Middle-Aged Adults Chapter 17

Middle-Aged Adults Chapter 17

• Middle adulthood encompasses ages 35-64.
• Learning outcomes include identifying psychological and spiritual changes, normal biological changes, major causes of death, health patterns, unique health opportunities in various occupations, and the influence of psychosocial stressors.
• Milestones of middle-aged adults include expanded responsibilities, family life transitions, increased productivity, and significant biological changes.
• Overall goals for health promotion include improving access to high quality health services promoting health and well-being for all groups and reducing inequities across racial and ethnic groups of Canadians.
• General body changes in middle adulthood include thinning and greying hair, drier skin with wrinkles, decrease in muscle mass and bone density, and hormonal changes.
• Common health problems in middle adulthood include kyphosis, osteoarthritis, osteopenia, and osteoporosis.
• Exercise recommendations for reducing fall risk and improving strength include balance and functional training at least twice weekly, and progressive resistance training twice weekly for muscle groups.
• Gender and genetics factors include constipation, menopause, erectile dysfunction, life expectancy (females: 83 yrs; males: 79 yrs) heart disease, cancer, accidents, higher mortality rate in men, and a correlation between marital status and better health.

Gordon's Functional Health Patterns

• Gordon's Functional Health Patterns framework categorizes health data into various patterns (Health Perception-Health Management; Nutritional-Metabolic; Elimination; Activity-Exercise; Sleep-Rest; Cognitive-Perceptual; Self-Perception-Self-Concept; Roles-Relationships; Sexuality-Reproductive; Coping-Stress Tolerance; Values-Beliefs)

• Example patterns include:

  • Habits: self-destructive behaviors (smoking, alcohol, overeating) and consequences.

  • Risk factors: age, gender, ethnicity, personal risks, health promotion needs, disease screening, and stopping self-destructive habits.

  • Nutritional-metabolic: obesity (BMI), chronic cardiovascular disease, diabetes, cancer risk. Dietary recommendations include reducing saturated fat intake and modifying lifestyle.

  • Nutritional-Metabolic (Further details): Calcium (1000-1500mg/day recommendation for adults), Caffeine (stimulant, potential addiction), and Sodium (influencing hypertension)

• Nutritional-Metabolic (Alcohol abuse): depressant, tolerance, risk of MVA, liver damage etc

• Elimination: Constipation (risk factors: age, sedentary lifestyle, inadequate fiber), stress incontinence (risk factors: women with multiple births and reduced exercise).

• Activity-Exercise: Exercise benefits (controlling chronic diseases, improving life expectancy, quality of life), recommendations (30 minutes daily, 5+ days/week with rhythmic activities like walking, jogging etc).

• Sleep-Rest: compared to younger adults, less time in deep sleep, need for regular sleep schedules, quality sleep, occasional napping, and cognitive-behavioral therapy for sleep problems. Sleep apnea is a common condition.

• Cognitive-Perceptual: intellectual ability continues throughout life, Piaget's stage of formal operations, Schaie's factors (involvement, lack of disease, etc). Changes in vision (presbyopia, glaucoma, cataracts), other sensory changes, and diabetes-related eye problems are discussed.

• Self-Perception-Self-Concept: Levinson's theory ("individual life structures"), age-associated seasons (midlife transition), struggles with meaning/value. Erikson's Theory of Generativity vs Stagnation. Physiological changes such as greying and thinning hair, wrinkles, body shape, perimenopause and menopause effects, depression, hormonal therapy (indications and controversies).

• Roles-Relationships: "Midlife crisis" and time of reassessment. Family life cycle stages (families with children, launching young adults, empty nest), multiple responsibilities including children, aging parents, job, and civic responsibilities. Single-parent families & over-involvement with children's activities. Work as a factor in health, injuries, traditional vs non-traditional roles, retirement planning, and employer health programs. Caring for aging parents, divorce, and death.

• Sexuality-Reproductive: high proportion of adults remain sexually active (pregnancy in post-menopausal women), changes in reproductive function for women (slower arousal, less intense orgasms), other problems (vaginal dryness, decreased libido, long refractory periods).

• Coping-Stress Tolerance: Factors related to coping with stress & health outcomes (stress hardiness, use of tranquilizers, maturity in defense mechanism etc). Coping with death and preparation (living wills, advance directive).

Environmental Processes

• Biological Agents: Illness transmitted through air, food & water, enter respiratory or gastrointestinal tract. Factors include Hepatitis A & B, bloodborne pathogens, occupational hazards of healthcare workers, pneumonia, and herpes zoster.
• Chemical Agents: Contaminants, pneumoconiosis (coal), mesothelioma, organic carcinogens (benzene, PVC), tobacco (long-term history in middle-age, increase in heart/lung disease & cancer). 2000 known chemicals in cigarettes (tar, cyanide, formaldehyde, carbon monoxide).

Nursing Application

• Nurses should assess individual health history, baseline health, environmental hazards, and target group health trends.
• Screening for diseases, health risks, and behaviours is necessary.
• Emphasize self-health promotion, safety, and organizational health-promotion programs.

Explore the significant psychological, biological, and health changes that occur during middle adulthood, ages 35-64. This chapter covers issues such as health patterns, causes of death, and unique occupational health opportunities. Gain insights into promoting well-being and addressing health inequities among middle-aged adults.