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Growth and Development image (Health care workers need to be aware of the…

- - - - Four main types
        
        Mental/Cognitive
        
        Refers to intellectual developments
        
        Includes learning how to solve problems, making judgements, and how to deal with situations
        
        Emotional
        
        Refers to feelings
        
        Includes dealing with love, hate, joy, fear, excitement, and other similar feelings
        
        Physical
        
        Refers to body growth
        
        Includes height, weight, and muscle growth
        
        Social
        
        Refers to interactions and relationships with other people
  - - - For example, learning to sit, then crawl, then stand, then walk, and then finally run
- - - - 12-18 years
        
        Often traumatic
        
        Physical development
        
        Muscle coordination slows down and awkwardness or clumsiness
        
        Puberty
        
        The development of secondary sexual characteristics
        
        Sudden growth spurt can cause rapid weight gain and in height as well
        
        Girls: 11-13
        Boys: 13-15
        
        Mental development
        
        Increase in knowledge and sharpening of skills
        
        Learn to make decisions and accept responsibility for action Adolescents need reassurance, support, and understanding
        
        Emotional development
        
        Stormy and in conflict
        
        Feel inadequate and insecure
        
        Worry about appearance, their abilities, and their relationship with others
        
        End of adolescence identity has been established
        
        Social development
        
        Spending less time with family and more with peers
        
        Seek security in groups of people own age with similar problems
        
        Develops self confidence from the approval of others and becomes more secure and satisfied
        
        Toward the end, more mature associate with adult behavior
      - Needs of adolescence
        
        In addition to the basic needs, adolescence need reassurance, support and understanding
        
        Many problems develop at this stage and can be traced back to feelings of inadequacy and insecurity
        
        Disorders in adolescence
        
        Anorexia nervosa
        
        A psychological disorder in which a person drastically reduces food intake or refuses to eat which results in excessive weight loss, and metabolic disturbances
        
        Bulimia
        
        A psychological disorder in which a person binges and fasts(refuses to eat)
        
        Bulimarexia
        
        When a person induces vomiting or uses laxatives to get rid of food that had been eaten
        
        More common in females
        
        Usually, psychological or psychiatric intervention is needed to treat any of these conditions
        
        Chemical abuse
        
        The use of substances such as alcohol or drugs and the development of a physical or mental dependence on the chemical
        
        Can occur at any life stage, but frequently begins in adolescence
        
        Reasons for use: anxiety or stress relief, peer pressure, escape from emotional or psychological problems, experimentation with the feelings these chemicals produce, desire for instant gratification, hereditary traits, and cultural influences
        
        Can lead to physical and mental disorders and diseases
        
        Treatment towards total rehabilitation
        
        Suicide
        
        One of the leading causes of death in adolescents
        
        Permanent solution to temporary problem
        
        Reasons for: depression, grief over a loss or love affair, failure in school, inability to meet expectations, influence of suicidal friends or lack of self esteem.
        
        Risks include: major loss or disappointment, previous suicide attempts, and or the recent suicide of friends, family, role model
        
        Impulsive nature of adolescents will also increase the risk
        
        Most give warning signs
        
        Sudden changes in appetite, withdrawal, depression, moodiness, excessive fatigue or agitation, neglect in personal hygiene, alcohol or drug abuse, losing interest in hobbies or aspects in life, preoccupation with death, injuring body parts, giving away possessions, and social withdrawal from friends and family
        
        Call for attention and should not be ignored- support, understanding, and psychological or psychiatric counseling are needed for the prevention of suicide
    - - 19-40 years
        
        Most productive life stage
        
        Physical development
        
        Complete
        
        Prime childbearing time
        
        Mental development
        
        Pursue additional education for career
        
        Independence, makes career choices, establishes life style, selects a marital partner, starts a family, establishes values
        
        Emotional development
        
        Many emotional stresses related to career, family, marriage
        
        If strong- can cope with worries
        
        Find satisfaction with achievements
        
        Learn to accept criticism and profit from mistakes
        
        Social development
        
        Moving away from peer groups
        
        Hang around people with similar ambitions and interests, regardless of age
        
        Becomes involved with a mate
    - - 6-12 years
        
        Also called preadolescence
        
        Physical development
        
        Weight gain of 4-7 pounds and height increases 2-3 inches per year
        
        Children engage in more physical activity
        
        Permanent teeth set in
        
        Visual acuity is at its best
        
        At 10-12 secondary sexual characteristics develop
        
        Mental development
        
        Speech skills and memory are more complex
        
        Reading and writing skills develop
        
        Use information to solve problems
        
        Understand abstract concepts such as honesty, loyalty, values, and morals
        
        Emotional development
        
        Emotions are under control
        
        Sexual maturation can lead to periods of depression followed by joy
        
        Can also leave the child restless, anxious, and hard to understand
        
        Social development
        
        7 year old tend to be by themselves
        
        8-10 year old form groups with same sex
        
        Learn from one another
        
        Children in this age need parental approval, reassurance, and peer acceptance
    - - 40-65 years
        
        Frequently called middle age
        
        Physical development
        
        Hair begins to thin and turn gray
        
        Skin begins to wrinkle
        
        Muscle tone decreases
        
        Hearing loss
        
        Visual acuity
        
        Weight gain
        
        Mental development
        
        Mental ability increases
        
        Acquire an understanding of life
        
        More confident in making decisions
        
        Emotional development
        
        Period of contentment and satisfaction or a time of crisis
        
        Emotional foundation of previous life stages determine your emotional status
        
        Social development
        
        Depend on family relationships, work relationships
        
        Husband and wife relationships can be stronger or divorce rates are high in this groups because they stayed for the children's sake
    - - 1-6 years
        
        Growth not as dramatic
      - Physical developments
        
        At age 6 their average wgt is 45 pounds
        
        Height 46 inches
        
        Skeletal/muscle development (child has adult like appearance)
        
        Legs and lower body develop quicker
        
        Muscle coordination improve; run, climb, and move
        
        Learns to write, draw, and use a fork and knife
        
        At age 2 or 3 most teeth are in
        
        Between 2-4 years they acquire bowel/bladder control
      - Mental developments
        
        Vocabulary of 1500-2500 words by age 6
        
        2 yr olds have short attention spans but like lots of activities
        
        Make decisions based on logic rather on trial and error
        
        Ask frequent questions
        
        Recognize letters and some words
        
        By age 6 can make decisions based on both past and present experiences
      - Emotional development
        
        1-2 year old develop self-awareness of how they affect others and defy the limits that are set
        
        Gain self-confidence, wants to learn and feel impatient or angry which can cause temper tantrums
        
        4-6 year old start to control their emotions and understand the concept of right and wrong
      - Social development
        
        Fear separation from parents
        
        Eventually have an interest in other
        
        Needs routine, order, and consistency which is how they learn to conform to rules
        
        Goes from a self-centered 1 year old to a social 6 year old
    - - 65 years and older
        
        Senior citizen, elderly, golden ager, and retired citizen
        
        Physical development
        
        On the decline and all body systems are affected
        
        Skin becomes dry, wrinkled, thinner
        
        Brown or yellow spots (age spots) appear
        
        Hair thin and lacks luster
        
        Bones become brittle and porous and are more likely to break
        
        Cartilage between vertebrae thins and can lead to stooping posture
        
        Muscle tone is lost leads to fatigue and poor coordination
        
        Decrease in hearing and visual acuity, decrease in tolerance of temperature
        
        Memory loss
        
        Heart is less efficient and circulation decreases
        
        Kidney and bladder less efficient
        
        Breathing capacity decreases and causes shortness of breath
        
        Mental development
        
        More active you are the less you show signs
        
        Short term memory fades first
        
        Alzheimer’s Disease- irreversible loss of memory deterioration of intellectual functions, speech and gait disturbances and disorientation
        
        Arteriosclerosis- a thickening and hardening of walls of the arteries can also decrease the amount of blood supply to the brain and decrease mental abilities
        
        Emotional development
        
        Some cope well, others become lonely, frustrated, withdrawn and depressed
        
        Deal with retirement, death of a spouse and loss of friends, physical abilities decrease, financial problems and loss of independence and the knowledge that life is ending can cause emotional distress
        
        Social development
        
        Can lead to a low self esteem due to retirement
        
        Development of new social contacts is important at this time
        
        Senior centers golden age groups, churches help provide
        
        The elderly need a sense of belonging, self-esteem, financial security, social acceptance, and love
    - - Birth to 1 year
      - Life stage with the most rapid changes
        
        Mental developments
        
        Responds to discomforts like pain, cold, and hunger by crying
        
        At 2-4 months they coo or babble when spoken to and are able to laugh out loud and squeal with pleasure
        
        At 6 months they understand some words and can make sounds such as "mama" and "dada"
        
        At 12 months they understand many words and can use single words in their vocabulary
        
        Emotional developments
        
        Newborns show social excitement
        
        At 4-6 months they display distress, delight, anger, disgust, and fear
        
        At 12 months they experience elation and affection for adults is evident
        
        Physical developments
        
        Newborn babies usually weigh 6-8 pounds and measure 18-22 inches long
        
        At the end of their first year their weight is tripled and their height is 29-30 inches
        
        Reflexes present at birth allow the baby to respond to the enviroment
        
        Rooting reflex
        
        Baby's head turns at slight touch of their cheek
        
        Sucking reflex
        
        Baby sucks at slight touch of their lips
        
        Moro/Startle reflex
        
        Baby reacts to loud noises
        
        Grasp reflex
        
        At 2-4 months they're able to lift their head, roll side to side, support on arms when prone, and grasp or reach objects
        
        At 4-6 months they can turn their body completely around. accept objects handed to them, grasp objects such as a bottle, and, with support, hold head while sitting
        
        At 8-10 months they can crawl, sing hands and knees, pull themselves to a sitting or a standing position, and use good hand-mouth coordination
        
        At 12 months they can walk without assistance, grasp objects with thumb and fingers, throw small objects, may have 10-12 teeth, and can only see close up in black and white
        
        Social developments
        
        At 4 months infants recognize their caregivers, smile readily and stare at others
        
        At 6 months of age infants watch the activities of others show signs of possessiveness and may become shy or withdraw in the presence of strangers
        
        At 12 months of age, infants may still be shy around strangers but socialize freely with familiar people, mimic sound and gestures, facial expressions and vocal sounds
    - - Death is “the final stage of growth”
        
        Experienced by everyone and no one escapes
      - Young people tend to ignore it and pretend it doesn’t exist
        
        Usually it is the elderly, who have lost others, who begin to think about their own death
      - Terminal illness
        
        A disease that cannot be cured and will result in death
      - People react in different ways
        
        Some act in fear and anxiety
        
        They fear abandonment and loneliness
        
        They fear the unknown
        
        Anxious about loved ones and about unfinished dreams
        
        Anxiety will diminish when they feel they have led full lives and who have strong religious beliefs regarding life after death
      - Hospice
        
        Palliative care only (care that provides support and comfort)
        
        Often in patient’s home but can be in hospitals, nursing homes
        
        Hospice is not limited to a specific time periods in a pts life usually when dr states less than 6 months. Don’t need the doctor to write for a script; a family member can call hospice to get the ball rolling
        
        Philosophy is to allow patient to die with dignity and comfort
        
        Provide hospital equipment (beds, wheelchairs, bedside commodes; offer psychological help spiritual, social and financial counseling and provide free or less expensive pain medication
        
        Personal care in hospital it is by staff, in the home, it is provided by home health aides,
        
        Volunteers are very important stay with pt after family leaves, provide support for their patients
        
        After death contact and services remain with the family during time of initial mourning
      - The right to die
        
        Ethical issues must be addressed by the health care worker
        
        Laws allowing “right to die” state that specific ways to end life cannot be undertaken
        
        Hospice encourages LIVE promise
        
        Learn about end of life services and care
        
        Implement plans or advanced directives to ensure wishes are honored
        
        Voice decisions
        
        Engage others in conversations about end of life care options
        
        Death is a part of life
        
        Health care workers must understand death and dying process and think about needs of dying patients
        
        Then health care workers will be able to provide the special care these individuals need
  - - - These are basic needs that must be resolved at each stage
        
        Erickson believed that if these needs were not met at the appropriate stage, then that individual would have trouble with that same need later in life
        
        Health care workers must understand that each life stage creates certain need in people
  - - - Dying patients and their families and friends may experience these stages experience several stages at once
        
        Some patients may not progress through them all, others may
        
        Stages may not occur in order
      - The five stages of grief
        
        Denial
        
        Refuses to believe. “No, Not me” stage. The person is told of a terminal illness and cannot accept the reality of death or when the person feels loves ones cannot accept the truth. HC worker should listen to the pt and try to provide support without confirming or denying
        
        Anger
        
        When no longer able to deny. “Why me?” or “It’s your fault” the pt may strike out at anyone who come in contact with them and they can become hostile, and bitter. They blame themselves, loved one, or health care worker. It is not a personal attack; it is the anger. Provide understanding and support
        
        Bargaining
        
        Accepts death, but wants more time. Patients turn to religion and spiritual beliefs. The will to live is strong, they want to see children graduate or get married. So they make promises to God to obtain more time.
        
        Depression
        
        Realizes death will come soon and will no longer be with family and friends. May express regrets or withdraw and become quiet. Health care worker need to be patient and know that it is ok to be depressed. Provide quiet understanding, support and a simple touch and allow patients to cry and express grief
        
        Acceptance
        
        Understands and accepts the fact they are going to die. Patients may complete unfinished business and try to help those around them deal with death, at the end they are at peace and can die with dignity. They still require support and the presence of others. Touch is important
  - - - Needs: lack of something that is required or desired
        
        Needs exist from birth to death
        
        Needs influence our behavior
        
        Needs have a priority status
      - Meeting the needs
        
        Motivation to act when needs felt, if the action is satisfied then you have a sense of satisfaction when needs met, if not, you feel a sense of frustration when needs not met
        
        Direct methods
        
        All these methods are directed toward meeting the need,
        
        Students who constantly fail tests and want to pass have a need for success
        
        Indirect methods
        
        These reduce the need and help relieve the tension created by the unmet need
        
        The need is still present but its intensity just decreases
        
        Defense mechanisms
        
        Unconscious acts that help a person deal with an unpleasant situation
        
        Provide methods for maintaining self esteem and relieving discomfort
        
        Rationalization
        
        Reasonable excuse for the behavior to avoid the real reason
        
        Projection
        
        Placing the blame for ones actions on someone else
        
        Displacement
        
        Transferring feelings about a person to someone else
        
        Compensation
        
        Substituting one goal for another to achieve success
        
        Repression
        
        Transferring of unacceptable or painful ideas, feelings, or thoughts into the unconscious mind-- forget
        
        Suppression
        
        Individual is aware of the unacceptable feelings and refuses to deal with them (breast cancer- refuses to dr)
        
        Denial
        
        Disbelief of an event or idea to shocking for a person to cope with (terminal illness)
        
        Withdrawal
        
        Avoids a conflict
        
        Daydreaming
        
        Dreamlike process that occurs when a person is awake b/c not satisfied with reality.
        
        Be aware of own needs and patient’s needs
        
        More efficient quality care can be provided when needs are recognized
        
        Better understanding of our behavior and that of others
        
        Must prioritize when several needs are felt at the same time
        
        Different needs can have different levels of intensity. The more intense the need is the greater the desire is