Clinical Considerations for Mature Clients Part 3 by Charlie Graham
Charlie Graham is an addiction therapist and program director of our Christian Treatment Program. This blog series is about the issues that face adults as they pass middle age and enter their golden years.
In 1987 Rowe and Kahn identified three elements of successful aging as: maintenance of mental and physical functioning, having a low risk of chronic disease, and maintenance of an active engagement in life. There are several ways that life expectancy can be extended. One thing that extends life is to be formally educated. People live longer who are mentally engaged, financially secure, with good health care, and with their brains engaged. It should be noted that however close the correlation between extended life and level of education, that it is a correlation and not necessarily a cause and effect. The next means of extending life is caloric restriction. Cutting back on calories definitely extends life as the more calories consumed, the more oxidative stress, toxins and free radicals enter the body. Regular exercise is the most highly correlated factor to a longer life. It aids in net calories metabolized, keeps the brain engage in external stimuli, and helps combat disease. Regular sleep is another factor that can extend life expectancy. Those who regularly get 8-9 hours of sleep a night live longer than those who do not.
Eating a well balanced diet that includes fruits and vegetables, rice and pasta, Mediterranean regional foods, healthy fats, foods containing Omega 3 fat as in cold water fish is correlated to successful aging. These fish are sardines, mackerel, salmon, cod and tuna. Extra virgin olive oil and a daily glass of red wine, which contains resveratrol and antioxidants that help prevent oxidizing and thus aging or the rusting of the body. Resveratrol comes from red grapes and Polygonum cuspidatum, also known as Japanese knotweed or Tiger Cane. It has been shown to support cardiovascular health and cancer fighting and anti-aging properties. It is an all-natural supplement that provides high levels of one of the most powerful antioxidants. Studies have shown that resveratrol supports a healthy heart and has the ability to activate the Sirtuin family of proteins. This is thought to mimic the anti-aging benefits of a reduced calorie diet and in turn help support the overall health of living cells. A synergistic effect is provided by the addition of grape seed extract and its active compounds known as OPC’s, which have shown to provide more antioxidant benefits than vitamins C and E. The juices from grapes, pomegranates, and tomatoes which are high in lycopene have many anti-aging properties.
Good dental health is also a strong correlate of successful aging in that flossing and brushing after meals removes bacteria that forms plaque in the mouth and spreads throughout the body. Periodontal disease is a marker for premature aging and early death. It is important to do the things we can that have reversing effects of aging. Some of these are having a positive attitude, regular exercise, regular sleep of 8-9 hours nightly, consuming a well-balanced diet that includes antioxidants and resveratrol, caloric restriction, omega 3 fats from cold water fish, trusting intimate relationships such as marriage and family life. Erik Erikson’s definition of wisdom is “life experience well-digested.” Possibly he was thinking of some nice cold water fish with a room temperature merlot.
The German theorist and psychology professor at the University of Virginia, Paul Baltes (1939-2006), who is credited with coining the term “successful aging”, had a two-fold view of the assessment of aging: that there is plasticity to our lives and growth until the end in ways you cannot grow unless you are older, called wisdom. The second is resilience of the tree that learns to bend lasts longer. He promoted the wisdom of aging contained in steady growth though the circumstances may change. This brings us to the models of assessment of older individuals.
The first model is called the SOC Model. The “S” stands for selection of the identified characteristics of the individual. The “O” stands for optimization in making the most of the capabilities they have; and the “C” stands for compensation as in making up for the losses with remaining strengths. An example of this would be compensating for the loss of memory by making lists of things as a reminder. This model stresses higher levels, less loneliness, and positive levels of emotions. It also states that heart health equals brain health. The biggest problem with aging is a drop in cognitive ability. Aging is about health. Society benefits from health aging and healthy living members.
The first step to assessment of older individuals is gaining a history, demographics, problems, family history, personal history, how they are advancing, their age, marital status, what medications (both Over the Counter and prescribed) they are taking. 60-75% of all OTC medication is taken by individuals 65 and over. The second portion deals with social archives. It is important to determine the attitude toward aging and retirement, death and dying, given that their view of the future is critical. Also included in the social archive is financial history, sexual history, alcohol and drug use, history of mental illness. The last step of assessment is the Mental Status Exam (MSE) where the client is evaluated on appearance, speech, functioning, feeding and taking care of themselves, and being oriented to time, place, and purpose.
The Folstein Mini Mental Status Exam helps psychologists to spot problems which may be caused byAlzheimer’s disease or Dementia. The average scores range from 29-25, diminishing with age. Those withat least nine years of education tend to score higher than those with less. There are eleven questions on thetest that have to do with orientation, registration, attention and calculation, recall, language, followingcommands, and directions. This is an exam that can give clues to determine whether or not Alzheimer’s ordementia is present in the client. Alzheimer’s disease makes up about 70% of all dementia and vascular dementia makes up 20%. The remaining 10% is made up of Parkinson’s disease, Huntington’s disease,substance abuse and CFS loss
