Human Lifespan Development: Adolescence to Late Adulthood (6)

Accident Prevention in Adolescence

  • Accidents = leading cause of death in adolescents.

    • Increased propensity for risk-taking behaviours (driving, swimming, sexual exploration, drug/alcohol use).

  • Essential preventive-education areas:

    • Driver’s education (seat-belt use, defensive driving, avoidance of intoxicated/ distracted driving).

    • Water-safety training (swimming skills, supervision, no diving in shallow water).

    • Safe-sex instruction (see next heading).

    • Drug and alcohol education (physiological, legal, and social consequences).

Safe Sex Practices (Safety Alert Box)

  • Over-arching message: earliest and strongest emphasis on abstinence.

  • Detailed guidelines:

    • The safest practice = abstinence.

    • Know your partner; discuss sexual lifestyle & history before intercourse.

    • Avoid partners who:

    • Use intravenous drugs.

    • Have multiple sexual partners.

    • Consistent, correct condom use (latex preferred).

    • Inspect for tears; discard condoms stored too long or exposed to heat.

    • Apply to erect penis; leave reservoir tip for semen.

    • Hold condom at rim while withdrawing to prevent slippage.

    • Avoid sexual contact with persons who have genital lesions or abnormal drainage.

    • Acknowledge higher HIV risk with oral sex; anal sex requires extra education (lubrication, barrier protection, STI testing).

Emotional Health in Adolescence

  • Stage characterised by marked mood variability.

    • Alternates between gregarious participation & withdrawn moodiness.

    • Families must differentiate normal mood swings from clinical depression.

  • Depression definition: persistent sadness, despair, hopelessness; seldom resolves without therapy.

    • Untreated depression → potential suicide.

    • Early detection/intervention ↑ success.

Signs of Depression & Suicide Risk (Box 24.18)

  • Behavioural & physical red flags:

    • Change in appetite.

    • Mood change (sadness/hopelessness).

    • Inability to concentrate.

    • Loss of interest in usual activities.

    • Sleep disruption (hypersomnia/insomnia).

    • Verbalisation of suicide.

    • Preoccupation with death/dying.

    • Giving away prized possessions.

  • Critical warning: Sudden switch from extreme sadness to manic cheerfulness may indicate decision to act on a suicide plan.

Developmental Tasks of Adolescence (Box 24.17)

  • Recognise individuality & personal strengths/weaknesses.

  • Establish a personal value system & life philosophy.

  • Assume responsibility for own actions.

  • Adapt to body (somatic) changes.

  • Acquire adult-living & independent social skills.

Early Adulthood (20–40 yrs)

Developmental Tasks (Box 24.19)

  • Achieve financial & social independence.

  • Maximise personal identity & worth.

  • Cultivate meaningful relationships; distinguish attraction vs. love/commitment.

  • Balance personal needs with societal expectations.

  • Make key life decisions: marriage, career, parenting.

Physical Characteristics

  • Period of optimal physiologic function.

    • Peak muscular strength, energy, endurance in mid-20s.

    • Senses at sharpest; visual acuity peaks ≈ 20 yrs20\text{ yrs}, plateaus until ≈ 40 yrs40\text{ yrs}.

  • Height: females max 16–17 yrs16–17\text{ yrs}; males 18–20 yrs18–20\text{ yrs}.

    • After 30–45 yrs30–45\text{ yrs} slight decline d/t spinal-disk compression.

  • Possible weight gain from ↑ adipose, ↓ muscle if activity declines.

Psychosocial Development

  • Rise of dual-career families (economic realities, feminist movement).

  • Key life structures: career, intimate partnership, potential parenting.

    • Decisions influenced by finances, support systems, housing, nuclear/extended-family roles.

  • Erikson: Intimacy vs. Isolation.

    • Intimacy = capacity for deep commitment, sharing, compromise.

    • Virtue gained = love.

    • Failure → isolation & self-absorption.

Cognitive Development

  • Piaget: formal-operational thought continues; adults integrate knowledge across wider experiences; problem-solving becomes more nuanced & multidimensional.

Health Promotion

Nutrition

  • Calorie needs ↓ post-growth; still required for cell repair & energy.

    • Individual factors: age, sex, size, activity, metabolism, stress.

  • Diet linked to prevention of heart disease & cancer.

    • Recommendations: low-fat, high-fiber, low-cholesterol.

    • Limit tobacco, alcohol, recreational drugs.

Rest & Sleep

  • Optimal: 7–9 hours7–9\text{ hours} nightly.

  • Daytime rest improves productivity; crucial for pregnant women.

Physical Activity

  • Regular, paced exercise → ↑ CV/resp capacity, ↓ BP, weight control, emotional well-being.

  • Sexual drive persists through adulthood for both sexes.

Screenings & Preventive Care

  • Annual physical exam.

    • Male: monthly testicular self-exam; clinical exam annually.

    • Female: annual Pap smear; ACS mammography options 40–44 yrs40–44\text{ yrs}, yearly 45–54 yrs45–54\text{ yrs}, then q1–2 yrs ≥55 yrs55\text{ yrs}.

    • Male prostate discussion at 50 yrs50\text{ yrs} (earlier 45 yrs45\text{ yrs} for African-American men or +family hx); PSA ± DRE.

  • Dental: q66 months. Eye exam: q22 yrs unless indicated.

Safety

  • Accidents (workplace, vehicle, sports, violence) = top cause of death/disability.

Middle Adulthood (40–65 yrs)

Developmental Tasks (Box 24.20)

  • Balance goals vs. realities, redirect energy.

  • Extend caring beyond family to community/society.

  • Achieve career/job satisfaction.

  • Adapt to physical changes.

  • Establish new roles with spouse, adult children, grandchildren, aging parents.

Physical Changes

  • Bone mass ↓ (osteoporosis risk; faster in post-menopausal women).

  • Height ↓ (vertebral compression), muscle fibres & strength ↓.

  • Basal metabolism ↓ → easier weight gain; calorie needs ↓.

  • Vision: presbyopia onset ≈40 yrs40\text{ yrs}.

  • Hearing: presbycusis (high-frequency loss) more in men.

  • Skin: ↓ elasticity & SC fat → wrinkles; hair greys (temples first), thins.

  • Periodontal disease incidence ↑; promote fluoride, flossing, cleanings.

  • Female climacteric (perimenopause ≈ 5 yrs5\text{ yrs}): ↓ estrogen/progesterone → irregular menses, hot flashes, night sweats, mood swings.

    • HRT pros: ↓ osteoporosis, ↓ atherosclerosis; cons: ↑ stroke, ↑ endometrial/breast ca, ↑ BP.

  • Male climacteric: possible ↓ libido, body-hair loss, delayed erection; largely psychological; potential "midlife crisis".

Psychosocial Development

  • Erikson: Generativity vs. Stagnation.

    • Generativity = productivity, creativity, guiding next generation (parenting, teaching, mentorship).

    • Failure → stagnation (self-absorption, inactivity).

  • Role transitions:

    • "Empty-nest"; marriage may strengthen/re-negotiate.

    • New identity as grandparents—often rewarding due to fewer constraints.

    • Emerging responsibility for aging parents → "parenting the parent"; ↑ stress, often shouldered by midlife daughters.

Health Promotion

Nutrition & Weight

  • Activity often ↓ → lower caloric requirement than youth.

    • CDC: >40%40\% Americans >20 yrs20\text{ yrs} are obese (≥20%20\% above ideal weight);
      highest in non-Hispanic black women (58.9%58.9\%), Hispanic men (45.7%45.7\%); lowest in Asian adults.

  • Multifactorial causes: excess intake, inactivity, genetics, diseases/medications.

  • Calcium:

    • Premenopausal women: 1000 mg/day1000\text{ mg/day}.

    • Postmenopausal (no estrogen): 1200 mg/day1200\text{ mg/day}.

    • Include phosphorus, magnesium; emphasise leafy greens, fruits, whole grains, dairy.

  • Fat intake: prefer unsaturated oils (soy, sunflower, corn, safflower); limit saturated fats & cholesterol.

Physical Activity

  • Weight-bearing & stress-reducing activities (walking, swimming, golf, tennis) support bone density & stress management.

Screenings & Care

  • Annual physical; biannual dental; follow ACS age-appropriate cancer screening.

Sleep & Rest

  • Total nightly sleep often ↓; difficulty falling/staying asleep (hormonal shifts, circadian change, stressors).

Late Adulthood (65 yrs +)

  • Fastest-growing demographic; preparing for aging is essential.

  • Aging studied via sociologic, physiologic, psychological lenses (discipline: gerontology).

    • Many 70-yr70\text{-yr}-olds today = functional 50-yr50\text{-yr}-olds of 1960s.

  • Physiologic changes not universal/inevitable; often modifiable with interventions.

  • Successful aging relies on adaptability, coping capacity, self-esteem.

  • Societal considerations: retirement, social security, health-care access, valuing elders’ skills.

  • Early adulthood planning (financial, lifestyle) facilitates later adjustment.