Week 9 Middle Aged Adult Continued PDF

Middle-Aged Adults Chapter 17 By Rosemary Scofich Learning Outcomes Identify Identify normal psychological and biological changes spiritual changes Identify major that result as...

Middle-Aged Adults Chapter 17 By Rosemary Scofich Learning Outcomes Identify Identify normal psychological and biological changes spiritual changes Identify major that result as that occur causes of death result of the aging frequently in process middle age Discuss unique Identify health Analyze the health patterns in the influence of opportunities middle-aged psychosocial related to adults stressors occupations 2  Milestones in the Middle-Aged Adult Expanded responsibilities Transition in family life Increased productivity Significant biological changes Normal aging changes 3  Health Promotion for Middle-Aged Adults Overall Goals Improve access to high- quality health services. Promote and improve health and well-being for all age groups. Reduce inequities across all racial and ethnic groups of Canadians 4  Biology and Genetics: Life Expectancy and Mortality Rates Middle adulthood: between 35−64 years of age Examples of general body changes Fat disposition, Skin drier, wrinkles, decreased muscle Thinning, greying hair coarsening facial Hormonal changes mass and bone features density changes 5 Common Health Problems: Middle-Aged Adult Kyphosis: angulation of posterior spine Osteoarthritis: degenerative joint disease Osteopenia: subnormal bone mineralization Osteoporosis: abnormal loss of bone density Osteoporosis Clinical Practice Guideline 7 Gender and Genetics Constipation: decreased stool frequency Menopause: cessation of menses Erectile dysfunction in males Life expectancy: o females: 83 yrs o males: 79 yrs Heart disease, cancer, accidents Biological sex and marital status o Men: higher mortality rate o Married people generally have better health.  Health Perception–Health Management Pattern Nutritional–Metabolic Pattern Elimination Pattern Activity–Exercise Pattern Gordon’s Sleep–Rest Pattern Cognitive–Perceptual Pattern Functional Self-Perception–Self-Concept Pattern Health Roles–Relationships Pattern Sexuality–Reproductive Pattern Patterns Coping–Stress Tolerance Pattern Values-Beliefs Pattern Health Perception– Health Management Pattern Habits: self- Smoking, alcohol, overeating Visible consequences destructive Risk factors: behavioural Age, gender, ethnicity, personal risks Health-promotion needs and Health screening of diseases and behaviours Stopping self-destructive behaviours environment Exercise 10 al  Nutritional–Metabolic Pattern Obesity (BMI more than 30; Diet high in saturated fat overweight: BMI 25–29) Substantially increased risk Has effect on of chronic cardiovascular cardiovascular and disease, diabetes, cancer cerebrovascular morbidity Risk increases with less and mortality education, low income, Recommended total ethnicity cholesterol is HDL less than Prevention and 5.2 mmol/L; LDL greater management than 0.9 mmol/L Fewer calories Lifestyle modifications, Exercise medications if needed 1 1 Social support groups Nutritional–Metabolic Pattern Recommendations: non-pregnant adults: 1000 mg; postmenopausal Calcium women without hormones: 1500 mg Absorption is enhanced by vitamin D. Stimulant; be aware of addiction potential Caffeine Controversy over health effects of moderate consumption Role in hypertension; increases High-sodium diet fluids, increases vascular resistance 12 Nutritional–Metabolic Pattern Alcohol abuse o Depressant; chronic use produces tolerance o Increases risk of MVA, liver disease, cancer, heart disease, pancreatitis o CAGE tool o Early detection and intervention can decrease long-term sequelae. Treatment is complex. Oral health o Gingivitis: teeth brushing and flossing needed o Dental hygiene and decay: check-ups, water fluoridation, sealants CAGE Tool 14 Elimination Pattern Risk: age, sedentary lifestyle, lack of Constipati dietary bulk Dietary fibre is preferable to on laxatives and fibre products Stress Risk: women who have had multiple incontinen births, little exercise ce 15  Activity–Exercise Pattern Exercise Initiating exercise Exercise benefits recommendations program Prevent or 30 minutes, 5 or Target (220 - age x manage chronic more days per 0.75 = BPM) illness (heart, week, total 3–4 Choose activities diabetes, hours per week enjoyed in past (if osteoporosis, Continuous, appropriate) depression, rhythmic exercise Consider potential cancer) (e.g., walking, for injury, proper Significant jogging, equipment increase in life swimming, Exercise testing if expectancy and bicycling) high risk quality of life 16 Sleep–Rest Pattern Compared to young adults o Less time in deep sleep o Less sleep overall Healthful guidelines o Regularly scheduled o Quality sleep o Occasional napping Cognitive-behavioural therapy for sleep problems Sleep apnea is a common disorder in adults o Disordered breathing during sleep o 2 types Cognitive-Perceptual Pattern Intellectual ability —learning Adult continues to accumulate “learning” intelligence continues through life Piaget’s stage of Can process complex problems of reasoning formal operations Schaie’s factors Focus on involvement, absence of chronic disease, flexibility, family, complexity, favourable that maintain socioeconomic status, personal satisfaction, cognitive function spouse with high cognitive function 18 Cognitive–Perceptual Pattern: Perceptual Changes Presbyopia (farsightedness) Glaucoma: increased intraocular pressure Decreased visual sensitivity and peripheral vision Cataracts: opacity of lens Diabetic retinopathy Macular degeneration: deterioration of retina Presbycusis: loss of higher frequency hearing Diminished sense of taste Self-Perception–Self-Concept Pattern Levinson’s theory—“individual life structures” o Age-associated seasons—midlife transition o Struggles with meaning, value, direction of lives Erikson’s theory—generativity vs. stagnation o Generativity: sense of productivity, creativity, caring for others o Stagnation: lack of accomplishment, self-absorption Physiological changes o Effects on self-esteem: greying hair, wrinkles, body shape o Perimenopause and menopause: Mood swings, nervousness, fatigue, depression Hormonal therapy: indications and controversy Roles–Relationships Pattern “Midlife crisis” o Time of reassessment, turmoil, change Family o Family life cycle Families with children (ages 13–20) Families launching young adults Families from empty nest to retirement o Multiple responsibilities and stresses Children, aging parents, job, and civic responsibilities Single-parent families, adult children at home Over-involvement with children’s activities Roles–Relationships Pattern Work o Plays major role in level of wellness, self- esteem o 240,000 non-fatal work-related injuries yearly Two-or-more-job family o Role changes—family stress factors Nontraditional female and male roles Retirement planning and mid-career changes o Elements of employer health-promotion programs Roles–Relationships Pattern Caring for aging parents o Additional demands of caring for parents and children (sandwich generation) Divorce o Multiple family member adaptations needed o Potential psychological effects on children Death o Spouse: grief for loss of companionship, loss of future o Increased awareness of finite nature of life o Midlife review is common Sexuality–Reproductive Pattern High proportion of adults remain sexually active Pregnancy o Pregnancies in women over 35 are unintended—perimenopause Changes in reproductive system o Slower arousal, orgasms less intense, long refractory between erection and ejaculation, vaginal dryness, decreased libido Coping–Stress Tolerance Pattern Factors related to coping with stress and health outcomes o Stress hardiness—control, commitment, challenge o Tranquilizer use o Maturity of defenses against stress o Framingham Study: worry, conflict, anger, ambitiousness affect blood pressure Coping with death of a parent o Preparation helps feelings of control o Examples: living will, advance directive, durable power of attorney Environmental Processes: Biological Agents Transmitted through air or food and water Enter respiratory or gastrointestinal tract Examples o Hepatitis A: fecal–oral route, poor sanitation o Hepatitis B Bloodborne pathogen Occupational hazard: health providers o Pneumonia: vaccine available o Herpes zoster (Shingles) vaccine available Environmental Processes: Chemical Agents Contaminants from workplace industry o Pneumoconiosis (black lung disease)—coal o Mesothelioma—asbestos o Organic carcinogens: benzene, PVC, others Tobacco o Middle age: by 50 many have a 30+-year history o Risk of heart or lung disease and cancer increased o 2000 known chemicals in cigarettes tar, cyanide, formaldehyde, carbon monoxide Smoking Rates& Costs 28 Source: PHO, 2023  Radon A radioactive gas found naturally in the environment Odourless 16% of lung cancers deaths related to radon 29 Determinants of Health: Social Factors and Environment Culture and ethnicity o Different interpretations of health and illness o Immigrants: poverty, poor living conditions Economics o Net income may be at highest level; also have greater financial responsibilities Health care delivery system o Service agencies o Long wait times Nursing Application Assess Individual health history Baseline health (employment physicals) Environmental hazards; workplace safety Target group health trends Screen for disease, health risks, behaviours Educate Emphasize self-health promotion Safety (fall prevention, fires, firearms, driving) Organizational health-promotion programs 31