Lifespan Development and Theory - Essay Example

Lifespan Development and Theory Paper Introduction: Assessment Anthony is a 66-year old male. He was admitted 2 days prior to this interview for chest pain. After a full work-up and examination, he was diagnosed with indigestion. He is of Asian descent and is a retired physician. He immigrated with his large family to the United States 33 years ago. After passing the USMLE (US Medical Licensure Examinations), he set-up his private practice as a general practitioner and family physician. He enjoyed a lucrative and successful career as a medical practitioner and is now enjoying retirement. Based on the physical domain, more particularly on his functional status, he can conduct all of the activities of daily living without assistance. He bathes, dresses, grooms, and feeds himself; and he can also transfer from the bed to his chair on his own. As to his instrumental activities, he can use the telephones, he can prepare his meals, can manage household finances, can take his medications, and can manage transportation. He needs assistance in doing the laundry, performing household tasks, and shopping. As for his mobility, he is very much mobile. He can walk from room to room without any assistance, he can also climb the stairs, and walk outside his home without any assistance. He has a slight limp because he had a hip fracture a year prior to this interview. He has since recovered from the fracture, and has had hip replacement surgery to repair the fracture. The fracture however has caused a slight imperfection in his gait. He has since adjusted to his uneven gait and has regained control and independence in his movements (Pompei, et.al., p. 49-52). As for his nutrition, his BMI is 27, and this classifies him as overweight. He admits to a fondness for red meats, and he says he does not exercise much. He also carries excess weight around his abdominal area. His fingers appear arthritic with some digits appearing bent and not in line with the joints. He admits to multiple episodes of arthritis. As for his vision and hearing, he wears glasses for reading and writing. He has cataract in his left eye and he admits that his right eye also had cataract, but he has since had corrective surgery for it. He has learned to adjust with using just one clear eye, and he is planning to have eye surgery for his left eye early next year. He does not suffer any difficulties in his hearing. He does not suffer from dementia. However, he does admit to being forgetful at times, but all in all, he still has an excellent memory. He sometimes feels sad and lonely especially since his wife died. They were married for 42 years until his wife suffered a heart attack 3 years prior to this interview. She had a DVT following an appendectomy. He now lives with his eldest daughter and her family and being with them keeps him from being sad and lonely. He also has close-relations with his other children and their respective families. They always make it a point to keep in touch with each other, and to get together for family dinners during the weekends. He counts himself fortunate for still being able to keep up with his grandchildren’s activities, but he admits that he now has physical limitations. He admits that he has fears about the years that will come. He sometimes fears that he will die of a heart attack, and he hopes that he will not suffer long when his final day would come. He often feels sad about facing the coming years without his wife. Despite assurances from his children that they would take care of him, he still fears that he will be too much of a burden to them if he would lose his mobility and independence. He has a strong support system from his family. They take care of him well and he can still perform his daily activities on his own. This makes him very much capable of socializing and joining in family socialization activities. He also socializes with various friends in the neighborhood. He plays poker with friends every Fridays at the YMCA, and he also joins in community events and activities. He expressed adamantly that he has no plans of remarrying because he had a good life with his wife. He is content and happy being with his children, grandchildren, and his friends. Expected developments On a physical scale, he exhibits the expected qualities of aging. He has spotty pigmentation in his skin and he also has dry and scaly skin. He also has a cooler temperature and he says he does not sweat as much. He has wrinkles and saggy skin in some areas of his arm and neck. He has more fat distributed in his abdominal area and less on his extremities. He also has thinning hair and is starting to grow bald. As expected of elderly patients, they would most likely experience some visual problems. His cataract is one of these expected changes. He has excellent hearing for a man his age. He says he has a decreased sense of taste, hence, he is fond of putting in more salt and hot sauce in his food. He exhibits a higher respiratory rate and a higher blood pressure. His BP however, is still within the normal range. For older adults, they are expected to exhibit urinary incontinence, and decreased bladder capacity. Anthony says he urinates more frequently, but not with as much volume as before. Older adults also tend to have shorter sleeping hours, but tend to sleep more frequently. Anthony says he finds it hard to sleep at night, and sometimes only gets to sleep for 3 hours at night. He tends to nap during the daytime – in the morning, and again in the afternoon (Crisp, et.al., p. 250). Based on the expected developments in an elderly adult thus far, Anthony is actually coping well. The qualities Anthony exhibits are expected qualities at this stage in his life. He is adjusting to his decreased physical strength and health. He knows he cannot engage in physically strenuous activities anymore. He mentioned how he used to be a weekend warrior, how he liked being engaged in carpentry work around the house. He mentions proudly how he made many of the fixtures and cabinets in his home. But now he knows he is not as spry and strong as he once was. In fact, his hip accident was a result of his miscalculation. He thought he could still carry some heavy planks, but he went weak in the knees while carrying the planks and before he knew it, he slipped and fell on his back. He is trying to adjust to the fact that his physical strength is not the same as it once was. He misses doing the physical work that he once engaged in during the weekends. Sometimes he still tries out those activities whenever one of his sons or his teenage grandchildren would visit him. He allows them to carry the heavier materials and to do the more physically straining parts of the activities. He had to adjust to other people helping him or doing things for him, and at first he refused to ask for anyone’s help. However, since his hip accident, he fears that he might fall again and suffer more injury. And so, now he has become more open to accepting help from other people. These adjustments are expected changes in the older adult’s life. Declining physical health and strength is an adjustment that affects them to a great degree because they do not like losing their independence. They also do not like admitting to weaknesses and having to ask other people for help (Bellack & Edlund, p. 315). He is also adjusting to retirement (Bellack & Edlund, p. 315). He misses his practice and seeing patients every day. He does not suffer much from a reduced income because his lucrative medical practice enabled him to save well for his retirement. In this regard, he is fortunate, because many elderly adults suffer from reduced income. Many of them are living in poor conditions because of their inadequate retirement savings. They are often deprived of basic and social services due to reduced income. He does admit that retirement has hit him more on an emotional level because he now has more time in his hands and at a loss as to how to spend his day. He spends time with his grandchildren when they are at home, however, most of the time, they are in school. Many of his friends have now been sent off to retirement and nursing homes, and he sometimes wonders if it will be better for him to be in one of these homes too. However, he knows he will miss his family too much. It is also not considered a part of their family culture to send off their elderly into retirement or nursing homes. Their culture dictates and favors a more family oriented-approach to caring for their elderly. Many elderly adults have to adjust with the death of a partner (Bellack & Edlund, p. 315). Anthony is one of these people. His long marriage and partnership with his wife created many happy memories. He still misses his wife dearly and he laments having to face the next years without her be his side. In the immediate year following her death, Anthony admitted to being extremely depressed about losing his wife and companion. But he has since come to terms with his loss. He still feels sad about it, but his children and grandchildren have been a strong support system for him. He has learned to adjust and participate in socialization activities (Bellack & Edlund, 315). This is an enlightening thing to note for Anthony because it allows him companionship and interaction with the community. It will help supplement his family as a support system. Based on the qualities that Anthony has exhibited, I would make a bold prediction that he will meet the next years of his life well. The most important aspect of his life is that he has a strong support system. On an emotional scale, many elderly adults suffer from despair and depression. They feel sad and lonely about being alone, and they feel depressed about their miserable physical and living conditions. They fear and they feel depressed about getting old, and about losing their independence in their daily activities. Older adults also come to terms with the things they have and have not done in their life. They fear that they may suffer some painful malady and eventually die from it. And their continuous fears often drive them further and further into depression and despair (Crisp, et.al., pp. 250-262). I do not think that such would be the case for Anthony. He has so far shown strength of character. He has come to emotionally adjust well with the loss of his wife. He has also learned to adjust well to his decreased physical strength and health by learning to accept help from his family. He also has a healthy social life through community activities. On a physical scale though, I predict that if he would not watch his diet, he may suffer a cardiovascular-related illness in the future. His fondness for red meats, his diminished physical activity, and his being overweight places him at risk for developing cardio-vascular related diseases. There is also a danger of falls. Many older adults who have experienced falls have a higher risk of experiencing another fall because of their decreased muscle and bone strength. He will also continue to suffer arthritis. The arthritis will limit his mobility. He will likely require assistance in waking up, in standing, in walking, and in conducting his daily activities every time his joints will be inflamed. During these times, his emotional fortitude will be challenged because he will lose independence in undertaking his ADLs. But, again, his strong support system will hurdle him through these times. He also has a strong psychological and emotional health which will allow him to get through these challenges with well adjusted coping skills. He will face frustration when his joints will be swollen from his arthritis because he is used to being active and being independent in his activities. He will face the indignities of having to be helped in standing up, walking, and even bathing. These moments will bring him sadness and will make him feel helpless. But again, he will cope well with emotional upheavals because of his strong support system. Many elderly adults face this challenge every day. They lose their mobility and independence. This frustrates them, and even causes them to lash out at their family members and caregivers. Their family will sometimes grow frustrated with them. Hence, many of these elderly adults end up in nursing homes (Crisp, et.al, pp. 250-262). I do not see this as the case with Anthony. I get the impression that their family is very traditional and very respectful of their father. They would take care of him well into his advancing years. They will also likely opt to employ a nurse who will help care for him rather than send him to a nursing home. Erikson’s Eight Stages of Man In Eric Erickson,’s Eight Stages of Man, he runs through the different stages of man’s development. The first stage of development is the trust vs. mistrust stage which is between birth and the first year of age (Wagner, “Theories of Personality”). Anthony mentions how he had a very stable and loving childhood in his home country. His mother stayed at home to care for him and his siblings while his father was the breadwinner of the family. He was able to develop trust and security as a child. This trust in the world gave him confidence and trust in other people. The second stage is the autonomy vs. shame and doubt stage (Wagner, “Theories of Personality”). This takes place during early childhood. Anthony says that he does not know how he was toilet trained as a child because he does not have any recollection of such events. But it is important to note that a child learns to control his body functions and to establish his independence at this stage. The best account he can give of his growing up years was that he had a lot of siblings to take care of him because he was the youngest child, and his mother was always around to take care of them. He recalls that they were an average income family and so he had plenty of hand-me-down toys and clothes. The third stage is the psychosocial stage or the initiative vs. guilt stage (Wagner, “Theories of Personality”). The child will play and interact at this stage. Anthony recalls how he liked to play with school mates and with his siblings when he was a child. This may account for his well-adjusted social skills. The next stage is the industry vs. inferiority stage (ages 5-11) (Wagner, “Theories of Personality”). He knew he was a bright student and he was a consistent honor student throughout grade school. He received a lot of encouragement from his family; and his parents were determined to give him a good education. This may account for his various accomplishments as a physician and his consistent performance as an honor student. The next stage is the identity vs. confusion stage (Wagner, “Theories of Personality”). His strong support system gave him a strong sense of self. As a teenager, he recalls how he was often tempted to try drugs, alcohol, smoking, and such other activities that other teenagers engaged in, but his strong sense of self gave him the necessary maturity to resist self-destructive behavior. The next stage is the intimacy vs. isolation stage (Wagner, “Theories of Personality”). This stage covers early adulthood when a person is exploring personal relationships. In Anthony’s case, he met and fell in love with his wife while he was in college taking up pre-med. They had a good friendship that grew into a deep and committed relationship. They married while he was still in med school. They went on to enjoy a challenging and healthy relationship as a married couple. Anthony’s strong sense of self was a good foundation for his relationship with his wife. And this carried them through 43 years of marriage. The next stage is the generativity vs. stagnation stage (Wagner, “Theories of Personality”). Anthony had a lucrative and fulfilling practice as a family physician. He said he knew he did not want to join the hospital setting because it was too hectic a life. He wanted to work from 9-5 and to go home to his family after work. He knew at the very start of his practice that joining the hospital setting would be a hectic life. He wanted to be more available to his family, and so he established a small but successful practice as a family physician. Many adults struggle at this point in their lives because they want to have both a committed family life and career. Anthony was able to enjoy both. The final stage is the integrity vs. despair stage (Wagner, “Theories of Personality”). It is no wonder that I assessed Anthony’s life and find an emotionally well-adjusted adult. He has developed a sense of integrity about his life. He admits that sometimes he has regrets about the decisions he has made in his life. He felt that he could have been a brilliant and even more successful physician if only he joined the hospital practice. But, he looks at his children and his grandchildren and he knows that the time he spent away from his career was well worth it. He sees his accomplishments in his children and in his grandchildren, not on his career as a physician. Maslow’s Hierarchy of Needs According to Maslow, there are five needs that have to be met in order for man to achieve growth and personal fulfillment. The first need is the physiological need. This represents basic needs of clothing, shelter, water, sleep, and such other fundamental needs (Wagner, “Theories of Personality’”). Anthony was not deprived of these needs as a child and as an adult. Although he came from a large family, he said that his parents worked hard to make sure that they were provided well. The next need is the security need. This represents the needs for survival like employment, health insurance, safe neighborhoods, and shelter (Wagner, “Theories of Personality”). He admits that when the family first migrated to the states and when he had not yet established his practice that he feared being unable to provide for his family. He felt the pressure of unemployment. But he used this pressure to prepare well and pass the USMLE and to establish his practice as a physician. He had a few years of limited clientele initially, but he was confident in his skills as a physician. He eventually was able to establish a loyal clientele which sustained his practice throughout the years. Through this private practice, he was able to support his family, to move them into a safe neighborhood and to avail of health insurance for them. And consequently, Anthony was able to fulfill his security needs through his hard work and perseverance. The third need is the social need. This need refers to needs for belonging, love and affection (Wagner, “Theories of Personality”). Anthony was able to achieve this need through his family and friends. He was a happily married man and well-loved and cared for by his children. He still gets to spend time with his friends and to join in the socialization activities in their community. He admits that he misses seeing and interacting with patients, but he is also thankful for the time that he can spend with his grandchildren. Esteem needs refer to those needs which reflect on self-esteem, personal worth, social recognition, and accomplishment (Wagner, “Theories of Personality”). Anthony admits that he sometimes feels regret for not having pursued a more lucrative practice as a physician. He compared himself with some of his contemporaries and he knows that many of them have gone on to be famous and top surgeons and practitioners in their chosen fields of specialization. However, Anthony always emphasizes how he has come to terms with what he has given up. He instead sees his life in the eyes of his children and grandchildren. He appears to be, for all intents and purposes, a very fulfilled man. Finally, the self-actualizing needs relate to a person’s self-awareness and personal growth (Wagner, “Theories of Personality”). Anthony has certainly achieved self-actualization. He is aware of his achievement and failings, his further potential for growth, and he is not overly concerned about other people’s opinions and actions. Works Cited Bellack, J. & Edlund, B. Nursing Assessment and Diagnosis. 1992. Massachusetts: Jones & Bartlett Publishers Crisp, J., et.al. Potter and Perrys fundamentals of nursing. 2005. New South Wales: Elsevier Australia Fillit, H., & Picariello, G. Practical Geriatric Assessment. 1998. New York: Cambridge University Press. Pompei, P., et.al. Geriatrics Review Syllabus. 2002. Massachusetts: Blackwell Publishing. Wagner, K. Eriksons Theory of Psychosocial Development. 2009. Theories of Personality. About Psychology. 22 July 2009 from Wagner, K., Maslow’s Hierarchy of Needs. 2009. Theories of Personality. About Psychology. 22 July 2009 from Read More