Through the Lifespan

 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 (continues)

 Infancy: birth to 1 year  Early childhood: 1–6 years  Late childhood: 6–12 years  Adolescence: 12–20 years  Early adulthood: 20–40 years  Middle adulthood: 40–65 years  Late adulthood: 65 years and older

 Physical: body growth  Mental: mind development  Emotional: feelings  Social: interactions and relationships with others  Four types above occur in each stage

 Erik Erikson was a psychoanalyst  A basic conflict or need must be met in each stage  See Table 8-1 in text

 Age: birth to 1 year old  Dramatic and rapid changes  Physical development  Mental development  Emotional development  Social development  Infants are dependent on others for all of their needs

 Baby’s weight can double in first year  Reflexes present at birth  Moro, Sucking, Grasp, Rooting  2-4 months: roll side to side  4-6 months: turn body completely around & grasp items handed to them  6-8 months: sit unsupported & grasp moving objects  8-10 months: crawl, pull to sitting or standing  12 months: walk without assistance, grasp objects with thumb & fingers, throw small objects

 Rapid development  Respond to discomforts: pain, cold, or hunger by crying  Become more aware of surroundings  2-4 months: coo or babble, laugh or squeal  6 months: understand some word and make basic sounds like “mama” & “dada”  12 months: understand many words and use singe words in vocabularies

 Newborns: show excitement  4-6 months: exhibit distress, delight, anger, disgust, & fear  12 months: elation & affection for adults is evident  Events occurring in the 1 st year of life when these emotions are first exhibited can have a strong influence on an individual’s emotional behavior during adulthood

 Gradually progresses from self-centeredness concept of the newborn to the recognition of others in environment  4 months: recognize caregivers & smile and stare at others  6 months: watch activities of others, show signs of possessiveness and may become shy in presence of strangers.  12 months: may be shy with strangers, but socialize freely with familiar people, mimic and imitate gestures, facial expressions & vocal sounds

 Dependent on others for all needs  Food, cleanliness & rest are essential for physical growth  Love & security are essential for emotional & social growth  Stimulation is essential for mental growth

 Age: 1–6 years old  Physical development  Mental development  Emotional development  Social development  The needs of early childhood include routine, order, and consistency

 1-6 years: growth slower than in infancy  1-3 years: most teeth have erupted and digestive system is mature enough to handle most adult foods.  2-4 years: most children learn bladder & bowel control  6 years: average weight is 45 pounds & average height is 46 inches  Legs & body tend to grow more rapidly than head, arms, chest (more adult appearance)  Muscle coordination better: use silverware, draw, run, climb & move freely

 Age 1: Several words  Age 6: vocabulary of 1500 – 2500 words  Age 2: short attention spans, interested in many different activities  Age 4: Asks frequent questions and usually recognize letters and some words. Begin to make decisions based on logic  Age 6: Very verbal & want to learn how to read and write. Memory developed to the point where the child can make decisions based on both past & present experiences.

 Age 1-2: begin to develop self-awareness & recognize the effect they have on other people and things. Limits established for safety  Age 2: begin to gain self-confidence, excited about learning new changes. Feel impatient & frustrated as new things are tried beyond their abilities, like routines & become angry if they are interrupted  Age 4-6:Gain more control over emotions, understand right & wrong, achieved independence & not as frustrated by lack of ability.  Age 6: show less anxiety when faced with new experiences

 Age 1:Self-centered, strongly attached to parents or caregivers & fear separation  Enjoy other children but are still possessive  Playing alongside other children more common than playing with them.  Age 6: Have become more social, learned to put self aside and take more of an interest in others. Make more of an effort to please others. Friends of their own age important

 Food, rest shelter, protection, love & security  Routines, order, & consistency in their daily lives  Must be taught to be responsible & conform to rules by making reasonable demands based on the child’s ability to comply

 Age: 6–12 years old  Physical development  Mental development  Emotional development  Social development  Children in this age group need parental approval, reassurance, peer acceptance

 Weight gain averages 4-7 pounds / year  Height gain increases approx 2-3 inches / yr  Muscle coordination is well developed  Engage in physical activities that require complex motor-sensory coordination  Primary teeth are lost & primary teeth erupt  Eyes are well developed & visual acuity best  Age 10-12: Secondary sexual characteristics may begin to develop in some children

 Increases rapidly since child’s life centers around school  Speech skills develop, reading & writing skills are learned  Begin to understand abstract concepts such as loyalty, honesty, values, and morals  More adept at making judgements

 Age 7: like activities they can do by themselves and do not usually like group activities  Want approval of others

 Age: 12–20 years old  Physical development  Mental development  Emotional development  Social development  Adolescents need reassurance, support, and understanding

 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

 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

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

 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

 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

 Family history of suicide  A major loss or disappointment  Previous suicide attempts  Recent suicide of friends, family, or role models (heroes or idols)

 Age: 20–40 years old  Physical development  Mental development  Emotional development  Social development

 Age: 40–65 years of age  Physical development  Mental development  Emotional development  Social development

 Age: 65 years of age and older  Physical development  Mental development  Emotional development  Social development  The elderly need a sense of belonging, self-esteem, financial security, social acceptance, and love

 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

 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

 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 (continues)

 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

 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

 Very challenging, but rewarding work  Supportive care  Health care worker must have self-awareness  Common to want to avoid feelings by avoiding dying patient

 Palliative care only  Often in patient’s home  Philosophy: allow patient to die with dignity and comfort  Personal care  Volunteers  After death contact and services

 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  Hospice encourages LIVE promise  Dying Person’s Bill of Rights

 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

 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)

 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 (continues)

 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

 Motivation to act when needs felt  Sense of satisfaction when needs met  Sense of frustration when needs not met  Must prioritize when several needs are felt at the same time  Different needs can have different levels of intensity

 Direct methods  Hard work  Set realistic goals  Evaluate situation  Cooperate with others (continues)

 Indirect methods  Defense mechanisms  Rationalization  Projection  Displacement  Compensation  Daydreaming

 Indirect methods (continued)  Repression  Suppression  Denial  Withdrawal

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