Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Chapter 12 Middle Adulthood Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Objectives Define middle adulthood. List the physiological changes that occur during middle adulthood. Define the major developmental tasks and challenges of middle adulthood. State the complexities of the menopausal experience in women. Discuss the male climacteric. Define midlife crisis. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Objectives (cont.) Discuss sexuality in the middle-adulthood phase of the life cycle. List preventative health-care measures appropriate for middle adulthood. Define the "sandwich generation." Describe the benefits of regular exercise during middle adulthood. List teaching strategies that may be effective for the patient in the middle-adult phase of the life cycle. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Key Terms climacteric “empty nest” syndrome generativity hot flashes identity accommodation menopause middle adulthood midlife crisis reproductive health sandwich generation sexuality Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Definition The period of development after the early adult years but before retirement Between 40 and 60 years of age Some theorists suggest that developmental changes are gradual and progressive, but others express the concept of passing through distinct stages See Lifespan Considerations Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Developmental Tasks Generativity Stagnation Maintaining a positive self-image is important Identity accommodation Effect of the spouse or significant other on continued development and life stability is important See Figure 12-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Challenges Maintaining optimum cognitive functioning is necessary Adjusting to changes in relationships Continue their education Marital separation, divorce, major illness or injury, loss of income, or unplanned pregnancy “Empty nest” syndrome Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 1 What impact does the failure to develop a sense of intimacy during young adulthood have on the middle-aged adult experiencing the empty nest syndrome? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Midlife Crisis May grieve lost youth and missed opportunities May start to engage in behaviors that are atypical for their character See Figure 12-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

The Sandwich Generation Must handle increased financial and emotional responsibilities related to their children and their older, and possibly dependent, parents A fulfilling marriage will help validate positive self-esteem Divorce, separation, conflicts with adult children or aging parents may have negative impact on psychological functioning Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 2 Many couples are starting their families later in life and advances in health care have contributed to greater longevity in late adulthood. How do these factors affect middle-aged adult families? What interventions could assist these families to cope? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Sexuality Often focused on career goals and financial stability, little time or energy may be set aside to fulfill sexual needs Options for sexual lifestyles for the single person Gradual hormonal changes Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Reproductive Health Climacteric Complex interactions exist among sex hormones, physiology, and physical and emotional well-being Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Women's Health Menopause Hot flashes Hormone replacement therapy (HRT) Complementary and alternative medicine (CAM) therapy See Boxes 12-1 and 12-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 3 Recent medical advances have prolonged the reproductive capabilities of some women. Given your knowledge of developmental tasks of family, parents, and middle adulthood, discuss the potential impact of having a child at age 40. Age 50 or older? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Men's Health Sexual concerns Male climacteric involves a gradual decline in the blood concentration of testosterone Testosterone-replacement therapy See Box 12-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Critical Thinking Question 4 Women’s health has become a recognized nursing and medical specialty. With increasing focus on men’s health concerns, what educational programs for health care providers and for men themselves could or should be implemented to encourage men to seek earlier medical and preventive care? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Physical Activity Maintain fitness and avoid disease Social outlet for an otherwise isolated person Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Teaching Techniques Stress can inhibit or motivate learning Incorporate the independence and competencies of the adult learner Provide information that coincides with the concerns and stresses See Table 12-1 and Figure 12-3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.