Growth and Development

What are the types of growth?

Physical, mental, social and emotional

Infancy(birth-1)

Conflict- Trust vs. Mistrust

Physical- roll over, crawl, walk, grasp objects

Mental- respond to temp,hunger, pain by crying and recognize surroundings

Responds to human voice and touch

Early childhood(1-6)

Conflict- (1-3 autonomy vs shame and doubt)(3-6 initiative vs. guilt)

Physical- muscle coordination allowing running, climbing, writinging, drawing

Mental- verbal growth, short attention san, asks questions, recognized words/letters

Late childhood(6-12)

Conflict- Industry vs inferiority

Physical- slow but steady, muscle coordination is well developed and they can engage in activities that require complex motor sensory

Mental- developing quickly and life is centered around school, reading&writing skills are learned and they start to understand concepts like honesty, loyalty, values, and morals

Emotional- achieve greater independence and personality, develop fears

Social- more group oriented activities, more ready to accept others opinions and learn rules, needs reassurance, parental and peer acceptance

Adolescence(12-20)

Conflict- identity vs role confusion

Physical- growth spurts, development of sexual organs, PUBERTY

Mental- increase in knowledge and sharpening skills, learn to make decisions and accept responsibility for actions

Emotional- stormy and conflicted, try to establish identities and independence, respond more to peer influence.

Social- less time with family and more time with friends,seek security from their peers, and develop an more developed/,mature attitude towards the end, need reassurance and support, issues can be traced to conflict & feelings of inadequacy and insecurity

Early Adulthood(20-40)

Conflict- Intimacy vs isolation

Physical- most productive life stage, physical development is at its peak and prime child bearing age

Emotional- many emotional stresses related to career, marriage, family, etc

Social- moving away from peer group to a group with those who have similar ambitions, most find a mate and start a family.

Middle Adulthood(40-65)

Conflict- Generativity vs Stagnation

Physical- hair greys and thingsm skin wrinkles, muscle tone decreases, hearing/vision loss, weight gain

Mental- can increase, confident decision makers and excellent at analyzing situation

Emotional- can be a period of contentment and satisfaction

Social- family relationships can decline , divorce rates are high, friendships are with people with similar interests and lifestyles

Late Adulthood(65+)

Conflict- ego integrity vs. despair

Physical- on the decline, skin dries/wrinkles + age spots, hair thins, msucle lose tone/strength, memory loss

Mental- those who remain mentally active tend to show fewer sighs of decreased mental ability

Emotional- varies

Social- retirement can leas to loss of self esteem, lost identity, & death of spouse/friends can cause changes in social relationships.

Individual differences to consider

• cultural

• ethnic/religious

• physical/personality

Maslow’s hierarchy of needs in order from bottom to top

(needs to be met first) physiological, safety, love/belonging, esteem, self-actualization

Direct methods for satisfying needs

• hard work

• set realistic goals

• evaluate situation

• cooperate with others

What are the five emotional stages of death/dying?

1. denial

2. anger

3. bargaining

4. depression

5. acceptance

denial

• when individual or loved ones cannot accept the reality of death

• may seek additional opinions/testing

• refuse to discuss

• healthcare provider should provide support and listen

• “no not me”

Anger

• patients may strike out or become hostile and bitter

• may blame themselves, loved ones, or healthcare provider for their illness

• not a personal attack- important for healthcare providers to listen and provide understanding and support

• “why me?”

Bargaining

• patients frequently turn to spiritual or religious beliefs

• will to live is strong- may have certain goals

• health care providers must be supportive and good listeners and help patients meet their goods when possible.

• “yes, but-”

Depression

• May express regrets or withdraw and become quiet

• Sadness and overwhelming despair

• Health care providers should let them know that it is “OK” to be depressed and provide quiet understanding, support and/or a simple touch- allow patients to cry or express their grief.

• “it is me”

Acceptance

• occurs when patients understand and accept the fact that they are going to die.

• May complete unfinished business and help others around them deal with their death. 

• Gradually separate themselves from the world and other people 

• Still need emotional support and the presence of others.

• “its a part of life” 

Physical fears of death

Helplessness, dependence, loss of physical abilities, pain

Social fears of death

Separation from family, leaving unfinished business

Emotional fears of death

Being unprepared for death and what happens after

Interventions of fears

• Talk as needed

• Avoid superficial answers (i.e. “It’s God’s will”)

• Provide religious support as the patient desires

• Stay with the patient as needed

• Work with families to strengthen and support

hospice care for death and dying

provides care while allowing death with dignity

Patient Self-Determination Act- Federal Law

mandates that every individual has the right to make decisions regarding medical care, including the right to refuse treatment and the right to die.

Death with Dignity laws

been passed by 8 states- allows for assisted suicide but not euthanasia. 

What is Apathy?

Apathy is a state of indifference, or a lack of emotion, interest, and concern, characterized by a, lack of motivation or goal-directed behavior.

Who made the 5 stages of death and dying?

ELISABETH KUBLER-ROSS