Nursing Educational Strategist for Older Adults
Development of Physical, Cognitive, and Psycho Social Aspects In Older Adults
During this stage of maturation, physiological changes begin to take place. Skin and muscle tone decreases, metabolism slows down, body weight tends to increase, endurance and energy levels decrease, hormonal changes bring about a variety of symptoms, and hearing and visual acuity begin to diminish. All these physical changes and others affect middle-aged adults' self-image, ability to learn, and motivation for learning about health promotion, disease prevention, and maintenance of health (Crandell et al., 2012).
The ability to learn from a cognitive stand-point remains at a steady state for middle aged adults as they continue in what Piaget (1951, 1952, 1976) labeled the formal operations stage of cognitive development. I have maintained that cognitive development stopped with this fourth stage (meaning the ability to perform abstract thinking). However, over the years the critics of Piaget's theory have begun to assert the existence of postformal operations.
That is, adult thought processes go beyond logical problem solving to include what is known as dialectical thinking. This type of thinking is defined as the ability to search for complex and changing understandings to find a variety of solutions to any given situation or problem. In other words, middle-aged adults see the bigger picture (Crandell et al., 2012).
For many adults, the accumulation of life experiences and their proven record of accomplishments often allow them to come to the teaching learning situation with confidence in their abilities as learners. However, if their past experiences with learning were minimal or not positive, their motivation likely will not be at a high enough level to easily facilitate learning. Physical changes, especially with respect to hearing and vision, may impede learning as well (Santrock, 2017).
Erikson (1963) labels this psychosocial stage of adulthood as generativity versus self-absorption and stagnation. Midlife marks a point at which adults realize that half of their potential life has been spent. This realization may cause them to question their level of achievement and success. Middle-aged adults, in fact, may choose to modify aspects of their lives that they perceive as unsatisfactory or adopt a new lifestyle as a solution to dissatisfaction.
Developing concern for the lives of their grown children, recognizing the physical changes in themselves, dealing with the new role of being a grandparent, and taking responsibility for their own parents whose health may be failing are all factors that may cause adults in this cohort to become aware of their own mortality. During this time, middle-aged adults may either feel greater motivation to follow health recommendations more closely or just the opposite may deny illnesses or abandon healthy practices altogether (Falvo, 2011).
The later years of middle adulthood are the phase in which productivity and contributions to society are valued. They offer an opportunity to feel a real sense of fulfillment from having cared for others-children, spouse, friends, parents, and colleagues for whom adults have served as mentors. During this time, individuals often become oriented away from self and family and toward the larger community.
New social interests and leisure activities are pursued as they find more free time from family responsibilities and career demands. As they move toward their retirement years, individuals begin to plan for what they want to do after completing their career. This transition sparks their interest in learning about financial planning, alternative lifestyles, and ways to remain healthy as they approach the later years (Crandell et al., 2012).
Teaching Strategies for Older Adults In Nursing Education For Older Adults
Depending on individual situations, middle-aged adults may be facing either a more relaxed lifestyle or an increase in stress level because of midlife crisis issues such as menopause, obvious physical changes in their bodies, responsibility for their own parents' declining health status, or concern about how finite their life really is. They may have regrets and feel they did not achieve the goals or live up to the values they had set for themselves in young adulthood or the expectations others had of them as young adults.
Santrock (2017) cites research indicating that this stage in life is not so much seen as a crisis but rather as a period of midlife consciousness.When teaching members of this age group, the nurse must be aware of their potential sources of stress, the health risk factors associated with this stage of life, and the concerns typical of mid life. Misconceptions regarding physical changes such as menopause are common. Stress may interfere with middle aged adults' ability to learn or may be a motivational force for learning (Merriam & Bierema, 2014).
Those who have lived healthy and productive lives are often motivated to contact health professionals to ensure maintenance of their healthy status. Such contacts represent an opportune time for the nurse educator to reach out to assist these middle aged adults in coping with stress and maintaining optimal health status. Many needs and want information related to chronic illnesses that can arise at this phase of life (Orshan , 2008).
Adult learners need to be reassured or complemented on their learning competencies. Reinforcement for learning is internalized and serves to reward them for their efforts. Teaching strategies for learning are similar in type to teaching methods and instrumental tools used for the young adult learner, but the content is different to match the concerns and problems specific to this group of learners.
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