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N104 - Aging > Week 1: Middle Adult > Flashcards

Week 1: Middle Adult Flashcards

1
Q

When does middle adulthood begin and last till?

A

40 - mid 60’s

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2
Q

What is the most significant physical change in women and in men in mid-life?

A 
Women = menopause
Men = Changes in sexual response
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3
Q

How do physical changes occur (speed) in mid-life?

A

Gradual

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4
Q

List key physical changes that occur in mid-life

A
  • Integumentary (greyish hair/saggy skin)
  • Height (dec) & Weight (increase)
  • Strength, joints & bones begin to change (less efficient)
  • Vision & Hearing (decline)
  • Cardiovascular (decline - fatty deposits accumalate)
  • Sleep (usually decreases + sleep problems such as sleep apnea can occur due to various reasons (Meds, CVD, depression, etc)
  • Lungs (less elasticity/more stiffening as we age)
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5
Q

When does menopause occur and why?

A

Usually between 45-60.

Ovaries stopped producing the hormone estrogen + progesterone.

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6
Q

What visible changes occur in mid-life (integumentary)?

A
  • Wrinkled/saggy skin (due to loss of collagen and fat under tissue)
  • Aging spots (localized hyperpigmentation - especially body parts most exposed to sun)
  • Hair thins/greys (decline in melanin production)
  • Finger/toes nails become thick and more brittle
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7
Q

Undergoing cosmetic surgery, dyeing hair, purchasing wigs, enrolling in weight reduction programs, participating in exercise regimens, and taking heavy doses of vitamins, as well as a strong interest in plastic surgery/botox reflect what about middle adulthood?

A

Desire to take control of the aging process

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8
Q

What causes height to decrease as we age?

A

Bone loss in vertebrae

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9
Q

As we age, we tend to gain weight, however, being obese can result in many chronic conditions such as?

A

DM type 2, CVD, hypertension, gallbladder disease, digestive disorders, and certain types of cancer.

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10
Q

What is sarcopenia? What are the risk factors for it?

A

Age-related loss of muscle mass and strength in the back and legs.

Obesity is a risk factor for sarcopenia.

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11
Q

How do bones and joint mobility change in mid-life?

A

Joints become stiff and difficult to move due to less efficient “cushions” (tendons/ligaments) between bones.

A progressive loss of bone density in mid-life. Break more easily and heal more slowly.

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12
Q

How is our cardiovascular health impacted in middle adulthood?

A

Fatty deposits and scar tissue accumulate in the linings of the blood vessels which gradually reduces blood flow to various organs, including the heart and brain.

Cholesterol levels increase, increasing the risk of CVD.

Increased BP (hypertension)

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13
Q

What is atherosclerosis and how does it occur?

A

Hardening of the arteries due to high LDL (bad cholesterol)

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14
Q

What is metabolic syndrome? And how does it impact middle adulthood?

A

It is a condition characterized by hypertension, obesity, and insulin resistance. It often leads to the development of DM and CVD.

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15
Q

In midlife, sleep problems are common amongst what type of individuals (what do they do?)?

A

Individuals who use a high # of non-prescription or prescription drugs, who are obese, have CVD, or are depressed.

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16
Q

How is sleep affected in mid-life?

A

Wakeful periods increase with age and deep sleep (stage 4) decreases with age.

Insomnia (due to many lifestyle reasons such as teenagers, financial stress, etc) increases with age. Sleep apnea is also experienced by many which disrupt the quality of sleep creating a cycle of restlessness.

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17
Q

What changes do the lungs go through as we age?

A

A decrease in elasticity and an increase in stiffness of the chest wall

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18
Q

What is menopause?

At a chemical level, what happens in the body? Symptoms?

A

Cessation of menstrual periods.

Ovaries stop producing estrogen and progesterone. Results in hot flashes, nausea, fatigue, and rapid heartbeat.

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19
Q

What are HRTs and what benefit do they provide in menopausal women?

A

Hormone replacement therapy.

It relieves symptoms of menopause. Some studies indicate that sometimes risks may outweigh the advantages. Alternatives to HRTs include regular exercise, dietary supplements, herbal remedies, relaxation therapy, acupuncture, and non-steroidal medications.

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20
Q

What is hypogonadism?

A

When the male body does not produce enough testosterone

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21
Q

What is TRT and how doe sit benefit men?t

A

Testosterone replacement therapy.

It increases testosterone in males with hypogonadism improving their sexual functioning, muscle strength, and bone health.

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22
Q

What hormonal changes do men face in mid-life?

A

A slow decline of testosterone/sperm count (1% per year.

Erectile dysfunction (50% experience this).

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23
Q

What is erectile dysfunction an indicator of in men and what are some risk factors?

A

Indicator of vascular health and a marker for cardiovascular risk.

Risk factors: low testosterone, smoking, DM, hypertension, elevated cholesterol levels, obesity, and lack of exercise.

Good to know: Viagra, Levitra, and Cialis are common drugs used to treat erectile dysfunction.
Testosterone therapy is not beneficial, indicating it is not induced by hormonal change.

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24
Q

What role does Viagra play in sexuality and STI’s in mid-life for adults?

A

The use of viagra in middle adulthood increases sexual activity. However, decreased immunity at mid-life increases risk of STI’s such as chlamydia, gonorrhoea, genital warts and herpes, syphilis, and HIV/AIDS.

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25
Q

What was found in the study that Horn & Donald conducted (1980)? What is the difference between the 2 types of intelligence?

A

Fluid Intelligence DECREASED- the ability to perceive and manipulate information

Crystallized Intelligence INCREASED - accumulated information and verbal skills

26
Q

What mental abilities increase in midlife? (Seattle Longitudinal Study)

A

Increase in:

Vocabulary - (ability o understand ideas expressed in words)

Inductive reasoning - (recognize and understand patterns and relationships in a problem and use the understanding to solve other instances of the problem - example: knowing when you should leave for work based on traffic patterns)

Verbal Memory - (ability to encode and recall meaningful language units, such as a list of words)

Spatial orientation - (ability to visualize and mentally rotate stimuli in 2-3 dimensional space

27
Q

What mental abilities decrease in midlife? (Seattle Longitudinal Study)

A

Decrease:

Numerical ability - (simple math such as addition, subtraction, and multiplication)

Perceptual speed - (ability to quickly and accurately make simple discriminations in visual stimuli)

28
Q

What abilities from the Seattle Longitudinal studies match horn’s study?

A

Crystalised intelligence = vocabulary

fluid intelligence = spatial orientation and inductive reasoning

29
Q

What is working memory (Denise Park) when looking at cognitive changes? How does working memory impact mid-life?

A

Working memory is known as the mental “workbench” where individuals manipulate and assemble information when making decisions, solving problems, and comprehending written and spoken language.

Park believes that there is a slight decline in memory in the late middle age because it is the result of information overload - the overcrowdedness of information that builds up as we go through the adult years. Thus, it becomes slightly harder to store new information and to retrieve older information.

30
Q

What is expertise (Denise Park) when looking at cognitive changes? And how does it change in middle adults?

A

Expertise involves having an extensive, highly organized knowledge, and understanding of a particular domain. Developing expertise and becoming an “expert” in a field usually is the result of many years of experience, learning, and effort. Therefore, it is at PEAK in middle adults as compared to young adults.

31
Q

In terms of cognition, does practical problem-solving impact middle adults?

A

There is no change or decline in everyday problem solving as we age because there is an increase in accumulated knowledge as adults grow older.

32
Q

How can the speed of information processing be assessed for a patient?

A

Through reaction-time tasks such as “press the button when you see a light”

33
Q

As adults grow older, what happens to their ‘speed of information processing’?

A

Slightly declines due to cognitive, neuroanatomical, and neurochemical changes.

34
Q

What happens to an individuals’ creativity as they age in midlife?

A

There is no certain pattern. It may increase or decrease depending on an individual’s ability to encounter the world with a degree of intensity and absorption. Increased encounters with the world heighten an individual’s consciousness of possibilities and limitations.

35
Q

List the key cognitive changes experienced by middle adults?

A

Slight declines/inclines:

  • Fluid intelligence declines
  • Crystallized intelligence increases
  • Vocabulary increases
  • Inductive reasoning increases
  • Verbal memory increases
  • Spatial orientation increases
  • Numerical ability decreases
  • Perceptual speed decreases
  • Speed of information processing decreases
  • Working memory declines
  • Expertise at PEAK
  • No change in practical problem solving
  • Change in a person’s control in terms of creativity
36
Q

List the key psychosocial changes experienced by middle adults?

A
  • Relationships change
  • “sandwich generation”
  • Balance between family, career, work, leisure, caring for children, caring for aging parents.
  • Family types: Singlehood, Marital changes, Family Transitions - all can bring in stress
  • Many reassess priorities/meaning of life
  • Generativity vs. stagnation (Erickson’s development theory)
37
Q

How can the nurse and patient work together to reduce stress? (3 ways)

A
  1. Minimize the frequency of stress-producing situations.
    - Identify approaches to prevent stressful situations, such as habituation, change avoidance, time blocking, time management, and environmental modification.
  2. Increase stress resistance by increasing psychophysiological preparation such as increasing self-esteem, improving assertiveness, redirecting goal alternatives, and reorienting cognitive appraisal.
  3. Avoid physiological response to stress. Nurses can teach patients relaxation techniques, imagery, and biofeedback to recondition their response to stress.
38
Q

What role does obesity play in mid-life and what are the consequences of it?

A

Obesity is at its peak in mid-life for most adults.

Consequences: High BP, High cholesterol, Type 2 DM, Coronary Heart Disease, Osteoarthritis, and Obstructive sleep apnea.

Nurses can provide counselling, nutritional info, and health literacy to promote wellness in patients.

39
Q

How can nurses promote a healthier lifestyle for patients?

A

Assess positive habits and negative habits. Provide health literacy because until external + internal barriers are minimized or eliminated, the patient will not benefit, therefore it is futile to encourage the patient to take actions that are going to be blocked.

External barriers - lack of facilities, materials, and social support.

Internal barriers - lack of knowledge, motivation, insufficient skills to effect change, and undefined short term and long term goals.

40
Q

What are the risk factors for depression in middle adulthood?

What should nurses do?

A

Women (esp. during menopause); stressors at job, school, or with relationships; the departure of the last child from home; family history.

Nurses should collect focused data regarding the individual as well as a family history of depressions, mood changes, cognitive changes, behavioural and social changes, and physical changes.

41
Q

Why does anxiety increase in some middle adults?

A

Due to physiological and psychological changes (view life as being half done). However, some adults use this anxiety as motivation to rethink life goals and stimulate productivity.

42
Q

Do accident rates incline or decline in mid-life?

A

Decline

43
Q

What role do chronic diseases play in mid-life?

List for men and women:

A

Become more common.

Common in men: fatal chronic conditions such as CAD, cancer, stroke

Common in women: nonfatal diseases such as arthritis, varicose veins, bursitis.

44
Q

What is the leading chronic disorder?

A

Arthritis followed by HTN

45
Q

List some nursing implications go mid-life health and well-being?

A
  • social support
  • support forming positive health habits
  • health teaching and counseling
  • primary healthcare: screening programmes, support groups
  • acute care: consider chronic diseases, family and work concerns
46
Q

What is Erikson’s stage 7 (middle adulthood) theory?

A

Generativity vs. stagnation

47
Q

What is generativity in Erikson’s stage 7 theory?

A

Generativity = an adult’s desire to leave a legacy to the next generation through the commitment of continuation and improvement of society. Achieving a kind of immortality as adults hope to leave a positive legacy of themselves and a gift for the next generation.

If generativity is not achieved, then stagnation occurs.

48
Q

What is stagnation in Erikson’s stage 7 theory?

A

It is sometimes called self-absorption and it develops when individuals sense they have done nothing for the next generation leaving them feeling unfulfilled.

49
Q

How can middle-aged adults develop generativity?

A

Through biological generativity: creating offspring

parental: nurturing and guiding children
work: adults develop skills that are passed down to others
cultural: create, renovate, or conserve some aspect of culture that ultimately survives.

50
Q

According to Erikson, what happens if generativity is resolved vs. un-resolved

A

If generativity is resolved then the individual develops the virtue of care for others; if unresolved, the middle-aged adult develops a lack of caring for others, sometimes called self-absorption

51
Q

Compare Erickons’s theory to Havighurst’s development tasks?

A

Havighurtst built on Erikson’s theory.

Series of age-specific essential tasks. Tasks arise from: physical maturity, cultural pressure, personal goals and aspirations

Critical periods where effective learning and achievement of tasks will be most successful

52
Q

According to the life-events approach, an individual’s development depends not only on their life events but also on what factors?

A

Mediating factors (physical health, family supports)

Individual’s adaptation to the life event (appraisal of the threat, coping strategies)

The life stage context (i.e divorce after being married for 3 years vs. 50 years)

Socio-historical context (i.e sing parenting in the 1950s compared to today)

53
Q

Define the life-event approach?

A

An approach that considers life events to be taxing circumstances for individuals forcing them to change their personalities. Events such as the death of a spouse, divorce, marriage, and so on were believed to involve varying degrees of stress and therefore were likely to influence the individual’s development.

54
Q

What are 2 drawbacks to the life-event approach when looking at development?

A
  1. It emphasizes too much on change and does not recognize stability in middle adults.
  2. It only considers major events to be “stressful” enough to cause change/development. Everyday stressors are not taken into account (i.e stressful job, a tense relationship, living in poverty)
55
Q

What is episodic stress and give examples?

A

Episodic stress is related to an event that once coped with, is over. Such stress can be positive because it is motivational. Example - writing an exam, competing on a team.

56
Q

What are the contexts to consider when looking at development?

A

Historical effects, gender effects, and cultural effects.

57
Q

How does historical context affect development?

A

Because the social environment of a particular age group can alter the”Social Clock” - the timetable according to which individuals are expected to accomplish life’s tasks, such as getting married, having children, or establishing themselves in a career or retiring.

Example - IVF recently became common, allowing middle adults to hold off on having offspring, or allow those a chance who cannot.

58
Q

What role does gender play in stage theories/development?

A

Stage theories have a male bias, For example, they focus on career and work achievement. Little importance is given to childbearing and childrearing - even though women’s roles are more complex (balancing work + family).

59
Q

How does culture affect the stage theories/development when it comes to mid-life?

A

Middle-aged is not addressed in all cultures as some countries either have a life expectancy of about 55 years or girls are married around 12 yrs old. They’re either consider “young” or “old” and there is no middle.

60
Q

What consequences may the “sandwich generation” face when caring for their children and aging parents?

A 
Lost time at work
Decreased productivity
Increased stress levels
Increased health problems
Lack of free time
Financial pressures
Negative impact on relationships
61
Q

What is the empty nest syndrome that many middle adults face?

A

Disequilibrium created in a parent’s life created by a child’s absence. It can lead to marital satisfaction or isolation.

N104 - Aging (6 decks)

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