Human Growth and Development Chapter 8 Human Growth and Development

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) (continues)

Life Stages (continued) Infancy: birth to 1 year Early childhood: 1–6 years Late childhood: 6–12 years

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

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)

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

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

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

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

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

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 (continues)

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

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

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

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

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

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

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)

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 (continues)

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

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

Methods for Satisfying Needs Direct methods Hard work Set realistic goals Evaluate situation Cooperate with others (continues)

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

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

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