Adult to Later Life

1. Young Adulthood (20 to 40 Years)

1.1. General

1.1.1. Peaks in

1.1.1.1. Strength

1.1.1.2. Flexibility

1.1.1.3. Functionality

1.1.1.4. Efficiency

1.1.2. great strength in

1.1.2.1. Muscular tone

1.1.2.2. stamina

1.1.2.3. resistance to disease

1.1.2.4. tissue regeneration

1.1.2.5. athletic prowess

1.1.2.6. physical prowess

1.2. Cognitive

1.2.1. brain cell development peaks

1.2.2. Synaptic pathways continue to form

1.2.2.1. allows for learning new information and skills

1.2.3. Formal operations

1.2.3.1. allows for complex thoughts

1.2.3.2. allows to think of long/short term consequences

1.2.3.3. is influenced by

1.2.3.3.1. education

1.2.3.3.2. tolerance of diverse view points

1.2.3.3.3. dialectical thinking

1.2.4. learning disorders from childhood

1.2.4.1. continue on through adulthood

1.2.4.2. could intensify as educational does

1.3. Moral Development

1.3.1. develop a social contract theory

1.3.2. ability to respect others views

1.3.3. civic duty increases

1.3.4. accepting responsibility for ones actions

1.3.5. increase in pro social habits

1.4. Gender and Sexuality

1.4.1. reproductive systems reach full maturity at age 20

1.4.1.1. reaching peak orgasm tops out in the late teens for males and late 30's for females

1.4.1.2. sex hormone production is highest in the 20's

1.4.1.3. High sex drive will persist until 70's and 80's

1.4.2. Intimacy Issues

1.4.2.1. leads to many break ups

1.4.2.2. comprehension of intimacy is not fully possible

1.4.2.3. relationships and relationship roles are easily adopted if wanted

1.4.3. Sexual identity

1.4.3.1. males typically come out around 19-21

1.4.3.2. females typically come out around 21-23

1.5. Sexual Relationships

1.5.1. at least 20% of young adults in in their 20's and 30's wont marry

1.5.1.1. the delay has been placed on pursuits of higher education and career opportunities

1.5.2. living together and sharing sexual activity outside of marriage is increasing

1.5.2.1. unmarried households became the majority in 2005

1.5.3. Some may choose singlehood

1.5.3.1. allows for freedom

1.5.3.2. spend money and time

1.5.3.3. increased career opportunities

1.6. Social Development (Intimacy vs. Isolation)

1.6.1. intimacy is the ability to form interpersonal relationships with commitment, reciprocity, attachment, and inter-dependency

1.6.1.1. not limited to sexual or sposal relationships

1.6.1.2. need a good self identity

1.6.2. isolation is feeling exploited, difficult cooperation with others, and having a fragile sense of identity

1.6.3. Women typically have an easier time with achieving intimacy then men and at an earlier age

1.7. Marriage and Parenthood :

1.7.1. Having a satisfying marriage and family life is the goal of 80% of college students

1.7.1.1. Marrying later appears to lead to more stable and satisfying relationships.

1.7.1.1.1. The average age of first marriage for men has increased from 23-27 years and for women from 20 to 25 years.

1.8. Collegiality With Parents

1.8.1. once a good self identity is found the young adult begins to understand there parents complexity

1.8.2. Young Adults begin finding mutuality between their parents and themselves

1.8.3. The young adult also receives advice from the parents but can also give some advice back to the parents

1.8.4. If parents are reluctant to relinquish their authoritarian role over the young adult this can hinder the relationship

1.9. Gender and Career Choices

1.9.1. The jobs available for women are ever increasing

1.9.2. Men and women who are career orientated are

1.9.2.1. more likely to postpone marriage

1.9.2.2. have less kids

1.9.2.3. delay parent hood

1.9.3. Women are still facing employment vulnerability as employers are worried about the future limitations that pregnancy and motherhood can create

1.9.4. women who assume multiple roles such as work and mother are prone to more stress

1.9.5. women who just work from home are prone to depression, acute sickness, and chronic health issues

1.9.6. Men prefer women who have job aspirations for economic sharing

2. Middle Age (40 to 65 Years)

2.1. Cognitive Development

2.1.1. Overall intelligence begins to decline at about age 30.

2.1.2. Loss of neurons and degeneration of neural pathways result in slower nerve conduction, which lengthens reaction times.

2.1.3. Alzheimer disease, Parkinson disease, and Huntington disease become more common.

2.1.4. Fluid intelligence (response speed, memory span) declines.

2.2. Gender and Sexuality:

2.2.1. For women, the menstrual cycle becomes less regular in the late 30s and 40s, it ceases for most women in their 50s (menopause).

2.2.1.1. Menopause is associated with a decrease in size of the reproductive organs, vaginal dryness, and atrophy due to decreased estrogen production. This process is called climacteric.

2.2.2. Men experience no single event to mark a "male climacteric."

2.2.2.1. Some adults do not handle the transition well, which can interfere with decision making, undermines partner relationships, and ability to be a parent.

2.2.2.2. Testosterone levels decline with age. Men with low testosterone in middle age report lower energy and libido.

2.3. Affective Development

2.3.1. This stage in life is characterized by reflection about life goals, assessment of personal and professional accomplishments, and thinking about the future.

2.3.2. Some are not able to effectively make the transition into middle age.

2.3.2.1. Could create negative results in decision making, partner relationships, and parenting.

2.3.3. Good support systems enhance coping ability while transitioning in this stage.

2.4. Social Development

2.4.1. Generativity vs. Stagnation (Erikson)

2.4.1.1. Generativity: guiding and contributing to the next generation.

2.4.1.1.1. Many middle-aged adults mentor younger colleagues to achieve generativity.

2.4.1.2. Stagnation: lack of productivity or creativity

2.4.1.2.1. Fixation at this stage in life could result in a mid-life crisis, making them feel helpless or trapped.

2.4.1.2.2. Many middle aged adults reevaluate their previous expectations of this stage in life.

2.5. Sexual Functioning:

2.5.1. A decrease in sexual desire may occur at about age 50; more significant drop in sexual activity occurs after age 70.

2.5.2. The frequency of sexual intercourse drops to a level of 3-4 times/month among couples married 30 years.

2.5.2.1. Older adults who have access to a regular partner report having intercourse about 2-3 times/month, even at age 70.

2.5.2.2. Older homosexual men report continued sexual activity and satisfactory relationships.

2.6. Parent-Child Relationship

2.6.1. Empty Nest: time period parents go through when their last child leaves home

2.6.1.1. Especially difficult for woman because they lose their role of being a mother

2.6.2. Elastic Nest: children leaving their family and home, and then returning because of life changes

2.6.2.1. Usually a temporary situation

2.6.3. It is becoming more common for parents and children to remain in the same household for financial reasons

2.6.3.1. Can be a permanent situation

2.6.4. Sandwich Generation: Adult childern that are being caught between continuing needs of their own children and their now-aging parents

3. Later Life (65+)

3.1. HEALTH AND THE AGING PROCESS: Changes in biological function are highly variable between elderly; decreased sensory, gradual loss of functional abilities, and loss in visual acuity occur; this can lead to FALLS, and an inability to be independent. DENTURES are common making chewing food difficult; undetected, these changes can lead to malnutrition and mood disorders; SLEEP DISTURBANCES are also common and can lead to a high use of sleeping drugs, OVERALL, wrinkles, gray hair and a decreased height are signs of normal aging

3.2. AFFECTIVE DEVELOPMENT: Anxiety or fear of development can arise in the elderly with conditions of depression, dementia, and general medical illness. Loss plays a major role in life transitions, DEPRESSION is common and the rates of suicide increase with age in both men and women; it is most common in those with a wide variety of chronic medical and neurological diseases, ALCOHOLISM in the elderly can be estimated to about 10-15% of the population; one third of the elderly begin heavily drinking later in life; POST-TRAUMATIC STRESS DISORDER is widely under-diagnosed;

3.3. COGNITIVE DEVELOPMENT: DEMENTIA affects less than 10% of those over 65 but can be progressive; ALZHEIMER'S affects 10-15% of adults over 65 is is more classic with familiar chronic symptoms, the MINI MENTAL STATUS EXAM is the most commonly exam used to assess the most common cognitive decline, EDUCATION LEVELS affect decline as well as CULTURAL CONCEPTS

3.4. GENDER AND SEXUALITY: Men have a significant decrease in sexual functioning with a decrease in semen production and little to no ejaculate being produced as they age; women are less affected but do experience menopause by the early to mid 50's showing decreased estrogen levels but no affected sexual activity; studies have shown that sexual activity is on the decline as people age due primarily to societal influences rather than biological changes: studies have shown a steady rise in the diagnosis of HIV and other STIs in the the age group older than 60; and is more prevalent in women who have experienced menopause than men

3.5. SOCIAL DEVELOPMENT: Those who do not view their life positively are more likely to experience despair and isolation; the elderly commonly lack a SUPPORT NETWORK of familiar people and objects that leads to little will to live; Physicial and neurosensory deterioration may lead to reliance on others and take their independence for self-care. Nursing homes and care are common in this population

3.6. VIOLENCE AND ABUSE: ELDER ABUSE includes physical, emotional, physiological, and financial abuse as well as self-neglect and neglect by caregivers FAST is Financial Abuse Specialist Team, sexual abuse tends to decline with age

3.7. SUBSTANCE ABUSE AMONG ELDERS: Nicotine is the most frequently used substance among current seniors with about 15% of older adults smoking; ILLICIT DRUG USE is rare, however it is on the rise, it has been deemed that MORE THAN SEVEN OTC medicines are common in the elderly; GAMBLING has emerged as an area of concern in our society

3.8. SPECIAL POPULATIONS: Gay, Lesbian, Bisexual, and Transgender Elders; there are an estimated 3 million of these older individuals in the US and it is looking to double by 2030; DISCRIMINATION can be seen in the health care and mental health care sectors

3.9. SUCCESSFUL AGING: can be described as emphasizing proper retirement with avid volunteerism; LONG TERM CARE includes home and community-based services along a spectrum of specialized health care and rehabilitative care; HOME HEALTH CARE SERVICES are becoming more common and provide a wide range of services in the clients home; RESPITE CARE: is short term and can be provided in the home or a facility to allow the family to have a break and regain perspective on what a family has chosen to undertake; LONG-TERM RESIDENTIAL SERVICES include assisted living and extended care facilities; HOSPICE CARE is used mainly on those with a terminal illness who can enjoy the remainder of their life in comfort

3.10. OLDER MINORITIES: are expected to account for 24% of those over the age of 65; EXTENDED CARE FACILITIES have be underutilized by minority populations due largely to cultural concerns that result in primarily family care; MEDICARE AND MEDICAID are the primary payers for nursing home services and many minorities do not qualify for these services