Nursing Adults
(Middle Adulthood)


Understanding health and illnes behaviour in adults.

You are encouraged to set yourself to be without distraction from your learning for the period of each lecture. For a self-paced lesson, a minimum of 15 minutes is recommended for each period. This is to enable you to adequately digest the instructions and content, to avoid misunderstanding and miscommunication, and to achieve meaningful learning.

The  School of Health Sciences, Ngee Ann Polytechnic, Singapore

Chapter curated and authored by Jeremy Chavell Jordan OLIVEIRO
Jeremy_CJ_OLIVEIRO@np.edu.sg 

Edited  by: Yasmeen SHARIFF
Webpage Built by CHONG Ching Liang 

Walking through a birthday card aisle offers plenty of reminders about how aging is something to avoid. Life begins at 40. Fifty is the new 30. Although these cards often represent tongue-in-cheek ways of helping the recipient feel better about aging, very little is known about how both perceptions of age and estimates of the timing of developmental transitions differ by age. Is 50 “old”? When do we stop being “young”? If individuals could choose to be any age, what age would they be? Here are some things for your consideration. Are there age differences in aging perceptions (e.g. how old do you feel?) and the timing of developmental transitions (e.g. when does someone become an older adult?). 

Topic 4 is all about adults. Generally, adulthood, the period in the human developmental lifespan in which physical and intellectual maturity is supposedly attained. Adulthood is commonly thought of as beginning at age 21 years in most countries and cultures (However, do recall that we learnt in the last topic that our brain fully matures as late as 25 years of age). Middle age is supposedly at about 40 years, and followed by old age at about 60 years.

Here's a little video to introduce Adulthood to you....

Physically, early and middle adulthood are marked by slow, gradual declines in body functioning, which accelerate as old age is reached. The muscle mass continues to increase through the mid-20s, thereafter gradually decreasing. The skeletal mass increases until age 30 or so, and then begins to decrease. Throughout adulthood there is a progressive deposition of cholesterol in the arteries, and the heart muscle eventually grows weaker even in the absence of detectable diseases. 

There is clear evidence that with increasing age adults display a slow, very gradual tendency toward decreasing speed of response in the execution of intellectual (and physical) tasks. Slowing rates of electrical activity in the older adult brain have been linked to the slowing of behaviour itself. This decline in the rate of central nervous system processing does not necessarily imply similar changes in learning, memory, or other intellectual functions. 

What are some struggles, issues and goals that adults face?  Looking at the milestones of an adult in Singapore. What does this mean to you when you think about adulthood?

The above infographics was built based on data found here. 

Maslow's Hierarchy of Needs

So then.... what are some psychological concerns does the average adult deal with. In this topic we will look first at motivation and then proceed with stress and coping. Let us take a look at the first theory of this chapter. 

If you couldn't catch what the lesson video is saying here it is in brief.

Maslow's hierarchy of needs is a motivational theory in psychology comprising a five-tier model of human needs, often depicted as hierarchical levels within a pyramid. The key take away is: needs lower down in the hierarchy must be satisfied before individuals would attend to higher needs. From the bottom of the hierarchy upwards, the needs are: physiological, safety, love and belonging, esteem, and self-actualization.

Maslow initially stated that individuals must satisfy lower level deficit needs before progressing on to meet higher level growth needs. However, he later clarified that satisfaction of a needs is not an “all-or-none” phenomenon, admitting that his earlier statements may have given the false impression that a need must be completely satisfied before the next need emerges.

When a deficit need has been 'more or less' satisfied it will go away, and our activities become habitually directed towards meeting the next set of needs that we have yet to satisfy. These then become our salient needs. 

Maslow's Hierarchy of Needs five-stage model includes:

Physiological Needs

These are biological requirements for human survival, e.g. air, food, drink, shelter, clothing, warmth, sex, sleep. 

If these needs are not satisfied the human body cannot function optimally. Maslow considered physiological needs the most important as all the other needs become secondary until these needs are met.

 Safety needs

Once an individual’s physiological needs are satisfied, the needs for security and safety become salient. People want to experience order, predictability and control in their lives. These needs can be fulfilled by the family and society (e.g. police, schools, business and medical care).

For example: emotional security, financial security (e.g. employment, social welfare), law and order, freedom from fear, social stability, property, health and wellbeing (e.g. safety against accidents and injury).

Love & belonging needs 

The third level of human needs is social and involves feelings of belongingness. The need for interpersonal relationships motivates behaviour

Examples include friendship, intimacy, trust, and acceptance, receiving and giving affection and love. Affiliating, being part of a group (family, friends, work).

Esteem 

Esteem needs is the fourth level in Maslow’s hierarchy - which Maslow classified into two categories: (i) esteem for oneself (dignity, achievement, mastery, independence) and (ii) the desire for reputation or respect from others (e.g., status, prestige).

Maslow indicated that the need for respect or reputation is most important for children and adolescents and precedes real self-esteem or dignity.

Self-actualization 

Self-actualization needs refer to the realization of a person's potential, self-fulfillment, seeking personal growth and peak experiences. Maslow  describes this level as the desire to accomplish everything that one can, to become the most that one can be.

Individuals may perceive or focus on this need very specifically. For example, one individual may have the strong desire to become an ideal parent. In another, the desire may be expressed economically, academically or athletically. For others it may be expressed creatively, in paintings, pictures, or inventions.

Every person is capable and has the desire to move up the hierarchy toward a level of self-actualization. Unfortunately, progress is often disrupted by a failure to meet lower level needs. Life experiences, including divorce and loss of a job, may cause an individual to fluctuate between levels of the hierarchy.

Therefore, not everyone will move through the hierarchy in a uni-directional manner but may move back and forth between the different types of needs.

Do psychologists still use Maslow's Hierarchy of Needs?

Learning Objectives

The key lesson from this section is to  discuss theories applicable to the psychology of adults. Science has found the rationale behind why they think and behave the way they typically would, and it is not without good reasons. This is the reason why future healthcare professionals like yourself need to take an introductory course in behavioural sciences because combating an illness is not just about knowing the correct treatment but also understanding and learning about how your patients think. 

Here are the areas covered in your learning journey for this week:

References

World Health Organisation. (n.d.). Infographics on adolescent health. Retrieved March 13, 2020, from https://www.who.int/maternal_child_adolescent/topics/adolescence/graphics/en/