1. Development of middle adulthood

2.  Define middle-aged adult and maturity during this age.  Describe physical changes of the middle – aged adult.  Identify psychosocial development of middle – aged adult.  Explain the cognitive development.  Discuss the health problems of the middle – aged adult.

3. Middle-Aged Adult: 40 - 60 years { years of stability and consolidation ( security)}. It is a time when children have grown and moved away. Maturity: is the state of maximal function and integration, or the state of being fully developed.

4. Maturity:  Mature people have the quality of self- acceptance; they are able to be reflective and insightful about life and to see them selves as others see them.  They confront the tasks of life in a realistic and mature manner, make decision, and accept responsibility for those decisions.

5. DescriptionCategory Hair begins to thin, and gray ( old) hair appears. Appearance Skin turgor and moisture decrease, S.C. fat decreases, wrinkling occurs. Fatty tissue is redistributed, resulting in fat deposit in the abdominal area.

6. DescriptionCategory Skeletal muscle bulk decreases at about age 60. Musculoskeletal system Thinning of the intervertebral discs causes a decrease in height of about 1 inch. Calcium loss from bone tissue is more common among postmenopausal women.

7. DescriptionCategory Blood vessels lose elasticity and become thicker.. Cardiovascular System Visual acuity declines, often by the late 40s, especially for near vision. Sensory perception Auditory acuity for high frequency sound also decreases, particularly in men. Taste sensations also diminish.

8. DescriptionCategory Metabolism slows, and may result in weight gain. Metabolism Gradual decrease in tone of large intestine may predispose the individual to constipation. Gastrointestinal Tract Nephron units are lost during this time, and glomerular filtration rate decreases. Urinary system

9. DescriptionCategory Hormonal changes take place in both men and women. Sexuality Ovarian activity declines until ovulation ceases. menopause occurs between ages 40-55, the average is about 47 years * Common symptoms: related to decline in estrogen, hot flashes, chilliness, a breast become smaller. * Insomnia and headaches may also occur

10. DescriptionCategory Achieving adult civic (public) and social responsibility. According to Havighurst Establishing and maintaining an economic standard of living. Accepting and adjusting to the physiologic changes of middle age. Has work as a central theme.

11. DescriptionCategory Inclusivity (generalized)versus exclusivity ( Limited). According to Slater Pride versus embarrassment (shame). Career productivity versus inadequacy. Being needed versus alienation (separation).

12. Cognitive and intellectual abilities change very little. Cognitive processes include reaction time, memory, perception, learning, problem solving, and creativity. Reaction time during the middle years stays much the same or diminishes during the later part of the middle years.

13. Memory and problem solving are maintained through the middle years. Learning continues and can be enhanced by increased motivation.

14. Injuries:  Motor vehicle crashes.  Decreased reaction to times and visual acuity leads to injuries.  Falls, fires, burns, poisonings and drowning.  Work-related injuries.

15. Cancer Men have a high incidence of cancer of the lung and bladder. In women, breast cancer is highest in incidence, followed by caner of colon and rectum, uterus, and lung.

16. Cardiovascular:  Coronary heart disease is leading cause of death on USA in middle - aged adult ( caused by smoking, obesity, hypertension, hyperlipidemia, DM, lifestyle, familial history of MI).  Physical inactivity places individuals at greater risk of developing CHD.

17. Obesity:  Decreased metabolic activity.  Decreased physical activity mean (indicate) a decrease in caloric need.  Alcoholism: Excessive use of alcohol can result in: Unemployment, Disrupted homes, Injuries, diseases.

18. Mental Health Alterations: Developmental stressors, such as the menopause, aging, impending retirement. Situational stressors such as divorce, unemployment, and death of a spouse, can precipitate increased anxiety and depression.

19. AssessmentAspect Exhibit weight within normal range for age and sex. Physical development Manifest vital signs within normal range for age and sex. Manifest visual and hearing abilities within normal range. Verbalize any changes in eating, elimination, or exercise.

20. AssessmentAspect Accept aging body.Psychosocial development: Feel comfortable and respect self. Enjoy new freedom to be independent.

21. AssessmentAspect Interact effectively and share companionable (Sociable, or pleasant) activities with life partner. Psychosocial development Expand and renew previous interests. Have a meaningful philosophy of life.

22. AssessmentAspect Interact effectively and share companionable activities with life partner. Psychosocial development Expand ( spread out) and renew ( restore) previous interests. Have a meaningful philosophy of life. Follow preventive health practiceActivities of daily living

23. AssessmentAspect Annually physical examination.Health test and screening Immunization as recommended. Regular dental assessment. Tonometry for signs of glaucoma and other eye diseases. Screenings for TB every 2 years.

24. AssessmentAspect Breast examination annuallyHealth test and screening Testicular examination annually. Screenings for cardiovascular disease. Screenings for colorectal, breast, cervical, uterine and prostate cancer.

25. AssessmentAspect Motor vehicle safety reinforcement. Safety Workplace safety measures. Home safety measures.

26. AssessmentAspect Importance of adequate protein, calcium, and vitamin D in diet. Nutrition and exercise Nutritional and exercise factors that may lead to cardiovascular disease. An exercise program that emphasizes skill and coordination.

27. AssessmentAspect Encourage discussion of feelings, concerns, and fears about a midlife crisis. Social interactions Providing time to expand and review previous interests. Retirement planning, with partner if appropriate.