Adolecence /Adult/Death and Dying

Adolescence and Adulthood

  • Developmental Period, lasting from about ages 12 to 18, during which many biological, cognitive, social and personality traits change from childlike to adult like.

Puberty

  • Developmental period between the ages of 9 and 17, when the individual experiences biological changes that result in developing sexual characteristics and reaching sexual maturity.

In Girls

  • Usually occurs between the ages of 9 and 13.
  • Usually occurs 2 years earlier than boys
  • Physical Growth: increased height, starts on average of yr. 9, 6-12 months before breast development
  • Female sexual maturity: Onset of Menarche ( first menstrual period, it is a signal that ovulation may have occurred and that the girl may have the potential to conceive and bear children).
  • Brought about by hormone changes due to increased estrogen ( a major female hormone, which stimulates the development of both primary and secondary sexual characteristics
  • Secondary Sexual Characteristics : development triggered by the increase of estrogen, including pubic hair, development of breasts, and a widening of the hips

Early vs late

  • Early maturation
    • Girl might have psychological problems due to the development
    • Late maturing can also have the same effect, for friends and the like have already entered this area before them.

In boys

  • Usually occurs between the ages of 10 and 14.
  • Usually occurs 2 years later than girls
  • Physical Growth: Increase in height ( dramatically), boy may feel strange as he discovers he is taller than his mother and or father.
  • Male sexual maturity is brought about by an increase in Testosterone ( major male hormone, that stimulates the growth of genital organs and the development of secondary sexual characterizes
  • Secondary sexual characteristics due to increase in Testosterone, include growth of the  pubic and facial hair, development of muscles, and a change ( usually a deepening) in the voice.

Early vs late

  • Boys found to go through early maturation are found to be more confident, relaxed, socially responsible, popular, and highly regarded by their peers than those who start later.
  • Interesting difference between boys and girls when maturing is that boys will find themselves more physically appealing or attractive, while girls will doubt this within themselves and are constantly comparing themselves to other girls.

Sex

  • BioPsychoSocial Approach: views adolescent development as a process that occurs simultaneously on many levels and includes hormonal, neural, sexual, cognitive, social, cultural, and personality changes that interact and influence each other ( I.E. Finding someone attractive naturally leads to seeking a more intimate relationship , which in adolescence raises the question of becoming sexually active or not.

Cognitive and emotional changes

  • Described like so “ It is like a car with a great accelerator but a weak break”.
  • Due to changes in the brain ( prefrontal cerebral cortex), an adolescence mood is unstable, since this part of the brain is not fully developed. This is why teens are upset so quickly and parents do not understand it’s cause.
  • Studies have shown that the limbic system ( widely controlled by hormones) has such an increase do to these hormones  that this is the cause of a teenagers irritability
  • With this combination of an underdeveloped pre frontal cortex, and a highly functioning limbic system, researchers believe that this is the case for lack of moral judgment as well as the washy washy emotional stability they possess.

Kohlberg’s Theory of Moral Reasoning

  • Level 1: Preconventional Level
    •  represents the lowest level of moral reasoning. This stage decisions are made primarily on fear of punishment or the need to be obedient. Guided most by satisfying one’s self interest, which may involve bargaining.
  • Level 2: Conventional Level
    •  represents an intermediate level of moral reasoning, decisions are gilded by conforming to the standards of others we value, determines most by conforming to laws of society
  • Level 3 : Postconcentional level
    •  represents the highest moral reasoning, decisions are made more carefully thinking about all the alternatives and striking a balance between human rights and laws of society

Beyond Adolecence into Adult

  • No two adults live the same lives
  • Adult psychology  is the changes linked to age in some way and shared by most or all adults in every generation
  • Cohort is a group of persons born within some narrow band of years , who thus share a certain cultural influence and historical experience
  • Life Span: Upper Boundary of years a given species can expect to live
    • Humans range from 85-120yrs
  • Longevity: Average expected length of life at any particular time in history , in a particular culture
  • Life Expectancy: Average number of years a person of a given age can still expect to live
  • Immune System
    • B Cell Depletion : cells that produce bone marrow
    • T Cell Depletion: cells that produced by the Thymus gland ( fight bacteria etc…)
    • Antibodies: react to foreign organisms to fight off viruses and bacteria
  • Lack of Antibodies
    • This can cause such ailments as :
      • Shingles (suppressed chickenpox virus)
      • Auto Immune Diseases
      • Flu/Pneumonia/COPD/ Asthma to be uncontrolled

Changes in men

  • Climacteric: Age- related loss of reproductive ability

In men

  •  Lessened sperm count
  • Decline in Testosterone ( major male hormone)
  • ED ( Erectile Dysfunction ): Inability for an adequate erection

Changes in women

  • In Women
    • Menopause: Ovarian failure is most common, this signals the end of a woman’s cycle and ability to have children
    • Estrogen and Progesterone loss: Often due to menopause, without these 2 hormones the uterus does not “ slough off “ its lining.
    • Hot Flashes: brief but abrupt rises in body temperature( this usually is the cause of why most women seek Hormone therapy to reduce these symptoms)

Changes in the body , physically, mentally

Appearance

  • Weight and height: Adults usually loose 1-2 inches in height with age, usually starts about the age of 40
  • Changes in weight occur in the 40’s usually rising, only to decline about 10 lbs. around the age of 50.
  • Fat is lost in the face, arms, legs, belly, thighs, and buttocks. This usually is why most “ older people” appear to be more apple shaped

Skin and Hair

  • Wrinkles in the skin begin around the age of 40
  • Skin Damage becomes noticeable especially around face, arms, and backs of hands
  • Hair begins to turn white or grey, Most prevalent in persons with darker hair colors

Vision

  • Vision is the last sense to develop and the first sense to show signs of ageing
  • When a person is around the age of 60 the retina gets around 30 % of the light it did when they where 20.
  • It is shown that for every 10 years we age between the ages of 20-80 significant changes in visual astuteness gradually decrease.

Hearing

  • Note if you are talking to an older person, talk to them at a normal voice first, if they say they cannot hear you then speak up, otherwise you are just yelling at an old person.
  • Most adults in their 30’s will experience some hearing loss

Taste

  • It is stated that although it is hard to tell with research, the 4 basic flavors of salty, bitter , sweet and sour do slightly change. Mostly with salty and bitter flavors.
  • Sour and sweet stay the same..
  • It is also stated that older people due to some of this change prefer food that is more pungent in flavors/spices.

Smell

  • The ole factory ( I.E the sniffer) does have a peak between the ages of 20-40, declines slightly between ages 40- 70 , and dropped down remarkably after the age of 70.
  • Ever wonder why grandma has you smell the milk??

Muscles

  • Studies show a significant decline in muscle over the span of adult years, however the most rapid of muscle loss occurs after the age of 50.
  • Strength training is encouraged in older adults to maintain their muscle strength .

Brain

  • Most believe that old age means deterioration of the brain, this is NOT true. 
  • The plasticity of neurons means they are capable of making changes with age.
  • The ability for the brain to shit down neurons that are not needed in order to “fine tune” the system and improve functioning of the remaining neurons is called Pruning.
  • Think of this like a bonsai tree… trim the ones that are not needed to make the tree go the direction you choose…. Hence the saying
  • If you don’t use it , you’ll loose it!

Another thing that changes is the slowing of transmission of information across the synapses between neurons

Death and Dying

Meanings of death

  • Death as an organizer of time: Death is defined as the endpoint of one’s ( physical) life, so this concept may be an important one for a person trying to organize his/her life
  • Death as a Punishment: Children generally think this way; in adults this is emphasized with the link between sin and death
  • Death as a loss: perhaps the most persuasive, loss of ability to carry out plans, projects, or just the loss of one’s body, relationship with others.

Fear/Anxiety

  • Researchers have quite consistently found that middle aged adults show the greatest fear of death, the older adults the least, with young adults falling somewhere in between.
  • The reason researchers believe that older adults are more at ease with death is due to their ability to talk more openly about it.

Process

  • These 5 stages are set forth by Elizabeth Kubler-Ross ( 1969), who created this model when working with terminally ill adults and children.
  • She Proposed that those who are dying and know, move through a series of steps or stages before they accept this knowledge

Denial

  • When confronted with a terminal diagnosis, the first reaction most patients report is some form of “ No, not me!” “ It must be a mistake,” “ The lab reports must have been mixed up,” “ I don’t feel that sick, so it can’t be true,” “ I’ll get another doctor’s opinion.” All these are forms of denial, which is a constructive defense to the news. It gives the patient a period of time in which to marshal other strategies of coping with the shock.

Anger

  • The classic second reaction is “ Why me?” The patient resents those who are healthy and becomes angry at whatever fate put him or her in this position. This may be reflected in angry outbursts at nurses, family, doctors- anyone within reach

Barganing

  • At some point, anger begins to be replaced by a new kind of defense. The patient now tried to “ make a deal” with doctors, with nurses, with God. “ If I do what I’m told and don’t yell at everyone, then I’ll be able to live till Christmas.”

Depression

  • Bargaining only works for so long, however and as disease processes continue and the signs of the body’s decline become more obvious, patients typically become depressed. This is a kind of mourning for the loss of relationships as well as one’s own life.

Acceptance

  • The final step, which is a quiet understanding a readiness for death. The patient is no longer depressed but may be quiet, even serene. It is best stated by Stewart Alsop an author who was dying of leukemia who stated
  • “A dying man needs to die as a sleepy man needs to sleep, and there comes a time when it is wrong, as well as useless, to resist.” (1973)

Note

  • Not everyone goes through all of those stages in the same order. Some people don’t truly go through any of them and accept their “ fate” with ease. It depends on the situation, age, and sometimes spiritual relationships one has.

Hospice

  • Provides dying people an alternative to endless medical treatment designed to cure their disease.
  • Emerged in England in the late 1960’s
  • Added to the list of Medicare in 1982 by the US Congress
  • More than 3000 programs exists, serving over ½ million terminally ill patients and their families each year.