HUMAN GROWTH &

DEVELOPMENT

Through the Lifespan

8:1 LIFE STAGES Growth spans an individual’s lifetime Development is the process of becoming

fully grown Health care workers need to be aware of

the various stages and needs of the individual to provide quality health care

(continues)

LIFE STAGES (CONTINUED)

Infancy: birth to 1 year Early childhood: 1–6 years Late childhood: 6–12 years Adolescence: 12–20 years Early adulthood: 20–40 years Middle adulthood: 40–65 years Late adulthood: 65 years and older

GROWTH AND DEVELOPMENT TYPES Physical: body growth Mental: mind development Emotional: feelings Social: interactions and relationships

with others Four types above occur in each stage

ERIKSON’S STAGES OFPSYCHOSOCIAL DEVELOPMENT

Erik Erikson was a psychoanalyst A basic conflict or need must be met

in each stage See Table 8-1 in text

INFANCY Age: birth to 1 year old Dramatic and rapid changes Physical development Mental development Emotional development Social development Infants are dependent on others for all

of their needs

INFANCY:PHYSICAL DEVELOPMENT Baby’s weight can double in first year Reflexes present at birth

Moro, Sucking, Grasp, Rooting 2-4 months: roll side to side 4-6 months: turn body completely around &

grasp items handed to them 6-8 months: sit unsupported & grasp moving

objects 8-10 months: crawl, pull to sitting or standing 12 months: walk without assistance, grasp

objects with thumb & fingers, throw small objects

INFANCY:MENTAL DEVELOPMENT Rapid development Respond to discomforts: pain, cold, or

hunger by crying Become more aware of surroundings 2-4 months: coo or babble, laugh or

squeal 6 months: understand some word and

make basic sounds like “mama” & “dada”

12 months: understand many words and use singe words in vocabularies

INFANCY:EMOTIONAL DEVELOPMENT Newborns: show excitement 4-6 months: exhibit distress, delight,

anger, disgust, & fear 12 months: elation & affection for adults

is evident Events occurring in the 1st year of life

when these emotions are first exhibited can have a strong influence on an individual’s emotional behavior during adulthood

INFANCY:SOCIAL DEVELOPMENT Gradually progresses from self-

centeredness concept of the newborn to the recognition of others in environment

4 months: recognize caregivers & smile and stare at others

6 months: watch activities of others, show signs of possessiveness and may become shy in presence of strangers.

12 months: may be shy with strangers, but socialize freely with familiar people, mimic and imitate gestures, facial expressions & vocal sounds

INFANCY:NEEDS Dependent on others for all needs Food, cleanliness & rest are essential for

physical growth Love & security are essential for

emotional & social growth Stimulation is essential for mental

growth

EARLY CHILDHOOD Age: 1–6 years old Physical development Mental development Emotional development Social development The needs of early childhood include

routine, order, and consistency

EARLY CHILDHOOD:PHYSICAL DEVELOPMENT 1-6 years: growth slower than in infancy 1-3 years: most teeth have erupted and

digestive system is mature enough to handle most adult foods.

2-4 years: most children learn bladder & bowel control

6 years: average weight is 45 pounds & average height is 46 inches

Legs & body tend to grow more rapidly than head, arms, chest (more adult appearance)

Muscle coordination better: use silverware, draw, run, climb & move freely

EARLY CHILDHOOD:MENTAL DEVELOPMENT Age 1: Several words Age 6: vocabulary of 1500 – 2500 words Age 2: short attention spans, interested

in many different activities Age 4: Asks frequent questions and

usually recognize letters and some words. Begin to make decisions based on logic

Age 6: Very verbal & want to learn how to read and write. Memory developed to the point where the child can make decisions based on both past & present experiences.

EARLY CHILDHOOD:EMOTIONAL DEVELOPMENT Age 1-2: begin to develop self-awareness &

recognize the effect they have on other people and things. Limits established for safety

Age 2: begin to gain self-confidence, excited about learning new changes. Feel impatient & frustrated as new things are tried beyond their abilities, like routines & become angry if they are interrupted

Age 4-6:Gain more control over emotions, understand right & wrong, achieved independence & not as frustrated by lack of ability.

Age 6: show less anxiety when faced with new experiences

EARLY CHILDHOOD:SOCIAL DEVELOPMENT Age 1:Self-centered, strongly attached

to parents or caregivers & fear separation

Enjoy other children but are still possessive

Playing alongside other children more common than playing with them.

Age 6: Have become more social, learned to put self aside and take more of an interest in others. Make more of an effort to please others. Friends of their own age important

NEEDS Food, rest shelter, protection, love &

security Routines, order, & consistency in their

daily lives Must be taught to be responsible &

conform to rules by making reasonable demands based on the child’s ability to comply

LATE CHILDHOOD OR PREADOLESCENCE Age: 6–12 years old Physical development Mental development Emotional development Social development Children in this age group need parental

approval, reassurance, peer acceptance

LATE CHILDHOOD:PHYSICAL DEVELOPMENT Weight gain averages 4-7 pounds / year Height gain increases approx 2-3

inches / yr Muscle coordination is well developed Engage in physical activities that require

complex motor-sensory coordination Primary teeth are lost & primary teeth

erupt Eyes are well developed & visual acuity

best Age 10-12: Secondary sexual

characteristics may begin to develop in some children

LATE CHILDHOOD:MENTAL DEVELOPMENT Increases rapidly since child’s life

centers around school Speech skills develop, reading & writing

skills are learned Begin to understand abstract concepts

such as loyalty, honesty, values, and morals

More adept at making judgements

LATE CHILDHOOD:SOCIAL DEVELOPMENT Age 7: like activities they can do by

themselves and do not usually like group activities

Want approval of others

ADOLESCENCE Age: 12–20 years

old Physical

development Mental development Emotional

development Social development Adolescents need

reassurance, support, and understanding

EATING DISORDERS Often develop from

an excessive concern for appearance

Anorexia nervosa Bulimia More common in

females Usually, psychological

or psychiatric intervention is needed to treat either

of these conditions

CHEMICAL ABUSE Use of alcohol or drugs with the

development of a physical and/or mental dependence on the chemical

Can occur at any life stage, but frequently begins in adolescence

Can lead to physical and mental disorders and diseases

Treatment towards total rehabilitation

REASONS CHEMICALS USED Trying to relieve stress or anxiety Peer pressure Escape from either emotional or

psychological problems Experimentation Seeking “instant gratification” Hereditary traits or cultural influences

SUICIDE One of the leading causes of death

in adolescents Permanent solution to temporary

problem Impulsive nature of adolescents Most give warning signs Call for attention Prevention of suicide

REASONS FOR SUICIDE Depression Grief over a loss or love affair Failure in school Inability to meet expectations Influence of suicidal friends or parents Lack of self-esteem

INCREASED RISK OF SUICIDE Family history of suicide A major loss or disappointment Previous suicide attempts Recent suicide of friends, family, or role

models (heroes or idols)

EARLY ADULTHOOD Age: 20–40 years old Physical development Mental development Emotional development Social development

MIDDLE ADULTHOOD (MIDDLE AGE) Age: 40–65 years of age Physical development Mental development Emotional development Social development

LATE ADULTHOOD Age: 65 years of age and older Physical development Mental development Emotional development Social development The elderly need a sense of belonging,

self-esteem, financial security, social acceptance, and love

8:2 DEATH AND DYING 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 Disease that cannot be cured and will

result in death People react in different ways Some patients fear the unknown while

others view death as a final peace

RESEARCH Dr. Elizabeth Kübler-Ross was the leading

expert in the field of death and dying and because of her researchMost medical personnel now believe patients

should be informed of approaching deathPatients should be left with some hope and

know they will not be left alone

Staff need to know extent of information known

by patients

(continues)

RESEARCH(CONTINUED)

Dr. Kübler-Ross identified five stages of grieving

Dying patients and their families and friends may experience these stagesStages may not occur in orderSome patients may not progress through them

all, others may experience several stages at once

STAGES OF DEATH AND DYING Denial—refuses to believe Anger—when no longer able to deny Bargaining—accepts death, but wants

more time Depression—realizes death will come

soon Acceptance—understands and accepts

the fact they are going to die

CARING FOR THE DYING PATIENT Very challenging, but rewarding work Supportive care Health care worker must have self-

awareness Common to want to avoid feelings by

avoiding dying patient

HOSPICE CARE Palliative care only Often in patient’s home Philosophy: allow patient to die with

dignity and comfort Personal care Volunteers After death contact and services

RIGHT TO DIE Ethical issues must be addressed by the

health care worker Laws allowing “right to die” Under these laws specific actions to end

life cannot be taken Hospice encourages LIVE promise Dying Person’s Bill of Rights

SUMMARY 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

8:3 HUMAN NEEDS Needs: lack of something that is

required or desired

Needs exist from birth to death Needs influence our behavior Needs have a priority status Maslow’s hierarchy of needs

(See Figure 8-15 in text)

ALTERED PHYSIOLOGICAL NEEDS Health care workers need to be aware

of how illness interferes with meeting physiological needs

Surgery or laboratory testing Anxiety Medications Loss of vision or hearing

(continues)

ALTERED PHYSIOLOGICAL NEEDS(CONTINUED)

Decreased sense of smell and taste Deterioration of muscles and joints Change in person’s behavior What the health care worker can do

to assist the patient with altered needs

MEETING NEEDS Motivation to act when needs felt Sense of satisfaction when needs met Sense of frustration when needs not met Must prioritize when several needs are

felt at the same time Different needs can have different levels

of intensity

METHODS FOR SATISFYING NEEDS Direct methods

Hard workSet realistic goalsEvaluate situationCooperate with others

(continues)

METHODS FOR SATISFYING NEEDS(CONTINUED)

Indirect methodsDefense mechanismsRationalizationProjectionDisplacementCompensationDaydreaming

METHODS FOR SATISFYING NEEDS(CONTINUED)

Indirect methods (continued)RepressionSuppressionDenialWithdrawal

SUMMARY 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