Health Promotion Across the Life Span • Life Expectancy • This is the average number of years an individual will probably live. • Life expectancy in the United States at the beginning of the twentieth century was 47.3 years. • Today, average life expectancy at birth in the United States is 77 years. • There are currently 18 countries that have a life expectancy greater than that of the United States. • Females outlive males by an average of 6 years.
Health Promotion Across the Life Span • Life Expectancy (continued) • Those in households with incomes of greater than $25,000 live 3 to 7 years longer depending on gender and race than do those in households with individual incomes of less than $10,000. • Infant Mortality • This is the number of deaths before the first year of life. • The infant mortality rate for African-American infants is more than double that of white infants.
Health Promotion Across the Life Span • Development • Begins at conception and ends with death • The study of life span development is the study of how and why persons change over time, as well as how they remain the same. • The eight stages of life span development • Infancy, toddler, preschool, school age, adolescence, early adulthood, middle adulthood, and late adulthood
Growth and Development • Growth • Refers to an increase in size of the whole or its parts • Development • Refers to function or the gradual process of change and differentiation from simple to complex • Cephalocaudal • Growth and development that proceed from the head toward the feet • Proximodistal • Growth and development that proceed from the center toward the outside
Growth and Development • Patterns of Growth • Growth patterns appear to be genetically controlled. • Nutrition, heredity, and environment play an important role in the patterns. • The blueprint for all inherited traits is contained in the chromosomes. • At conception, the individual is endowed with a complex set of biologic potentials involving characteristics such as height and skin, hair, and eye color.
Growth and Development • The Beginnings • Development begins with conception. • After fertilization, the zygote has 23 pairs of chromosomes, for a total of 46 chromosomes. • One of each pair has been contributed by the mother and one by the father. • Teratogen • Any substance, an agent, or a process that interferes with normal prenatal development, causing the formation of one or more developmental abnormalities in the fetus
The Family • The family is the basic unit of society. • Families are composed of two or more people who are united by marriage, blood, adoption, emotional bonds, and/or social roles. • The individuals of the family usually share ties that often last a lifetime. • Family is the first socializing agent for teaching children society’s expectations and limitations • Part of socialization • Family is responsible for ensuring that the child receives a formal education
The Family • Family is responsible for instilling morals, values, and ideals into children • The birth of a baby and the death of a family member are happenings that create the need to rearrange family roles and structures • Types of families • Nuclear, extended, single-parent, blended, social contract family and cohabitation, homosexual, adoptive, and foster
The Family • Types of Families • Nuclear family • Biological parents and their offspring • Thought of as traditional family • Sex-based roles assigned to its members • Consists of a husband and wife with or without children living in independent household setting • Both parents work and share equally in financial support, roles, and responsibilities • Extended family • Consist of biological parents, children, grandparent, grandchildren, aunts, uncles, other family members • Sharing of support, roles, and responsibilities • Basic family group in many societies
The Family • Types of Families • Single-parent family • Family style of choice or a result of death, divorce, separation, or abandonment • More than 40% are result of divorce • Head of household is either male or female • Result of unwed parent living alone or from decision of a single person to adopt a child • Blended (Reconstituted) family • Also called step family • Adults remarry and bring together their children from previous marriages • Losses from death or divorce may cause both adults and children to be fearful of love and trust • A child’s loyalties to an absent parent may interfere with forming ties to a stepparent, especially when the child goes back and forth between two households
The Family • Types of Families • Social contract family and cohabitation • Involves unmarried couple living together and sharing roles and responsibilities • Homosexual family • Group made up of same-sex couple • Homosexual adults form family units • Their members share bonds of emotional commitment and roles of child rearing • Consists of either natural children or adopted or foster children • Each family type has common parenting concerns and responsibilities
The Family • Types of Families • Adoptive family • Family unit with adopted children • Childless or infertile couples often are lonely and lack fulfillment of joys parenthood • Ordeal of adoption may be time consuming and anxiety provoking • Role of parenting both exciting and fulfilling for natural and adoptive families
The Family • Types of Families • Foster family • Allows for care supervision, and nurturing of children whose parents are unable to care for them • Length of stay maybe temporary and depends on individual circumstances • Basic functions are inherent to family unit • Protection, nurturance, education, sustenance, and socialization • Unconditional affection, acceptance, and companionship are guaranteed to each family member
The Family • Types of Families • Nuclear • Consists of married man and woman and their children • Lives in independent household • Extended • Nuclear plus additional family members living in same household • Provides a sharing of responsibilities • Single-parent • Occurs by divorce, death, separation, abandonment, or choice • More common in recent years • Typically adult must perform roles of two people
The Family • Types of Families • Blended (reconstituted) • Occurs when adults from previous marriage remarry and combine children within new household • Social contract and cohabitation • Made up of man and woman living together without legal commitment but sharing roles and responsibilities • Homosexual • Involves homosexual partners living together with shared responsibilities • Adoptive • Consists of traditional members, husband, wife and adoptive child • Foster • Responsible for care, supervision, and nurturing of children in their charge
The Family • Family Patterns • Refers to the way in which family members relate to each other • Types of family patterns • Autocratic • Patriarchal • Matriarchal • Democratic
The Family • Family Patterns • Autocratic • Relationships are unequal • Parents attempt to control the children with strict, rigid rules and expectations • Least open to outside influence • Patriarchal • Male assumes dominant role • Male member functions in work role • Male responsible for control of finances • Male makes most decision
The Family • Family Patterns • Matriarchal • Known as matrifocal • Female assumes primary dominance in areas of child care and homemaking as well as finance decisions • Older female relative provides child care so that mother of children is free to work outside of home • Democratic • Adult members function as equals • Children are treated with respect and recognized as individuals • Encourages joint decision making, it recognizes and supports uniqueness of each member • Favors negotiation, compromise and growth
The Family • 12 qualities of functional families • 1. sense of commitment toward promoting members’ well-being • 2. sense of appreciation and encouragement for tasks accomplished • 3. directed effort toward spending quality time with individual members • 4. sense of purpose that encourages progress during good or difficult times • 5. sense of harmony between members of family
The Family • 12 qualities of functional families • 6. effective communications between individuals • 7. established values, rules, and beliefs • 8. Variety of different coping techniques to enhance functioning • 9. use of effective problem-solving measures and use of a variety of options • 10. positive outlook • 11. ability to be flexible and adapt to changes • 12. use of varied resources to facilitate coping skills
The Family • Stages of Family Development • Engagement/commitment stage • Begins when the couple acknowledges to themselves and others that they are considering marriage • Establishment stage • Extends from the wedding up until the birth of the first child • Expectant stage • Begins with conception and continues through pregnancy
The Family • Stages of Family Development • Parenthood stage • Begins at birth or adoption of the first child • Disengagement stage of parenthood • Period of family life when the grown children depart from the home • Senescence stage • Last stage of the life cycle, which requires the individual to cope with a large range of changes
The Family • Causes of Family Stress • Common Signs of Stress in Children • Mood swings • Acting out behavior • Change in eating or sleeping patterns • Frequent stomachaches, headaches, or other unexplained somatic complaints • Excessive clinging to parents • Thumb-sucking • Bed wetting • Return to behavior typical of an earlier stage of development
The Family • Causes of Family Stress • Chronic illness • Working mothers • Abuse • Divorce
The Family • Causes of Family Stress • Chronic Illness • Physical or emotional illness of parent or child affects all family members • Financial resources, family stability, adequate support system determine individual’s ability to cope with family member’s chronic illness
The Family • Causes of Family Stress • Working mother • Create wider role models for young children • Compensate for time rhey are not with their child by establishing quality time during their limited at-home time • Care giving arrangement • In-home care by a relative or paid caregiver or out of home in a group-organized setting • Choosing a day care, consider: • Balance of age-appropriate educational structure and an open environment • Ample space with a variety of materials and activities • Small calss size with appropriate staff/child ratio • Environment that fosters active staff invlovement, positive encouragement and high quality care in a safe environment
The Family • Causes of Family Stress • Abuse • Refers to physical, emotional, financial, or sexual assault or neglect • About 6 million women, children and men are victims of physical abuse inflicted by parents, spouses, siblings, children and other relatives • Visible factors related to family violence • Financial strain, social isolation, low self-esteem, history of abuse • Presence of these indicate individual is more prone to abuse and possess ineffective coping skills that prevent maintaining family wellness and safety
The Family • Causes of Family Stress • Abuse – cont’d • Characteristics of parents who abuse their children: • Abused themselves as children • Loners, harsh, strict and punitive • Have unreasonable expectations • Immature, lack self-control, and have low self-esteem • Early recognition, prompt reporting, preventive measures are employed to help detect and end all forms of abuse and neglect
The Family • Causes of Family Stress • Divorce • Effects of divorce on children are varied and complex • One factor is age of child • Younger children feel abandoned and feel they are no longer loved by both parents • Other factors that affect child are bitterness surrounding the conflicts, the child’s prior relationship with the absent parent, and effects of divorce on custodial parent, and post-divorce relationship of parents • Children have reconciliation fantasies for extended periods after divorce is finalized
The Family • Tips for divorcing parents • Encourage children to talk about their feelings • Don not use children as pawns or “go-betweens” • Never speak negatively about ex-spouse in front of children • Seek professional help if children need additional support
Stages of Growth and Development • Infancy: 1 to 12 Months • Physical Characteristics • Gains about 1.5 lbs. per month until 5 months • Doubles birth weight by 4 to 6 months • By 1 year of age, birth weight triples • Vital Signs • At 2 months, the average apical rate is about 120 beats per minute. At 12 months, average resting respirations is about 30 breaths per minute and blood pressure will gradually increase to 90/60.
Stages of Growth and Development • Infancy: 1 to 12 Months • Motor Development • 2 months: holds up head • 4 months: holds head up steadily to a 90- degree angle. • 6 months: balances head • 7 months: sits up easily without support and crawls • 9 months: creeping • 8 to 15 months: standing with support and walking
Figure 8-2 (From Wong, D.L. . Whaley & Wong's nursing care of infants and children. [5th ed.]. St. Louis: Mosby.) Development of locomotion.
Stages of Growth and Development • Infancy: 1 to 12 Months • Dentition • Teething begins at about 5 to 6 months • Signs of teethingirritability, edematous red gums, excessive drooling, change in stools usually begin 3 to 4 weeks before appearance of tooth. • Oral hygiene consists of offering sips of clear water and wiping and massaging the infant’s gums. • Tooth brushing should begin after the first teeth appear.
Stages of Growth and Development • Infancy: 1 to 12 Months • Psychosocial Development • Basic trust versus mistrust • Cognitive and Intellectual Development • Infant uses senses to learn about self and the environment. • Infant learns through exploration of objects and events and through interaction. • Infants are in the sensorimotor stage of cognitive development; knowledge occurs primarily through sensory impressions and motor activities.
Figure 8-3 (From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. . Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.) Nine-month-old infant enjoying own image in a mirror.
Stages of Growth and Development • Infancy: 1 to 12 Months • Communication and Language • During infancy, the unique ability of the brain to sort out basic sounds and to extract from sentences becomes apparent. • Infants will not speak spontaneously; the environment must provide a means for them to acquire these skills. • The rate of speech development varies from child to child and is directly related to neurologic competence and intellectual development.
Stages of Growth and Development • Infancy: 1 to 12 Months • Nutrition • Both human breast milk and commercially prepared formula are available to meet the nutritional needs of the infant. • Foods that should be avoided in the first 6 months of life are citrus fruits, egg whites, wheat flour all frequently identified as allergy-producing substances. • Rules for solid foods: introduce only one new food at a time; introduce cereals first, then fruits and vegetables, and meat last.
Stages of Growth and Development • Infancy: 1 to 12 Months • Sleep, Play Activity, and Safety • Newborns and infants sleep 18 of 24 hours. • Toward the end of the first 3 months, definite sleep patterns emerge. • By the end of the first year, the infant will sleep 12 hours at night and take one nap during the day. • Play is important for learning. • Accidents are the leading cause of injury and death in infants and young children.
Stages of Growth and Development • Toddler: 1 to 3 Years • Physical Characteristics • Rate of growth is slower in the toddler than in infancy. • In the beginning of this stage, the toddler’s body proportions result in a top-heavy appearance, but by the end they have a more proportionate body appearance. • Toddlers have an exaggerated lumbar lordosis and protruding abdomen. • By 2.5 years, all 20 deciduous teeth are present.
Stages of Growth and Development • Toddler: 1 to 3 Years • Vital Signs • Pulse: 90-100 beats per minute • Blood pressure: 100-80/64 • Temperature: 98-100º F • Respirations: 20-30 breaths per minute • Neuromuscular Development • Walking, climbing, hopping, running, pulling, holding on tight skills • Scribble and copy a circle
Stages of Growth and Development • Toddler: 1 to 3 Years • Toilet Training • Children do not reach the physiologic or psychological maturity necessary to be toilet trained until 18 to 24 months of age. • Nighttime control may be achieved after daytime control is established. • Success should be praised and accidents should be ignored.
Stages of Growth and Development • Toddler: 1 to 3 Years • Psychosocial Development • The toddler is an uninhibited, energetic little person always seeking attention, approval, and personal goals. • Autonomy versus shame and doubt • Use of the word “no” gives a sense of control. • Possessiveness and a desire to have things go their way are characteristic. • Ritualistic behavior and repetitive rituals • Temper tantrums are common.
Stages of Growth and Development • Toddler: 1 to 3 Years • Cognitive and Intellectual Behavior • The period from 12 to 24 months is the last phase of the sensorimotor development. • Preoperational thought stage • The child focuses on the use of language as a tool to meet needs. • The child has the emerging ability to think mentally. • Toddlers are constantly absorbing new ideas, widening their cognitive world, and expanding their memory.
Stages of Growth and Development • Toddler: 1 to 3 Years • Communication and Language • Toddlers think about their actions and make their will known to their caregivers. • They identify objects by use. • At age 2.5, their vocabulary is about 450 words. • By age 3.5, the child can answer questions, use brief sentences, and recite television commercials.
Stages of Growth and Development • Toddler: 1 to 3 Years • Nutrition • One serving of meat, two or more servings of vegetables, at least two servings of fruit, cereal or bread • Twenty-four ounces of milk per day • Bite-size pieces, finger foods, and smaller portions
Figure 8-8 (From Mahan, L.K., Escott-Stump, S. . Krause’s food, nutrition, and diet therapy. [11th ed.]. Philadelphia: Saunders.) Milk and other dairy products supply the toddler with the calcium and vitamin D for growing bones.
Stages of Growth and Development • Toddler: 1 to 3 Years • Sleep, Play Activity, and Safety • Toddlers expend a high level of energy in daily growing, playing, and exploring. • They require 12 hours of sleep each night plus a daytime nap. • Parallel play: play alongside of, but not with, peers • Running, jumping, and climbing help develop their growing bones and muscles. • More than half of all childhood deaths are caused by accidents, many of which are motor vehicle accidents.
Figure 8-5 (From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. . Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.) Children are most likely to ingest substances that are on their level.