
relax by listening to music, reading, or participating in low-stress
activities that you enjoy, such as a walk around your neighborhood.
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31. Contd..
• Put things in perspective. Accept that there are some things you just can't control—try
to see the positive aspects of change. Solve whatever problems you can and let go of the
rest. Also, don't forget the value of humor.
• Get professional help. If you are still struggling with stress or depression, talk with your
health care provider. Sometimes treatment with counseling or medication is needed to help
you get back on track. Treatment is nothing to be ashamed of, and it usually does work.
• Research has shown that having a pet can reduce blood pressure and stress in
the elderly. Many nursing homes now allow pets to visit.
• Maintain sleep hygiene
• Other treatments effective for some people include
meditation
biofeedback
massage
acupuncture
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35. Information Seeking
• Lack of information and fear of the unknown can
lead to stress
• To conquer fear of the unknown, gather
information about a specific circumstance
• Collecting and processing facts can solve the
problem and regain emotional stability
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36. Social Support Groups
• Friends, family are essential to help buffer the
effects of crisis
• Support groups enhance feelings of acceptance
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37. Hobbies
• Hobbies serve as a good mental escape
• Hobbies help make order out of chaos
(gardening)
• Organizational skills can transfer to other
aspects of life
• Cautionary note: Hobbies can produce stress at
times
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38. Forgiveness
• Forgiveness is considered an antidote
for anger
• Forgiveness is done for you, not the
person who wronged you
• Forgiveness is a means of letting go so
you can move on with your life
• Forgiveness doesn’t mean restitution,
don’t wait for an apology
• Forgiveness also involves the aspect
of acceptance
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39. Dream Therapy
• Freud called dreams the royal road to the
unconscious
• Freud said dreams conceal the truth
• Jung said dreams reveal the truth
• Dreams can offer insight to resolve personal
issues
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40. Prayer and Faith
• Prayer is considered to be one of the oldest coping
techniques
• Prayer is one of the top coping skills for older adults
• There are several different methods of prayers
• Prayer: building a bond with a higher power
• Prayer is not the same thing as meditation
Ways to Pray
1. Send a clear transmission
2. Communicate in the present tense
3. Express your thoughts in a positive mind frame
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41. Exercise, Yoga, and Meditation
• The use of these therapies is
increasing.Several studies of
exercise and yoga have
demonstrated therapeutic
effectiveness superior to no-
activity controls and
comparable with established
depression and anxiety
treatments.
• Mindful meditation and
exercise have positive effects as
adjunctive treatments for
depressive disorders,
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42. Ineffective Coping Strategies
• All coping techniques that avoid stress rather
than confront it are ineffective
• Our worst health concerns are examples of poor
coping techniques
• Drinking that leads to alcoholism
• Fighting that leads to spousal abuse
• Drug experimentation that leads to addiction
• Avoidance of any kind that perpetuates stress
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43. Research studies:
• Lack of Sleep, Stress Leads to Inflammation in Older
Adults
By Traci Pedersen Associate News Editor on March 2, 2012
• The immune system of an older adult who doesn’t get enough
sleep responds to stress with inflammation, increasing the
risk for mental and physical health problems, according to
researchers at the University of Rochester Medical Center.
• “This study offers more evidence that better sleep not only can
improve overall well-being but also may help prevent poor
physiological and psychological outcomes associated with
inflammation,” said Kathi L. Heffner, Ph.D., assistant
professor of psychiatry at the Medical Center.
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44. STRESS AND EXERCISE AMONG THE JAPANESE ELDERLY
NEAL KRAUSE, LINDA GOLDENHAR, JERSEY LIANC,GINA JAY and DAISAKU
MAEDA’
• The findings reveal that more frequent physical
exercise is associated with less psychological
distress.
• Most important the results reveal that social
support tends to promote more frequent
exercise.more emotional support was related to
better exercise habits.
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45. Stress and Depression Among the Oldest-Old: A
Longitudinal Analysis
Hae-Sook Jeon1 and Ruth E. Dunkle2
• Using multilevel modeling analyses, longitudinal
results showed that changes in positive life
events, daily hassles (worries), and mastery were
significantly associated with changes in late-life
depression among the oldest-old.
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46. • Elders aged 85 and older are more vulnerable to stress
and depression than other age due to increasing
stressors with age resulting from declining health and
dwindling social relationships (Borson et al. 2001).
• Diminishing psychosocial resources with increasing age
further contribute to increasing depression This is an
important consideration as psychological and social
resources act as protective factors to depression by
contributing to decreasing depression directly or
mediating the impact of stress on depression (Hobfoll et
al. 2003; Holahan et al. 1999; Lazarus and Folkman
1984; Pearlin 1989).
• Researchers suggest that there are significant individual
differences in available psychosocial resources that
influence the relationship between stress and
depression.
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