HUMAN GROWTH AND DEVELOPMENT

EDPC 238
DR ODEK SALOME
• Growth generally takes place during the first 20 years of life.
• Development continues after that.
 Growth
• Is physical change and increase in size.
• It can be measured quantitatively.
• Indicators of growth includes height, weight, bone size, and
dentition.
• Growth rates vary during different stages of growth and
development.
• The growth rate is rapid during the prenatal, neonatal,
infancy and adolescent stages and slows during childhood.
• Physical growth is minimal during adulthood
 Development
• Is an increase in the complexity of function and skill
progression.
• It is the capacity and skill of a person to adapt to the
environment
• Development is the behavioral aspect of growth
• Tabula rasa theory your mental content comes only from your
experience.
• The meaning of tabula rasa originates from Latin “blank slate” or
“white paper”; it means that you’re born with an empty mind which
is to be filled with your life experiences which, according to tabula
rasa theory, are the unique source of mental content.
• One of the most famous philosophers who held belief in tabula rasa is
probably English philosopher John Locke who claimed that “all ideas
come from sensation or reflection”
• Nurture vs Nature
• Nature refers to biological/genetic predispositions' impact on human
traits
• Nurture describes the influence of learning and other influences from
one's environment.
• Nature is what we think of as pre-wiring and is influenced by genetic
inheritance and other biological factors.
• Nurture is generally taken as the influence of external factors after
conception, e.g., the product of exposure, life experiences and
learning on an individual
• Nature refers to all of the genes and hereditary factors that
influence who we are—from our physical appearance to our
personality characteristics.
• Nurture refers to all the environmental variables that impact who
we are, including our early childhood experiences, how we were
raised, our social relationships, and our surrounding culture.
 Genetic factors

• Genetic predisposition is the importance factors which influence the

growth and development of children.
• Sex
• Race and Nationality
 Prenatal factors

• Intrauterine environment is an important predominant factor of

growth and development.
• Various conditions influence the fetal growth in utero.
• Maternal malnutrition
• Maternal infection
• Maternal substance abuse
• Maternal illness
• Hormones
 Postnatal factors

• Growth potential
• Nutrition
• Childhood illness
• Physical environment
• Psychological environment
• Cultural influence
• Socio economic status
• Climate and season
 Factors that affect human growth and
development

• Heredity
• Sex
• Socioeconomic
• Nutritional:
• Hormones:
• Pollution
• Race
 Human Development through the Life Span
• Life is a journey, with each developmental stage posing a
new set of challenges and opportunities.
• As professional counselors, we are in the unique position of
not only experiencing our own growth and development, but
also facilitating our clients’ journey.
• The life-span perspective not only includes the belief that
development is lifelong, but also that it is multidimensional,
multidisciplinary and contextual, multidirectional, and
plastic.
• Life span developmental theory provides an organizational framework
for understanding how the different stages of life are linked together
and how the three adaptive processes of growth, maintenance, and
regulation of loss are part of the developmental journey from infancy
through old age.
• Erik Erikson
• 15 June 1902 – 12 May 1994) theory on psychosocial development
theory professor at Harvard
• Psychoanalytic sexual theory
• Sigmund Freud (1856–1939) observed that during the
predictable stages of early childhood development, the
child's behavior is oriented towards certain parts of his or
her body, e.g. the mouth during breast-feeding, the anus
during toilet-training
• Emphasizes behaviors unconscious forces and internal
conflicts in explaining
• SuperEgo – source of guilt & moral values
• “conscience” – knowledge of behaviors that are wrong
• “ego ideal” – knowledge of behaviors that are right
• Three Levels of Consciousness
• EGO – conscious & unconscious self
• Allows controlled ID expression within the boundaries of the SuperEgo
• Rational, Thoughtful, Realistic
• Operates on the “reality principle” – finds socially acceptable ways to
gratify the ID
Jean Piaget
• Piaget's (1936) theory of cognitive development explains how a child
constructs a mental model of the world. He disagreed with the idea
that intelligence was a fixed trait, and regarded cognitive
development as a which occurs due to biological maturation and
interaction with the environment
 Lawrence Kohlberg
• Expanded on the earlier work of cognitive theorist Jean Piaget to
explain the moral development of children, which he believed follows
a series of stages. Kohlberg defined three levels of moral
development: preconventional, conventional, and postconventional.
Each level has two distinct stages.
• Classical conditioning by Ivan Pavlov
• Operant conditioning by Skinner
STAGES OF HUMAN DEVELOPMENT
Pre-natal Development • Divided into 3 stages
• Germinal stage – conception to implantation – zygote:
fertilized egg
• Embryonic Stage – Third week after conception – Embryo:
mass of cells – until 8th week of pregnancy
• Fetal Stage – Longest stage – Rapid growth and
development – Heartbeat grows stronger – Sexual
characteristics become prominent – Fetus become heavier –
Preparation of life after birth
• Environmental impacts on pre- natal development • Drug use –
thalidomide drugs causes deformities on the fetus • Alcohol use –
Fetal Alcohol Syndrome • Tobacco exposure – low birth weight, SIDS,
developmental problems
• Maternal factors • Maternal age – too young or too old are high risk
pregnancies • Socio-economic status – affects nutrition, pre- natal
and post-natal care • Emotional status • Maternal illness – HIV,
German measles
• Infancy and Childhood • Newborn – different senses and
reflexes begin to develop – Rooting reflex: turning of head
towards the direction of the check; indicate hunger – Sucking
and swallowing reflex: newborns will suck anything that
touches their lips; breastfeeding – Gag reflex – closing of
throat and pushing of tongue to expel; throat clearing
• Age Physical and Language Emotional Social 10-12 months Says a few
words Stands Creeps Crawls Fear of strangers Curiosity exploration
Responds to own name Wave bye bye Plays pat-a-cake 1-1 ½ years
Walks Makes line on paper Upset when separated from mother Fears
bath Feeds self Obeys commands 1 ½ - 2 years Run, kicks Bowel
control Vocabulary 200 words Temper tantrums Does opposite of
what is told 2-3 years Rides a bike Says phrases or sentences
Negativistic Resist parental demands
• 3-4 years Stands on one leg Draws a circle Self-sufficient
Genital manipulation Oedipus complex Electra complex Likes
to share Imaginary friend Identify to same sex parent 4-5
years Talks clearly Dresses self Copies triangle and square
Feels pride and accomplishment Responsibility and guilt
Prefers to play with other children Competitive Prefers
gender appropriate activities
 Pre school child
• At 3 years
• Physical or biologic development:
• Weight approximately 12.5-16.5 kg(27.5-36.3 lb) has gained 2.27 kg (5
lb) during third year
• Height approximately 90.5-101.5 cm (35.5- 40inches) gained 8 cm (3
inches) in 3rd year
• Pulse 105±15 (average 95 beats/min)
• Respiration 25±5 per minute
• Blood pressure 100±24/67±25
• Gross motor :
• walks a straight line,
• walks backward,
• walks on tiptoe,
• runs without looking at feet,
• catches ball with extended arms ,
• kicks a ball, jumps from a height of several inches,
• rides tricycle using pedals
• Fine motor :
• builds a tower of 9-16 blocks ,
• copies a circle,
• uses blunt scissors with one hand to cut ,
• puts beads on strings,
• can help with simple household tasks(dusting etc)
• Self care :
• dressing skills ,
• can put coat without assistance,
• can undress self in most instances,
• toileting & grooming skills,
• can pull pants up & down,
• can go to toilet alone,
• brushes teeth with help
• Sensory development : Visual acuity : 20/20
• Psychosocial development:
• Beginning development of sense of initiative(3-5 years)
• Negative counterpart: guilt
• Egocentric in thought & behavior
• Alternates between reality and imagination
• Able to share but express idea of “mine”
• Less dependent on parents but needs reassurance & help
• Tolerates short separations from parents
• Significant decrease in ritualism & negativism
• Fears the dark
• May have dream & nightmares
• Knows own sex
• Psychosexual development
• Phallic stage (3-6 years) :
• It is 3rd stage of psychosexual development
• The child becomes aware of anatomical sex differences,
which sets in motion the conflict between erotic attraction,
resentment, rivalry, jealousy and fear which Freud called the
Oedipus complex (in boys) and the Electra complex (in girls).
Spiritual development :
• Intuitive projective faith
• The cognitive development of children of this age is such that they are
unable to think abstractly and are generally unable to see the world from
anyone else's perspective.
• Faith is not a thought-out set of ideas, but instead a set of impressions that
are largely gained from their parents or other significant adults in their
lives.
• In this way children become involved with the rituals of their religious
community by experiencing them and learning from those around them.
• Preoperational thought :
• Pre conceptual phase(2-4 years) In this stage, children
develop their language skills.
• They begin representing things with words and images. Also
this stage marked by egocentric thinking and animistic
thought.
• A child who displays animistic thought tends to assign living
attributes to inanimate objects, for example that a glass
would feel pain if it were broken.
Moral development :
• Pre conventional morality :Stage I (2 to 3 years ) Obedience and
Punishment Orientation. The child/individual is good in order to
avoid being punished. If a person is punished, they must have
done wrong.
Language development
• Receptive language :
• Can obey two propositional commands (ex: on, under)
• Expressive language : Uses 4 words sentences- asks why, uses
plurals - Gives sex & full name - Names figures in a picture - Has
vocabulary of 800-1000 words
Play stimulation :
• Plays competitive exercise games
• Loves to transport things in trucks, cars, wagons
• Provide : simple games for competitive & team play,
• See-saw ,jungle gym ,sleds ,jump rope ,& skates for motor
activity
• Construction toys ,paper dolls ,opportunities for collecting nature
specimens for creative activity
• Color sets ,books ,& puzzles for quiet play
Needs
Emotional & social need :
• Love & security : child develop a preference for one parent.
• They begin to direct some concerns & interests to one parent & some
to others
• Limits to children's behavior must be set & consistently maintained.
• Limits set by parents give children a feeling of security. Suggestion not
commands are made in positive form
• Choices should be given when possible. The number of choices may
be limited to prevent overwhelming children with too much variety of
choices
• Dependence progressing to independence : nursery school increases
the capacity for independent action, self-confidence, & feeling of
security in variety of actions
• Nursery schools provides the activities that the child performs daily at
home, toileting, napping, health practices, & play both indoor &
outdoor
• Separation :some parents & children separate easily whereas others
have a difficult time.
• Arrangements should be made to meet the teacher, to develop a
feeling of trust in this new interaction
• Children must feel at school that the teacher will take care of them
when parents is not there
Discipline leading to self control :
• Bedtime problems –sleep : more difficulty in putting the child in bed
& walking during the night.
• Both of these are normal phenomena but may become problem.
• Suggested interventions includes putting the child to bed firmly at the
appropriate hour, ignoring crying or other attention seeking
behaviors, reading a brief story.
• Clearly state its bed time. fairy tales & television may cause night
walking reactions.
• Selfishness : children are not born with the ability to share
with others what is theirs.
• Slowly they learn the joy of giving & of sharing with others.
adults can help children learn to share with others.
• Children should be allowed to decide whether to give or
refuse to give. to learn the difficult & often unpleasant
lesson of sharing.
• Hurting others : children who repeatedly want to hurt others by
biting, scratching, pulling hair, or hitting are troubled children.
• They must not be allowed to hurt other children. they need to know
that someone who loves them deeply will control them & so to
prevent the unpleasant consequences of their behavior.
• Toys & other objects with which a child can hurt others can be
removed.
• Destructiveness : all children occasionally break things.
• The cause of destructiveness must be found & appropriate
treatment given.
• The parents should avoid scolding or punishing. They should
help direct the child’s energy into appropriate activities.
• Developing self esteem: developing self esteem include
consistent & sincere encouragement by parents & family
members, teacher & peer opinions regarding adequacies &
acquisition of motor, language & self care skills.
Physiological & biological needs :
• Control of bodily functions :
• Enuresis (involuntary urination): enuresis may also have physical
cause.
• The physician & the parents should analyze the situation to
determine the child’s specific problem.
• Enuresis may be due to dark hall. Giving less fluid in evening may be
tried.
• Parents should help child to achieve a positive attitude towards the
enuresis & to develop confidence in the ability to control elimination.
• Encopresis : this usually indicates an emotional disturbance.
• As with enuresis, encopresis may be due to too rigid toilet training or
to a poor parent child relationship.
• Child should be observed for megacolon & psychiatric treatment also
may be required for unresolved emotional problems
• Middle childhood (usually defined as ages 6 to 12) is a
time when children develop foundational skills for
building healthy social relationships and learn roles that
will prepare them for adolescence and adulthood.
Physical growth during the primary school years is slow but
steady.
• Having good muscle control and coordination
• Developing eye-hand coordination
• Having good personal hygiene
• Being aware of safety habits.
• Grades 1 to 3
• Weight gain averages about 6.5 pounds a year.
• Most children will have slimmer appearance compared
to their preschool years
• A child’s legs are longer and more proportioned to the
body than they were before.
• A number of factors could indicate how much a child
grows, or how much changes in the body will take
place: genes, food, climate, exercise, medical
MOTOR DEVELOPMENT
• Most children have a good sense of balance.
• They like testing their muscle strength and skills skip, hop, jump,
tumble, roll and dance.
• Gross motor skills are already developed, they can now perform
activities like catching a ball with one hand, tying their shoelaces, they
can manage zippers and buttons.
• Performing unimanual (require the use of one hand) and bi-
manual(require the use of two hands)activities becomes easier.
Children’s graphic activities
• Motor development skills include coordination, balance, speed, agility
and power.
• Children develop eye-hand and eye-foot coordination
when they play games and sports Balance.
• Static balance- is the ability to maintain equilibrium in a
fixed position, like balancing on one foot.
• Agility- is one’s ability to quickly change or shift the
direction of the body.
• Power- is the ability to perform a maximum effort in the
shortest possible time.
• Children have better understanding of their thinking skills.
• Logic Concrete operational thinkers
• Inductive logic involves thinking from specific experience to
a general principles.
• Reversibility awareness that can action can be reversed.
• Example : Teacher: Jacob, do you have a brother ? Jacob:
Yes. Teacher: What is his name? Jacob: Marjun. Teacher:
Does Marjun have a brother ? Jacob: Yes.
• Cognitive. The skills they learn are in a sequential
manner, meaning they need to understand numbers
before they can perform a mathematical equation. Can
read
• Information Processing Skills - the mind receives
information, performs operations to change its form and
content, stores and locates it and generate responses
from it.
• Socio-emotional - Industry vs. Inferiority.
• Industry refers to a child’s involvement in situations
where long, patient work is demanded to them
• While inferiority is the feeling created when a child gets
a feeling of failure when they cannot finish or master
their school work.
• Self-concept is the knowledge about themselves. Personality
traits, physical characteristics, abilities, values, goals and
roles.
• It means that he like himself, feels accepted by his family and
friends and believes that he can do well.
• Begin to interact with, including teachers and classmates.
Children have a growing understanding of their place in the
world.
• Self-confident and able to cope well with social interactions.
The issues of fairness and equality become important to them
as they learn to care for people who are not part of their
families.
• Building friendships making friends is a crucial but very
important of children’s social and emotional growth.
• Children, during this stage, most likely belong to a peer group
of the same gender.
• Anti social behavior - When children poke, pull, hit or kick
other it is fairly normal.
• Children at this age are still forming their own world views and
other children may seem like a curiosity that they need to
explore.
• Parents and teachers can help children make friends.
• They like receiving positive feedback from their parents and
teachers. This become a great opportunity for parents and
teachers to encourage positive emotional responses from
children by acknowledging their mature, compassionate
behaviors.
 ADOLESCENCE STAGE
• Adolescence • Early Adolescence: 11-14 years • Middle
Adolescence: 14-18 years • Late Adolescence: 18-21 years
• A Stormy phase - viewed adolescence as a period of
inevitable turmoil that takes place during the transition from
childhood to adulthood.
• The perception of young people as emotional volcanoes
ready to explode has taken on a life of its own.
• Conflict with parents: •Adolescents tend to rebel against
authority figures as they seek greater independence and
autonomy.
• Period of ‘storm and stress’- emotional turmoil/rebellious.
• Cultural and social environment plays a major role in shaping
behavior and experiences. • Biological changes are universal.
• This is the period in which the individual is no longer a
child, but not an adult.
• Mood disruption: Hormonal changes and the psychological
stress of adolescence can cause uncontrollable shifts in
emotions.
• Risky behavior: • The combination of a neurological need for
stimulation and emotional immaturity lead to increased risk-
Developmental tasks of an adolescent –
• Acceptance of changed physical appearance.
• Development of gender role identity.
• Development of cognitive skills and acquisition of
knowledge.
• Development of own identity.
• Development of independence from parents and other
adults.
• Selection of and preparation of a career.
• Development of social responsible behaviour.
• Acceptance of and adjustment to certain groups.
• Establishments of heterosexual relationships.
• Development of strong emotional bonds with another person.
• Preparation of marriage and family responsibilities.
• Achievement of financial independence.
• Development of moral concepts and values that could serve as
guidelines for behaviour.
• Development of a value system based on realistic and scientific
world view.
• Development of a philosophy of life.
Cognitive development: Middle adolescence:
• Has some experience in using more complex thinking
processes.
• Expands thinking to include more philosophical and
futuristic concerns.
• Often questions more extensively.
• Often analyzes more extensively.
• Thinks about and begins to form his or her own code of
ethics (for example, What do I think is right?).
Thinks about different possibilities and begins to develop own
identity (for example, Who am I?).
• Thinks about and begins to systematically consider possible
future goals (for example, What do I want?)
• Thinks about and begins to make his or her own plans.
• Begins to think long-term. • Uses systematic thinking begins
to influence relationships with others.
Cognitive development: Late adolescence:
• Uses complex thinking to focus on less self-centered
concepts and personal decision-making.
• Has increased thoughts about more global concepts such as
justice, history, politics, and patriotism.
• Often develops idealistic views on specific topics or
concerns.
• May debate and develop intolerance of opposing views.
• Begins to focus thinking on making career decisions.
• Absolute thinking • Categories things into fixed characteristics.
• They believe that the world is inherently stable and fixed. Any change
that occurs is the result of external forces.
• Perceive that the environment has a more important influence than
the individual.
• They are of the opinion that there is only one cause for a certain
result.
• They tend to believe that there is no exception for a rule.
• They believe that their existing knowledge cannot be contradicted by
facts obtained.
• They place things into categories that are not changed.
• Adolescent egocentricity: Adolescents think that others
perceive them the same way they perceive themselves.
• They believe that their own thoughts are shared by others
and are prominent in the thoughts of others.
• The inability of adolescents to decenter from their own
focus.
• The imaginary audience (the inability of adolescents to
distinguish between their own ideas and conceptions and
those of others)
• Personal fable (the inability of adolescents to distinguish
• Imaginary audience • Is the result of becoming extremely self conscious.
• They think they are the focus of all attention, • That they are the
interest of all others. • As if they are being watched by an audience
• The effects are evident in adolescents’ increased concern about their
physical appearance. • Eg paying attention to hairstyles and clothing.
• Personal fable • Results from the conception of adolescents that they
are unique and their personal experiences are unlike those of others.
• Because adolescents think of themselves as unique and special, they
think they are invulnerable and indestructible.
• They might think that something may happen to others but never to
them. • The personal fable is also related to high risk behaviour.
• The entry into new social environments. • Identity
development may lead to feelings of uniqueness and
invulnerability.
• Greater in girls than in boys probably due to socialisation.
• Parental rejection enhances self consciousness and
egocentrism. • Brought about by formal operational thought.
• Erikson’s theory: identity vs identity confusion • Identity
crisis: temporary period of identity crisis.
• Psychosocial moratorium: when adolescents find themselves
and their roles as adults. Investigation of careers and
 order to develop an own identity, adolescents have to master tasks:
In

• Ego-synthesis /adolescent have to form a continuous, integrated,

unified image of the self.
• He/she should feel that he is still the same person, regardless of time
or changes.
• It is the development of an own identity with the integration of all
experiences
• To create a whole picture of themselves regardless of changes
• That takes place over time.
• Forming of socio-cultural identity/ it include the value-orientations of
his culture.
• Adolescents are able to integrate and create and identity that follow
within the values of their culture.
• Establishment of Gender-role identity/ they establish their male or
female role.
• Whereby adolescents reaches sexual maturity.
• They identify with being male or female and incorporate the
expectations at the gender.
• Career identity/ Adolescents realise their strong points and talents in
order to make a career choice.
• Own value system/ rethink certain values in order to form own basic
philosophy
• Which may serve as an anchor to their lives.
• To be able to decide for themselves which values they would like to
• Identity confusion • When adolescents are indecisive about
themselves and their roles.
• Results in the following: • Identity foreclosure: • Identity
foreclosure is a commitment to something without personal
exploration of self. This often results in delays of optimal
psychological health and self esteem.
• Negative identity: • When adolescents adopt an identity that is
opposite what is expected of them. Usually occurs when
adolescents feel that the roles their parents and society expect
them to fulfill are unattainable or unappealing, yet they cannot
find any alternatives that are truly their own.
• Factors which influence identity development
self activity:
• Cognitive ability
• Influence of parents
• Cultural historical influences
• Social development – Parent adolescent relationship:
Conflict • Generation- gap
• Autonomy and attachment: • Cognitive autonomy- making
decisions and assuming responsibility for these choices. •
Behavioral autonomy- making choices regarding friendships.
• Emotional autonomy- being self reliant and independent of
their parents and being able to exert self control.
• Moral/value autonomy- forming an own value system that
could serve as guideline fro their own behaviour. •
Attachment bonds • Separation anxiety • Parenting styles
• Stages of peer group formation - young people formed cliques,
usually small groups of the same sex.
• Social development • Romantic relationships • Group activities •
Group dating • Informal dating • Serious involvement
• Moral development • Kohlberg theory • For Piaget, the highest
stage of moral development, characteristic of adolescence, is
moral autonomy. Dependent on the attainment of formal or
abstract reasoning ability, moral autonomy commonly begins at
puberty. In a game situation, like monopoly, chess, dominos- the
adolescent reveals interest not only in the rules by which the
game is played but also in possible new rules to make the game
more interesting or more challenging.
 EARLY ADULTHOOD
EARLY ADULTHOOD (19-29 years old)
• Individuals who are typically vibrant, active and healthy, and
are focused on friendships, romance, child bearing and
careers.
• Yet serious conditions, such as violent events, depression
and eating disorders, can negatively impact young adults.
PHYSICAL CHANGES
• Females reach their adult heights by age 18,and, except for
some males who continue to grow in their early 20’s, most
have reached their adult heights by the age of 21.
• Death rates due to disease are low in this life stage, but the
rate of violence-related deaths is high.
• People in this age group is eating disorders, which include
anorexia nervosa, bulimia nervosa, and binge-eating
disorder.
COGNITIVE CHANGES
• Brain growth already has taken place, and individuals are
now applying and using their knowledge, and analytical
capabilities.
• Adults have more flexibility in their thought patterns,
understanding that there are multiple opinions on issues,
and that there is more than one way to approach a problem.
• They are focused on developing their careers and achieving
independence from their families- a crucial requirement for
balanced, well functioning adults.
EMOTIONAL CHANGES
• Marks the time when individuals seek to form intimate relationships.
• A healthy adult is one who can “love and work.” Simply stated, this
developmental stage is characterized by relationships and work.
 MIDDLE ADULTHOOD
MIDDLE ADULTHOOD (30-60 years old)
• The ubiquitous term “middle crisis” that many in society take
for granted, doesn’t exist, according to many developmental
psychology researchers
• Most people during middle adulthood are satisfied and
pleased with their lives.
• They maintain that healthy and unhealthy lifestyles and
attitudes are the main concern for those in this age group.
PHYSICAL CHANGES
• Gray and thinning hair, wrinkles, the need for reading and bifocal
eyeglasses, and some hearing loss.
• Internally, changes are taking place as well, with some decline in
the major organs, including the lungs, heart and digestive
system; additionally women undergo menopause sometime
between the ages of 42 and 51.
• “Joy of living” during the middle adult years as they have found
high correlations between positive, upbeat attitudes and physical
and mental health.
COGNITIVE CHANGES
• Fluid intelligence, or the ability to process new concepts and
facts quickly and creatively, including abstract reasoning
problems, independent of previous education or learning,
peaks in adolescence
• Then starts a gradual decline between the ages of 30 and 40.
• Those in this age group typically need to simultaneously
manage a variety of family issues including children at
various ages of development, aging, ill parents and financial
concerns and worries.
EMOTIONAL CHANGES
• This is a time of great emotional upheaval, anxiety, and
drastic changes in behavior.
• Most middle-aged individuals say that they are in
meaningful intimate relationships, including those who have
been married for several years. For those who divorce and
remarry, many report satisfying intimacy although most report
that remarriage brings a new set of challenges.
• Most people in this age group have less problems with their
children and also better relationships with their own parents.
LATE ADULTHOOD (61 years and above)
PHYSICAL CHANGES
• Primary aging, or inevitable changes in the body, occurs
regardless of human behavior. Gray hair, wrinkles, visible
blood vessels on the skin, and fat deposits on your chin or
abdomen affect those in this age group.
• Also, diminished eyesight and hearing, to some extent,
affects all older adults.
• And some in their 70’s will lose a significant portion of their
taste and smell senses.
• All the major organs and bodily systems slow-down –
cardiovascular, respiratory, digestive, and renal/urinary.
COGNITIVE CHANGES
• Overall, memory fades as people age and there are marked
differences in each decade- the 70’s, 80’s, and 90’s.
• However, some people defy that general trends and either
maintain their mental sharpness into their 80’s and 90’s, or,
more rarely develop a form of dementia in the middle or
beginning of late adulthood.
• One of the central concern as people age is dementia, which
includes many diseases and syndromes, including
Alzheimer’s, Parkinson's, Huntington’s, multiple sclerosis,
• And some in their 70’s will lose a significant portion of their
taste and smell senses.
• All the major organs and bodily systems slow-down –
cardiovascular, respiratory, digestive, and renal/urinary.
EMOTIONAL CHANGES
• Theorist Erik Erikson (1902-1994) devised a framework for
development based on psychosocial stages, and he defined
the last stage of life as a tension between integrity and
despair.
• Individuals either come to accept their lives as having
meaning and integrity, or they contemplate their life as
unproductive and unfulfilling- feeling despair.
DYING
• Occurs when a valued person, object, or situation is changed
• Actual Loss can be recognized by others including the person
sustaining the loss, eg: a person losing a limb, spouse, valued
object, job etc.
• Perceived loss felt by the person but is intangible to others loss of
your youth, financial dependence.
• Anticipated loss the person displays loss and grief behaviors for
loss that has yet to take place. E.g: families with terminally ill
patients and serves to lessen the impact of actual loss
• Physical loss- loss of an arm from a car accident Physical loss.
• Psychological loss- caused by an altered self image and the
inability to return to his or her occupation.
• A person who is scared but has not lost a limb may suffer
from perceived and psychological loss of self image.
• Grief- Is the Emotional Reaction to Loss.( e.g Many people
who divorce experience grief, loss of a body part, a job, a
house or a pet.)
• Bereavement-State of grieving during which a person goes
through grief reaction. (eg when a person neglects their own
health to an extreme.)
• Mourning-Period of acceptance of loss and grief during
which the person learns to deal with the loss. (eg a person
returning to normal living habits.)
• Loss of appetite, Disturbed personal identity related to impaired
physical mobility and body image, Risk for complicated grieving
related to permanent loss of mobility.
• Name, Age, Sex, Cause of Death 2.Time and date of death and
all actions taken to respond to impending death. 3.Name of
healthcare provider certifying the death. 4.Persons notified of
the death. (Health providers, Family members, organ requests
team, morgue, funeral home, spiritual care providers.)
5.Request for organ or tissue donation made and by whom.
• Dying- Irreversible cessation of circulatory, respiratory & brain
function.
• Death is the cessation or permanent termination of all the biological
functions that sustain a living organism.
• Denial and isolation- Person denies that he or she will die.
• Anger- The person expresses hostility in the anger stage and adopts.
• Bargaining- The person tries to beg for more time.
• Depression- Period of grief before death. Characterized by crying and
not speaking
• Acceptance- Accepted death and is prepared to die.
• Relief from loneliness, fear & depression.
• Maintenance of security, self-confidence & dignity.
• Maintenance of hope & spiritual comfort.
• Maintenance of a comfortable & peaceful environment.
• Use therapeutic communication.
• Protect against Isolation.
• Assist with end- of- life decision making.
• Palliative care is the prevention, relief, reduction or soothing of
symptoms of disease or disorders throughout the entire course
of an illness, including care of dying and bereavement follow-up
for the family.
• Respects the goals, likes and choices of the dying person:
Looks after medical, emotional, social, and spiritual needs of
the dying person. Supports the needs of the family members.
Helps person gain access to needed healthcare providers and
appropriate settings. Builds ways to provide excellent end of
life care.