Adulthood and Old Age

1. Adulthood and Old Age Chapter 5 Introduction to Psychology

2. What is Adulthood? • the period of time in your life after your physical growth has stopped and you are fully developed • the state (and responsibilities) of a person who has attained maturity

3. Erik Erikson’s Theory The adolescence and adult stages are as follows (the ages for each stage are very approximate): Stage 5. Adolescence (13–19 years): avoid role confusion and develop a sense of identity; social focus is on peer groups Stage 6. Early adulthood (20–30 years): most adults commit themselves to a love relationship and to intimacy; other adults develop a sense of isolation; social focus in this stage is on friendships

4. Erikson’s Theory (continued) Stage 7. Middle adulthood (30–60 years most adults commit themselves to productive and socially valuable work (including bringing up their own children and being concerned with others within society), or they become stagnant and self-centered Erikson described these two extremes as generativity and stagnation. Generativity refers to “the interest in establishing and guiding the next generation.” The social focus is on the household.

5. Erikson continued • Stage 8. Oldage (60 years onwards): Adults in this stage try to make sense of their lives. If they are successful in doing so, they gain wisdom; if they cannot do this, then they experience despair. The social focus is on humankind.

6. Early Adulthood • developing the ability to share intimacy, seeking to form relationships and find intimate love. • Career Choices • Marriage/Children • Successful marriage =how people handle the good times and how they handle the bad times • Children (married couples) – 2.3 as of 2008 (US Census Bureau)

7. Divorce • Roughly 60% of those who marry a first time will divorce in the United States. • Those who marry a second time are divorcing at a 75% rate. • Divorce is especially likely during the first five years of marriage, and other “danger periods” are after 15 and 25 years of marriage. • Divorce is the second most stressful life event after death of one’s spouse.

8. 6 Psychosocial Stages of Divorce It has been argued that those getting divorced tend to go through a series of stages during the divorce process. For example, Bohannon (1970) proposed the following six stages: • Emotional divorce • Legal divorce • Economic divorce • Co-parental divorce • Community divorce • Psychic divorce

10. Alternative Arrangements? • Such alternatives to marriage as “living together” (cohabitation) have become more common. In 1997, the Census Bureau estimated that 4.13 million unwed couples lived in the United States.

11. Work/career choice • socioeconomic status • Friends • political values • residence location • child care • job stress • other aspects of life • And while income is important in both career selection and career longevity, so are achievement, recognition, satisfaction, security, and challenge.

12. Adulthood is either a time of fulfilling one’s dreams or a time to realize that what was dreamed cannot be fulfilled—the frustrations of this can lead to despair.

13. Physical Changes- Adulthood • One theory—our cells break down and cannot repair themselves. • Another theory—our cells are “biological clocks” that can only divide and multiply so many times. • Peak physical condition 18-30 • Changes in sight are very noticeable • Hearing is not as good—especially when more than two people are talking.

14. Middle Adulthood • Robert Havighurst lists seven major tasks in the middle years: • accepting and adjusting to physiological changes, such as menopause • reaching and maintaining satisfaction in one's occupation • adjusting to and possibly caring for aging parents • helping teenage children to become responsible adults • achieving adult social and civic responsibility • relating to one's spouse as a person • developing leisure-time activities

15. Health Problems • Staying away from bad stuff keeps up looking younger longer. • No tobacco, drugs, booze, and a sensible well-balanced diet along with a moderate exercise regimen are also very good. • The three most common causes for death—heart disease, cancer, cirrhosis may all be a result of the living we do as younger people. • Lesser causes are drug abuse, and death due to accidents—both more prevalent in younger ages.

16. Menopause • Between the ages of 45-50, a woman stops ovulating and menstruating so she cannot bear any more children. • Negativity associated with menopause is merely the effect of stereotyping and have no physical basis. • Men have no counterpart to menopause—men have fathered children well into their 80s (Aaron Burr).

17. Reproduction After Menopause -With help of technology, women can now conceive and carry a baby to term after menopause. (Very Rare) • The age of the mother is a controversial issue, while the age of the father is not.

18. Case Study • A 66 year old woman by the name of Maria del Carmen Bousada from Spain who suddenly decided she wanted to have a baby • Came to the United States, lied about her age, told the doctors that she was 55 and had an in-vitro fertilization procedure performed. • The procedure was successful and resulted in the birth of twins (boys), giving her the record for being the oldest woman to give birth. • The procedure cost over $59,000 not including the cost of preparation, travel, and all other medical expenses. • She passed away at age 69 of cancer, which may be related to the influx of hormones given to her when she was trying to conceive. http://208.111.134.1/video/playlist/5895/1022548?cpt=8&title=health&wpid=0

19. Sexual Behavior • It is thought that sex drive may only diminish if one is bored with a partner, is in poor physical condition, is extremely ill, or accepts that age kills everything. • Sexual Functioning • Sexual effectiveness need not disappear as humans age. • Healthy men and women often function sexually into their 80s. • Although time takes its toll, it need not eliminate sexual desire nor bar its fulfillment.

20. Social and Personality Development • Levinson’s Theory of Male Development • Levinson’s sample: • Levinson interviewed 40 men in four occupational groups (novelists, biologists, business executives, and factory workers) between the ages of 35-45.  Five percent were black.  All had been married at least once.

21. STAGES OF ADULT LIFE—EARLY ADULT TRANSITION (17-22) • Move from pre-adulthood to adulthood • Graduation from school, move out of family home, go to work. • Independence from family.  Financial and emotional autonomy. • College and military are transitional institutions – away from family but not total independence. • Make choices about how adult life will be lived • Men have a “dream,” a vision of the future usually viewed in terms of career • Men have a “mentor,” an older (8-15 years) role model – someone with experience and seniority in the world the young adult wishes to enter. • Second important relationship – a woman who supports dream, makes man feel capable of obtaining it.

22. Levinson's Five Stages of Male Development: • Entering the Adult World • The Age-Thirty Crisis • Settling Down/ BOOM period • The Midlife Transition • Middle Adulthood

23. Female Development • The mentor - Women substantially less likely to have a mentor • Love relationship – Men seek women to support their dreams.  Women seek a “special man” but see themselves as supporting his dreams. • Men dream of occupational achievement, status accomplishment. Women – less clear dreams; more tentative mix of family and career interests • Women are a bit different at the midlife stage especially as many are going back to college or going back to work.

24. The “Empty Nest” Syndrome • When the last child has left home the women may suffer from depression especially if her marriage is not so good. Otherwise, they may be at their happiest with the new-found freedom.

25. Depression in Midlife • Most common in middle aged women; menopause can lead to depression as mothers now sense that their role in the life cycle is over.  

26. Midlife Crisis • While a midlife crisis is not regarded as a universal phenomenon, during one's 40s and 50s comes the recognition that more than half of one's life is gone. • That recognition may prompt some to feel that the clock is ticking and that they must make sudden, drastic changes in order to achieve their goals, while others focus on finding satisfaction with the present course of their lives.

27. Life Expectancy • Life expectancy of Americans now at least 76 years • Middle of life falls statistically at age 38 years. • Middle age typically defined as considerably later.

28. Late Adulthood • Old age is generally considered to begin at about age 65. • Erik Erikson suggests that at this time it is important to find meaning and satisfaction in life rather than to become bitter and disillusioned, that is, to resolve the conflict of integrity vs. despair.

29. It has been estimated that by the year 2030, Americans over 65 will make up 20% of the population. • Despite the problems associated with longevity, studies of people in their 70s have shown that growing old is not necessarily synonymous with substantial mental or physical deterioration. Many older people are happy and engaged in a variety of activities.

30. Gerontology • an interdisciplinary field that studies the process of aging and the aging population, involves psychology, biology, sociology, and other fields

31. What are the improvements needed in the area of gerontology? • Experts & researchers need to communicate & collaborate across disciplines, as well as use a uniform common language to enhance communication. • Nurses need to analyze & reduce the complexity of these theories and place emphasis on the quality of life of older adults. • Society must develop a positive view of older adults & their potential within society. • Nurses must see older adults as unique individuals with valuable life experiences & recollections that should be utilized. • Also recognize the losses experienced i.e. physical & social. • Society must change or eliminate stereotypes about older adults.

32.  What is a common fear in our society? • The fear of dying is very prevalent. • Society’s View of Aging: • We treat aging negatively in jokes, in advertisements to replace old products with newer ones, in retiring older workers and replacing them with younger ones, and by using the euphemisms for the word old.

33. Development in Late Adulthood Theories of successful aging. • Disengagement theory • Activity theory

34. Disengagement theory • Refers to an inevitable process in which many of the relationships between a person and other members of society are severed & those remaining are altered in quality. • Withdrawal may be initiated by the aging person or by society, and may be partial or total. • It was observed that older people are less involved with life than they were as younger adults. • As people age they experience greater distance from society & they develop new types of relationships with society. • In America, there is evidence that society forces withdrawal on older people whether or not they want it. • This theory is recognized as the 1st formal theory that attempted to explain the process of growing older.

35. Activity theory • Is another theory that describes the psychosocial aging process. • Activity theory emphasizes the importance of ongoing social activity. • This theory suggests that a person's self-concept is related to the roles held by that person i.e. retiring may not be so harmful if the person actively maintains other roles, such as familial roles, recreational roles, volunteer & community roles. • To maintain a positive sense of self the person must substitute new roles for those that are lost because of age. And studies show that the type of activity does matter, just as it does with younger people.

36. Ageism • Ageism may be defined as the prejudice or discrimination that occurs on the basis of age. • Although it can be used against people of all ages, older people are most frequently its target and it may often result in forced retirement. • Stereotyping of the elderly is also an aspect of ageism, as seen in such a statement as “He drives like a little old lady.”

37. Physical Changes • atrophy of the brain and a decrease in the rate of neural processes • Respiratory and circulatory • Bone mass /osteoporosis. • Muscles • Skin • Hair loss • decreased sensitivity in all of the sensory modalities, including olfaction, taste, touch, hearing, and vision

38. Cognitive Changes Cognitive changes. The study of cognitive changes in the older population is complex. John Horn proposed two types of intelligence: fluid and crystallized.

39. Intellectual changes in late adulthood do not always result in reduction of ability. • While fluid intelligence(the ability to see and to use patterns and relationships to solve problems) does decline in later years, crystallized intelligence(the ability to use accumulated information to solve problems and make decisions) has been shown to rise slightly over the entire life span.

40. Dementia • Dementias are usually responsible for cognitive defects seen in older people. These disorders, however, occur only in about 15% of people over 65. • The leading cause of dementia in the United States is Alzheimer's disease, a progressive, eventually fatal disease that begins with confusion and memory lapses and ends with the loss of ability to care for oneself. • http://www.hbo.com/alzheimers/memory-loss-tapes.html

41. Retirement. Retirement at age 65 is the conventional choice for many people, although some work until much later. • Widowhood. Women tend to marry men older than they are and, on average, live 5 to 7 years longer than men. One study found ten times as many widows as widowers. Widowhood is particularly stressful if the death of the spouse occurs early in life; close support of friends, particularly other widows, can be very helpful.

42. Psychology- Video on Demand • http://www.learner.org/vod/vod_window.html?pid=1515

43. Thanatology: The Study of Death and Dying • During the past thirty years social patterns that call for the "hiding of death" have in large measure been reversed and the field of thanatology—the study of death—has grown.

44. Right to Die Movement • The death awareness movement asserts that a basic human right is the power to control one's own dying process. • Much criticism is currently leveled at the way modern technology is applied to the terminally ill. • According to this view, too much is done for too long a period at too high a cost, all at the expense of basic human considerations and sensitivities. • Probably the most controversial position of the right-to-die movement concerns the issue of euthanasia.

45. Controversial Issues • Terri Schiavo case- http://www.bing.com/videos/watch/video/terri-schiavo-dies/6lboew0 • Dr. Jack Kevorkian- http://www.bing.com/videos/watch/video/kevorkian-speaks-out/60m36w8

46. The Hospice Movement • The hospice approach entails a variety of programs that are designed to afford an alternative to conventional hospital care for the terminally ill, especially cancer patients. • The emphasis of the movement falls on "comfort-care." • Most hospice programs are centered around care of the dying person at home.

47. The Dying Process • Defining Death • A growing acceptance in medical and legal circles of the need for an additional criterion of death has resulted in a legal definition that includes the absence of spontaneous brain function.

48. Confronting One's Own Death • A realistic acceptance of death may well be the hallmark of emotional maturity. • People differ considerably, however, in the degree to which they are consciously aware of and think about death. • Death is a highly personal matter, and its meaning tends to vary from individual to individual. • Some psychologists have suggested that the elderly tend to take stock of their lives, to reflect and to reminisce about it in a life review process. • Researchers agree that only a relatively small proportion of the elderly express a fear of death.

49. Near-Death Experiences • Clinically dead but left their bodies and undergone otherworldly experiences? • Scientific evidence of a spiritual existence beyond death? • Skeptics rejoin that the visions reported by dying people are hallucinations associated with the intense arousal of the central nervous system and the disorganization of normal brain functioning.

50. Dying • Elisabeth Kübler-Ross identifies five stages through which dying persons typically pass: Denial, anger, bargaining, depression, and acceptance.