Occupational Competence Exam 3

Middle Adulthood

Period between young and older adulthood characterized by balancing career, family, and physical changes due to aging.

Middle Adulthood Developmental Theorist: Levinson

Reappraising life structure, exploring possibilities for change, and making choices for a stable next stage.

Middle Adulthood Age Range

Typically 35-65 (sometimes begins at 40).

Middle Adulthood Physiological Changes

Normal aging changes; decline in bone and muscle mass, slower reaction time, decreased cardiovascular and respiratory efficiency.

Middle Adulthood Cognitive Changes

Gradual neural degeneration, reduced working memory, minor decreases in processing speed, but crystallized intelligence (knowledge and experience) remains stable or improves.

Middle Adulthood Sensory Changes

Reduced ability to hear high-pitched sounds

Visual changes due to internal/external eye structure alterations.

Middle Adulthood Health Risks

Osteoporosis, arthritis, cardiovascular disease, hypertension, diabetes, myocardial infarction, and cancer.

Middle Adulthood Reproductive & Hormonal Changes (Women)

Menopause, estrogen decreases, cessation of fertility, hot flashes, and sleep disturbance possible.

Middle Adulthood Reproductive & Hormonal Changes (Men)

Gradual testosterone decline, changes in sexual performance, enlarged prostate, longer time to achieve erection.

Middle Adulthood Psychosocial Characteristics

Balancing work, family, and identity

Awareness of mortality

Redefining values and priorities.

Middle Adulthood Erikson's Stage

Generativity vs. Stagnation: Adults strive to nurture things that outlast them

(e.g., parenting, mentoring, career impact).

Middle Adulthood Generativity Definition

Concern for guiding the next generation and contributing to society.

Middle Adulthood Stagnation Definition

Self-absorption or lack of growth

Feeling unproductive or disconnected.

Middle Adulthood Roles

Family member, spouse/partner, friend, caregiver, worker, volunteer, community member, grandparent, pre-retiree.

Middle Adulthood Role Strain

Tension within a single role

(e.g., caregiver).

Middle Adulthood Role Conflict

Clash between two roles

(e.g., balancing work and family).

Middle Adulthood Sandwich Generation

Caring simultaneously for children and aging parents.

Middle Adulthood Empty Nest Transition

Emotional adjustment when children leave home

Rediscovering self and hobbies.

Middle Adulthood Boomerang Effect

Adult children returning home due to financial or personal reasons.

Middle Adulthood Midlife Crisis

Reevaluation or questioning of life choices and values; not universal but common.

Middle Adulthood Major Life Tasks

Commitment to family, career, and community

Care for children and aging parents

Manage household and finances

Adapt to physical changes

Experience loss and reflection

Prepare for retirement

Occupations in Middle Adulthood

ADLs/IADLs (stable but disrupted by stress or illness)

Work/career (peak or transition phase)

Caregiving (children and elders)

Volunteering/community engagement

Recreation/leisure

Religion/spirituality changes

Middle Adulthood Responsible Stage (Schaie & Willis)

Focus on family, work, and community; adults experience chronic stress from competing demands.

Older Adulthood Definition

Life stage involving adaptation to physical decline, loss, and shifting roles

Includes young-old (60-85) and frail elderly (85+).

Older Adulthood Biological Aging

Progressive, universal process involving gradual decline in cellular and physiological function.

Older Adulthood Characteristics of Aging

Biochemical composition changes

Decreased physiological capacity

Reduced response to stimuli Increased disease susceptibility

Higher mortality with age

Older Adulthood Developmental Theory (Neugarten)

Acceptance of mortality, coping with infirmity, care decisions, and maintaining social ties.

Older Adulthood Erikson's Stage

Ego Integrity vs. Despair: Reflecting on life's meaning; achieving wisdom

Acceptance vs. regret and despair.

Older Adulthood Gerotranscendence (Tornstam, 1997)

Positive aging theory emphasizing growth toward maturity, wisdom, and transcendence of self.

Older Adulthood Cardiovascular System

Decreased efficiency, arterial stiffening, reduced cardiac output.

Older Adulthood Respiratory System

Reduced lung elasticity and capacity.

Older Adulthood Musculoskeletal System

Decreased bone mass, muscle atrophy, joint stiffness.

Older Adulthood Hearing

Difficulty filtering background noise; reduced speech discrimination.

Older Adulthood Vision

Lens thickening, cataracts, glaucoma, macular degeneration.

Older Adulthood Integumentary System

Thinner, less elastic skin

Decreased sebaceous glands and pigment cells.

Older Adulthood Neurological System

Neuronal loss, reduced cerebral blood flow, decreased coordination.

Older Adulthood Gastrointestinal System

Slower digestion, altered absorption, constipation.

Older Adulthood Endocrine System

Impaired glucose regulation, decreased vitamin D metabolism.

Older Adulthood Urinary System

Prostate enlargement, reduced bladder contractility.

Older Adulthood Psychomotor Function

Slower reaction time, reduced fine motor control.

Older Adulthood Attention

More easily distracted

Divided attention harder

Older Adulthood Processing Speed

Slower information processing.

Older Adulthood Intellectual Abilities

Fluid intelligence declines

Crystallized intelligence stable.

Older Adulthood Memory

Learning requires more time and repetition.

Older Adulthood Major Roles

Family member, spouse, friend, religious participant, retiree, volunteer, patient.

Older Adulthood Role Transitions

Worker to retiree, caregiver to care recipient, independent to assisted living resident.

Older Adulthood ADLs/IADLs

Self-care, home maintenance, financial management with adaptations.

Older Adulthood Caregiving

Often shifts to spouse or grandchildren.

Older Adulthood Leisure

Reading, gardening, volunteering.

Older Adulthood Social Participation

Maintaining friendships, community involvement.

Older Adulthood Health Management

Medication, exercise, diet, appointments.

Older Adulthood Religious/Spiritual Engagement

Often increases in importance.

Older Adulthood Major Life Tasks

Adjusting to physical/sensory changes

Adapting to retirement and routines

Managing losses (spouse, friends, health)

Maintaining autonomy and dignity

Redefining identity post-work

Accepting mortality and finding meaning

Continuing personal growth

Older Adulthood Living Arrangements

Downsizing, CCRC, assisted living, SNF.

Older Adulthood Psychological Themes

Integrity, despair, and adaptation.

Environmental Definition

Aspects of the physical, social, and attitudinal surroundings that affect performance and participation in occupations.

Natural Environment and Human-Made Changes Definition

Physical surroundings such as terrain, climate, and built environment.

Natural Environment and Human-Made Changes Examples

Terrain

Weather

Building design

Ramps

Lighting

Clutter

Accessibility

Noise

Pollution

Products and Technology Definition

Equipment, devices, or systems used in daily life.

Products and Technology Examples

Assistive devices (wheelchairs, grab bars)

Phones

Computers

Prosthetics

Adaptive utensils

Smart tech

Transportation aids.

Support and Relationships Definition

People and animals providing emotional, physical, or practical support.

Support and Relationships Examples

Family, friends, caregivers, teachers, coworkers, peers, pets, healthcare professionals.

Attitudes Definition

Observable beliefs or values of individuals and groups that influence participation.

Attitudes Examples

Societal stigma

Family acceptance

Cultural views on independence or disability.

Services, Systems, and Policies Definition

Programs

Agencies

Laws influencing access, rights, and participation.

Services, Systems, and Policies Examples

Transportation

Insurance

ADA

Medicare/Medicaid

Housing and workplace policies

Institutional rules