CHAPTER 8 Life Span Development Middle Adulthood: 40 to 65-years-old

1. CHAPTER 8Life Span Development Middle Adulthood: 40 to 65-years-old

2. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Most enjoy a healthy body • Changes result in gradual shift of balance away from peak performance • Extent of changes directly related to: • Diet, heredity, exercise, rest, mental outlook, stress and disease • Shifts in responsibilities and physical adjustments

3. Stages of Growth and Development • Developmental Tasks of Middle Adulthood • Balances goals and realities and redirects energies as necessary • Extends caring and concern beyond immediate family (to neighborhood, community, society) • Develops career/job satisfaction • Adapts to physical changes • Establishes new roles and relationships with spouse, children, grandchildren, and parents

4. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Physical Characteristics • Bone mass decreases skeletal growth cells. • Women lose calcium from bone tissue after menopause • Leads to increased risk of osteoporosis • Men lose calcium but more gradual rate than women • Slight changes in height occur. • Compression of spinal vertebrae and hardening of collagen fibers • Changes in muscle strength may be related more to level of activity than to age. • Body shape and contour changes occur related to a redistribution of body weight. • Decrease in basal metabolism and less activity may necessitate calorie reductions to prevent weight gain

5. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Physical Characteristics – cont’d • Presbyopia • Changes in vision • Defect in vision in advancing age involving loss of accommodation or the recession of near vision caused by loss of elasticity of crystalline lens • Presbycusis • Normal loss of hearing acuity, speech intelligibility, auditory threshold, pitch associated with aging • Progressive loss of hearing in advancing age • More common in men than women

6. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Physical Characteristics – cont’d • Skin appearance changes • Decrease in elastic fibers and slight loss of subcutaneous tissue, giving a looser, more wrinkled appearance • Onset of graying • Begins in temple area • Scalp hair becomes thinner • There is a higher incidence of periodontal disease • Preventive programs • Fluoride usage, regular flossing, dental cleaning

7. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Physical Characteristics • Hormonal changes include the woman’s inability to produce estrogen and progesterone. • Signs of menopause: irregular menstrual periods, flow changes, excess fluid retention, breast tenderness, hot flashes, flushes, palpitations, night sweats, and irritability and mood swings • Women given estrogen to relieve complications • HRT reduce osteoporosis and atherosclerosis and heart disease • HRT increases risk of stroke, endometrial cancer, breast cancer and high BP

8. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Physical Characteristics • Male climacteric: decreased libido, loss of body hair, and delayed erection • Male do not lose ability to reproduce at this stage • Changes in body appearance • Weight gain, hair loss, decreased muscle strength • Changes often related to psychologic than physiologic • Some men go through “midlife crisis” • Engage in extramarital affairs, leading to divorce

9. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Psychosocial Development • Erickson, the developmental task of middle age is generativity versus stagnation • Accepting responsibility for and offering guidance to the next generation • Generativity encourages productivity, continuity, and creativity • May become stagnantinactive and lifeless • Time for vocational, interpersonal, and personal fulfillment • Family roles change during this stage

10. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Psychosocial development • Relationships between spouses change, and couple may have to refamiliarize themselves with each other • Survival of marriage depend on growth, maturity, and commitment of each partner

11. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Psychosocial Development • Role of grandparenting often begins • No longer responsible for children in the home; relationships with spouses change • Most adults not prepared for the increased responsibility of caring for aging parents • Economic stress and emotional pressure are both associated with the role reversal sometimes known as “parenting the parent”

12. Figure 8-19 (From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.) According to Erikson, generativity is the developmental task of middle adulthood.

13. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Health Promotion • Nutrition • They need fewer calories • Of the population, 25% are overweight • Good diet with vitamins and minerals combined with regular exercise is important to help lessen effects of menopause • A reduced intake of fat is recommended • Stress reducing exercises • Walking, swimming, golf, or tennis may enhance calcium utilization

14. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Health Promotion • Nutrition • Premenopausal women should have 1gm to 1.2gm of calcium per day • Diet rich in phosphorus and magnesuim • Green leafy vegetables, fresh fruits, whole grain cereals or breads, and dairy products

15. Stages of Growth and Development • Middle Adulthood: 40 to 65 Years • Health Promotion • Physical and Dental Examinations • They should have regular physical and dental examinations • Sleep and Rest • They sleep less and have more awakenings • Need for daytime rest lessen number of nighttime hours of sleep required • END!!!

16. Stages of Growth and Development • Late Adulthood: 65 Years and Older • Ageisma form of discrimination and prejudice against the older adultdefinitely exists • Theories of aging • Autoimmunity theory • Free radical theory • Wear and tear theory • Biological programming theory • Disengagement theory • Activity theory • Continuity theory

17. Stages of Growth and Development • Late Adulthood: 65 Years and Older • Physical Characteristics • Gradual decline in weight • Decrease in trunk length as a result of the increase in spinal curvature • Abnormal postures and contours • Kyphosis • Barrel chest

18. Stages of Growth and Development • Late Adulthood: 65 Years and Older • Psychosocial Development • Older years should be viewed as a time of satisfaction and pleasure. • Ego integrity versus despair • Evaluate one’s life and accomplishments and find satisfaction and meaning in life. • Retirement is a major adjustment.

19. Figure 8-23 (From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.) Many older people continue to work and learn after the traditional retirement age.

20. Stages of Growth and Development • Late Adulthood: 65 Years and Older • Family Roles Change with Time • Today’s grandparent may be working and highly active. • Caring for grandchildren may be a full-time responsibility. • Couples may need to adjust to increased time together, companionship, and closeness. • The impact of the death of a spouse is traumatic; being widowed is more common for women than for men.

21. Figure 8-20 (From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.) A loving relationship with a spouse is an example of a positive influence during older adulthood.

22. Figure 8-21 Beauty throughout the life span.

23. Stages of Growth and Development • Late Adulthood: 65 Years and Older • Cognitive and Intellectual Development • Older adults in good health and nurturing environments will have the capacity to maintain or increase their level of functioning. • Memory • Some older adults notice some changes; benign forgetfulness. • There appears to be a greater loss of recent memory over remote memory.

24. Stages of Growth and Development • Late Adulthood: 65 years and Older • Nutrition • Older adults should have a diet of foods higher in quality and lower in quantity while maintaining the basic nutrient content. • Most frequently recommended are diets that are low in saturated fats and carbohydrates and high in fiber. • Psychosocial factors: economic factors, loneliness; inability to shop for and prepare meals • Adequate fluid intake is important.

25. Stages of Growth and Development • Late Adulthood: 65 Years and Older • Activity • Exercise is crucial to general well-being. • Sleep • More rest but less actual sleep is required. • Safety • Most accidents are preventable. • The key to prevention is knowledge and recognition of the contributory factors that place the person at greater risk.