LEARNER OBJECTIVES 

  1. Define the developmental task for the age groups 18 through late adulthood.
  2. Identify the common health problems for each age group.
  3. Discuss the health care needs of the various age groups.
  4. Identify any special considerations for each age group listed.
  5. List some of the interventions required for each age group.

 

AGE 18 to 29 YEARS EARLY ADULTHOOD

  • DEVELOPMENTAL TASKS
    • Accepting oneself & stabilizing self-concept and body image.
    • Establishing a personal identity.
    • Achieving independence from parental control.
    • Establishing and maintaining a residence.
    • Establishing intimate relationships outside the family.
    • Becoming established in a career that provides personal satisfaction, economic security and a feeling of contributing to the welfare of society.
    • Establishing a personal set of values and formulating a meaningful philosophy of life.
  • COMMON HEALTH PROBLEMS
    • Four major causes of death are all related to violent death:
      • -vehicular accident
      • -other accident
      • -suicide
      • -homicide
    • Anxiety and depression related to pressures of independence, competition in the workplace, acceptance by peers.
    • Stress and new found freedom may lead to experimentation with various lifestyles and may contribute to substance use and abuse.
    • Physical health problems may include pregnancy complications, cervical or breast cancer and orthopedic injuries.
  • HEALTH CARE NEEDS
    • At least one thorough health assessment including screening for STDs, hypertension and cholesterol level during this period.
    • Health education to help develop good lifestyle habits with emphasis on weight control, exercise, problems related to human sexuality, effects of drugs and alcohol, family planning, child care and home management.
  • INTERVENTIONS
    • Involve individual/significant other in plan of care.
    • Explore impact of hospitalization/illness to work/job, family, children.
    • Watch for body language as a cue for feelings.
    • Allow for as much decision making as possible.
    • Assess for potential stresses related to multiple roles of the young adult.
    • Assess and manage pain based on patient needs and response:
    • -use a preventative approach
    • -titrate to effect and monitor response
    • -PCA
    • Provide information on pain control methods, assessment scale, schedule for pain management, need to ask for pain medication as soon as pain begins, providing information on degree of pain relief, types of pain medications and methods of pain management.
    • Provide essential teaching based on how the individual learns best.

 

AGE 30 to 44 YEARS YOUNG ADULTHOOD

  • DEVELOPMENTAL TASKS

Goals of this range are an extension of those listed previously and are related to managing a household, rearing children and developing a career.

  • COMMON HEALTH PROBLEMS
    • Major causes of death reflect the stresses of this period and the impact of unhealthy lifestyles adopted earlier in life. Causes of death differ in relation to sex and race.
    • Factors contributing to illness and death include external environment conditions such as job stress and other occupational hazards, marital problems and adjustment to parenting.
  • HEALTH CARE NEEDS
    • Health habits are firmly entrenched. Goals are health promotion and prevention of chronic diseases.
    • Specific interventions include:
      • -stress management
      • -utilization of resources and instruction in household management and parenting
      • -dietary management; reduction in intake of sodium and sugar and maintenance of normal body weight
      • -development of awareness of dangers of substance abuse
      • -development of healthy habits for smokers and overweight individuals
      • -encouraging a program of moderate exercise
      • Periodic assessment to screen for hypertension, anemia, cholesterol levels, cervical and testicular cancer screening and dental care.
  • INTERVENTIONS
    • Involve individual/significant other in plan of care.
    • Explore impact of hospitalization/illness to work/job, family, children.
    • Watch for body language as a cue for feelings.
    • Allow for as much decision-making as possible.
    • Assess for potential stresses related to multiple roles of the young adult.
    • Assess and manage pain based on patient needs and response:
    • -use a preventative approach
    • -titrate to effect and monitor response
    • -PCA
    • Provide information on pain control methods, assessment scale, schedule for pain management, need to ask for pain medication as soon as pain begins, providing information on degree of pain relief, types of pain medications and methods of pain management.
    • Provide essential teaching based on how the individual learns best.

 

AGE 45 to 59 YEARS MIDDLE ADULTHOOD

  • DEVELOPMENTAL TASKS
    • Discovering and developing new satisfaction, if the person is married, by enjoying joint activities and developing an abiding sense of intimacy and unity with the marriage partner.
    • Helping growing and grown children become happy and responsible adults and freeing oneself from emotional dependence on children. Creating a pleasant, hospitable, and comfortable home that is compatible with one’s values and resources.
    • Balancing work with other roles and preparing for retirement.
    • Accepting role reversal with aging parents and preparing emotionally for the death of living parents.
    • Achieving mature social and civic responsibility and involvement in altruistic activities and concerns.
    • Accepting and adjusting to the physical changes of middle adulthood and maintaining healthful ways of living.
  • COMMON HEALTH PROBLEMS
    • Cardiovascular diseases such as heart attack and stroke become the major causes of death in both males and females as they reach their middle years. Among the top five causes of mortality are lung and breast cancer and cirrhosis of the liver. Chronic respiratory disease and hypertension are also major health problems that require continuous, cooperative management on the part of the patient and health care providers.
    • External and internal factors that contribute to deterioration of health status in the middle-aged are:
      • – bone mass begins to decrease
      • – loss of skeletal height, calcium loss especially after menopause
      • – decrease in muscle strength & mass if not used; endurance declines
      • – loss of skin elasticity, dry skin, increase appearance of wrinkles
      • – decreased renal functioning, metabolic rate, heat/cold tolerance, prone to infection
      • – receding hairline in males, more facial hair in females
      • – slowing of reflexes
      • – muscle activity may increase or decrease
      • – noticeable loss of hearing and taste
      • – muscle/joints respond more slowly
      • – decreased balance & coordination
      • – more prolonged response to stress
  • HEALTH CARE NEEDS
    • Related to preserving and prolonging the period of maximum energy and optimal mental and social activity.
    • Physical exams annually at 50 years of age to rule out hypertension, diabetes, respiratory diseases and cancer.
    • Assessment of nutrition, exercise, occupational hazards, sexual dysfunction and adjustment to menopause, use of over the counter medications, alcohol and tobacco use.
  • INTERVENTIONS
    • Allow choices if possible.
    • Explore relation of illness/disease to body image & career.
    • Provide decision-making opportunities related to care.
    • Encourage as much self-care as possible.
    • Provide information on pain control methods, assessment scale, schedule for pain management, need to ask for pain medication as soon as pain begins, providing information on degree of pain relief, types of pain medications and methods of pain management.
    • Provide essential teaching based on how the individual learns best.

 

AGE 60 to ELDERLY LATE ADULTHOOD                          

  • DEVELOPMENTAL TASKS
    • Adaptation to physical changes that accompany aging.
    • Redirection of energy and talents to new roles and activities.
    • Acceptance of one’s life with its joys and limitations.
    • Development of a personal view of death that prepares one for this final stage of life.
  • COMMON HEALTH PROBLEMS
    • Chronic conditions:cardiovascular disease, cancer, diabetes, acute and chronic respiratory disease and gastrointestinal problems. Decreased tolerance to heat/cold. Decreased peripheral circulation.
    • Declining cardiac/renal function.
    • Decreased response to stress & sensory stimuli.
    • Atrophy of reproductive organs.
    • Loss of teeth leading to changes in food intake.
    • More skeletal changes.
  • HEALTH CARE NEEDS
    • Management of chronic illnesses.
    • Help prolong the period of optimal physical, mental and social activity.
    • Annual physical exams and dental exams.
    • Retirement planning.
    • Minimize physical handicaps and discomforts of illnesses.
    • Nutrition assessment and counseling, high fiber, reduction in sodium, simple sugars and calories.
  • INTERVENTIONS
    • Explore individual’s support system.
    • Explore related existing conditions.
    • Involve family with care.
    • Provide adequate nutrition.
    • Keep environment safe, e.g. wheels locked, siderails up, bed in low position.
    • Turn/assist q 2 hours.
    • Assess skin integrity frequently.
    • Monitor bowel elimination q 24 hours.
    • Continue with pain assessment & management. Narcotics with long half-life may cause problems with side effects, e.g. confusion, constipation.
    • Use adjuvant analgesics with caution; increases side effects.
    • Apply lotion to skin immediately after bathing.
    • Be aware of possible need for a warmer environment (room temperature, need for an extra blanket).