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Slide 1 ight © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. CHAPTER 8 Life Span Development Middle Adulthood: 40 to 65-years-old

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Slide 1Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

CHAPTER 8

Life Span DevelopmentMiddle Adulthood:

40 to 65-years-old

CHAPTER 8

Life Span DevelopmentMiddle Adulthood:

40 to 65-years-old

Slide 2Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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

Stages of Growth and DevelopmentStages of Growth and Development

Slide 3Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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

Slide 4Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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

o 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

Slide 5Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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

Slide 6Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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

o Fluoride usage, regular flossing, dental cleaning

Slide 7Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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

Stages of Growth and DevelopmentStages of Growth and Development

Slide 8Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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”

o Engage in extramarital affairs, leading to divorce

Slide 9Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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 stagnantinactive and lifeless

• Time for vocational, interpersonal, and personal fulfillment

• Family roles change during this stage

Stages of Growth and DevelopmentStages of Growth and Development

Slide 10Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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

Slide 11Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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”

Slide 12Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Figure 8-19Figure 8-19

According to Erikson, generativity is the developmental task of middle adulthood.

(From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

Slide 13Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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

o Walking, swimming, golf, or tennis may enhance calcium utilization

Slide 14Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages of Growth and Development

• Middle Adulthood: 40 to 65 Years Health Promotion

• Nutrition Premenopausal women should have 1gm to 1.2gm of

calcium per dayo Diet rich in phosphorus and magnesuimo Green leafy vegetables, fresh fruits, whole grain

cereals or breads, and dairy products

Slide 15Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Stages of Growth and DevelopmentStages 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!!!

Slide 16Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• Late Adulthood: 65 Years and Older Ageisma form of discrimination and prejudice

against the older adultdefinitely exists Theories of aging

• Autoimmunity theory

• Free radical theory

• Wear and tear theory

• Biological programming theory

• Disengagement theory

• Activity theory

• Continuity theory

Stages of Growth and DevelopmentStages of Growth and Development

Slide 17Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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

Stages of Growth and DevelopmentStages of Growth and Development

Slide 18Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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.

Stages of Growth and DevelopmentStages of Growth and Development

Slide 19Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Figure 8-23Figure 8-23

Many older people continue to work and learn after the traditional retirement age.

(From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

Slide 20Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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.

Stages of Growth and DevelopmentStages of Growth and Development

Slide 21Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Figure 8-20Figure 8-20

A loving relationship with a spouse is an example of a positive influence during older adulthood.

(From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

Slide 22Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Figure 8-21Figure 8-21

Beauty throughout the life span .

Slide 23Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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.

Stages of Growth and DevelopmentStages of Growth and Development

Slide 24Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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.

Stages of Growth and DevelopmentStages of Growth and Development

Slide 25Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

• 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.

Stages of Growth and DevelopmentStages of Growth and Development