Health Occupations

1. Health Occupations Life Stages

2. Growth & Development • Begins @ birth, ends @ death • During all stages, individual needs must be met • Need to be aware of the various stages & needs in order to provide quality health care

3. Life Stages • Individuals vary, but everyone passes through certain stages of growth & development • Four main types of growth & development in each stage • Physical – body growth, muscle & nerve development, body organ changes • Mental – development of the mind, problem solving, judgment, & coping • Emotional – feelings, love, hate, joy, fear, excitement • Social – interactions & relationships with others

4. Life Stages • Each stage has own characteristics & contains specific developmental tasks • Tasks progress from simple to complex • Each stage establishes foundation for next stage • Rate of progress varies (speech development, puberty, etc)

5. Erikson’s 8 stages of psychosocial development • A basic conflict or need must be resolved at each stage • If a person does not master conflict during the stage, they will struggle with the conflict later in life • Each life stage creates needs in people • Factors affect life stages & needs • Gender, race, heredity, culture, life experiences, & health status • Injury or illness usually has a negative effect & impairs development or changes needs

6. Life Stage 1 – Infancy Ages – Birth to age 1 • Physical • Dramatic & rapid • Newborn – 6-8 lbs, 18-22 inches long • First year – weight triples (21-24 lbs, height now 29-30 inches) • Muscular & nervous systems immature @ birth • Reflexes present @ birth to allow infant to react to environment • Morro – startle due to loud noise or movement • Rooting – touch to cheek causes infant to turn head & mouth to open • Sucking – caused by slight touch on lips • Grasp – response to object placed in hand

7. Infancy – Physical changes • Muscle coordination develops in stages • Newborns can lift head slightly • 2 months – roll • 4-5 months – turn body around, hold head up when sitting, accept objects handed to them, grasp stationary objects • 6-7 months – sit unsupported, grasps moving objects, crawl on stomachs • 12 months – freq walk without assistance, grasp objects with thumb & forefinger, throw small objects • Born without teeth, 10 –12 by end of 1st year

8. Infancy – Physical changes • Vision – • Poor at birth, limited to black & white, eye movements uncoordinated • By age 1, close vision good, in color, & can readily focus on small objects • Smell, taste, sensitivity to hot & cold, hearing good at birth but become more refined & exact

9. Infancy – Mental development • Rapid during first year • Respond to discomfort by crying • Gradually begin to recognize caregivers • Speech • At birth, cannot speak • 6 months – understand words, make sounds • 12 months – understand many words, use many single words in their vocabulary

10. Infancy – emotional development • Newborns show excitement • 4-6 months – distress, delight, anger, disgust, fear • 12 months- elation, affection for adults • Events that occur in the first year of life when these emotions are first exhibited can have a strong influence on their emotional behavior as adults

11. Infants – Social development • Self-centered newborns to recognition of others in environment • 4 months- recognize caregivers, smile, gaze intently at others • 6 months- watch others’ activities, are possessive, may have stranger anxiety • 12 months – socialize freely with familiar people, mimic & imitate gestures & vocal sounds • Dependent on others for all needs – food, cleanliness, rest, love, security, stimulation

12. Early childhood – 1 – 6 years • Physical development • Slower than infancy, by age 6, weight is 45 lbs, heights is 46 inches • Skeletal & muscle development helps child to look more adult like • Legs & lower body grow faster than head, arms, chest • Muscle coordination improves & child can run, climb, & move freely • Write, draw, use a knife & fork • By 2-3, have most baby teeth & can eat most food • 2-4 years, develop bladder & bowel control

13. Early childhood – mental development • Advances rapidly – verbal grows from several words @ age 1 to 1500-2500 words at age 6 • Age 2 – short attention span but interested in many activities, remember details, begin understanding concepts • Age 4 – ask questions, recognize letters & words, make decisions based on logic not trial & error • Age 6 – very verbal, want to read & write, memory develops so child can make decisions based on past & present experiences

14. Early childhood – emotional development • Age 1-2 – Begin to develop self awareness, accept or defy limits, feel impatient & frustrated when they try to do things beyond their ability, temper tantrums, like routines • Age 4-6 – begin to control their emotions, understand right & wrong, more independent, less frustrated, less anxiety when there is a new situation

15. Early childhood – social development • Self-centered to social • Early years – attached to parents, fear separation, begin to play with others but still are possessive, parallel play • Later years – put self aside, take more interest in others, trust others, make more effort to please others, more social & agreeable, like to have friends their own age

16. Early childhood needs • Food, rest, shelter, protection, love, security – just as infant does • Routine, order, & consistency • Must be taught responsibility & conformity to rules • Need to make reasonable demands based on their ability to comply

17. Late childhood (6 – 12 years) – Physical development • Slow but steady, weight gain 5-7 lbs. per year, height increases 2-3 in/year • Muscle coordination well developed • Physical activities complex • Primary (baby) teeth lost, permanent teeth erupt • Visual acuity at its best • Sexual maturation begins at age 10-12

18. Late Childhood – mental development • Life centers around school – increases rapidly • Speech skills develop • Reading & writing skills have been learned • Use information to solve problems • Memory becomes more complex • Abstract concepts – loyalty, honesty, values, morals • More adept at making judgments

19. Late childhood- emotional development • Achieve greater independence & more distinct personality • Age 6 – frightened & uncertain, need reassuring parents & success in school to gain confidence, coping replaces fears, learn to control emotions • Age 10-12 –puberty leads to periods of depression followed by joy, emotional changes can cause children to be restless & anxious & difficult to understand

20. Late childhood – social development • Age 7 – like activities they can do alone, want approval of others • Age 8-10 – more group oriented, form groups with members of own sex, ready to accept others’ opinions, learn to conform to rules & standards of behaviors • Age 10-12 – make friends more easily, develop awareness of opposite sex, gradually move away from their parents & dependency upon them

21. Late childhood needs • Basic needs of infancy & early childhood • Reassurance, parental approval, & peer acceptance

22. Adolescence (12-20) – Physical development • Most dramatic in early period • Growth spurt – girls age 11-13, boys age 13-15 • Muscle coordination does not occur as quickly, leads to awkwardness or clumsiness • Puberty – sexual organs & secondary sexual characteristics develop • Menstruation in girls, sperm/semen in boys • Females – pubic/axillary hair, breast & hip development, body fat distribution • Males – deeper voice, more muscle mass, broader shoulders, pubic/facial/body hair

23. Adolescence – mental development • Increase in knowledge & sharpening of skills • Learn to make decisions & accept responsibility for actions • Causes conflict because treated as both children & adults (grow up vs. be a kid)

24. Adolescence – Emotional development • Stormy & conflicted • Uncertain, feel inadequate & insecure in trying to establish independence & identity • Worry about appearance, ability, relationships • Peer group influences – can change attitudes & values • Later years – self-identity established & feel more comfortable with who they are, focus on who they will become, gain more control of feelings, become more mature emotionally

25. Adolescence – social development • Move away from family to association with peers • Security with people own age with similar problems & conflicts • If peers help them develop self-confidence, become more secure & satisfied • Later years – develop more mature attitude & patterns of behavior that identify them as adults

26. Adolescence Needs • Reassurance, support, understanding along with basic needs • Conflict & feelings of inadequacy & insecurity can lead to development of problems • Eating disorders, drug/alcohol abuse, suicide • These occur in other stages, but are frequently associated with adolescents

27. Eating Disorders • Often develop from excessive concern about appearance • Anorexia nervosa - psychological disorder where food intake is drastically reduced or nonexistent • Can include excessive exercise • Results in metabolic disturbances, excessive weight loss, weakness, death if untreated • Bulimia – psychological disorder where bingeing alternates with fasting or purging • Can result in metabolic disturbances, damage to teeth, weakness, death if untreated • More common in females, but does occur in males

28. Chemical abuse • Use of drugs or alcohol to the point of developing a chemical dependence • Frequently begins in adolescence • Reasons for use • Relieving anxiety/stress • Peer pressure • Escape from problems • Experimentation or instant gratification • Heredity or cultural influences • Can lead to physical & mental disorders & disease • Treatment directed toward total rehab

29. Suicide • One of leading causes of death in adolescents • Reasons for suicide • Depression • Grief over loss or love affair • Failure in school • Inability to meet expectations • Influence of suicidal friends/parents • Lack of self-esteem

30. Suicide • Causes for increased risk • Family history • Major loss or disappointment • Previous suicide attempts • Recent suicide of friends, family, role models • Impulsive nature increases risk

31. Warning signs of suicide • Verbal statements – “I’d rather be dead” • Sudden changes in appetite or sleep habits • Withdrawal, depression, moodiness • Excessive fatigue or agitation • Neglect of personal hygiene • Alcohol or drug abuse • Loss of interest in other aspects of life • Injuring one’s body • Giving away possessions • Saying goodbye to loved ones

32. Suicide • Attempts are a cry for help • Usually person responds to assistance • Should NEVER be ignored • Prevention of suicide • Provide support & understanding • Psychological or psychiatric counseling

33. Early adulthood (20-40) – Physical development • Frequently most productive life stage • Development complete • Motor coordination at its peak • Prime childbearing time • Usually produces healthier babies • Male/female sexual development at its peak

34. Early adulthood – mental development • Continues through this stage – additional education common • Make many decisions, form judgments • Deal with independence • Make career choices • Determine life style & select marital partner • Start a family • Establish values

35. Early adulthood – emotional development • Preserving stability established previously • Many emotional stressors – family, careers, marriage • Find satisfaction in achievements • Take responsibility for actions • Learn to accept criticism & profit from mistakes

36. Early adulthood – social development • Move away from peer group • Associate with others who have similar ambitions & interests, regardless of age • Own family becomes very important • Do not necessarily accept traditional sex roles & frequently accept nontraditional roles (both male & female nurses, doctors, administrators, teachers, etc)

37. Middle adulthood (40-65) – Physical development • Physical changes • Hair grays & thins • Wrinkles appear, muscle tone decreases • Hearing & vision loss • Weight gain occurs • Females -Menopause – end of menstruation • Males have slowing of hormone production, often called male menopause but never lose the ability to reproduce unless due to injury, disease, or surgery

38. Middle adulthood – mental development • Mental ability continues to increase • Many seek educational opportunities • Acquired life understanding • Confident decision makers • Excellent at analyzing situations

39. Middle adulthood – emotional development • Can be period of contentment & satisfaction or a time of crisis • Emotional status is determined by emotional foundation of previous stages • Emotional satisfaction – job stability, financial success, end of child rearing, good health • Emotional stress – loss of job, fear of aging/loss of youth, illness, marital problems, problems with children or aging parents • Emotional status varies determined by events occurring during this stage

40. Middle Adulthood – social development • Family relationships may see a decline • Children begin lives of own • Parents die • Work relationships may replace family • Marital relationships may become stronger or can end in divorce • Friendships are usually with people who have same interests & lifestyles

41. Late adulthood (65 and up) – Physical development • Declining with all body systems affected • Skin dry, wrinkled, thinner with brown or yellow spots • Hair thin, loses shine • Bone brittle & more porous, likely to fx • Cartilage between vertebrae thins leading to stooped posture • Muscle tone decreases • Hearing & vision loss • Decreased tolerance for heat & cold

42. Late adulthood – physical development • Heart is less efficient, circulation decreases • Kidney & bladder less efficient • Breathing capacity decreases • These changes occur SLOWLY & many people DO NOT show signs until their seventies or eighties

43. Late adulthood – mental development • Varies, people who remain active show less decline • Short term memory first to go • Alzheimer’s disease • Irreversible loss of memory • Deterioration of intellectual function • Speech & gait disturbances • Disorientation • Arteriosclerosis – thickening & hardening of arterial walls that can decrease blood to brain & cause a decrease in mental acuity

44. Late adulthood – emotional development • Some cope well with aging, others become lonely, frustrated, withdrawn, or depressed • Emotional adjustment necessary • Retirement • Death of spouse or friends • Physical disabilities • Financial problems • Loss of independence • Knowing that life must end • Usually people adjust as they have previously

45. Late adulthood – social development • Retirement – can lead to loss of self-esteem, especially if identity is closely related to work • More limited circle of friends • Many people start new activities & make new friends while others limit relationships • Changes in social relationships occurs with spouse & friend deaths & moves to new environment • Development of social contacts important • Senior centers, golden age groups, churches

46. Late adulthood needs • Same as those of all ages • Sense of belonging • Self-esteem • Financial security • Social acceptance & love

47. Death & Dying • Final stage of growth • Experience by everyone, cannot be evaded • Young people tend to ignore it • Elderly often think of own deaths

48. Terminal disease • Disease that cannot be cured & will result in death • Some people react in fear • Pain, abandonment, loneliness • Unknown • Anxious about loved ones • Anxious about unfinished work & dreams • Others view death as a final peace • Lived a full life • Strong religious beliefs • Relief from suffering, pain, loneliness

49. Elisabeth Kubler-Ross • Extensive research on death & dying • Results of research show • Most HCP believe that pt. should be told of approaching death • Should be left with some hope & reassured that they won’t be left alone • Important to know how much info pt has & how they reacted

50. 5 stages of grieving • Experienced in preparation for death • Stages may not occur in order & may overlap or be repeated several times • Some patients may not progress through them • May be in more than one stage at the same time • Denial, anger, bargaining, depression, acceptance