Human Growth and Development Human Growth and development is a process that begins at birth and ends at death During all the stages of growth individual needs that have to met. A healthcare worker must be aware of these needs in order to provide quality care

Life Stages Infancy: birth to 1 year old Early Childhood: 1 – 6 years old Late Childhood: 6 - 12 years old Adolescence: 12 – 20 years old Early Adulthood: 20 – 40 years old Middle Adulthood: 40 – 65 years old Late Adulthood: 65 and up

Types of Growth and Development As we pass through the various life stages four main types/areas of growth and development occur. Physical – body growth, height weight, muscles, nerves and body organs Mental – mind, learning how to solve problems, make judgments and deal with situations Emotional – feelings, dealing with love, hate, joy, fear and excitement Social – interactions and relationships with others

Ways to Resolve Conflict Stage of Development Basic Conflict Major Life Event Ways to Resolve Conflict Infancy    Birth to 1  Trust vs Mistrust  Feeding  Infant develops trust in self and others, when caregiver responds to basic needs Toddler  1 – 3 years old  Autonomy vs Shame and self doubt  Toilet Training  Toddler learns control, while mastering skills of feeding, toilet training and getting dresses Preschool   3 – 6 years old  Initiative vs Guilt  Independence  Child begins to initiate activates rather than imitate, uses imagination, develops a conscious. School-Age  6 – 12 years old  Industry vs inferiority  School  Child becomes productive by mastering success, learns to deal with academics, group activates Adolescence  12 – 18 years old  Role vs Confusion  Peer Relationships  Adolescent searches for self-identity by making choices, occupation, sexual preferences, lifestyle. Depends on peers for reassurance Young Adulthood  19 – 40 years old  Intimacy vs Isolation  Love Relationships  Learn personal commitment to others, learn to share life events with others. Middle Adulthood  40 – 65 years old  Generativity vs Stagnation  Parenting  Adult seeks satisfaction, purpose and success using career, family and civic interests to provide for others. Older Adulthood  65 - death  Ego Integrity vs Despair  Reflection on and acceptance of Life Adult reflects on life in positive manner, feels fulfillment with accomplishments, deals with losses and prepares for death.

Adolescence – ages 12 – 20 Often considered the most traumatic life stage! Physical Development – sudden growth spurts, puberty – sexual characteristics Emotional Development – often stormy and full of conflict. Trying to establish identity. Uncertain, feel inadequate and insecure Worry about appearance, abilities, relationships Respond more and more to peer influences – sometimes at odds with values and ethics previously learned Towards end of Adolescence – teenagers feel more comfortable with who they are and focus more on who they are going to become. Become more in control of feelings and become more emotionally mature.

Adolescence - Ages 12 - 20 Mental Development – focuses on increase in knowledge and sharpening of skills Learn to make decisions and accept responsibility for actions Sometimes can cause conflict because told to “grow up” while being reminded you are still children. Social Development – Usually involves less time with family and more with peer groups. Attempt to develop self-identity and independence Seek security in groups of people like themselves – age, gender, similar conflicts and problems If these peer relationships help develop self-confidence through approval adolescence become more secure and satisfied

Adolescence - Ages 12 - 20 Social Development (Continued) Many problems in this stage can be traced to feelings of inadequacy and insecurity. Develop eating disorders, drugs/alcohol abuse and suicide. Eating disorders occur from an excessive concern with appearance. More common in females than males Anorexia Nervosa – psychological disorder, that person drastically reduces food intake or refuses to eat at all See a fat person all the time Can lead to death Bulimia – psychological disorder, binges and purges/laxatives

Anorexia Nervosa

Adolescence - Ages 12 - 20 Chemical Abuse – alcohol/drugs Reasons: Anxiety, stress relief, peer pressure, escape from problems, experimentation of feelings that chemicals produce. Suicide – one of leading causes of deaths in adolescence. Permanent solution to temporary problems Reasons: depression, grief over loss, failure in school, inability to meet expectations, influence of suicidal friends, lack of self- esteem. Many individuals thinking of suicide give warning signs: Statements: “Rather be dead, better off without me”

Suicide Warning Signs Sudden changes in appetite and sleep patterns Withdrawal, depression and moodiness Excessive fatigue or agitation Neglect of personal hygiene Alcohol or drug abuse Losing interest in hobbies and other aspects of life Injuring one’s body Giving away possessions Saying goodbye to family and friends Usually calling out for attention or help and will respond to assistance.

Death and Dying Death is often referred to as the final stage of life. Experienced by everyone and can not be avoided. The young tend to ignore it, elderly who lost loved one or friends begin to think of own death. Mostly all people go through 5 stages of grieving that dying patients/family/friends may experience.

Five Stages of Grieving with death Stage 1 – Denial: No not me stage, patients may seek 2nd and 3rd opinions as they just can’t accept situation. Stage 2 – Anger: Why me? Its your fault, patients may strike out at anyone, become hostile, bitter, may blame themselves, family even healthcare workers. Stage 3 – Bargaining: Accept death but turn to religion and spiritual beliefs to try to buy more time. Will to live is strong, work hard to achieve goals.

5 Stages of Death Stage 4 – Depression: occurs when patients no death will come soon and they won’t be able to be with family or friends. Experience great sadness, express regret, become withdrawn and quiet. Healthcare worker should let them know its OK to be depressed. Stage 5 – Acceptance: Patients understand and accept the fact that they are going to die. May complete unfinished business, help others deal with their dying. Patients gradually separate from others and they are at peace and can die with dignity. Healthcare workers still need to provide support, with understanding words and gentle touch.

Care of Dying Patients Hospice plays an important role in meting the needs of the dying patient. Hospice provides palliative care or care that provides support and comfort. Offered in Hospitals, medical centers, special facilities and most frequently in the patients home. Started after a doctor has determined a patients has six months or less to live.

Right to Live Many healthcare workers are at conflict with a patients right to die. Many healthcare workers are ethically concerned with promoting life. Allowing a person to die can cause great conflict. Many states have Rights to Die Laws, Living wills, etc.

Human Needs Generally defined as “lack of something that is required or desired” From the moment of birth till death all humans have needs. Needs motivate individuals to behave in certain ways or to acts in order to have needs met. At times some needs can take priority over other needs, ie: will for food or survival over social norms or approval.

Human Needs Abraham Maslow (noted psychologist) developed the “Human Hierarchy of Needs”. According to Maslow: the lower needs should be met before an individual can try to meet the higher needs. Only when satisfaction is meet on one level will a person be motivated to move towards meeting needs of a higher level.

Maslow’s Hierarchy of Needs

Methods of Satisfying Human Needs Needs can be met in two Methods – Direct or Indirect Direct Method Hard Work Realistic Goals Situational Awareness Cooperation with others

Methods of Satisfying Needs Indirect Methods of dealing with needs usually reduce the need and/or relieve tension but the needs are still unmet! The need is still present but the intensity decreases Defense Mechanism: unconscious act that helps the individual deal with unpleasant situations as their needs aren’t met.

Methods of Satisfying Needs Indirect method : Defense Mechanism Rationalization – make excuses or acceptable explanations: fear of lab tests, I can’t take time off from my job. Projection – Placing blame on someone else, I failed because the teacher doesn’t like me. Displacement – Transfer of feeling about someone to another person, getting mad at spouse or kids rather than boss for fear of getting fired. Compensation – Substituting one goal for another, person wanted to be a doctor but couldn’t afford it/couldn’t do school work so became a nurse.

Methods of Satisfying needs Daydreaming – Dreamlike thought process while awake, provides a means of escape, if dreams provide a course for achieving goals than this is a good defense mechanism if it’s a substitute for reality than its bad. Repression – Transfer of thoughts, painful feelings into unconscious mind. If pain is so great than feelings and memory can be forgotten. They can however resurface in dreams or affect behavior. Suppression – Similar to repression but individual is aware of feelings and memories just refuses to deal with them.

Methods of Satisfying Human Needs Denial – involves disbelief of an event or idea that is too frightening or shocking for an individual to cope with. Withdrawal – Two mains ways withdrawal can occur: Cease to communicate Remove themselves physically from situation. Example: conflict with another student, choose not to talk to that person anymore or move, change schools.

Effective Communication Communication is an exchange of information, thoughts, ideas and feelings Verbal – spoken words Non Verbal – facial expression, body language and touch

Communication Process The communication process involves three things: Sender – individual who creates the message Message – information, thoughts or ideas Receiver – individual that receives the message

Effective Communication Message must be clear – both can understand Message must be delivered in clear concise manner – good grammar, no slang, or double meaning Receiver must be able to hear and receive message – patients that are heavily medicated or weak may nod head that they understand but in reality they don’t. Receiver must be able to understand message – using unfamiliar terminology, language differences Interruptions and distractions need to avoided – can interfere with any conversation

Listening Show interest and concern Be alert and maintain eye contact Avoid interrupting speaker Pay attention Avoid thinking of response till they are done speaking Eliminate you own prejudices and see from someone else's view Eliminate distractions Watch speaker closely for actions that may contradict words Reflect statements back to speaker knows you understand Ask for clarification if you don’t understand Keep your temper under control and maintain positive attitude

Barriers to Effective Communication Deafness Blindness or impaired vision Speech Impairments Psychological Barriers – prejudice, attitudes, personalities