Lifespan Development – Unit IV Nursing Care Across the Lifespan (1)

Objectives

• Differentiate types of family patterns & their social functions.

• Identify stresses commonly affecting contemporary families.

• Summarize Piaget’s four stages of cognitive development.

• Describe physical characteristics for every stage of the life-cycle.

• List psychosocial changes across developmental stages.

• Identify normal age-related changes in all major body systems.

• Explain effects of aging on personality, intelligence, learning & memory.

• Discuss Erikson’s stages of psychosocial development.

• Outline early-childhood cognitive changes.

• State developmental tasks of adolescence.

• List tasks for early adulthood.

• Describe tasks for middle adulthood.

• Define aging.

• Discuss major biological & psychosocial theories of aging.

Key Terms (with concise explanations)

• Adoptive family – non-biologic parents legally raise child.

• Ageism – prejudice or discrimination based on age (often against older adults).

• Autocratic family pattern – authority centered in one adult; strict rules.

• Blended (reconstituted) family – adults remarry & combine children from previous unions; may add new children.

• Cephalocaudal – growth proceeds head ➜ feet.

• Chromosomes – thread-like nuclear structures carrying genetic code.

• Cohabitation – two adults share household without legal marriage.

• Conception (fertilization) – union of sperm & ovum initiating pregnancy.

• Concrete operational phase – Piaget stage (≈ 7–11 yr) logical but concrete thinking.

• Democratic family pattern – authority & decision-making shared by adults & older children.

• Depression – mood disorder marked by persistent sadness; highlighted in older adults.

• Development – progressive functional & skill changes (simple ➜ complex).

• Disengagement stage – family life-cycle step when grown children leave home.

• Engagement / Commitment stage – couple plans future marriage.

• Establishment stage – new family unit formed; integrate goals & traditions.

• Expectant stage – pregnancy period; parental role preparation.

• Extended family – nuclear family plus other relatives in same home.

• Formal operational thought – Piaget stage (≈ 12 yr ➜ adult) abstract reasoning.

• Foster family – adults receive state license to raise children temporarily/permanently.

• Grandfamilies – grandparents raising grandchildren.

• Growth – quantitative increase in size or parts.

• Infant mortality rate – deaths <1 yr per 1{,}000 live births.

• Life expectancy – probable years of life for people with similar traits.

• Matriarchal family pattern – mother/grandmother is authority figure.

• Nuclear family – married couple + biological children in independent household.

• Parenthood stage – child-rearing years.

• Patriarchal family pattern – authority vested in eldest male.

• Preoperational thought – Piaget stage (≈ 2–7 yr) symbolic, egocentric thought.

• Presbycusis – age-related hearing loss (esp. high-pitch).

• Presbyopia – age-related difficulty focusing on near objects.

• Proximodistal – growth proceeds center ➜ periphery.

• Schema – cognitive framework used to organize information.

• School violence – physical or psychological harm within school settings.

• Senescence stage – family life-cycle phase of aging parents after retirement.

• Sensorimotor stage – Piaget stage (birth–2 yr) learning via senses & movement.

• Single-parent family – one adult raising child(ren).

• Social contract family – see Cohabitation.

• Surrogacy – woman carries pregnancy for another person/couple.

• Teratogen – agent causing prenatal developmental abnormalities.

• Transgender family – at least one parent identifies as transgender.

• Zygote – fertilized ovum prior to uterine implantation.

Healthy People 2030: Leading Health Indicators (All Ages)

• Increase oral-health-system utilization.

• Reduce added-sugar consumption among ≥2-yr-olds.

• Lower drug-overdose deaths.

• Decrease population exposure days to unhealthy air.

• Reduce homicides.

• Reduce household food insecurity & hunger.

• Raise proportion receiving annual influenza vaccine.

• Increase knowledge of HIV status.

• Expand health-insurance coverage.

• Reduce suicide rate.

• Substance-abuse prevention.

• Tobacco-use reduction.

Five overarching goals (next 10 yr):

1. Achieve thriving lives free of preventable problems.

2. Eliminate disparities & increase health equity/literacy.

3. Create supportive social, physical & economic environments.

4. Promote healthy development/behaviors across all stages.

5. Engage leadership & public to design health-promoting policies.

Life Expectancy & Mortality Trends

• Early 20^{th} century U.S. expectancy: 47.3 yr.

• 2019 U.S. expectancy:
  • Men 76.3 yr • Women 81.4 yr.

• Switzerland 2019: Men 82.1 yr; Women 85.8 yr.

• Japan 2019: Men 81.4 yr; Women 87.5 yr.

• Drug-overdose death rate increased >5-fold to 32.5 deaths/100{,}000.

• Income gap: households >25{,}000 enjoy 3–7 extra years vs. <10{,}000.

• African-American infant-mortality >2\times Caucasian rate.

Implications:
• Lifestyle (diet, inactivity) → ↑ heart attack, stroke, diabetes & premature deaths.
• Public-health focus on preventive care, education & socioeconomic determinants.

Lifespan Stages (approximate ages)

• Infancy: birth–1 yr

• Toddler: 1–3 yr

• Preschool: 3–5 yr

• School Age: 6–12 yr

• Adolescence: 13–19 yr

• Early Adulthood: 20–40 yr

• Middle Adulthood: 40–65 yr

• Late Adulthood: ≥65 yr

Notes:
• Milestones vary; guidelines provide average expectations.
• Growing older-adult population requires gerontologic competency.

Principles of Growth & Development

• Highly individualized rates; anticipate variation in responses.

• Continuous & interdependent; feature growth spurts & plateaus.

• Progression from simple ➜ complex in predictable order.

• Organ systems mature at different times (e.g., gonads at puberty).

• Holistic: physical, cognitive, social & emotional growth interrelate.

Directional patterns:
• Cephalocaudal: head ➜ feet (e.g., infants lift head before standing).
• Proximodistal: center ➜ extremities (e.g., shoulder control precedes finger dexterity).

Genetic Blueprint & Environmental Influence

• Human somatic cells: 46 chromosomes ( 23 pairs ).

• Sex determination: Ovum X; Sperm X or Y ( XY ➜ male ; XX ➜ female ).

• Identical twins share identical chromosome set (karyotype).

• Teratogens (drugs, alcohol, nicotine, viral agents) ↑ risk of fetal anomalies; smoking linked to 5–25\% adverse outcomes & low-birth-weight.

Ethical / Practical Considerations:
• Genetic testing (e.g., Tay-Sachs, sickle-cell disease) guides reproductive decisions; requires counseling & psychosocial support.
• Balancing parental autonomy with potential societal costs (philosophical bioethics).

Family: Definitions, Roles & Functions

• Basic social unit; members tied by blood, marriage, adoption, or long-term commitment.

• Core functions: protection, nurturance, education, sustenance & socialization.

• Provides unconditional affection, acceptance & companionship ➜ fosters self-esteem & identity.

• First agent of cultural transmission: morals, values, expectations.

• Family roles are dynamic; life events (birth, death) necessitate restructuring.

Cultural competence tips:
• Identify family & kinship network.
• Recognize authority flow & gender roles.
• Observe verbal/non-verbal cultural cues.
• Account for dietary & religious practices influencing health.

Modern Influences Changing Family Structure (Box 24.1)

• Economic shifts ➜ ↑ women in workforce.

• Feminist movement & evolving gender roles.

• Later marriage & delayed childbearing.

• Rising (then plateauing) divorce rates.

• Diversified family structures.

• Expanded educational opportunities for low/middle-income adults.

Major Family Types (Box 24.2)

• Nuclear – married man & woman + biological children, independent household; roles now often dual-earner.
• Extended – nuclear unit + relatives (grandparents, aunts) cohabiting; share caregiving & finances.
• Single-Parent – one adult due to divorce, death, separation, choice or adoption; performs dual roles.
• Blended (Reconstituted) – remarried adults merge children; issues: loyalty conflicts, merging traditions, sibling rivalry.
• Social Contract / Cohabitation – unmarried couple share household & responsibilities; may include children from any partner.
• LGBTQ – parents identifying as lesbian, gay, bisexual, transgender, queer; structures parallel heterosexual families, face potential discrimination & legal challenges in adoption.
• Adoptive – parents legally adopt non-biologic child; over 135{,}000 U.S. adoptions/year; 40\% trans-racial/ethnic; involve legal, financial & psychosocial complexities.
• Grandfamilies – grandparents are primary caregivers; biological parents variably involved.
• Foster – state-licensed caregivers provide temporary/permanent care; focus on supervision, nurturing & stability.

Significance for Nursing Practice:

• Assessment must include family composition & functioning to tailor care plans.

• Recognize stressors unique to each family pattern (financial strain, role overload, identity conflicts).

• Provide resources: counseling, support groups, legal aid when indicated.

Practical Links to Earlier & Future Course Content

• Piaget & Erikson frameworks underpin pediatric through geriatric nursing assessments.

• Healthy-People objectives align with community-health planning & patient-education interventions.

• Genetic counseling interfaces with reproductive health, ethics & advances in genomic medicine.

• Understanding family diversity aids culturally sensitive communication, a theme repeated in transcultural nursing modules.

Numerical / Statistical References (formatted)

• Life expectancy U.S. men 76.3\text{ yr}; women 81.4\text{ yr}.

• Switzerland men 82.1\text{ yr}; women 85.8\text{ yr}.

• Japan men 81.4\text{ yr}; women 87.5\text{ yr}.

• Drug-overdose mortality 32.5\text{ deaths}/100{,}000.

• Infant mortality disparity: African-American rate >2\times white rate.

• Adoption figure 135{,}000 children/year; 40\% trans-racial.

• Adult LGBTQ identification 5.6\% (≈ 1 in 18 adults).

• One-in-three Americans part of a blended family.

Ethical, Philosophical & Practical Implications Highlighted

• Ageism shapes access to resources & influences mental health; nurses must advocate against discriminatory practices.

• Genetic screening raises autonomy vs. potential eugenics concerns; informed consent & counseling are paramount.

• Family diversity challenges traditional policy frameworks; nursing must push for inclusive, equitable health-care policies.

• Public-health focus on environmental & social determinants acknowledges holistic view of wellbeing across the lifespan.

Summary Insights

• Lifespan development is continuous from conception to death, governed by genetic blueprints yet highly responsive to environmental, cultural & socioeconomic factors.

• Family structures are diversifying; effective nursing care requires flexible, culturally competent approaches that honor each family’s unique composition and stressors.

• Current demographic & epidemiologic trends (aging population, chronic disease prevalence, substance abuse) underscore the importance of health-promotion strategies rooted in Healthy People 2030 goals.

• Mastery of growth & development principles provides a foundation for age-appropriate patient assessment, education & interventions throughout the nursing curriculum.