HBP101/3 SPOT QUESTION FOR EXAM PART 1: AGING DEATH AND GRIEF

Question 1: Aging There are three major psychosocial theories which describe how people develop in old age. Disengagement theory Activity theory Continuity theory

State and distinguish between these three theories. ANSWER The disengagement theory of aging states that "aging is an inevitable, mutual withdrawal or disengagement, resulting in decreased interaction between the aging person and others in the social system he belongs to". The theory claims that it is natural and acceptable for older adults to withdraw from society. The activity theory proposes that successful aging occurs when older adults stay active and maintain social interactions. It takes the view that the aging process is delayed and the quality of life is enhanced when old people remain socially active The continuity theory states that older adults will usually maintain the same activities, behaviours, personalities, and relationships as they did in their earlier years of life. According to this theory, older adults try to maintain this continuity of lifestyle by adapting strategies that are connected to their past experiences.

Question 2: Aging and Memory Loss Alzheimer's is a type of dementia that causes problems with memory, thinking and behaviour. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. What is dementia? Is it a part of normal aging? What causes it? ANSWER Dementia is a collection of symptoms including memory loss, personality change, and impaired intellectual functions resulting from disease or trauma to the brain. These changes are not part of normal aging and are severe enough to impact daily living, independence, and relationships. Dementia can be caused by: Medical conditions that progressively attack brain cells and connections, most commonly seen in Alzheimer's disease, Parkinson's disease, or Huntington's disease. Medical conditions such as strokes that disrupt oxygen flow and rob the brain of vital nutrients. Additional strokes may be prevented by reducing high blood pressure, treating heart disease, and quitting smoking. Poor nutrition, dehydration, and certain substances, including drugs and alcohol. Treating conditions such as insulin resistance, metabolic disorders, and vitamin deficiencies may reduce or eliminate symptoms of dementia. Single trauma or repeated injuries to the brain. Depending on the location of the brain injury, cognitive skills and memory may be impaired. Infection or illness that affects the central nervous system, including CreutzfeldtJakob disease and HIV. Some conditions are treatable, including liver or kidney disease, depression-induced pseudodementia, and operable brain tumors.

Question 3: Death Elisabeth Kbler-Ross, a Swiss-born psychiatrist, outlined the five stages of grief of someone who is dying in her 1969 book, On Death and Dying: Denial Anger Bargaining Depression Acceptance

Briefly describe these stages, give examples of response during these stages. Will they be experienced by all dying people in the same order? Why? ANSWER Denial is the first reaction of a person when he/she first learn that he/she have a terminal illness. They conscious or unconsciously refuse to accept the facts that they are going to die. E.g. he/she may insist on a second or third medical opinion or continue with their normal activities, behaving as they had never received this news. As denial dwindles, it is replaced by the emotional reaction of anger. He or she lash out at loved ones and medical personnel over the unfairness of death. Why me may be a common response during this stage. The third stage is bargaining. He or she attempts to strike a deal for more time with doctors, God, or the universe. E.g. he/she may want to live just long to see his/her daughter to get married. These bargains may be unrealistic and impossible to be fulfilled. Then, he/she will become depressed. He/she will become extremely sad and lost interest in usual activities. It's a sort of acceptance with emotional attachment. It shows that the person has at least begun to accept the reality. Finally, he/she gains acceptance. A peace and calm characterize the dying as they face the end of life. The most common response done during this stage is separate his/herself from all but few of their loved ones as he/she prepare for lifes ending. Not every dying person experiences all these stages in the same order. This is because death, like many other developmental processes, in influenced by a variety of factors, including ones personality and coping style, the type of support received from family members and health professionals, and the nature of terminal illness. People may also experience similar reactions then they face a divorce, unemployment, or even failure in academic studies.

Question 4: Bereavement and Grief Upon losing her husband, Carrie experienced a chaotic grief process. A smell, a song on a radio or anything else she associates with her passed husband will burst her into tears. Sometimes she even finds herself suddenly in tears when sitting at her desk, or doing the dishes, even when she wasnt aware she was thinking about her husband. She consulted a counsellor and was told that this was not evidence that she is losing the ability to cope, but a common response to loss. Bereavement and Grief are the common ways how we respond when a loved ones dies. Define bereavement and grief. Why is it important for us to undergo the process of grief? ANSWER Bereavement is the experience of losing a loved one. Grief is our emotional reaction to that loss. The significance of the grief process includes: Accepting the reality of the loss. From the moment we are told that a loved one has died, or may die, we know it mentally but it may take a longer time to accept it emotionally. It is then that we have to remind ourselves of the loss and accept that the loved one is gone. Experience the pain of grief. Grief last for different length of time for everyone and different situation. It can take several years to establish a new sense of normalcy. But life does go on; the process of grieving can help us restore harmony and balance our life. Adjust our life without our loved one. Each day we mat be confronted in small or large ways with the absence of our loved one. The process of adjusting may go on over the course of a lifetime. Finding ways to remember. At first, we may struggle to adjust to life without our loved one, but as time goes on, our life will continue to evolve, just as we do. This means shifting from being with that person to just having thoughts of that person. As time goes on, we will be chossing memories, rituals and other ways of remembering and relating to our loved one. As we grow and change, our memories of our loved one will grow and change as well.

Question 5: Death and Bereavement A young lung cancer patient passed away. As his chest physician, your duty isnt finish yet: What can you do for his bereaved family members? ANSWER A physician can: Formally express condolences on patient's death (eg, card, call, or letter). This offer tribute to the deceased as someone who was important, and serve as a source of comfort to the survivors. Mourners will appreciate that you took the time to sit and compose a personal message to them or share a memory of the deceased. Bereavement visit. The physician can assist the family with uncomplicated grief by listening to how the bereaved family member is doing, educating about the grief process, and normalizing the experience by offering a bereavement visit . Acknowledge the loss. The clinician's respect for the grief process may make a difference in the ability of the bereaved family members to move toward their life goals, such as appreciation of a significant relationship, acceptance of change, and development of new life patterns and relationships. Encourage participatory activities. Encourage the bereaved person to talk about what it is like to live without the deceased. Encourage him or her to attend the funeral or memorial service, participate in personal rituals, and write letters to family and friends, recounting the story and feelings. Treat anxiety, depression, insomnia. Give supportive counseling to the depressed bereaved person. If counseling is insufficient, medical management of anxiety, depression, insomnia, or other common grief reactions can be helpful for short periods of time (weeks to months). Encourage physical activity and proper diet.

HBP101/3 SPOT QUESTION FOR EXAM PART 2: THE CONCEPT OF MIND CONSCIOUSNESS

Question 1: What are the 2 types of sleep apnea and its causes? There are 2 types of sleep apnea which are obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea is caused by the relaxing of the muscle at the back of a persons throat. They may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair their ability to reach the desired deep, restful phases of sleep, and they'll probably feel sleepy when they woke up. People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, some people with this type of sleep apnea think they sleep well all night. Central sleep apnea occurs when a persons brain fails to transmit signals to their breathing muscles. They may awaken with shortness of breath or have a difficult time getting to sleep or staying asleep. The most common cause of central sleep apnea is heart failure and, less commonly, a stroke. People with central sleep apnea may be more likely to remember awakening than are people with obstructive sleep apnea.

Question 2: What are the complications of narcolepsy? Narcolepsy can interfere with a persons intimate relationship where extreme sleepiness may cause low sex drive or impotence, and people with narcolepsy may even fall asleep while having sex. The problems caused by sexual dysfunction can be further complicated by emotional difficulties. Intense feelings, such as anger or joy, can trigger some signs of narcolepsy such as cataplexy, causing affected people to withdraw from emotional interactions. Other than that, narcolepsy results in obesity in an affected person. People with narcolepsy are twice as likely to be overweight. The weight gain may be related to lack of physical activity, binge eating, hypocretin or orexin (a type of neurotransmitter) deficiency or a combination of these factors.

Question 3: Define briefly the sleep cycle stages. There are 5 stages of sleep cycle. The first stage is lightest stage of sleep characterized by peacefulness, slowed pulse and respiration, decrease blood pressure and episodic body movements. Next, second stage is largest percentages of sleep time, bruxism (tooth grinding). Both first and second are not yet in deep sleep. Next, third and forth is the deepest, most relax sleep, and have sleep disorder such as night terrors, sleep walking (somnambulism), and bad wetting (enuresis) may occur. These stages have entered the deep sleep. The last stage is stage five. In this stage, our brain is in active and has the rapid eye movement sleep. The dreaming, penal and clitoral erection, increase pulse, respiration and blood pressure, absence of skeletal muscle movement.

Question 4: What is the treatment of the major sleep disorder? Insomnia: Avoidance of caffeine, especially before bed time. Maintaining a fix sleeping and waking schedule

Breathing-related sleep disorder: Surgery to enlarge the air way such as uvulopalatoplasty. Continuous positive airway pressure (CPAP). Tracheostomy.

Narcolepsy: Stimulant drug methylphenidate (if cataplexy is present, antidepressant may be added). Schedule day time nap.

Question 5: Describe how sleep changes is measured? Electrophysiological instruments can be used in the sleep laboratory to assess the physiological changes that occur during an episode of sleep. For example is Electroencephalograph (EEG). It is a brain-wave machine that amplifies and records electrical activity in the brain. Electroencephalography (EEG) is the recording of electrical activity along the scalp produced by the firing of neurons within the brain. In awake state Beta and Alpha waves characterize the electroencephalogram (EEG) of the awake individual.