Human Growth and Development Chapter 8 Human Growth and Development

8:1 Life Stages Growth spans an individual’s lifetime Growth= measurable physical changes that occur through out a person’s life Development is the process of becoming fully grown Also refer to changes in intellect, mental, emotional, social and functional skills Health care workers need to be aware of the various stages and needs of the individual to provide quality health care (continues)

Life Stages (continued) 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

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

Erikson’s Stages of Psychosocial Development Erik Erikson was a psychoanalysis Identified 8 stages of psychosocial development A basic conflict or need must be met in each stage-- See Table 8-1 in text His belief- If conflict not resolved you will struggle with the conflict in later life What stage of Erikson development are you in ? Give an example?

Infancy Age: birth to 1 year old Dramatic and rapid changes Physical development Muscular & nervous system most dramatic Muscular development occurs in stages Nervous system reflexes allow response to environment Reflexes– Moro or startle reflex Rooting reflex Sucking reflex Grasp reflex

Infancy Mental development Emotional development- Rapid in the 1st year Newborns responds to discomforts such as: pain, hunger, cold Sounds develop by 6 months 12 months many infants can understand and use 1 word in their vocabulary Emotional development- 4-6 months- they show distress, anger, fear, delight Social development- is self- centered 4 mo. Recognize caregiver, smile, stare 6 mo. Shy, withdraw, watch intently, possessiveness 12 mo. Mimic, imitate, facial expressions, vocal sounds

Infants are dependent on others for all of their needs Infancy Infants are dependent on others for all of their needs

Early Childhood Age: 1–6 years old Physical development Slows down @ age 6– average WT is 45 lbs/ Ht 46 in. Improved muscle coordination 2-3 yrs old- Dentition in place & GI tract can handle most adult foods 2-4 yrs old- most have full bowel & bladder control

Early Childhood Mental development Emotional development Rapid during this stage Vocabulary increases to 2500 words/ age 6 Letter, word recognition Desire to read & write emerges Emotional development Vey rapid in this stage Increase self confidence & enthusiasm Easily frustrated– routine is important

Early Childhood Social development Expands from self- centered to more social beings Early on they fear separation Gradually enjoy playing alongside and then with others Trust relationship are developing The needs of early childhood include routine, order, and consistency

Late Childhood or Preadolescence Age: 6–12 years old Physical development Slow but steady Wt increase 4-7 lbs & Ht 2-3 in /year Muscle coordination – well developed Permanent teeth 10-12 yr- 2nd sex characteristics develop

Late Childhood or Preadolescence Mental development Rapid- life revolves around school & learning Problem solving Begin understanding abstract concepts Loyalty-honesty-values-morals Active thinking & can make judgments Emotional & Social development Fears lead to coping skills Group oriented Make friends Begins to lessen their dependency on caregivers

Early Childhood or Preadolescence Children in this age group need parental approval, reassurance, peer acceptance

Adolescence Age: 12–20 years old Physical development Traumatic life stage Physical development Growth spurt Increase of Wt 25 lbs/ Ht several inches per month Puberty- Secretion of sex hormones leads to menstruation in girls & sperm production in boys

Adolescence Mental development Emotional development Increase in knowledge Decision making & acceptance of responsibilities of actions Period of great conflict Emotional development Stormy Identify versus independence Peer become central Self –identity should be establish by the end of this stage

Adolescence Social development Less time with family- more time with friends Security in groups Goal--Develop adult like behaviors and patterns Adolescents need reassurance, support, and understanding

Adolescent Challenges

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

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

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 development Most productive stage in life Physical development Complete Sexual development at peak Prime childbearing years Mental development Formal education--- College- careers Family establishment

Early Adulthood Emotional development Social development Stability Stress related to career, family, marriage Accept criticism and profit from mistakes Social development Move away from peers, family Selection of a mate Assimilation into traditional patterns of society

Middle Adulthood (Middle Age) Age: 40–65 years of age Physical development Graying of hair, wrinkles, decrease muscle tone, visual & hearing acuity changes, wt gain Menopause & male climacteric Mental development Formal education common Understanding of life- cope well with stressors Excel making decisions & analyzing situations

Middle Adulthood Emotional development Social development Contentment & satisfaction Job stability-financial success- end of child rearing-good health Common stressors include: Aging parents Children Job loss Marital problems Loss of youth Social development Decline- children move on Marital relationship often strengthen Friendships emerge

Late Adulthood Age: 65 years of age and older Physical development Elderly, Seniors,, golden age, Physical development Decline of body systems Occur slowly Mental development Vary Reduction in short term memory Alzheimer's disease- irreversible memory loss

Late Adulthood Emotional development Social development Some cope well– others do not Withdrawn- depression Social development Retirement Death of spouse- friends Financial changes Loss of independence The elderly need a sense of belonging, self-esteem, financial security, social acceptance, and love

Death & Dying

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 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 (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

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

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

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 Hospice encourages LIVE promise Dying Person’s Bill of Rights

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

Human Needs

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 (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

Meeting 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

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 Projection Displacement Compensation Daydreaming

Methods for Satisfying Needs (continued) Indirect methods (continued) Repression Suppression Denial Withdrawal

Summary 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