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. 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.

Lifespan Consideration Metabolic needs decrease during middle adulthood. Diet and exercise should be a part of lifestyle Changes of fat distribution, loss of elasticity of skin, and thinning hair, among other changes due to hormonal level changes Middle-aged adults are at risk for cardiovascular disorders due to inappropriate diet, inadequate exercise, stress, and smoking Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Developmental Tasks Erikson Stage-Generativity contributing to family and community Stagnation-total concern about self and denial Maintaining a positive self-image is important Identity accommodation Effect of the spouse or significant other on continued development and life stability is important Adults in this age group are more productive if they feel loved and useful The middle adult must manage finances and households and maintain family and social relationships 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-remember may take more time to learn information but once retained it, it stays 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.

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.

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-decrease in muscle mass, strength, and decrease in sex drive (libido) 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-45-55 yrs of age; Hot flashes-capillaries dilate and blood rushes to skin surface; then sweat and feel cold 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.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Men's Health Sexual concerns-decrease due to concern about performance and fears failure Male climacteric involves a gradual decline in the blood concentration of testosterone Screening for prostate cancer; new procedures to help diagnose Testosterone-replacement therapy can help with strength, decrease fat accumulation, restore libido, and sense of well being, but does not correct erectile dysfunction See Box 12-2. 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 Inform clients that exercise is essential but also explain that strenuous exercising can reduce testosterone levels lower 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 such as health concerns and stressors common to this age group See Table 12-1 and Figure 12-3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.