Physical Changes- Developmental Stages:

• Weight, height, motor skills, hormonal changes

• Boys tend to be more muscular

• Girls are taller at first, then boys surpass

• Girls have more adipose tissue

Middle adulthood:

• Height

  • Men lose a half inch between 30-50

  • Women 25-75 lose about 2 inches

• Weight

  • Some gain, some lose

• Skin

  • Aging: wrinkles, saggy skin (some people don’t!)

  • Pigmentation: discoloration, moles

• strength/joints/bones

  • Sarcopenia: loss of skeletal muscle mass and strength

    • Women more at risk

    • Smoking and diabetes: 2 main risk factors

    • Back and legs are first signs

    • Decrease progression: weight management and resistance training

  • Sarcopenia obesity

    • Having sarcopenia and also being obese

Cognitive Function:

• Extensive brain development continues after birth, through infancy, and later

• Depressed brain activity has been found in children who grow up in a deprived environment

• Vygotsky: cognitive development

  • the idea that infants develop new social and cognitive skills through interactions with older individuals.

• Piaget: play advances cognitive development

Brain

• Certain brain regions play a role in emotions

• Spina Bifida: neural tube disorder that causes brain and spine abnormalities

• Motor development:

  • 3 yr old: simple movements

  • 4 yr old: more adventurous

  • 5 yr old: more risky (climbing, jumping off high objects, running, touch interesting but dangerous things)

• Fine motor skills:

  • 3 yr old: clumsy

  • 4 yr old: Improved fine coordination

  • 5 yr old: body coordination

• Middle adulthood:

  • Shrinking

  • Processes slow down

  • Weight of brain decreases

  • Memory loss associated with unmyelinated sections

  • prefrontal cortex begins to shrink

  • Decrease of production of neurotransmitters

Alzheimer

Alzheimer’s Disease involves a deficiency in acetylcholine

• Most common in women

• Decrease in memory and loss of function

• African americans: twice as many cases

• Genetics

• Treatments: medications

• Support: emotional and physical

  • Respite care: temporary nursing home facility so the primary caregiver(s) can have some rest

Dementia

Multi-infarct dementia

• More common in men

Benefits of respite care:

• Temporary relief for caregivers

• Can ease stress

• Break from the burden

• Provides temporary guilt (caregiver feels like they’re not capable)

Respite care: short-term relief for primary caregivers

Parkinson

Treatment for Parkinson Disease can involve brain stimulation and L-dopa

• Gene therapy

• Stem cell transplant

Mild Cognitive Impairment

• Starting to forget a little bit

• Risk factor for Alzheimer’s

• For some it progresses, others it does not

Alcohol Use

• Can cause birth defects or negatively alter cognitive and behavioral outcomes

Consequences of alcohol abuse:

• Depression

• Frequent falls

• Inadequate nutrition

• Congestive heart failure

Sleep

• Typical newborn sleeps 16-17 hours per day

• Early childhood: Need 10-13 hours of sleep

• The recommended hours of sleep for Late Adulthood is 7-8 hours of sleep

Sleep Problems:

• Narcolepsy: falling asleep randomly during the day

• Insomnia: trouble going to sleep or staying asleep

• Nightmares

quality interactions with parents = longer sleep duration

Strategies for better sleep:

Avoiding caffeine

Removing electronics at a certain time

Staying mentally active

Getting exercise

Reading before bed

Avoiding over the counter sleep medication

Memory- explicit, implicit, semantic, source, prospective

• Explicit: deals with facts and experiences, ie remembering grocery list

  • More affected by aging

  • Recalling the plot of a movie

• Implicit: involves skills, routines, and procedures, ie driving a car

  • Remember how people can remember to play piano when they think they’ve forgotten (aka muscle memory)

• Semantic: knowledge about the world, ie academic knowledge

• Source: recalling the source of learned information

• Prospective: remembering to do something in the future

Vision- cataracts, glaucoma, macular degeneration

• Cataracts: thickening of the lenses that causes vision to become cloudy

  • If not as severe, glasses or laser surgery can fix it

  • Diabetes #1 risk factor

• Glaucoma: increase in intraocular pressure

  • can cause vision loss and blindness by damaging the optic nerve

• Macular Degeneration: can see peripherally but not right in front of them

  • Vitamins, supplements, laser surgery

  • The leading cause of blindness

Any of these vision problems can put patients at risk for falls

• Put room close to nurses station

• Education: how to help person with daily tasks, get rid of rugs (tripping hazard), night lights

TRT

• Testosterone Replacement Therapy

  • Reduces sex drive when losing testosterone

• Benefits:

  • increased libido and energy level

  • beneficial effects on bone density, strength and muscle

  • cardioprotective effects

HRT

• Hormone replacement therapy

• Not recommended to stay on for forever

• Lowers risk of bone loss and bone fractures

• Decreases chances of CAD (Coronary Artery Disease)

• Risks: increased risk of breast cancer

HRT alternatives

• Exercise

• Dietary supplements

  • Can be dangerous when combined with prescribed medications

Climacteric: midlife transition when fertility is lowest (in women)

Life Expectancy: current is 79 years; average # of years that a person can expect to live

Hearing

• For some, can start to decline at 40

• First sound to start decreasing is high-pitched sound

Hearing problems are linked to

• Impaired activities of daily living

• Increases in falls

• Decrease in cognitive functioning

• Less time spent outside of home (isolation)

For people with hearing problems, speak slower and clearer and close the door to the room to minimize noise from outside. You need to make sure they understand what you’re telling them

Chronic conditions

• Middle age and older adult deaths are usually associated with chronic disease

• Arthritis: inflammation of the joints

• Osteoporosis: extensive loss of bone tissue

Menopause

• Perimenopause: transition from having periods to no periods (in between phase)

  • Mood swings

  • Depression / depressed mood

  • Hot flashes

  • Headaches

  • Palpitations

• Menopause: ages 40-50: when a woman hasn’t had a period (menstrual cycle) in a year

  • Early onset: stroke, cardiovascular disease, osteoporosis

  • Late onset: increased chances of breast cancer

Widowhood and self esteem

Hormones that promote growth and development

• Testosterone

• Hormones: chemicals secreted by the endocrine glands and carried throughout the body by the bloodstream

• Increases in testosterone and estradiol

Amygdala, Corpus Callosum

• The amygdala helps regulate emotions such as fear, pleasure, or anger

• Corpus callosum: connects the two brain hemispheres, allowing them to communicate with each other

Anorexia Nervosa

relentless pursuit of thinness through starvation

Characteristics:

• Weigh less than 85% considered normal for age and height

• Intense fear of gaining weight that doesn’t decrease w/ weight loss

• Distorted image of body shape

Piaget

• Simple reflexes:

  • Birth to 1 month

  • Rooting, sucking, grasping

• First habits:

  • 1 to 4 months

  • Repeating a body sensation first experienced by chance (such as thumb sucking)

• Secondary circular reactions:

  • 4 to 8 months

  • More object-oriented

  • An infant coos to make a person stay near. As the person leaves, the infant starts to coo again

Object Permanence: object still exists even if they can’t see it

• Usually sets in around 6 months

concrete operational

• 7-11 years old

• Operations that are applied to real, concrete objects

  • Seriation: ability to order stimuli in a quantitative dimension (numbers)

  • Transitivity: older children can infer that if John is taller than Mary, and Mary is taller than Sue, then John is taller than Sue

Formal operational stage (11+ years)

• More abstract than concrete operational thought

• Increased verbal problem solving ability

• Increased tendency to think about thought itself

• Thoughts of idealism and possibilities

• More logical thought

  • Hypothetical-deductive reasoning: involves creating a hypothesis and deducting its implications

Erikson’s- Know all stages

• Erikson: in order to build trust, you have to have physical comfort and self-care

• Trust vs mistrust

• Autonomy vs shame

• Initiative vs guilt

• Industry vs inferiority

• Identity vs role confusion

• Generativity vs stagnation

• Ego integrity vs despair

Personal Fable: involves a sense of uniqueness and invincibility

• Invincibility attitudes

• Risky behaviors

Pessimists, Narcissists

• Narcissism: a self-centered and self-concerned approach towards others

  • Narcissist: a person has an inflated sense of self-importance

• Pessimism: a negative mental attitude in which an undesirable outcome is anticipated from a given situation

  • Pessimist: a person who tends to see the worst aspect of things or believe that the worst will happen

Peer Relations

Bullying

• Verbal or physical behavior intended to disturb someone less powerful

• 70-80% of victims and bullies are in the same classroom

• Boys and younger middle school students are most likely to be affected

• Outcomes:

  • Depression

  • Suicidal ideation

  • Attempted suicide

  • More health problems

Most teens prefer a smaller number of friendships that are more intense are more intimate

Friends become increasingly important in meeting social needs

Gossip about peers can lead to relational aggression

Peer pressure

Characteristics of friends have an important influence

• Friends’ grade-point average is a consistent predictor of positive school achievement

Cliques

• a small group of people, with shared interests or other features in common, who spend time together and do not readily allow others to join them

Romantic Relationships

3 stages:

1. Entry into romantic attractions and affiliations at about 11 to 13 years of age

2. Exploring romantic relationships at approximately 14 to 16 years of age

3. Consolidating dyadic romantic bonds at about 17 to 19 years of age

Many date other-sex peers, which can help clarify or disguise their sexual orientation

Sociocultural Contexts and Dating

• Differences in dating patterns among ethnic groups in the US

• Values, beliefs, and traditions often dictate the age at which dating begins

Leading causes of death

• prenatal death SIDS is the leading cause of infant death

• Children:

  • 1. Motor vehicle accidents (MVA)

  • 2. Cancer

  • 3. Cardiovascular disease

• Middle/late childhood:

  • 1. MVA

  • 2. Cancer, specifically leukemia

• Adolescence

  • 2. suicide

• Late adulthood:

  • Cardiovascular disease

STDs- HPV, Herpes, HIV

Contraception and STIs

Adolescents are increasing their use of contraceptives

US has much lower condom use and pill use than European countries

Most prevalent:

• Gonorrhea

• Syphilis

• Chlamydia

• Genital herpes

• AIDS

• Genital warts

Concern: recent increase in STIs

Strategies

• Know your partners

• Medical exam

• Protection

• Not having multiple partners

Secure attachment and adults

• Secure attachment = less likely to have emotional difficulties

• Secure Attachment: positive views of relationships, easy to get close to others, not easily stressed

Cohabiting

• the arrangement between two individuals who live together, either as spouses or unmarried partners

Levinson’s Seasons of a man’s life (middle adulthood)

• Levinson’s season of a man’s life

  • Teens: transition from dependence to independence

  • 20s are a novice phase of adult development

  • 30s are a time for focusing on family and career development

  • 40s, man has a stable career and now must look forward to the kind of life he will lead

Personality traits and change

The Self

• The development of self understanding

• During middle and late childhood:

  • Defining one’s self shifts to using internal characteristics or personality traits

  • Children recognize social aspects of the self

  • Social comparison increases

1. Contemporary life events approach

   1. How life events influence the individual’s development. Depends on:

      1. The life event itself (child born, new job, marriage, an accident)

      2. Mediating factors (physical health, family)

      3. The individual’s adaptation (coping strategies)

      4. Life-stage context (the life stage you are in)

      5. Sociohistorical context (natural disaster, policy changes, the pandemic)

Example: You witness 9/11 first hand in person as a young adult, though you are not directly involved. You see the planes hit the building not on a TV but right as it happens.

I. the life event: witnessing 9/11 first hand

II. mental health

III. therapy, coping strategies

IV. early adulthood

V. 9/11, “never forget”

1. The Life-Events Approach

   1. Drawbacks:

      1. Life events approach places too much emphasis on change, not adequately recognizing stability

      2. It may not be life’s major events that are the primary sources of stress, but our daily experiences

Grandparent style

Hospice versus palliative care

• Palliative care: this type of care is designed to reduce pain and suffering with or without curative intent

• Hospice care is for people who are nearing the end of life. The services are provided by a team of health care professionals who maximize comfort for a person who is terminally ill by reducing pain and addressing physical, psychological, social and spiritual needs.

Parenting styles

• Authoritarian: favoring strict, high expectations; disciplined, unsupportive

• Authoritative: encourages child to be independent; clear expectations; definite rules; supportive

• Neglectful: uninvolved; little support

• Indulgent: lower expectations, excessive attention; best friend relationship

Autonomy vs Attachment

• Push for autonomy

• May puzzle and anger many parents

Adolescents ability to attain autonomy and gain control over their behavior is acquired through appropriate adult reactions to their desire for control

Boys are often given more independence than girls

Biological Theories of Aging

Immunity and Late Adulthood

Attention: Selective/ Divided

Attention: the focusing of mental resources on select information

• Selective: can only focus on one thing (ignore the rest)

• Divided: can focus on 2 things at once (read slides and type at same time)

• Sustained: focused attention, length of sustained attention increases with age. At 3 months a child’s attention can be held for 5-10 sec

• Executive: planning it out (tasks needed to be completed, organizing, writing out goals)

Tip of the tongue Phenomenon: remembering something but unable to retrieve it from memory

Common Sense, Wisdom

Matching hypothesis

Predictors of depression

• Genetics

• Death or loss

• Conflict

• Abuse

• Life events such as: a new job, loss of employment or income, marriage. Divorce, having a baby, etc.

• Postpartum depression

Reminiscence Therapy

• reminiscence therapy is a treatment that uses all the senses — sight, touch, taste, smell and sound — to help individuals with dementia remember events, people and places from their past lives.

• Used to treat those with severe memory loss or dementia

Think about that elderly woman on tik tok who couldn’t remember how to play piano but her muscle memory did

Activity Theory

• older adults are happiest when they stay active and maintain social interactions

• these activities, especially when meaningful, help the elderly to replace lost life roles after retirement and, therefore, resist the social pressures that limit an older person's world

Socioemotional Selectivity Theory: with age, a person’s social goals shift from being knowledge based to emotions based

Self Esteem and the Late Adulthood

• Self esteem could be lost due to stagnation or despair (erikson stages)

• Due to loss of loved ones

Living arrangements and late adulthood

• Hospitals

• Nursing homes

• Assisted living

• Funeral homes

Nutrition

• Infants

  • 50 calories per day for each pound they weigh

  • Fruits and vegetables by end of 1st year

  • Poor dietary patterns lead to increasing rates of overweight and obese infants

  • Breastfeeding reduces the risk of obesity

• Early weaning can cause malnutrition

  • 2 life-threatening conditions resulting from malnutrition:

    • Marasmus: a severe protein-calorie deficiency resulting in a wasting away of body tissues

    • Kwashiorkor: a severe protein deficiency that causes the abdomen and feet to swell with water

  • Severe and lengthy malnutrition is detrimental to physical, cognitive,emotional, and social development

• Early Childhood

  • Obesity: major health concern

• Research: 38 million children under 5 yrs old were overweight or obese

• Raises the risk of medical and psychological problems

  • Can result in hypertension, high cholesterol, diabetes

  • Might be depressed or bullied

• Adolescence

  • Decrease in eating fresh fruits and vegetables

  • Exercise increases self esteem and decreases risk for type 2 diabetes

• Middle Adulthood

  • Caloric restriction never recommended for nutrition

  • Healthy diet

  • Exercise: aerobic exercise; jogging, swimming, etc

    • Stress management

Malnutrition: iron deficiency

Sexuality

• A time of sexual exploration and experimentation, sexual fantasies and realities, and incorporating sexuality into one’s identity

• Adolescents who view more sexual content on television are more likely to initiate sexual intercourse earlier

Developing a sexual identity involves

• Learning to manage sexual feelings

• Developing new forms of intimacy

• Learning skills to regulate sexual behavior

Sexual Indetity Includes

• Activities

• Interests

• Styles of behavior

• Indication of sexual orientation

Gay males and lesbians struggle with same-sex attractions

Ageism: discrimination against individuals or groups on the basis of their age

• a socially constructed way of thinking about older persons based on negative attitudes and stereotypes about aging and a tendency to structure society based on an assumption that everyone is young, thereby failing to respond appropriately to the real needs of older persons

Brain Death

When is someone dead?

• No pulse

• No respirations

• Pupils fixed

When do we say STOP to treatments

• When the patient is considered brain dead

  • No electrical activity

  • EEG to determine if brain dead

Euthanasia

Euthanasia - is the act of painlessly ending a terminal or severely disabled patient’s life to prevent suffering.

Active euthanasia - is actively giving a patient a lethal dose of a medication to end a patient’s life.

Passive euthanasia - is allowing death to occur by withholding treatment that might keep the patient alive

• for example taking a patient off a ventilator.

Kubler- Ross- know stages

• Denial (no it can’t be me)

• Anger (why me)

• Bargaining (If I do this will I get more time)

• Depression

• Acceptance (at peace)

Five stages of grief

Assimilation and accommodation

• Assimilation of knowledge occurs when a learner encounters a new idea, and must 'fit' that idea into what they already know

• Accommodation of knowledge is more substantial, requiring the learner to reshape those containers

Activities to improve older adults

• Walking or hiking.

• Dancing.

• Swimming.

• Water aerobics.

• Jogging or running.

• Aerobic exercise classes.

• yoga.

Freud: Stages of Psychosexual Theory of Development

1. Oral Stage

   1. Birth to 1 yr

   2. gets much satisfaction from putting all sorts of things in its mouth

   3. Sucking, biting, breastfeeding

2. Anal Stage

   1. 1-3 yrs

   2. The child is now fully aware that they are a person in their own right and that their wishes can bring them into conflict with the demands of the outside world

3. Phallic Stage

   1. 3-6 yrs

   2. The child becomes aware of anatomical sex differences, which sets in motion the conflict between erotic attraction, resentment, rivalry, jealousy and fear

   3. Oedipus complex (in boys)

   4. Electra complex (in girls)

4. Latency Stage

   1. 6-puberty

   2. most sexual impulses are repressed during the latent stage, and sexual energy can be sublimated towards school work, hobbies, and friendships

5. Genital Stage

   1. Puberty-adult

   2. It is a time of adolescent sexual experimentation, the successful resolution of which is settling down in a loving one-to-one relationship with another person in our 20's.

the id is the primitive and instinctual part of the mind that contains sexual and aggressive drives and hidden memories, the super-ego operates as a moral conscience, and the ego is the realistic part that mediates between the desires of the id and the super-ego

Prenatal Stages, Birth Defects, Separation Protest

• Stages

  • Germinal period: first 2 weeks after conception

  • Embryonic period: 2 to 8 weeks after conception

  • Fetal period: 2 months after conception until birth

    • Around 3 months can feel fetal movement

• Defects

  • What are some hazards/agents that can cause a birth defect or negatively alter cognitive and behavioral outcomes?

• Deli meats

• Alcohol and drugs

• Caffeine

• Smoking

• Extreme stress

• Different medications

• Pollutants

• Radiation

• Over exertion

• Environmental factors

• Blood type

Separation protest: crying when the caregiver leaves

• Due to anxiety about being separated from their caregivers

• Typically peaks at about 15 months

• Cultural variations