1. Human Growth and Development
Chapter 8
Human Growth and Development

2. 8:1 Life Stages Growth spans an individual’s lifetime
Development is the process of becoming fully grown
Health care workers need to be aware of the various stages and needs of the individual to provide quality health care
GROWTH – measurable physical changes that occur throughout life (height, weight, body shape, physical characteristics, etc)
DEVELOPMENT – harder to measure (changes in intellectual, mental, emotional, social skills over time)
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3. Life Stages (continued)
Infancy: birth to 1 year
Early childhood: 1–6 years
Late childhood: 6–12 years

4. Life Stages (continued)
Adolescence: 12–20 years
Early adulthood: 20–40 years
Middle adulthood: 40–65 years
Late adulthood: 65 years and older

5. Growth and Development Types
Physical: body growth
Mental: mind development
Emotional: feelings
Social: interactions and relationships with others
Four types above occur in each stage

6. Growth and Development Types
Physical: sit  stand  crawl  walk
Mental: ABC’s  adding  concepts
Emotional: pain  included  stress
Social: others  friends  specific people

7. Erikson’s Stages of Psychosocial Development
Erik Erikson was a psychoanalyst
A basic conflict or need must be met in each stage
See Table 8-1 in text
**Erikson believes that if an individual is not able to resolve a conflict at the appropriate stage, the individual will struggle with the same conflict later in life

9. Infancy Age: birth to 1 year old Dramatic and rapid changes
Physical development
Mental development (pain, cold, hunger by crying)
Emotional development (delight, anger, disgust, fear)
Social development (caregivers, shyness)
Infants are dependent on others for all of their needs
Weight usually triples by 1 year old
2-4 months: roll form side to back
4-6 months: turn the body completely around, grasp bottle, hold head up while sitting
6-8 months: sit unsupported, crawl on stomach
8-10 months: crawl using knees and hands, pull from sitting to standing position
By 12 months: walk without assistance

10. Early Childhood Age: 1–6 years old Physical: 45lbs, 46” tall
Mental: verbal growth
Emotional: self-awareness & right vs. wrong
Social: self-centered  sociable
The needs of early childhood include routine, order, and consistency
PHYSICAL – muscle coordination allows child to run, climb, write, draw, fork and knife
MENTAL – remember details, and begin to understand concepts, make decisions based on past and present experiences

11. Late Childhood or Preadolescence
Age: 6–12 years old
Physical: 4-7 lb gain per year, 2-3” gain height
Mental: speech, memory, abstract thoughts
Emotional: independence
Social: awareness of the opposite sex
Children in this age group need parental approval, reassurance, peer acceptance
MENTAL – memory becomes more complex due to life centered in school

12. Adolescence Age: 12–20 years old Physical: puberty changes
Mental: knowledge & sharpen skills
Emotional: stormy & conflicted
Social: family  peer group-centered
Adolescents need reassurance, support, and understanding
PHYSICAL – secretion of sex hormones leads to secondary sexual characteristics developing throughout puberty
MENTAL – make decisions and accept responsibility for their actions
EMOTIONAL – establish identity and independence, which may make adolescence feel uncertain and feel inadequate and insecure

13. Adolescence
Many problems can be traced to the conflict and feelings of inadequacy and insecurity that adolescents experience
Examples:
Eating Disorders
Drug/Alcohol Abuse
Suicide
**Occur in earlier and later stages of life, most common in adolescence

14. Eating Disorders
Often develop from an excessive concern for appearance
Anorexia nervosa
Bulimia
More common in females
Usually, psychological or psychiatric intervention is needed to treat either of these conditions
ANOREXIA NERVOSA – dramatically reduces food intake or refused to eat at all
BULIMIA – alternately binges (eats excessively) and then fasts, or refuses to eat at all
BULIMAREXIA – induces vomiting to get rid of food that has been eaten

15. Chemical Abuse
Use of alcohol or drugs with the development of a physical and/or mental dependence on the chemical
Can occur at any life stage, but frequently begins in adolescence
Can lead to physical and mental disorders and diseases
Treatment towards total rehabilitation

16. Reasons Chemicals Used
Trying to relieve stress or anxiety
Peer pressure
Escape from either emotional or psychological problems
Experimentation
Seeking “instant gratification”
Hereditary traits or cultural influences

17. Suicide One of the leading causes of death in adolescents
Permanent solution to temporary problem
Impulsive nature of adolescents
Most give warning signs
Call for attention
Prevention of suicide
WARNING SIGNS – sudden changes in appetite, withdrawal, depression, moodiness, alcohol or drug abuse, etc.

18. Reasons for Suicide Depression Grief over a loss or love affair
Failure in school
Inability to meet expectations
Influence of suicidal friends or parents
Lack of self-esteem

19. Increased Risk of Suicide
Family history of suicide
A major loss or disappointment
Previous suicide attempts
Recent suicide of friends, family, or role models (heroes or idols)

20. Early Adulthood Age: 20–40 years old
Physical: complete (muscles developed, strong)
Mental: decisions & judgments
Emotional: preserving stability
Social: away from peer group  mate selection
MENTAL – independence, career choices, selects marital partner, starts a family
EMOTIONAL – subject to emotions of stresses related to career, marriage, family

21. Middle Adulthood (Middle Age)
Age: 40–65 years of age
Physical: decline of physical peak
Mental: concrete, confident, analytical
Emotional: contentment vs. crisis
Social: family & work relationships
PHYSICAL – hair turns gray and thin, skin wrinkles, muscle tone decreases, hearing loss starts, visual acuity declines, weight gain occurs
MENTAL – experiences create confidence
EMOTIONAL – job security, financial success VS. fear of aging, loss of youth, marital problems
SOCIAL – family relationships decline as children grow, parents die, work relationships replace family

22. Late Adulthood Age: 65 years of age and older
Physical: body is in decline
Mental: acuity caused by illness
Emotional: happy vs. lonely
Social: retirement – “Circle of friends”
The elderly need a sense of belonging, self-esteem, financial security, social acceptance, and love
PHYSICAL – skin becomes dry, wrinkled, and thin, hair becomes thin and loses its shine, bones become brittle
MENTAL – short term memory is first to decline

23. 8:2 Death and Dying Death is “the final stage of growth”
Experienced by everyone and no one escapes
Young people tend to ignore it and pretend it doesn’t exist
Usually it is the elderly, who have lost others, who begin to think about their own death

24. Terminal Illness
Terminal Illness: Disease that cannot be cured and will result in death
People react in different ways
Some patients fear the unknown while others view death as a final peace

25. Research
Dr. Elizabeth Kübler-Ross was the leading expert in the field of death and dying and because of her research
Most medical personnel now believe patients should be informed of approaching death
Patients should be left with some hope and know they will not be left alone
Staff need to know extent of information known by patients and how the patient reacted
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26. Research (continued)
Dr. Kübler-Ross identified five stages of grieving
Dying patients and their families and friends may experience these stages
Stages may not occur in order
Some patients may not progress through them all, others may experience several stages at once

27. Stages of Death and Dying
Denial—refuses to believe
Anger—when no longer able to deny
Bargaining—accepts death, but wants more time
Depression—realizes death will come soon
Acceptance—understands and accepts the fact they are going to die
BARGAINING – usually when people turn to religion or spiritual beliefs

28. Caring for the Dying Patient
Very challenging, but rewarding work
Supportive care
Health care worker must have self-awareness
Common to want to avoid feelings by avoiding dying patient
Health care workers must first understand their own personal feelings about death and come to terms with these feelings

29. Hospice Care Palliative care only (support and comfort)
Often in patient’s home
Philosophy: allow patient to die with dignity and comfort
Personal care
Volunteers
After death contact and services
PALLIATIVE – short term care, does not treat to figure out the underlying cause of problem

30. Right to Die
Ethical issues must be addressed by the health care worker
Laws allowing “right to die”
Under these laws specific actions to end life cannot be taken (respirators, pacemakers)
Hospice encourages LIVE promise
Dying Person’s Bill of Rights
LIVE PROMISE:
(L) LEARN ABOUT END-OF-LIFE SERVICES AND CARE
IMPLEMENT PLANS SO WISHES ARE HONORED
(V) VOICE DECISIONS
(E) ENGAGE OTHERS IN CONVERSATIONS ABOUT END-OF-LIFE CARE OPTIONS

31. Summary Death is a part of life
Health care workers must understand death and dying process and think about needs of dying patients
Then health care workers will be able to provide the special care these individuals need

32. 8:3 Human Needs Needs: lack of something that is required or desired
Needs exist from birth to death
Needs influence our behavior
Needs have a priority status
Maslow’s hierarchy of needs (See Figure 8-15 in text)

33. Altered Physiological Needs
Health care workers need to be aware of how illness interferes with meeting physiological needs
Surgery or laboratory testing
Anxiety
Medications
Loss of vision or hearing
ANXIETY ABOUT ILLNESS MAY INTERFERE WITH A PATIENT’S SLEEP OR ELIMINATION PATTERNS
MEDICATIONS MAY AFFECT PATIENT’S APPETITE
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34. Altered Physiological Needs (continued)
Decreased sense of smell and taste
Deterioration of muscles and joints
Change in person’s behavior
What the health care worker can do to assist the patient with altered needs
Can provide understanding and support to the patient and make efforts to help satisfy needs

35. Meeting Needs When needs felt, individual is motivated to act
Sense of satisfaction when needs met
Sense of frustration when needs not met
Must prioritize when several needs are felt at the same time (i.e. eat vs. sleep)
Different needs can have different levels of intensity
Individuals may have greater desire to meet or reduce the need

36. Methods for Satisfying Needs
Direct methods
Hard work
Set realistic goals
Evaluate situation
Cooperate with others
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37. Methods for Satisfying Needs (continued)
Indirect methods
Defense mechanisms
Rationalization (excuse or explanation)
Projection (put it on someone else)
Displacement (transfer feelings to wrong person)
Compensation (substituting one goal for another)
Daydreaming (provides escape from reality)
Intensity of need decreases
DEFENSE MECHANISMS – unconscious acts that help a person deal with an unpleasant situation

38. Methods for Satisfying Needs (continued)
Indirect methods (continued)
Repression (transfer to the unconscious mind)
Suppression (refuses to deal with thoughts and feelings)
Denial (disbelief of events or ideas)
Withdrawal (stop communication, or remove themselves physically from situation)
REPRESSION – transfer of unacceptable or painful ideas, feelings, and thoughts into the unconscious mind

39. Summary Be aware of own needs and patient’s needs
Better understanding of our behavior and that of others
More efficient quality care can be provided when needs are recognized