MIDDLE ADULTHOOD...

MIDDLE ADULTHOOD... THE EMPTY NEST

Gerontology is the study of aging. It is distinguished from geriatrics, which is the study of the diseases of the aging. Gerontology... Gerontology covers the social, psychological, and biological aspects of aging. A “gerontologist” must take a multidiciplinary approach, focusing on senescence, which is the combination of processes of deterioration which follow the period of development of an organism. Their studiesmight include an investigation of the effects of our aging population on society, and applying this knowledge to policies and programs.

Middle adulthood is considered that period of time between ages 40 and 59. With increases in human longevity, middle age expectations have changed. The American population is living longer, primarily due to better living conditions and advanced healthcare. Middle age... Humor is a reflection of the human condition and culture. In the U.S. culture of youth, aging becomes the target of many jokes. This is especially true when adults reach milestones such as 40, 50, and 60 years old. I demand a recount. After fifty everything that doesn't hurt doesn't work! In dog years I'm dead. Just when I find the key to success, someone goes and changes all the locks. Once over the hill, you pick up speed. Be kind to your kids; they'll be choosing your nursing home. I don't have hot flashes, I have power surges. 50 year old; one owner; needs parts; make offer. Age is like underwear, it creeps up on you! Age is important only if you're cheese or wine. Eat right, exercise regularly, die anyway. Seen it all, done it all, can't remember most of it. We are born naked, wet & hungry; then things get worse.

Mid-life crisis... A mid-life crisis is an emotional state of doubt and anxiety in which a person becomes uncomfortable with the realization that life is halfway over. It commonly involves reflection on what the individual has done with his or her life up to that point, often with feelings that not enough was accomplished. The individuals experiencing such may feel boredom with their lives, jobs, or their partners, and may feel a strong desire to make changes in these areas. Rates of depression, suicide, and divorce, however, show no significant increase during the “midlife crisis” years. The “crisis” condition ranges from the ages of 35-50, with the average age of onset being 46. Mid life crises last about 3-10 years in men and 2-5 years in women, but length varies. There is research indicating that midlife crises occur more often in men than women. Midlife crisis may occur naturally or may be triggered by life-altering events such as death, divorce, children leaving, etc… or may not occur at all.

This text of this car ad targets men who may be experiencing boredom, associated with mid-life crisis: “These dazzling models ooze style and power -- perfect candidates for revving up boring lifestyles and dispelling the blues!” “Symptoms” associated with a mid-life crisis or transition may include… Exhaustion, or frantic energy Self-questioning Daydreaming Irritability, unexpected anger Acting on alcohol, drug, food or other compulsions Greatly decreased or increased sexual desire Sexual affairs, especially with someone much younger Greatly decreased or increased ambition Discontentment or boredom with life or with the lifestyle (including people and things) that have provided fulfillment for a long time Feeling restless and wanting to do something completely different Questioning decisions made years earlier and the meaning of life Confusion about who you are or where your life is going

The term “midlife crisis” was coined by Canadian psychologist Elliot Jacques, but the credit for recognizing and understanding this emotional state must be given to psychologist Carl Jung. In his mid-life studies he described the crisis as “normal” in the process of maturing. He developed a model containing 5 stages of mid-life: Accommodation: the different ways people present themselves to others. Those who present personas that are not in line with their inner selves tend to have more difficult times in midlife Separation: deals with the evaluation of the different personas and masks and discovering why certain masks are used and if they reflect the inner self accurately Liminality: the person may feel unsure of his/her identity and looks towards others for feedback Reintegration: occurs when the person when the person begins to feel comfortable with himself or herself although a bit of uncertainty is still normal Individuation: the person recognizes inner conflict, accepts it, and attempts to discover a balance between these conflicts.

Empty nest syndrome... Empty nest syndrome refers to feelings of depression, sadness, and/or grief experienced by parents and caregivers after children come of age and leave their childhood homes. This may occur when children go to college or get married.. Sociologists popularized the term in the 1970s, and the media have helped make its existence part of conventional wisdom. Empty-nest syndrome was once considered a problem for women only, as stay-at-home mothers seemed to exist only for their children. An unprecedented number of mothers now work outside the home, however, giving them a role beyond that of parent. They may now feel less emptiness when their children leave home. Cheaper long-distance charges, e-mail and lower airfares have also made it easier to stay in touch once children leave home. Now men have as much difficulty dealing with children leaving home as women.

Many parents actually look forward to, and enjoy the advantages of the empty nest. Grocery bills are lower. There's food in the refrigerator. The house stays clean. They only have to wash clothes and towels once a week. Their calendar is often just as busy as it ever was, but it is filled with fun things to do with spouse or friends. The hard work of raising children is now finished. With more free time, they are now able to do projects and hobbies that they never had time or money for before. There is an absence of the day-to-day stressors that come with living together and children's often stormy adolescences.

Adult children coming back home... Empty nests are now refilling in record numbers as adult children return home after college or even after their first post-college jobs. According to the 2000 census, almost four million young adults between 25 and 34 years old now live with their parents--possibly the result of a tough job market, delayed marriage, high housing costs, economics, divorce, extended education, drug or alcohol problems, or temporary transitions. Psychologist Allan Scheinberg coined the phrase "boomerang kids“, noting that many of these young adults want the "limited responsibility of childhood and the privileges of adulthood.“ Some expect to live the same lifestyle with the same material possessions that their parents have achieved after working many years… so move back home to get them.

Middle age conception... Conception during middle age presents risks, but having a baby later in life is a consideration for some couples. Women sometimes delay childbearing, due to careers. Still other couples want to have a baby, to delay the “empty nest”. Female fertility declines significantly after age 40, and an advanced maternal age increases the risk of a child being born with some disorders such as Down’s Syndrome. Some conditions are also correlated with advanced paternal age. Achondroplasia (Dwarfism); craniofacial disorders such as Apert Syndrome and Crouzon Syndrome; mental retardation of unknown origins; autism; and 25% of schizophrenia cases are correlated with advanced paternal age. Down’s Syndrome Apert Syndrome

Menopause... Menopause is the physiological cessation of menstrual cycles associated with advancing age in women. The menopause is sometimes referred to as change of life or climacteric. Menopause occurs as the ovaries stop producing estrogen, causing the reproductive system to gradually shut down. The term menopause comes from the Greek roots 'meno-' (month) and 'pausis' (a pause, a cessation). As the body adapts to the decreasing levels of the hormones estrogen, progesterone, and testosterone, vasomotor (muscles and nerves) symptoms such as hot flashes and palpitations (fast heartbeat), psychological symptoms such as depression, anxiety, irritability, mood swings, lack of concentration, and atrophic symptoms such as vaginal dryness and urgency of urination appear. Together with these symptoms, the woman may also have increasingly erratic menstrual periods.

Hormone Replacement Therapy (HRT) provides the best relief, but certain forms appear to pose significant health risks such as slightly increased risk of breast cancer, heart disease, stroke, and Alzheimer’s disease. A woman has officially reached menopause when she has not had a period for one year. Changes and symptoms can start several years earlier…taking 2-5 years: Shorter, longer, lighter, or heavier periods Hot flashes and/or night sweats Trouble sleeping Vaginal dryness Mood swings Trouble focusing Less hair on head, more on face Decreased elasticity of skin Urinary frequency, urgency, and/or incontinence Osteoporosis and/or muscle, joint, or back pain

It's estimated that, by the age of 55, one in five women will have had their uterus surgically removed; one in 3 women by the age of 60. This operation is called a hysterectomy. Hysterectomy... A hysterectomy ends the possibility of reproduction, and if the ovaries are removed it begins menopause. Types of hysterectomies: Partial – removes uterus but not cervix Total – removes uterus and cervix Hysterectomy and Oophorectomy – removes uterus, cervix, fallopian tubes, and ovaries Radical – removes all reproductive tissue as well as the top of the vagina and surrounding lymph nodes • A hysterectomy might be recommended for of: • Fibroids – noncancerous tumors • Endometriosis – uterine tissue grows elsewhere in the body, such as in the vagina • Uterine prolapse - when the uterus drops into the vagina • Cancer of the uterus, cervix, or ovaries • Vaginal bleeding that persists despite treatment • Chronic pelvic pain

Andropause... Andropause is a biological change experienced by men during their mid-life, often compared to the female menopause. The concept of andropause is more widely accepted in Australia and Europe than it is in this country. Most clinicians in the United States recognize a progressive decline in levels of male androgens, specifically testosterone, but not dramatic, and not enough to end reproductive abilities. Many recognize symptoms associated with andropause as psychological rather than physiological. Andropause occurs between the ages of 40 and 55, though it can occur as early as 35 or as late as 65. Symptoms of this “male climacteric” may include loss of libido (sexual desire), nervousness, depression, impaired memory, the inability to concentrate, fatigue, insomnia, hot flushes, sweating, and some degree of erectile dysfunction (impotence). Treatment for andropause often includes the discouragement of smoking and drinking alcohol, improving nutrition and exercise, and possibly hormone replacement therapy.

Adult child caregivers... According to a report by the U.S. Bureau of the Census, by the year 2050 the U.S. population age 65 or older will grow more than 135% from 1995 levels. Many middle aged adults will become the caregivers of aging parents. Currently, one in every ten adults ages 51 and over are providing assistance with basic everyday activities for an aging parent. Adult children may need to “take away the car keys” and provide transportation, take over finances, assist with personal hygiene care, do cleaning and cooking, telephone daily, visit frequently, make long-term care decisions, etc. About a third of aging parents who need help currently live with their children. Stress on the adult child caregiver, due to overwhelming time demands of the aging parent, often leads to tension in the caregiver’s marital relationship, anxiety, depression, irritability, sleeplessness, fatigue, and a total reorganization of the family’s lifestyle.

In one respect, aging family members can be a source of both financial and emotional support to the caregiver and their family, and "keepers of the family history" for younger family members. However, they may also be seen as burdensome as they age and need more daily care. Adult child caregivers often experience intense guilt and feelings of confusion because of this. There are options to help: The parent may be able to stay in their own home if safety features could be installed, including first-floor bathrooms, grab bars in hallways and bathrooms, and a personal emergency response system in case the parent needs assistance while alone. If your parent is in need of daily assistance with meals, chores, or personal hygiene, he or she can apply for several services, such as Meals on Wheels, or home health care. Adult day care is a good way to get your parent to socialize with other adults, but may cost up to $100 a day, depending on the amount of attention and activities provided.

Social development... Psychologist Erik Erikson developed the 8 stage theory of psychosocial development. The 7th stage is called generativity which individuals experience during middle adulthood. A chief concern is to assist the younger generation in developing and leading useful lives. We give back to society through raising our children, being productive at work, and becoming involved in community activities and organizations. When we fail to achieve these objectives, the result is “stagnation”. Men tend to decrease the number and intensity of same-gender friends. Men most often meet other men in work settings. Because of this, many of their potential friends are people with whom they compete for raises or advancement, or with whom they are involved either as supervisors or subordinates. Neither of these conditions is conducive to the openness and concern necessary for the development of a close friendship. Social relationships may depend on family availability and interaction. Friendships and neighbor interactions are important.Women’s friendships are very personal, but they tend to separate friends into “work friends”, “activity friends”, and “real friends”.

The Red Hat Society... The Red Hat Society is a social organization for women over 50, founded in 1998 by Sue Ellen Cooper of California. As of October 2006 there are about 1.5 million registered members in over forty thousand chapters in the United States and thirty other countries. The founder or leader of a local chapter is usually referred to as a "Queen". Members are called "Red Hatters". The Society takes its name from the opening lines of the poem Warning by Jenny Joseph, which starts: “When I am an old woman I shall wear purpleWith a red hat that doesn't go and doesn't suit me.” Queen Sue Ellen Cooper and her court.

The Red Hat Society fondly refers to itself as a "dis-organization" with the aim of social interaction, tea parties, and to encourage fun, silliness, creativity, and friendship in middle age and beyond. The Society is not a sorority or a voluntary service club. There are no initiations or fundraising projects. Members over fifty years old wear red hats and purple attire to all functions. A woman under age fifty may also become a member, but she wears a pink hat and lavender attire until reaching her fiftieth birthday.

Homeostasis... Homeostasis is the property of a living organism to regulate its internal environment to maintain a stable, constant condition. Human beings, as they age, will lose efficiency in their control systems. This is known as homeostatic imbalance, and will increase the risk for illness and be responsible for some physical changes associated with aging.There are 3 important mechanisms human bodies need to regulate: Among the most important are: Thermo-regulation - the ability to keep body temperature within certain boundaries, even when temperature surrounding is very different Osmo-regulation - the active regulation of bodily fluids, including concentration and pressure; this will directly affect absorption of nutrients, excretion, hormone levels, blood, skin, hydration, and kidney function Glucoregulation - the maintenance of blood sugar levels

Beginning at age 40, individuals need to: 1. Go to the dentist every year for an exam and cleaning. Health issues... 2. Have their blood pressure checked every year 3. Have cholesterol checked, and if normal, have it rechecked every 5 years 4. Have a physical exam every 1-5 years 5. Have a tetanus-diphtheria booster vaccination every 10 years Men over the age of 50 need a yearly rectal exam to check for colorectal cancer and prostate cancer. Women over the age of 40 should continue with monthly breast self-exams, have yearly pelvic exams and pap smears, and have a mammogram done every year to check for breast cancer.

Coronary heart disease is the #1 cause of death in the U.S. 20% of deaths due to heart disease occur in men and women under the age of 65. Risk factors for heart disease include smoking, obesity, high-fat diet, physical inactivity, high blood pressure, high cholesterol levels, stress, and type A personality. Type A Personality: impatient, excessively time-conscious, insecure about one's status, highly competitive, hostile and aggressive, incapable of relaxation, workaholics, hard-driving, frequent hostility, driven by deadlines

Osteoporosis is a condition that features loss of the normal density of bone, and fragile bone associated with ageing. Osteoporosis... Osteoporosis leads to abnormally porous bone. This disorder of the skeleton weakens the bone leading to an increase in the risk of breaking bones (bone fracture). Normal bone is composed of protein, collagen, and calcium. Bones that are affected by osteoporosis can fracture with only a minor fall or injury that normally would not cause a bone fracture. It is estimated that 1 in 3 women and 1 in 12 men over the age of 50 worldwide have osteoporosis. Risk factors include: Getting older Being small and thin (frailty) Family history of osteoporosis Taking certain medicines Being a white or Asian woman Having low bone mass Tobacco smoking Alcoholism Calcium/ Vitamin D deficiencies Insufficient physical activity Excessive physical activity Exposure to heavy metals such as cadmium or lead

Aging eyesight... Everyone should have regular eye exams every 2 years after the age of 40. After the age of 45, a check for glaucoma should be included. Glaucoma is the leading cause of blindness, affecting one in two hundred people aged fifty and younger and one in ten over the age of eighty. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness. Glaucoma initially causes no symptoms, and the loss of peripheral vision is only slightly noticeable. Normal optic nerve Damaged optic nerve Advanced damage People at the highest risk of developing glaucoma are women, diabetics, African-Americans, Asians, Inuits, people who use steroids, and those with a family history of the disease. There are medicinal and surgical treatment options.

Most forms of glaucoma are characterized by high intraocular pressure. Intraocular pressure is maintained at normal levels when some of the fluid produced by the eye is allowed to flow out. When fluid cannot flow out effectively, this causes an increase in intraocular pressure and damage to the optic nerve… leading to vision loss. Early detection is the key to successful treatment.

Intellectual development... Research on intellectual development during middle adulthood shows declines in perceptual speed (ability to make visual discriminations) and numerical ability (simple arithmetic calculations). It shows stable and/or peaks in abilities in vocabulary (understand ideas expressed in verbal form), verbal memory (recall lists of words, etc.), inductive reasoning (recognize patterns and relationships and use them to solve further problems), and spatial orientation (visualize rotated stimuli in 3-D space. IQ tests rely on timed, physical responses, so may lack validity for middle aged adults due to decreases in perceptual speed and reaction times rather than cognitive changes.

Psychologist Jean Piaget categorized cognitive development into 4 stages : sensorimotor, preoperational, concrete, and formal operational. Middle aged adults, however, are capable of postformal thought in solving problems. They go beyond abstract thought, relying on subjective feelings and intuition. They can integrate opposing views, and are able to reconcile and/or choose between conflicting views. Fluid and crystallized intelligence are factors of general intelligence identified by Raymond Cattell (1971). Fluid intelligence is the ability to find meaning in confusion and solve new problems. It is the ability to draw inferences and understand the relationships of various concepts, independent of acquired knowledge. It appears to peak during early adulthood and then declines during middle age. Crystallized intelligence is the ability to use skills, knowledge, and experience. It should not be equated with memory or knowledge, but it does rely on accessing information from long-term memory. It appears to be stable, peaks, or improves during middle age and beyond. JEAN PIAGET 1896 - 1980

Memory is an organism's ability to store, retain, and subsequently recall information. A steady decline in many cognitive processes are seen across the lifespan, starting in one's thirties. Memory loss... Short-term memoryrefers to the amount or bits of information we can hold in our head at any given time and lasts between 1 second and 24 hours depending upon how much importance you put on the information. You would use this type of memory for phone numbers, messages, and zip codes. Research does not show a noticeable decline in short term memory with normal ageing. There are 3 types of long-term memory. Research has found decline in explicit memory with ageing, but not of implicit or semantic memory: Explicit or episodic memories are facts that you made a conscious effort to learn and that you can remember at will, for example, the names of state capitals; also includes memories of events and experiences.Implicit or procedural memory is information you draw on automatically in order to perform actions such as driving a car or riding a bicycle.Semantic memories are facts that are so deeply ingrained they require no effort to recall. An example would be the months of the year.

Lack of appropriate effort, interference or distraction, inefficient memory strategies, and health problems may decrease memory. To improve or maintain memory you can… Increase your sensory abilities (use of prescription glasses or hearing aid) Keep prescription and over-the-counter medications to a minimum Take care of your physical health Eat a well-balanced diet Get physical exercise to increase blood and oxygen flow Keep mentally fit by challenging your mind Use external aids such as lists, calendars, timers, or computers Maintain an organized living environment Use context cues to recall information Avoid depression, as it can affect thinking and memory Alcohol can affect your thinking and memory. ????

More than 10 million elective cosmetic surgery procedures were performed in the United States in 2006, about 40% of which were people entering middle age and wanting to look younger. Cosmetic surgery... Cosmetic surgery is performed to improve appearance and self-esteem. It involves reshaping parts of the body that are otherwise functioning properly. Costs of various procedures range from a few hundred to tens of thousands of dollars. Procedures include: Botox (injections to temporarily smooth out wrinkles), Blepharoplasty (eyelid surgery), Breast augmentation, Breast lift, Brow lift, Buttock Augmentation, Chemical peel, Dermabrasion, Endoscopy (Keyhole plastic surgery), Face lift, Facial implant, Facial scar revision, Forehead lift, Gynecomastia (Male breast tissue) reduction, Hair replacement, Laser skin resurfacing, Liposuction, Mentoplasty (chin surgery), Otoplasty (ear surgery), Microdermabrasion (skin rejuvenation), Rhinoplasty (nosejob surgery), Rhytidectomy (face surgery), Thighplasty (thigh lift), Thread lift, and Tummy tuck.

MIDDLE ADULTHOOD... THE EMPTY NEST THE END

MIDDLE ADULTHOOD...