My future position in the healthcare industry is to be a Healthcare Administrator. In my current or past positions, I did not work with finances, so this is new to me, though definitely will be dealing with it as an Administrator. There are several ways that I would utilize financial information. It will be utilized when dealing with insurance and reimbursements, will I qualify for meaningful use, paying staff, allocating finances for quality improvement, improving technology equipment as well as other equipment and marketing are just some of the ways I will utilize financial information. As a patient, I have had the experience of having to pay for healthcare costs out of pocket. I have also reviewed the bill to ensure correctness of charges, called facility for questions regarding billing, and also have reviewed the EOB (explanation of Benefits) this also will ensure correctness and assure me of all charges. Guadalupe Martinez 010/30/19 PSYC 2103 ESSAY QUESTIONS 1.Identify and explain the significant steps of Early Childhood Development and include the relevant theories. The development of a child starts with physical development before getting to psychological development. Physical development involves growth in height and weight. During the early stages, the girls are averagely taller than boys. One of the challenges in physical development is obesity, a health problem that is caused by diet, social characteristics, and genetic make-up. The psychological aspect involves growth in education, which is enhanced for all learners through systems such as special education. The special education units involve providing the learners with differentiated instructions to facilitate learning at various levels. The early development stages require the support of the parents, especially the protection that the father offers to the children. Similarly, the development of the children includes dieting and the challenge of obesity among children can be addressed by ensuring that children access healthy meals. 2.Describe the challenges faced by learners in the early stages of development and suggest viable solutions to the setbacks. Bullying at school and instability in the family set up can disrupt the learning progress and ruin the future of the kids. Bullying inflicts physical pain and injuries and scares the victims from attending school. This problem can be addressed by teaching discipline in school. Bullying is responsible for over 90% truancy in elementary and middle schools as students fear being harassed and they choose to stay at home. Children who are exposed to bullying might develop low self-esteem, while the perpetrators are likely to engage in crimes in future. The issue of family disputes affects the children because they lack the required parental support. The challenge can be solved by listening and responding to their concerns. The adults might be well adapted to facing wi ...

1. My future position in the healthcare industry is to be a
Healthcare Administrator. In my
current or past positions, I did not work with finances, so this is
new to me, though definitely
will be dealing with it as an Administrator. There are several
ways that I would utilize financial
information. It will be utilized when dealing with insurance and
reimbursements, will I qualify
for meaningful use, paying staff, allocating finances for quality
improvement, improving
technology equipment as well as other equipment and marketing
are just some of the ways I will utilize financial information.
As a patient, I have had the experience of having to pay for
healthcare costs out of
pocket. I have also reviewed the bill to ensure correctness of
charges, called facility for questions regarding billing, and also
have reviewed the EOB (explanation of Benefits) this also will
ensure correctness and assure me of all charges.
Guadalupe Martinez
010/30/19
PSYC 2103
ESSAY QUESTIONS
1.Identify and explain the significant steps of Early Childhood
Development and include the relevant theories.
The development of a child starts with physical development
before getting to psychological development. Physical
development involves growth in height and weight. During the
early stages, the girls are averagely taller than boys. One of the
challenges in physical development is obesity, a health problem
that is caused by diet, social characteristics, and genetic make-
up. The psychological aspect involves growth in education,

2. which is enhanced for all learners through systems such as
special education.
The special education units involve providing the learners with
differentiated instructions to facilitate learning at various
levels. The early development stages require the support of the
parents, especially the protection that the father offers to the
children. Similarly, the development of the children includes
dieting and the challenge of obesity among children can be
addressed by ensuring that children access healthy meals.
2.Describe the challenges faced by learners in the early stages
of development and suggest viable solutions to the setbacks.
Bullying at school and instability in the family set up can
disrupt the learning progress and ruin the future of the kids.
Bullying inflicts physical pain and injuries and scares the
victims from attending school. This problem can be addressed
by teaching discipline in school. Bullying is responsible for
over 90% truancy in elementary and middle schools as students
fear being harassed and they choose to stay at home. Children
who are exposed to bullying might develop low self-esteem,
while the perpetrators are likely to engage in crimes in future.
The issue of family disputes affects the children because they
lack the required parental support. The challenge can be solved
by listening and responding to their concerns. The adults might
be well adapted to facing with the challenges of emotional
disruptions, but the children are vulnerable, so they suffer from
depression and emotional instability.
3. Elaborate on two main challenges that face adolescents and
suggest possible solutions.
The use of illegal drugs is prevalent and detrimental to the
development of adolescents into responsible adults. The
involvement in drug abuse often lead teenagers into criminal
activities and other problems such as teenage pregnancies and
high rates of truancy. The academic expectations of such
students are low and they perform poorly in school. The youth
should be educated on the problems of drug abuse and provided

3. with rehabilitation services.
Similarly, teenagers are affected by the challenge of sexuality
and sex. The teenage period involves shaping the adult life, and
most teenagers are confused about the changes in their bodies.
The lack of sufficient information on how to face the changes
can expose them to sexual assaults and harassment by evil
adults. The teens should be offered with all the necessary
information concerning the issues of sexuality.
4.Explain how Bulimia and Anorexia Nervosa affects teenagers.
Anorexia Nervosa is a life-threatening eating disorder that
involves resistance to eating, grave fear of weight gain, and loss
of menstrual periods in girls. The patients suffer organ failures
such as kidney and heart problems and generally weakened
bodies such as brittle bones. The general weakness of the body
leads to other major health complications that can result into
death. Such teens should be taken for mental clinics and get
constant encouragement to accept their bodies.
On the other hand, Bulimia is an eating disorder that is
characterized by behavior such as self-induced vomiting,
laxative or diuretic abuse, and excessive concern over weight
and shape. The effects include tooth decay, inflammation or
rupture of the esophagus, and electrolyte imbalance caused by
dehydration. Reversing such adverse health effects is usually a
challenge, but the best treatment should start by changing the
mindset through guidance and counseling.
5.Explain the social learning theory and cognitive approaches
during early childhood development.
Social learning is learning from the context, and it involves
observation, imitation, and modeling in education. Social
learning theory assures that learning can take place without
behavioral change. Children are the best known for learning
through observation and imitation because their language and
expression is usually incomplete during the early stages. They
should be exposed to positive learning experiences to promote
positive academic growth.

4. The cognitive theory operates on the development of acceptable
rules as stipulated by society. The societal values play a
significant role in shaping the characters and behaviors of
individuals. The children, especially, are shaped by their
immediate environment even into their adulthood lives.
Unit I Essay Examples
1. Define SIDS and describe some of the possible causes and
preventions of this syndrome.
SIDS is a condition that occurs when an infant stops
breathing suddenly without an apparent cause.
Research has shown that infants who are placed to sleep
on their stomach have a higher incidence of SIDS due to the
inability to breath effectively or arouse from sleep when their
face is down. It also restricts the infant’s ability to swallow
effectively. Also, heart arrhythmias are estimated to occur in as
many as 10-15% of SIDS cases. Some of the other instances
that it is more likely to occur is in infants with low birth
weight, infants who are passively exposed to cigarette smoke,
when infants sleep in the same bed as their parents and when
they don’t use a pacifier to go to sleep.
To reduce the risk of SIDS, the American Academy of
Pediatrics has recommended that infants be place to sleep on
their back on a firm surface, do not sleep with the infant, and
don’t expose the infant to cigarette in utero or after birth. It is
shocking that the CDC web site states that approx. 4,000 infants
die of SIDS every year in the US.
2. Briefly describe the three cognitive theories presented in the
book and their main differences.
A cognitive theory focuses on how children develop
complex thinking skills. .
a. Piaget’s Theory- His belief is that children construct

5. their understanding of the world and go through four states of
cognitive development.; Sensorimotor stage, preoperational
stage, concrete operational stage and formal operational stage.
b. Vygotsky’s Theory- Socialcultural -He believed that
children actively construct their knowledge through social
interaction and culture activities. He stressed that cognitive
development involves learning to sue the inventions of society,
such as language, mathematical systems, and memory strategies.
c. Information-Processing Theory- individuals
manipulate information, monitor it, and strategize about it. The
processes of memory and thinking are central.
Vygotsky and the Information Processing theory differ from
Piaget’s theory in that they recognize that cognition and
memory directs language and they suggest that education merely
refines the cognitive skills that have already emerged whereas
Piaget’s main focus is on language and education.
3. Name and define the four Parenting Styles as defined by
Diana Baumrind and discuss how other cultures view them.
a) authoritarian parenting -- restrictive, punitive style
demanding obedience and respect
b) authoritative parenting -- encourages independence but
still places limits and controls
c) neglectful parenting -- parent is very uninvolved in the
child's life
d) indulgent parenting -- highly involved with but place few
demands or controls
While we tend to think that the authoritative parenting style is
the most effective for the child in America. The authoritarian
style has had good results in Arab and Asian worlds. They tend
to have high academic achievement due to the strict parental
controls. Their goals are perseverance, working hard in school,

6. and respecting their parent’s wishes. Maybe we need a mix of
both to boost our academic achievement and decrease our “if it
feels good, do it” attitude in America.
4. Motor development begins with some basic reflexes that
infants are born with. Describe two of the reflexes and when
they begin to disappear and also define some of the reflexes that
never disappears.
a. Rooting reflex: This is a survival reflex and occurs
when the infant’s cheek is stroked or the side of the mouth is
touched. This disappears after 3-4 months.
b. Moro reflex: This occurs in response to a sudden,
intense noise or movement. This disappears after 3-4 months.
Some of the reflexes that we are born with and continue
to use as an adult are coughing, sneezing, and blinking. The
most interesting to me is the reflex that allows a newborn, when
immersed in water, to hold its breath and contract its throat to
keep water out. Unfortunately this goes away during the first
year. We are born with amazing bodies.
5. From the video, Biology of Dads, describe some of the ways
that a dad has an influence on his child.
a. Toddler- Physical play with the dad helps to exert
power and learns limits. They learn to respect boundaries and
take risk. Dad’s use less baby talk and therefore dads aid in
language development of the child.
b. Child- Dad’s provide the child with entertainment,
more structure and a stronger sense of security and
independence.
c. Teen- Dad’s encourage competitiveness and to
respect discipline. They tend to take the emotion out of it and
set rules and boundaries.
In each area, Dad’s have the opportunity to positively impact a
child’s life. Dad’s have an influence as a role model on a girls

7. choice in a future husband and a son relationship with a future
wife. This can be positive or negative according to how
effective and present a dad is in his child’s life. It is amazing
how important our dads are.
Human development
Unit III
Young Adulthood (Early 20’s-Early 40’s)
Unit III
Unit III (Young Adulthood-Late Adulthood)
Young Adulthood (Early 20’s-Early 40’s)
Middle Adulthood (Early 40’s-Early 60’s)
Late Adulthood (Early 60’s-Death)
Young Adulthood~Early 20’s-Early 40’s
The Growing Years…
Young Adulthood
Typically, physical development/ maturation already complete
Small % still gain in height in early 20’s
Brain continues to grow in weight, reaching its maximum

8. weight during young adulthood and then contracting in size
Senses are typically at their peak
Peak Physical Strength
Reaction time quicker
Muscle strength greater
Hand-eye coordination sharp
The College Years
69% of white high school graduates, 61% of African American
graduates, and 47% of Hispanic graduates enter college
Only around 40% of those who start college graduate 4 years
later with a degree
Although about half of those who do not graduate will
eventually finish, the other half never obtain a college degree
More women that men attend college and graduate
Women receive 133 bachelor’s degrees for every 100 men
This proportion continues to increase
The Multiple Demands of College
Often multiple life changes come along with entering college
High stress with demands of coursework
Additional financial stress
Change in social groups/ peers
Being away from home for the 1st time
First-year adjustment reaction – a cluster of psychological
symptoms often experienced by first-year college students,
including:
Loneliness

9. Anxiety
Withdrawal
Depression
Adjusting to the Demands of College
How do students adjust?
Making friends
Joining teams, clubs, fraternities/ sororities
Some students benefit from counseling to support them during
the transition***GHC offers free counseling services
Possible signs that professional help is warranted:
Psychological distress that lingers, interferes with a person’s
well-being and ability to function
Feeling unable to cope with stress
Hopeless or depressed feelings (sometimes without an apparent
reason)
Inability to develop close relationships
Psychosomatic symptoms
https://www2.highlands.edu/site/sss-counseling-support
7
Relationships: Young Adulthood
Intimacy and Love
According to Erik Erikson, the focus of early adulthood is the
intimacy vs. isolation stage.
Individuals must develop the ability to form deep, intimate
relationships with other people.
Not directed specifically toward sexual intimacy, but toward
forming long-lasting emotional bonds with another person.
Erikson’s components of intimacy:
Selflessness – sacrificing one’s own needs for those of another

10. Sexuality – gratification of joint pleasure
Deep devotion – fusing of identities
Difficulties during this stage?
Loneliness, isolation, fear of relationships
Possible result from failure to resolve conflict of previous stage
Friendships
Humans have a need for belongingness – leads people in early
adulthood to form and preserve relationships that allow them to
experience a sense of belonging with others
How are friendships formed?
Proximity (distance)*We are statistically more likely to be
attracted to our neighbor-close proximity.
Similarity (similarity in intelligence, personality and
attractiveness)
Gender differences – much more evident in this phase of life
females: emotional sharing of confidences
males: shared activities, interests
females tend to discuss things in greater depth
more self-revealing
confide less about strengths, victories, achievements
Men & Women
Differ when Selecting a Mate
V (Visual)
T (Touch)
N (Nasal)
N (Nasal)

11. E (Emotional)
E (Emotional)
V (Visual)
T (Touch)
Men
Women
Externally
Internally
How Men & Women Differ
Men
Women
Men are highly visual
Men fall in love with what they “see”
Women like to talk first
Men like to have sex first; talk second
Women have more at stake then men
Men are “physically” touchy feely
Women are more emotional
Men are 75% testosterone & 25% estrogen
Women tend to put touch last
Women are 75% estrogen & 25% testosterone
The Two Faces of Love
Two categories of love:
Passionate
Companionate
Passionate love (romantic love)
State of powerful absorption
Intense physiological arousal
Rapid emotional swings

12. Companionate love
Strong affection for those with whom we are deeply involved
Sternberg’s Triangular Theory of Love
Sternberg believed that love has three basic components
The three basic components are:
Intimacy, the emotional component, which involves liking and
feelings of closeness
Passion, the motivational component, which contains drives that
trigger attraction, romance and sexual desire
Commitment, the cognitive component, which reflects the
decision to make a long-term commitment to a loved partner.
The Combinations of Love
Intimacy alone is described as liking
Passion alone is described as infatuation
The combination of intimacy and passion is called romantic
love.
Commitment alone is called empty love
The combination of commitment and passion is referred to as
fatuous love (foolish and silly)
The combination of commitment and intimacy is known as
companionate love, a secure and trusting partnership.
A combination of all three components is known as consummate
love, (a relationship that is in the highest degree, near perfect).
The absence of all three components results in non-love.
Cohabitation vs. Marriage

13. Cohabitation – couples living together without being married
Various reasons for choosing cohabitation over marriage:
Not ready for lifelong commitment
“Practice” for marriage (problems with this?)
Reject marriage altogether
Why marry?
Appropriate culmination of a loving relationship
“Right” thing to do
Desire support of a spouse (economic, sexual, social roles)
Children out of wedlock not accepted by all sects of society
Legal benefits (insurance/ survivor benefits)
The research suggests that couples who cohabitate are more
likely to divorce.
Only about 40% of couples who cohabitate go on to marry
The rate of domestic violence is higher in couples who
cohabitate
The reported sex lives is greater in couples who are married
Couples who are married save more money
Couples who are married work harder to ensure proper child
rearing
Marriage provides greater perceptions of stability
The Pros/Cons of Cohabitation vs Marriage
What Makes Marriage Work?
Conflict in marriage is not unusual
Nearly half of newly married couples experience a significant
degree of conflict
Many others view the early years of marriage as deeply
satisfying
Characteristics of a good marriage:
Visible affection

14. Communicate relatively little negativity
Partners hold similar interests
Partners agree on distribution of roles
View themselves as an interdependent couple
A sense of obligation to the partner and family
This awareness has not helped prevent the epidemic of divorce
Nearly half of all marriages in the U.S. end in divorce (56%)
Most divorces occur during the first ten years of marriage
Why Do Couples Divorce?
Possible Factors:
poor communication; lack of support; lack of intimacy
women are now more financially independent, less likely to
remain in bad marriages
young people expect more from marriage than previous
generations
couples realize that exposing children to continued conflict does
greater damage
Remarriages are far less stable. As many as 70-90% of second
and third marriages end in divorce
46% of women and 64% of men report infidelity in their
marriages
At-Risk for Divorce:
teens have higher divorce rates
high school or college drop-out
if the father is unemployed, under age 30, or living in poverty
those who cohabitated before marriage
Psychological Side

15. How to Stay Together (4 C’s)
1. Communication
Be Upfront
Be Honest
Listen
2. Change
One has to be willing to change lifestyles
3. Compromise
Give & Take
Share
4. Commitment
Marriage or Union
Remember: You will always find others attractive and someone
will always find you attractive. This does not mean one always
needs to take action on attraction.
Adjusting to Divorce
adjustment depends on how people feel about themselves and
former partners
involves relief, sadness, guilt, apprehension and anger
rejection, loss of control, powerlessness
requires emotional detachment
those with more personal resources and friends adjust better
divorce lowers the standard of living
Men are more likely to remarry sooner.
Men are often better adjusted following a divorce
Women are more likely to leave the marriage

16. Choosing to Become a Parent.
Pleasure in watching their children grow
Fulfillment from their children’s accomplishments
Bonding with children
Societal norm – “First comes love, then comes marriage, then
comes baby in the baby carriage.”
Self-serving element
Children care for/ provide for parents in old age
Run family business
Provide companionship
For some couples, there is no “decision” to have children
Failure/ absence of birth control methods
Nearly 90% of married couples have at least one child
Two lines. You know…
The Transition to Parenthood
Marital satisfaction is U-Shaped (happiest before children and
happiest when they leave)
Marital satisfaction is at it’s lowest when children are young
The arrival of a child alters every aspect of family life
Changes in day-to-day life
Dramatic shift in the roles spouses play
Financial strain
Study in 2001 indicated that the average middle class family
with 2 children spends 233,000 on each child by the time they
are 18
Choosing a Career
Another critical aspect of early adulthood is choosing a career

17. path
Ginzberg’s Career Choice Theory – suggests that people move
through a series of stages in choosing a career
Fantasy period – Until age 11 – Career choices are made
without regard to skills, abilities, or job availability. Focus on
what sounds appealing
Tentative period – Through adolescence – Begin thinking about
the requirements of certain jobs as well as tying in their own
abilities and interests
Realistic period – Early Adulthood – Adults explore specific
career options either through actual experience or training
Human development
Unit III
Late Adulthood (early 60’s-death)
Unit III
Unit III (Young Adulthood-Late Adulthood)
Young Adulthood (Early 20’s-Early 40’s)
Middle Adulthood (Early 40’s-Early 60’s)
Late Adulthood (Early 60’s-Death)
Late adulthood
Physical, Cognitive, Socioemotional

18. Early 60’s through >>>
My Grandma’s 90th Birthday!
Physical and Cognitive Development in Late Adulthood
Outward signs of aging
Thinning/ graying hair
Face/ skin wrinkling
People become noticeably shorter
Internal aging
Brain becomes smaller and lighter
Blood flow is reduced within the brain
Hardening and shrinking of blood vessels throughout the body
Respiratory system is less efficient
Digestive system less efficient
My Grandma’s 95th
A Theory of Aging: Cellular Clock Theory
Leonard Hayflick (1977)

19. On average, the human cell can only divide about 50 times –
this is a finite amount. At this point, it becomes inactive. It just
stops.
But how does it know? What is the 'timer' inside of it?
Every time it divides, the cell loses a part of its
telomeres (think of the tips of your shoelaces – these are the
ends of your chromosomes) - the telomeres keep the
chromosome together and from sticking to other chromosomes
Telomeres getting shorter is like your molecular clock
FUN FACT:
People can get tested to measure how long their telomeres are!
Keep in mind, this "length of life" is barring any accidental or
physiological death that may be caused by other factors. It's the
natural state of death.
First of all... When we think of aging for someone YOUNGER,
we think of them growing stronger, healthier, bigger, taller – as
a positive part of development. For a while, it makes us
BETTER. But at some point, it becomes a point of decline.
Why?
Contributed by: Rachel Bartels
TELOMERASE
Is associated with lengthening telomeres – this is what we have
with CANCER
Cancer cells divide indefinitely! They won't stop, they won't die
– in a way, cancer is the immortal cell within us
So, maybe we have telomeres that shorten for a very good
reason – otherwise they could become cancerous...
Contributed by: Rachel Bartels

20. Psychological and Mental Disorders
15-25% of individuals over the age of 65 show symptoms of
psychological disorder
Major depression – feelings of intense sadness, pessimism and
hopelessness
Partly due to cumulative loss (death of partner and friends)
Declining health and physical capabilities
Loss of independence and control
Drug-induced psychological disorders
Drug intoxication
Anxiety
Dementia
Broad category of serious memory loss and decline in mental
functioning
Lessened intellectual functioning
The most common mental disorder in late adulthood
Chances of experiencing dementia increases with age
Alzheimer’s Disease
A progressive brain disorder that produces memory loss and
confusion
Symptoms of Alzheimer’s appear gradually
Unusual forgetfulness
Trouble recalling certain words during conversation
Recent memory deteriorates first, then older memories
Eventual total confusion – inability to speak intelligently or
recognize family and friends
Loss of muscle control and bed confinement (near the end of
life)
Memory: Remembrance of Things Past – and Present

21. Episodic memory
Specific life experiences
Most memory losses
Semantic memory
General knowledge and facts
Typically unaffected by age
Short-term memory
Declines gradually until age 70 (more pronounced)
Information presented quickly and verbally is forgotten sooner
Newer information is more difficult to recall
10
Living in Nursing Homes
Greater the extent of nursing home care = greater adjustment
required of residents
Loss of independence brought about by institutional life may
lead to difficulties
Elderly people are as susceptible to society’s stereotypes about
nursing homes
The Cost of Staying Well
Elderly face rising health costs
Average older person spends 20 percent of his or her income on
health care costs
Nursing homes can cost $30,000 to $40,000 a year

22. 12
Elder Abuse
Physical or psychological mistreatment or neglect of elderly
individuals
May affect as many as 2 million people above the age of 60
each year
Is most frequently committed by family member
Life Expectancy at Birth for Different Countries:
2010CountryAgeCountryAgeAndorra83.5Brazil62.9San
Marino81.1Cambodia56.5Japan80.7South
Africa51.1Sweden79.6Haiti49.2Italy79.0Somalia46.2United
States77.1Afghanistan45.9China71.4Uganda42.9Vietnam69.3Bo
tswana39.3Iraq69.3Angola38.3Egypt63.3Malawi37.6India62.5Z
ambia37.2
14
Gerontology and the Study of Aging
Gerontologists study aging and its effects
Intellectual Abilities:
Fluid Abilities: Abilities requiring speed or rapid learning;

23. based on perceptual and motor abilities; may decrease with age
Crystallized Abilities: Learned (accumulated) knowledge and
skills; vocabulary and basic facts
Disengagement Theory: Assumes that it is normal and desirable
for people to withdraw from society as they age
Activity Theory: People who remain active physically,
mentally, and socially will adjust better to aging
Ageism: Discrimination or prejudice based on age
Coping with Aging
Bernice Neugarten studied the different ways people cope with
aging:
Disintegrated and disorganized personalities are unable to
accept aging, experience despair as they get older, often end up
in nursing homes or hospitalized
Passive-dependent personalities lead lives filled with fear of
falling ill, fear of the future, fear of their own inability to cope
Defended personalities seek to ward off aging and attempt to act
young, exercising vigorously, and engaging in youthful
activities that could lead to unrealistic expectations and
disappointment
Integrated personalities cope comfortably with aging and accept
becoming older with a sense of dignity
My Mom, age 69
Fig. 4.6 Longer life expectancy will produce an unprecedented
increase in the percentage of the population over age 65. The
“boom” is expected to start at the turn of the century and peak
by about 2030 to 2050 (Taebuer, 1993).

24. Four Psychological Characteristics of Healthy, Happy Older
People (Vailant, 2002)
Optimism, hope, and interest in the future
Gratitude and forgiveness; an ability to focus on what is good in
life
Empathy; an ability to share the feelings of others and see the
world through their eyes
Connection with others; an ability to reach out, to give and
receive social support
Fig 4.4 Negative emotions are more common before age 50 than
after. The frequency of positive feelings tends to increase from
midlife on into old age.
Confronting Death
Dr Elisabeth Kübler-Ross pioneered methods in the support and
counseling of personal trauma, grief and grieving, associated
with death and dying.
She also dramatically improved the understanding and practices
in relation to bereavement and hospice care.
The study of death and dying is actually known as thanatology
(from the Greek word 'thanatos' meaning death).
Kübler-Ross's five stages of grief model was developed initially
as a model for helping dying patients to cope with death and
bereavement, however the concept also provides insight and
guidance for coming to terms with personal trauma and change,
and for helping others with emotional adjustment and coping

25. Kübler-Ross's five stages of grief
Denial:
Denial is usually only a temporary defense for the individual.
This feeling is generally replaced with heightened awareness of
situations and individuals that will be left behind after death.
Anger:
Once in the second stage, the individual recognizes that denial
cannot continue. Because of anger, the person is very difficult
to care for due to misplaced feelings of rage and envy. Any
individual that symbolizes life or energy is subject to projected
resentment and jealousy
Bargaining:
The third stage involves the hope that the individual can
somehow postpone or delay death. Usually, the negotiation for
an extended life is made with a higher power in exchange for a
reformed lifestyle.
Depression:
During the fourth stage, the dying person begins to understand
the certainty of death. Because of this, the individual may
become silent, refuse visitors and spend much of the time crying
and grieving. This process allows the dying person to
disconnect themselves from things of love and affection. It is
not recommended to attempt to cheer an individual up that is in
this stage. It is an important time for grieving that must be
processed
Acceptance:
This final stage comes with peace and understanding of the
death that is approaching. Generally, the person in the fifth
stage will want to be left alone. Additionally, feelings and
physical pain may be non-existent. This stage has also been
described as the end of the dying struggle
Five Basic Reactions to Death (Kubler-Ross)
Denial and Isolation: Denying death’s reality and isolating

26. oneself from information confirming that death will occur. “It’s
a mistake; the doctors are wrong.”
Anger: Asking “why me?” Anger may then be projected onto
the living
Bargaining: Terminally ill will bargain with God or with
themselves. “If I can live longer I’ll be a better person.”
Depression: Feelings of futility, exhaustion and deep sadness
Acceptance: If death is not sudden, many will accept death
calmly. Person is at peace finally with the concept of death
It has been argued that not all go through these stages in a
staged pattern.
Bereavement and Grief
Bereavement: Period of adjustment that follows death of loved
one
Grief: Intense sorrow and distress following death of loved one
Shock: Emotional numbness experienced after death of loved
one
Pangs of Grief: Intense and anguished yearning for one who has
died
Resolution: Acceptance of loss and need to build a new life
Happiness
Subjective Well-Being: Feelings of well-being occur when
people are satisfied with their lives, have frequent positive
emotions, and have relatively few negative emotions
Happier people tend to be
Married
Comfortable with their work

27. Extraverted
Religious
Generally optimistic and satisfied with their lives
Attitudes Toward Death
Hospice: Medical facility or program that provides supportive
care for terminally ill; goal is to improve person’s final days
Living Will: Written statement that a person does not wish to
have his/her life artificially prolonged if terminally ill; a “Do
Not Resuscitate” order to doctors
I encourage all students to have a living will in place--notarized
Euthanasia
Passive: Death allowed to occur but not actively caused
Active: Steps taken, at patient’s request, to deliberately speed
death; usually by injecting drugs that painlessly cause death
Physician-assisted dying: Doctor provides lethal dose of drug
that patients take to end life
And a Warm thanks!
With smiles, Elizabeth

28. Human development
Unit III
Young Adulthood (Early 20’s-Early 40’s) Middle Adulthood
(early 40’s-early 60’s) & Late Adulthood (early 60’s-death)
Unit III
Unit III (Young Adulthood-Late Adulthood)
Young Adulthood (Early 20’s-Early 40’s)
Middle Adulthood (Early 40’s-Early 60’s)
Late Adulthood (Early 60’s-Death)
Middle adulthood
Physical, Cognitive & Socioemotional
Middle Adult Years (Early 40’s-Early 60’s)
Changing Midlife
Boundaries of middle age are being pushed upward
More people lead healthier lifestyles; medical discoveries are
holding off the aging process
Middle age is starting later and lasting longer
Midlife serves as an important preparation for late adulthood
An increasing percentage of the population is made up of
middle-aged and older adults
“Rectangularization” of the age distribution

29. Generativity vs. Stagnation
Erikson’s Generativity vs. Stagnation (40-65):
Generativity: adults’ desire to leave legacies of themselves to
the next generation
Stagnation: develops when individuals sense that they have
done nothing for the next generation
Research supports Erikson’s theory
Generativity: adults’ desire to leave legacies of themselves to
the next generation
Biological generativity
Parental generativity
Work generativity
Cultural generativity
For many, middle age is a time for:
Declining physical skills and increasing responsibility
An awareness of the young-old polarity
Transmitting something meaningful to the next generation
Reaching and maintaining career satisfaction
A reassessment of life’s priorities
6
Physical Changes
Physical Changes:
Usually gradual; aging rates vary
Wrinkling and sagging of skin, age spots, thinning gray hair,
thicker brittle nails, yellowing of teeth
Height tends to shrink in middle age, due to bone loss in the
vertebrae
Many gain weight, which is a critical health problem in middle

30. adulthood
Sarcopenia: age-related loss of muscle mass and strength,
specially common in the back and legs -- exercise can reduce
these declines
Cushions for bone movement become less efficient, often
leading to joint stiffness and difficulty in movement
Progressive bone loss
7
Physical Changes
Ability to focus and maintain an image declines between 40–59
years
Difficulty viewing close objects
Reduced blood supply decreases visual field
Hearing can start to decline by age 40
Hearing loss occurs in up to 50% of individuals over the age of
50
High-pitched sounds are typically lost first
Physical Changes
Blood pressure typically rises in the 40’s and 50’s
At menopause, a woman’s blood pressure
rises sharply, remaining higher than that
of men into the later years
Metabolic Syndrome: a condition characterized by hypertension,
obesity, and insulin resistance
Exercise, weight control, and a diet rich in fruits, vegetables,
and whole grains can help to reduce many cardiovascular

31. problems
Lung tissue becomes less elastic at about age 55
Decreases lung’s capacity
Nonsmokers have much better lung capacity
Wakeful periods become more frequent in the 40’s
Less deep sleep (stage 4)
Feeling less rested in the morning
9
Health and Disease
Frequency of accidents declines
Individuals are less susceptible to colds and allergies
Stress is a key factor in disease, especially
if cumulative
Immune system functioning decreases with normal aging
Chronic emotional stress is associated with high blood pressure,
heart disease, and early death
Culture plays an important role in coronary disease
Ni-Hon-San Study
Chronic Disorders: characterized by a slow onset and a long
duration
Rare in early adulthood but increase in middle age
Men have higher rates of fatal chronic conditions, while women
have higher rates of nonfatal chronic conditions
10
Mortality Rates
Chronic diseases are the main cause of death during middle
adulthood

32. Heart disease
Cancer
Cerebrovascular disease
In the 1st half of middle age, cancer claims more lives than
heart disease; trend is reversed during the 2nd half of middle
age
Men have higher mortality rates than women
Sexuality
Climacteric: the midlife transition in which fertility declines
Menopause: time in middle age (late 40’s to early 50’s) when a
woman’s menstrual periods completely cease
Perimenopause: transitional period; often takes up to 10 years
Heredity and experience influence the onset of menopause
Hormone Replacement Therapy (HRT) is controversial because
it has been linked to increased risk of stroke, dementia, and
cancer
Cross-cultural studies show that the menopausal experience
varies among women, but it is not generally as negative as it
was once thought to be
12
Sexuality
Hormonal Changes in Men:
Most men do not lose the ability to father children
Modest decline in sexual hormone level and activity

33. Erectile Dysfunction is common in middle-aged men
May stem from physiological problems
Sexual Attitudes and Behavior:
Sexual activity occurs less frequently in middle adulthood
Middle-aged men are more interested in sex than middle-aged
women
Living with a spouse or partner makes all the difference in
terms of engaging in sexual activity
Cognitive Development
Crystallized Intelligence: an individual’s accumulated
information and verbal skills
Continues to increase throughout life
Fluid Intelligence: the ability to reason abstractly
May begin to decline in middle adulthood
Some cognitive functions peak during middle adulthood, while
others decline
Depends on how studies are conducted
Cross-sectional studies show more decline than longitudinal
studies
Starting in late middle age, more time is needed to learn new
information
The Seattle Longitudinal Study: study of intellectual abilities in
adulthood years
Peak performance on vocabulary, verbal memory, inductive
reasoning, and spatial orientation was attained in middle age

34. Decline in numerical ability and perceptual speed
Declines in memory, word fluency, and perceptual speed in
middle adulthood were linked to neuropsychologists’ ratings of
individuals’ cognitive impairment in late adulthood
Extensive individual differences
Speed of information processing declines moderately during
middle adulthood
Multiple potential causes
Memory declines may occur exclusively during the later part of
middle age or in late adulthood
Memory decline is more likely to occur when individuals do not
use effective memory strategies
14
Religion and Adult Lives
More than 70% of middle-aged adults are religious and consider
spirituality a major part of their lives
Role of individual differences
Increase in spirituality tends to occur between late middle
adulthood and late adulthood
Women have consistently shown a stronger interest in religion
than males
Religious commitment helps to moderate blood pressure and
hypertension and is associated with increased longevity
Religion and Adult Lives
Baumeister has argued that the quest for the meaning of life
may be understood in terms of four main needs:
Need for purpose
Need for values
Need for a sense of efficacy

35. Need for self-worth
Frankl (1984) emphasized each person’s uniqueness and the
finiteness of life
Frankl identified the three most distinct human qualities as:
Spirituality
Freedom
Responsibility
In middle adulthood, the reality of approaching death often
forces people to examine the meaning of their life
16
Stages of Adulthood
How pervasive are midlife crises?
Vaillant’s “Grant Study”:
The 40’s are a decade of reassessing and recording the truth
about the adolescent and adult years
Only a minority of adults experience a midlife crisis
Reports of general well-being and life satisfaction tend to be
high during mid-life
Another study found that 26% of adults experienced a midlife
crisis
Most attributed this to negative life events rather than aging
Adult developmental experts generally agree that midlife crises
have been exaggerated
Adults often experience a peak of personal control and power
during middle age
Adults’ ability to master their environment, autonomy, and
personal relations improve during middle age
Adult developmental experts generally agree that midlife crises

36. have been exaggerated
In general, stage theories place too much emphasis on crises in
development
There is often considerable individual variation in the way
people experience the stages
Individual Variations:
Stage theories do not adequately address individual variations
in adult development
Some individuals may experience a midlife crisis in some
contexts of their lives but not others
In 1/3 of cases where individuals report experiencing a midlife
crisis, the crisis was triggered by life events such as job loss,
financial problems, or illness
17
Is Our Personality Stable?
The Baltimore Study used the big five factors of personality to
study 1,000 college-educated persons aged 20 to 96 starting
from the 1950s and continuing today:
Considerable stability in the five personality factors
Agreeableness and conscientiousness increased in early and
middle adulthood
Neuroticism decreased in early adulthood
Openness to experience increased in adolescence/early
adulthood and then decreased in late adulthood
What about Love and Marriage?
Romantic love is typically strong in early adulthood
Affectionate love increases during middle adulthood
Most married individuals are satisfied with their marriages
during midlife
Divorce in midlife can be less intense due to increased

37. resources and lessened child-rearing responsibilities
However, emotional and time commitment to a long-lasting
marriage is typically not given up easily
Staying married because of the children is a common reason for
waiting to get a divorce
The Empty Nest
Empty Nest Syndrome: a decline in marital satisfaction after the
children leave the home
For most parents, marital satisfaction actually increases during
the years after child rearing
Refilling of empty nest is becoming a common occurrence
Adult children are returning to live at home for financial
reasons
Loss of privacy is a common complaint for both parents and
adult children
Grand parenting
Many adults become grandparents during middle age
Grandmothers have more contact with grandchildren than
grandfathers
Three prominent meanings:
Source of biological reward and continuity
Source of emotional self-fulfillment
Remote role
The grandparent role and its functions vary among families,
ethnic groups, and cultures
Grandparenting

38. Three Grandparenting Styles:
Fun-seeking style
Distant-figure style
Formal style
An increasing number of U.S. grandchildren live with their
grandparents
2.3 million in 1980; 6.1 million in 2005
Most common reasons are divorce, adolescent pregnancies, and
parental drug use
Tends to be more stressful for younger grandparents, when
grandchildren have physical and psychological problems, and
when there is low family cohesion
Grandparents who take in grandchildren are in better health, are
better educated, are more likely to be working outside the home,
and are younger than grandparents who move in with their
children
Concern over grandparent visitation of children has become
more common
22
Intergenerational Relationships
Differences in gender:
Mothers and daughters have closer relationships during their
adult years than mothers and sons, fathers and daughters, and
fathers and sons
Married men are more involved with their wives’ families than
with their own
Maternal aunts and grandmothers are cited as the most
important or loved relative twice as often as their paternal
counterparts

39. Middle-aged and older adults typically express a strong feeling
of responsibility between generations in their family
They share their experiences and transmit values to the younger
generation
Family members typically maintain considerable contact across
generations
When conflicts arise, parents most often cite habits and lifestyle
choices, while adult children cite communication and
interaction styles
23
STABILITY AND CHANGE
Vaillant’s Studies: conducted three longitudinal studies from
the 1920s through today:
Alcohol abuse and smoking at age 50 was the best predictor of
death between ages 75 and 80
Factors at age 50 which are best predictors of
“happy-well” between ages 75 and 80:
Regular exercise and avoiding being overweight
Well-educated and future oriented
Having a stable marriage and good coping skills
Being thankful, forgiving, and empathetic
Being active with other people
Middle Age Issues: Mid-Life Crises?
Menopause: Menstruation ends and a woman is no longer able
to bear children. Estrogen levels also drop, sometimes causing
mood or appearance changes.
Hot flashes: Sudden uncomfortable sensation of heat; symptom
of menopause in some women
Climacteric: When men experience a significant change in vigor
or appearance; may be psychological in origin

40. Andropause: Reduced testosterone levels; can lead to decreased
sex drive, fatigue, and obesity
Empty Nest Syndrome: A woman may become depressed after
her last child leaves home