1. Middle adulthood Lecture 9 Middle Adulthood

2. : After the completion of this lecture, the student will be able to: 1. Define middle adulthood. 2. list the physiological changes that occur during middle adulthood. 3. Define the major developmental tasks and challenges of middle adulthood. 4. state the complexities of the menopausal experience in women. 5. Discuss the male climacteric.

3. : 6. Define midlife crisis 7. List preventative health care measures appropriate for middle adulthood 9. Define the “sandwich generation”. 10. list teaching strategies that may be effective for the patient in the middle adult phase of the life cycle

4. Definition - Middle adulthood is currently defined as the period of development after the early adult years but before retirement. - Middle adulthood is often referred to as the period between 40 and 60 years of age - It is influenced by genetic and the environment.

5. Physiological Changes: ● Metabolic needs decrease during middle adulthood and if diet and exercise are not part of a healthy lifestyle excess weight begins to accumulate. ● A decrease in energy and perceived physical attractiveness may occur A loss of muscle tone and skin elasticity may result in less firm appearance of body contours. ● Eye changes common to middle age can be easily corrected with glasses, contact lenses, or laser surgery. ● Diet, smoking and lack of exercise influence cardiovascular changes that occur during midlife, but hormonal changes also influence risk factors for cardiovascular disease.

6. Developmental Tasks 1. The main task or crisis of middle adulthood is generativity versus stagnation (Erikson1994). -Generativity has been defined as contributing in a positive way to family or community. -This contribution improves self image and promotes subjective well being. - Failure to achieve generativity result in stagnation which is total concern of self and denial of the developmental process. 2. Managing a career and finances 3. Managing a household and nurturing marriage and family relationship. 4. Maintaining a positive self esteem

7. Challenges - Maintaining optimum cognitive functioning is necessary to prevent a decrease in problem solving skills. - Women at midlife are at high risk for social isolation due to divorce, separation, or widowhood. “The empty nest “ syndrome that can occur when grown children start to leave home for the first time may increase the feeling of isolation

8. Midlife Crisis ● Middle adulthood is a time of self reflection, reevaluation and prioritization. ● Looking back, the adult may grieve lost youth and missed opportunities. ● Adults may fear the inevitability of their own mortality. This may lead to despair.

9. The Sandwich Generation - Middle adults are known to be sandwich generation. That means they must deal with increased financial and emotional responsibilities related to their children in addition to increased demands placed on them by their older and possibly dependent parents. Where responsibilities include the care of children and older parents. - These stressors contribute to the challenges of middle adulthood.

10. Reproductive Health - Reproductive health is a term used to describe the health of the reproductive organs in all persons. - The climacteric refers to the time in life in which hormonal changes result in cessation the reproductive ability in the female and a corresponding decrease in sexual activity in the male. Women’s Health ● Menopause is the cessation of menstrual period due to hormonal changes in the body. ● Menopause usually begins between 45 and 55 years of age and is genetically controlled. Essential health screening for middle-aged women and men;

11. Signs of Menopausal Changes in Women *Hot flashes *Heart palpitations *Headache *Decreased vaginal lubrication *Fatigue *Insomnia *Emotional liability(happy on minute, crying the next)

12. Men’s Health - Although women’s health has become a specialty in medicine, a specialty in men’s health is rarely seen. - In each leading cause of death in adults, men have a higher rate of mortality. - The morbidity rate is generally higher for women in both acute and chronic conditions. - Generally, men remain in the workforce longer than women and may partake in activities that pose a higher potential for injuries.

13. Essential Health Screening for Middle-Aged Women and Men Healthy middle-aged women and men should have the following screening tests performed at regular intervals; *Vision testing *Dental checkups *Blood pressure monitoring *Lipid screening (Cholesterol, triglycerides) *Cardiovascular screening *Colorectal cancer screening

14. Essential Health Screening for Middle-Aged Women and Men Women: * * Breast examination mammogram * * Papanicolaou (Pap) testing Men: * * Testicular examination * * Prostate cancer screening

15. Teaching Techniques for the middle-aged adult - Content of teaching plans should be related the problems and concerns of the individual and the age group. - Help adjusting to the role of the grandparent. - Help the middle adult accept the aging process in a positive way and build self esteem.