Lifespan Growth & Development
Developed by
Dede Carr, BS, LDA
Karen Neu, MSN, CNE, CNP
1
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the prior authorization of the copyright owner.”
2
Awareness & Sensitivity to
Clients’ Health Care Needs
Competency:
 Describe the major stages of human
development & basic health needs of humans
 1. Describe five common characteristics of growth
and development.
 2.Describe human needs theory regarding human
actualization
3
 “There's only one corner of the universe you can be certain of
improving, and that's your own self.” Aldous Huxley
 “The great thing in the world is not so much where we stand as
in what direction we are moving.” Oliver Wendell Holmes
 “The growth and development of people is the highest calling
of leadership.” Harvey S. Firestone
 “You’ve got to do your own growing, no matter how tall your
grandfather was.” Irish Saying
 “If you wish to achieve worthwhile things in your personal and
career life, you must become a worthwhile person in your own
self-development.” Brian Tracy
4
Growth
Growth: Physical change & increase in size
 Indicators of Growth
 Height, Weight, Bone Size, & Dentition, Sensory
Adaptation, & Development of sexual organs &
characteristics
 Although physical growth is similar for all people,
growth rates vary during different stages of growth &
development
 Growth is rapid during prenatal, neonatal, infancy, &
adolescence, but slows during childhood & is minimal
during adulthood
(Ramont & Niedringhaus)
5
Development
Development: An increase in complex functions &
progression of skills
 Development refers to a person’s capacity & skill to
adapt to the environment
 Development is the behavioral aspect of growth &
includes abilities to walk, talk, & run, speak, etc.
(Ramont & Niedringhaus)
6
Principles of
Growth &
Development
7
Principles of Growth & Development
 Growth & development take place in an organized
way, but do not progress at same rate with all
individuals
 Cephalocaudally: Growth & development
progresses from the head (cephalo) to tail (caudal);
for example an infant gains head control before
control of extremities
 Proximal to Distal: Growth & development
progress from the center of the body outward-body’s
midline to extremities (infant rolls before grasp is
perfected)
 (Ramont & Niedringhaus)
8
Principles of Growth & Development
 General to Specific: Walking is learned before
running or skipping
 Growth & development are independent,
interrelated processes: Muscles, bones, & nervous
system must grow to certain point before one can
walk (Ramont & Niedringhaus)
9
Growth & Development Principles
Growth & Development
 Continuous, orderly, & sequential processes
influenced by maturity (age), the environment, &
genetic factors
 Each stage is predictable, although the time of onset,
length of stage, & effects of each stage varies with
persons
 Each developmental stage has its own characteristics
 Development proceeds from simple to complex or
from single acts to integrated acts
(Ramont & Niedringhaus)
10
Growth & Development Principles
 Development becomes increasingly differentiated
(advance from general response to skilled specific
response)
 Example: An infant’s response to a stimulus involves
the whole body while a five year old might respond
with laughter
 (Ramont & Niedringhaus)
11
Growth & Development Principles
 Certain stages are more critical than others (1st 10-12
weeks after conception most critical—risks for defects
from exposure to viruses, chemicals, & drugs)
 Uneven pace of growth & development (ex. Rapid
spurts of growth during prenatal, neonatal, infancy, &
adolescence periods) (Ramont & Niedringhaus)
12
Sequence of Development--Order for Infants
 6 Months
 2 Months
 Able to lift head up on
his own
 3 Months
 Can roll over
 4 Months
 Can sit propped up
without falling over
 Able to sit up without
support
 7 Months
 Begins to stand while
holding onto things for
support
 9 Months
 Can begin to walk, still
using support
(All Psych & Heffner Media
Group, Inc., )
13
Sequence of Development--Order for Infants
 10 Months
 Able to momentarily
 14 Months
 Walk backward without
support
stand on her own
without support
 17 Months
 11 Months
 Walk up steps with
little /no support
 Stand alone with more
confidence
 18 Months
 12 Months
 Manipulate objects
with feet while walking,
 Begin walking alone
such as kicking a ball
without support
14
Factors that Influence
Growth & Development
Genetic inheritance—remains unchanged
throughout life & determines characteristics: sex,
physical stature, & race
(Ramont & Niedringhaus)
(www.saintbarnabas.com, n.d.)
15
Factors that Influence
Growth & Development
Environmental
 Family
 Religion
 Schools
 Climate
 Culture
 Community
 Nutrition
(Ramont & Niedringhaus)
(www.saintbarnabas.com, n.d.)
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Growth & Development:
Why is it important in health care?
 Knowledge of growth & development is essential
when working in health care occupations because it is
necessary to identify needs & problems (varies with
age & developmental stage) & necessary to decide
what & how to provide the appropriate health
promotion/care needed.
17
Growth & Development:
Why is it important in health care?
 It encompasses the prenatal period throughout the
lifespan (fetus to neonate to old adult including
physiological, psychosocial, cognitive, moral, &
spiritual aspects of each life stage)
 Remember how you care for someone will depend on
their age, size, mental, physical, & emotional
abilities—(growth & development)
(Ramont &
Niedringhaus)
18
Components of
Human Growth &
Development
19
Relationship between
Growth & Development
 Each person’s rate of growth & development is highly
individualized, but sequence (progress) is
predictable
20
Five Major Components of Growth
& Development
 Physiological: Relates to human body
 Psychosocial: Relationship between oneself &
others; emotions (love, hate, fear, anxiety, joy),
attitudes
 Cognitive: An awareness of & interaction between
oneself & environment; development of intelligence,
conscious thought, & problem-solving ability that
begins in infancy
 Moral: Relates to judgments of right & wrong
 Spiritual: Pertains to relationship with a higher
power (God)
(Ramont & Niedringhaus)
21
Life Stages & Developmental Tasks
 As people mature from infancy to old age,
persons pass through several developmental
stages as identified in each of the five
components of growth & development
 Developmental tasks have to be accomplished at
each of the developmental stages in order for the
person to progress.
 There are several developmental tasks that one
should achieve in each of the physiological,
psychosocial, cognitive, moral, & spiritual growth
experiences
(Ramont & Niedringhaus)
22
Physiologic Component
23
Physiological
Component
Pertains to the “body”
Growth:
 Physical change & increase in size; Can be measured
quantitatively
 Indicators of growth includes height, weight, bone
size, & dentition
Growth rates vary during different stages of growth &
development
 Growth rate is rapid during the prenatal, neonatal,
infancy & adolescent stages & slows during
childhood
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 Physical growth is minimal during adulthood
Physiological Component
Development of the Body:
 Increases in the complexity of functions & skills
progression (what a person can do, such as
walking, running, skating, feeding self, etc.)
 Capacity & skill of a person to adapt to the
environment
Development is the behavioral aspect of growth
(Ramont & Niedringhaus)
25
Cognitive Component
26
Cognitive Component
 The cognitive theory cited most often in the
cognitive development in children is Jean Piaget’s
(1896-1980) theory.
(All Psych & Heffner Media Group, Inc., )
27
Cognitive Component
 As with all stage theories, Piaget’s Theory of
Cognitive Development maintains that children go
through specific stages as their intellect & ability to
see relationships matures
 These stages are completed in a fixed order with all
children, even those in other countries
 The age range, however can vary from child to child
(All Psych & Heffner Media Group, Inc., )
28
Piaget’s Theory of
Cognitive Development
Cognitive refers to the process of acquiring knowledge
by the use of reasoning, intuition, or perception;
relating to thought processes (Encarta Dictionary)
(All Psych & Heffner Media Group, Inc., )
29
4 Stages of Piaget’s Theory of
Cognitive Development
 Sensorimotor Stage [0-2 years]
 Preoperational Stage (Divided into 2 Phases)
 Preconceptual [2-4 years]
 Intuitive [4-7 years]
 Concrete Operations Stage [7-11/12 years]
 Formal Operations Stage [11/12 years & upwards]
(All Psych & Heffner Media Group, Inc., )
30
Piaget’s Cognitive Development
31
Cognitive Component of
Growth & Development
See the following slides for explanations and
examples of each of the stages of Piaget’s Theory
of Cognitive Development as depicted on the
diagram.
Think of someone you know for each of the stages
of cognitive development.
32
Cognitive Stage #1:
Sensorimotor Stage
(Birth – 2 years)
During this stage, child learns to manipulate objects although
they fail to understand the permanency of these objects if they
are not within their sight (current sensory perception). In
other words, once an object is removed from the child’s view,
he/she is unable to understand that the object still exists.
Major achievement is Object Permanency (ability to
understand that these objects do in fact continue to exist)
Includes child’s ability to understand that when mom leaves the
room, she will eventually return, resulting in an increased
sense of safety & security
Object Permanency occurs during end of this stage &
represents child’s ability to maintain a mental image of the
object (or person) without the actual perception or seeing the
object (or person)
(All Psych & Heffner Media Group, Inc., ) [Image from www.lobo.sbc.edu]
33
Stage #2: Preoperational Stage
Stage #2--Phase #1: Preconceptual (2-4 years)
 Marked by “Egocentrism” (Child’s belief that everyone sees
the world the same way that he/she does)
 Everything is significant & relates to “me”
 Child explores the environment
 Develops language at a rapid pace
 Associates words with objects
Child fails to understand the differences in perception & believes
that inanimate objects have the same perceptions the child
does, such as seeing things, feeling, hearing & the sense of
touch
(All Psych & Heffner Media Group, Inc., )
34
Stage #2: Preoperational Stage
Stage #2-Phase #2 Intuitive Thought (4-7 years)
 Children learn how to interact with their environment in a




more complex manner through the use of words & images
Egocentric (“me”) thinking diminishes; child thinks of one
idea at a time
Includes others in the environment & learns to play with their
peers, increasing the number of friends as they grow older
Child’s words express thought & they
learn about feelings: cry, sad, laugh
related to the words
Child gradually emerges as social beings
(Berman et al., p. 210)
(www.littlescholarspreschoolfl.com, n.d.)
35
Stage #2: Preoperational Stage
 A second important factor in this stage is that of
conservation (ability to understand that quantity does
not change if the shape changes)
 In other words, if a short & wide glass of milk is poured
into a tall & thin glass, children will perceive the taller
glass as having more milk due only because of it’s height
 Children’s inability to understand reversibility & their
focus on only one aspect of a stimulus is called
centration; (Focus is only on height as opposed
to understanding other aspects as glass width)
(All Psych & Heffner Media Group, Inc., )
(www.clips.tojsiab.com, n.d.)
36
Cognitive Stage #3:
Concrete Operations
Between ages 7-11/12 years
Stage #3 is marked by a gradual decrease in centristic thought &
the increased ability to focus on more than one aspect of a
stimulus or item
Children can understand the concept of grouping, knowing that
a small dog & a large dog are still both dogs, or that pennies,
quarters, & dollar bills are part of the bigger concept of money
They can only apply this new understanding to concrete objects
(those they have actually experienced)
In other words, imagined objects or those they have not seen,
heard, or touched continue to remain somewhat mystical to
these children, & abstract thinking has yet to develop
(All Psych & Heffner Media Group, Inc., )
37
Cognitive Stage #4:
Formal Operations
(12 years & Beyond)
Children begin to develop a more abstract view of the world
They are able to apply reversibility & conservation to both real &
imagined situations;
They develop an increased understanding of the world & the idea
of cause & effect
By teenage years- they are able to develop their own theories
about the world; Stage #4 is achieved by most children,
although failure to do so has been associated with lower
intelligence
Early in the period there is a return to egocentric (focus on “me”)
thought
(All Psych & Heffner Media Group, Inc., )
38
Cognitive Stage #4:
Formal Operations
(12 years & Beyond)
 Moving from concrete to formal thinking, & driven by a




sense of urgency, teens may want it all, right here, right now!
Not unlike the terrible twos, teens are craving to break loose,
to look at the other side of the fence, & to take a walk on “the
wild side”
Teens fight for the emergence of their own will, while seeking
love from trusted ones
Teenagers are on a quest to answer satisfactorily & happily
the question "Who am I?"
They will seek the leadership of chosen others, & gradually
develop a set of ideals, socially congruent & desirable in the
case of successful integration; furthermore, in the process of
growing up they will acquire a sense of self worth & establish
clear sexual identities
(Lego Group)
39
Moral Component
40
Kohlberg’s
Levels of Moral Development
Kohlberg’s (1973) stages of moral development breaks our
development of morality into three levels, each of which
is divided further into two stages:
Pre-conventional Level (up to age nine):
~Self Focused Morality~
Conventional Level (age nine to
adolescence): Other Focused Morality~
Post-conventional Level (adulthood):
~Higher Focused Morality~
(Ramont & Niedringhaus, p. 208)
41
Kohlberg’s
Levels of Moral Development
 Pre-conventional Level (up to 9 years):
 Self-focused morality
 Morality is defined as obeying rules & avoiding negative
consequences
 Children in this stage see rules set, typically by parents, as
defining moral law
 That which satisfies the child’s needs is seen as good &
moral—most actions taken by the child are to satisfy the
child’s own needs
 They believe that activity is wrong if one is punished & activity
is right if one I not punished
(Ramont & Niedringhaus, p. 208)
42
Kohlberg’s
Levels of Moral Development
Conventional Level (9 years to adolescence):
 Other -focused morality (think of others rather than self)
 Children begin to understand what is expected of them by
their parents, teacher, etc.
 Morality is seen as meeting or achieving these expectations
 Fulfilling obligations as well as following expectations are
seen as moral law for children in this stage
 Action is taken to please another & gain approval
 Right behavior is obeying the law & following the rules
(Ramont & Niedringhaus, p. 208)
43
Kohlberg’s
Levels of Moral Development
Post-conventional Level (adulthood):
 Higher-focused morality
 Adults begin to understand that people have different
opinions about morality & that rules & laws vary from
group to group & culture to culture
 Morality is seen as upholding values of one’s group or
culture
 Understanding one’s own personal beliefs allows adults to
judge themselves & others based upon higher levels of
morality
 What is right & wrong is based upon the circumstances
surrounding an action
(Ramont & Niedringhaus, p. 208)
44
Kohlberg’s
Stages of Moral Development
Post-conventional Level (adulthood):
 Basics of morality are the foundation with independent
thought playing an important role
 Standards of behaviors are based on adhering to laws
that protect the welfare & rights of others
 Personal values & opinions are recognized, & violating
the rights of others is avoided
 Universal moral principles are internalized
 The person in this stage respects other humans &
believes that relationships are based on mutual trust
(Ramont & Niedringhaus, p. 208)
45
Psychosocial Component
46
Psychosocial Component
Development of Personality
 Psychosocial development refers to the development of
personality, a complex concept—difficult to define
 Consider as outward (interpersonal) expression of inner
(intrapersonal) self
 Encompasses a person’s temperament, feelings, selfesteem, character traits, independence, self-concept,
behavior, ability to interact with others, & ability to adapt
to life changes
(Berman et al., p. 350)
The following slides show the stages, age range, &
Erikson’s Psychosocial Stages (central tasks)
47
Psychosocial Component
of Growth & Development
 Psychosocial aspects of each life stage are based on
Erikson’s Stages of Psychosocial Development
 Erikson studied human responses to life’s events to gain an
understanding of how attitudes & behaviors change
throughout the lifespan
 In each stage, Erikson believed people experience a conflict
that serves as a turning point in development
(Berman et al., p. 350)
48
Erikson’s Psychosocial
Developmental Stages
 Conflicts centered on either developing a psychological
quality or failing to develop that quality
 During these times of conflict, the potential for personal
growth is high, but so is the potential for failure to accomplish
the devel0pmental tasks
 Once the conflicts are successfully resolved the individual
advances to the next stage of development
(Berman et al., p. 350)
49
Erikson’s Psychosocial
Stages of Development
Stage
Age
Erikson Stage
Prenatal
Conception - Birth
Infancy
Birth – 1 year
Trust vs. Mistrust
Toddler
1 – 3 years
Autonomy vs.
Shame/Doubt
Preschooler
3 – 6 years
Initiative vs. Guilt
50
Erikson’s Psychosocial
Stages of Development
Stage
Age
Erikson Stage
School-Age Child
6 – 12 years
Industry vs.
Inferiority
Adolescence
12 – 20 years
Identity vs. Role
Confusion
Young Adulthood
20s and 30s
Intimacy vs.
Isolation
Middle Adulthood
40s and 50s
Generativity vs.
Stagnation
Later Adulthood
60s to death
Ego Integrity vs.
Despair
51
Video Explanation of
Developmental Stages
See the following U-Tube Videos showing Erikson’s
Psychosocial Stages of Development
The first video presents all eight stages
 Erikson's Psychosocial Stages
This video presents only the first four stages, but
explains them well.
 Erikson's Psychosocial Stages of DevelopmentFirst Four
(www.parents.lego.com, n. d.)
52
Infancy: Trust versus Mistrust
 Infant is totally dependent for cares: feeding,
diapering, bathing, comforting, etc.
 Development of trust based on the dependability &
quality of caregivers
 If a child successfully develops trust, child will feel safe
& secure in the world
 Caregivers who are inconsistent, emotionally
unavailable, or rejecting contribute to feelings of
mistrust in the children they care for.
 Failure to develop trust will result in fear & a
belief that the world is inconsistent &
unpredictable (Berman et al., p. 350)
53
Developmental Tasks of Infancy
 Establishes a trusting, meaningful relationship; recognizes the






primary caregiver, develops attachment behavior
Learns to recognize objects, develops exploration skills & can
predict responses to environment
Develops communication skills by beginning vocalization,
develops nonverbal communication system, & imitates simple
vocalization (cooing sounds)
Develops muscular control, eye-hand coordination, & object
manipulation
Develops mobility: crawling, creeping, cruising, & walking
Establishes patterns of living: eating, sleeping, & elimination
habits
Begins to develop independent living skills, including selffeeding, walking, undressing, & communication of needs
(Polan, p. 163)
54
Toddler/Early Childhood
Autonomy versus Shame & Doubt
 Ages: 18 months- 3 years
 Begin to assert their independence, by walking away
from mother, picking toy to play with, & making food
choices, clothing to wear,
 Focus on developing a greater sense of personal control
 Learning to control one’s body functions leads to a feeling of
control & a sense of independence
(Toilet training)
(Ramont & Niedringhaus, pp. 206-209)
55
Toddler/Early Childhood
Autonomy versus Shame & Doubt
 If encouraged-become successful: feel secure &
confident
 If criticized, overly controlled, or not given
opportunities to assert: will develop a sense of
inadequacy, self-doubt & shame, lack of self-esteem,
overly dependent on others (doubt abilities)
(Ramont & Niedringhaus, pp. 206-209)
56
Developmental Tasks of Toddlers
 Recognizes self as a separate person; tolerates separation





from primary caregiver, expresses own ideas & needs
Develops increased attention span
Begins to develop communication skills
Masters toilet-training basics
Achieves independent mobility
Develops independent skills of daily living, feeding,
dressing, toileting, managing simple tasks
(Polan, p. 166)
57
Late Childhood: Initiative vs. Guilt
 Preschool years: 3-5 years
 Begin to assert their power & control over the world
through directing play, planning activities, making up
games, initiating activities with others, & other social
interaction
 If successful, children develop a sense of initiative; feel
secure in their ability to lead others & make decisions.
 Those who fail are left with a sense of guilt, self-doubt
and lack of initiative
(Ramont & Niedringhaus, pp. 209-210)
58
Developmental Tasks of
Preschoolers
 Develops stronger sense of self; can express own needs, ideas,







& feelings, can postpone immediate gratification
Attains greater attention span; listens more attentively
Develops & refines gross motor skills & fine motor skills
Recognizes sex identification
Begins to work & play more cooperatively with others
Improves communication skills
Develops self-control skills, learns socially acceptable ways of
expressing anger, frustration, & disappointment; obeys simple
rules; develops self-awareness & sense of self-protection
Seeks information, asks questions, learns values & beliefs of
family
(Polan, p. 169)
59
School Age
Industry versus Inferiority
 School age: 6-12 years
 Through social interactions, children begin to develop a
sense of pride in their accomplishments & abilities
 In encouraged, reinforced for initiatives, & commended
by parents & teachers, children will begin to feel
industrious, develop a feeling of competence & belief
ability to achieve goals & in their skills
 If children receive little or no
encouragement from parents, teachers, or peers they
will feel inferior & doubt their ability to be successful
(Ramont & Niedringhaus, pp. 210-211)
60
Developmental Tasks of School-Age
 Develops a sense of belonging with family, peers
 Develops work habits; learns to organize, set & reach
goals, evaluate work, accept criticism
 Learns competence in reading, writing, calculation,
grammar, & communication
 Refines fine & gross motor coordination
(Polan, p. 171)
61
Adolescence: Identity vs. Confusion
 Adolescence: 12/13 to 20 years
 Exploring their independence, developing a sense of self,
& beginning to look at the future in terms of career,
relationships, families, housing, etc.
 In forming their identity, students will begin to think
about who they are, where they are going & how they fit
in; may try new hairstyles, experiment with new clothing
styles, & form a group of people with whom they hang out
(Ramont & Niedringhaus, pp. 211-213)
62
Adolescence: Identity vs. Confusion
 If they receive proper encouragement & reinforcement
through personal exploration will emerge with a
strong sense of self & a feeling of independence &
control
 Those who remain unsure of their beliefs & desires
will become insecure & confused about themselves &
the future
(Ramont & Niedringhaus, pp. 211-213)
63
Developmental Tasks of Adolescents
 Recognizes individuality
 Accepts strengths & weaknesses
 Develops own value system
 Assumes responsibility for one’s behaviors
 Develops philosophy of life
 Adapts to somatic (body) changes
 Acquires skills necessary for adult living
 Refines social skills
 Develops independent living skills
(Polan, p. 174)
64
Young Adult: Intimacy vs. Isolation
 Early Adulthood: 18-25 years
 Exploring personal relationships: it’s vital that people
develop close, committed relationships with other
people
 If successful, adult will develop secure relationships
with a sense of commitment, safety, & care within the
relationship
(Ramont & Niedringhaus, p. 214)
65
Young Adult: Intimacy vs. Isolation
 Must have a strong sense of personal identity to
develop intimate relationships
 Those with a poor sense of self tend to have less
committed relationships & are more likely to suffer
emotional isolation, loneliness, & depression
(Ramont & Niedringhaus, p. 214)
66
Developmental Tasks of
Young Adult
 Achieves independence financially & socially
 Maximizes personal worth & identity
 Develops meaningful & satisfying social relationships
 Assumes responsibilities & independent decision-making
 Learns to balance personal needs & societal expectations
 Accepts self & others
 Distinguishes physical attraction from love & permanent
commitment
 Decides on marriage, career, & children (Polan, p. 176)
67
Middle Adulthood:
Generativity versus Stagnation
 Middle Adulthood: 25- 65 years
 Continue to build lives, need to create or nurture
things that will outlast them by focusing on career &
family or creating a positive change that benefits other
people.
 Give back to society: establish careers by being
productive at work; settle down within a relationship;
begin families & develop a sense of being a part of the
bigger picture by involvement in community activities
& organizations
(Ramont & Niedringhaus, pp. 214-216)
68
Middle Adulthood:
Generativity versus Stagnation
 If successful, individuals will feel they are
contributing to the world (active in their home &
community); feelings of usefulness & accomplishment
 Those who fail to attain this skill will feel
unproductive& uninvolved in the world which results
in shallow involvement in the world
(Ramont & Niedringhaus, pp. 214-220)
69
Developmental Tasks of
Middle Adulthood
 Balances goals & realities & redirects energies as




necessary
Extends caring & concern beyond immediate family
(to neighborhood, community, & society)
Develops career/job satisfaction
Adapts to physical changes
Establishes new roles & relationships with spouse,
children, grandchildren, & parents (Polan, p. 177)
70
Young-Old Adult
Integrity vs. Despair
 Young-Old Adult: 65 years to 74 years
 Adaptation to retirement & changing physical abilities
 Maintain physical & social activities; Maintain peer group
interactions
 Those who feel proud of their accomplishments will feel a
sense of integrity; successfully look back with few regrets
& a general feeling of satisfaction; will attain wisdom,
even when confronting death
 If unsuccessful, individuals will feel that their life has
been wasted & will experience many regrets, leaving
the individual with feelings of bitterness & despair
(Ramont & Niedringhaus, pp. 214-220)
71
Middle-Old Adult:
Integrity vs. Despair
 Middle-Old Adult: 75 years to 84 years
 Adaptation to decline in speed of movement, reaction time, &




increasing dependence on others may be necessary
Assist clients to cope with loss (hearing, sensory abilities,
eyesight, death of loved one, independence)
Must consider safety measures
Those who feel proud of their accomplishments will feel a
sense of integrity; successfully look back with few regrets & a
general feeling of satisfaction; will attain wisdom, even when
confronting death
If unsuccessful individuals will feel that their life
has been wasted & will experience many regrets,
leaving individual with feelings of bitterness & despair
(Ramont & Niedringhaus, pp. 214-220)
72
Old-Old Adult:
Integrity vs. Despair
 Old-Old Adult: 85 years and older
 Increasing physical & sometimes mental acuity
problems may develop
 Those who feel proud of their accomplishments will feel
a sense of integrity; successfully look back with few
regrets & a general feeling of satisfaction; will attain
wisdom, even when confronting death
 If unsuccessful individuals will feel that their life has
been wasted & will experience many regrets, leaving the
individual with feelings of bitterness & despair
(Ramont & Niedringhaus, pp. 214-220)
73
Developmental Tasks of
Late Adulthood
 Accepts own life
 Recognizes accomplishments
 Finds satisfaction with new roles, relationships, &
leisure time
 Maximizes independence & maintains high level of
involvement
 Accepts own mortality & prepares for death
(Polan, p. 185)
74
Spiritual Component
75
Spiritual Component
 Spiritual-Development of Faith as a force that gives
meaning to a person’s life
 Faith – “a form of knowing, a way of being in relation to
an ultimate environment”
 Faith- “an active ‘mode-of-being-in-relation’ to another or
others in which we invest commitment, belief, love, risk,
& hope” (Fowler & Keen, 1985, p. 18 as cited in Berman et al., p. 361)
 Development of faith – an interactive process between
the person & environment (Fowler, Streib, Keller, , as cited in
Berman et al., p. 361)
 Fowler’s spiritual theory was influenced by Piaget,
Kohlberg, & Erikson (Berman et al.)
76
Spiritual Component
 In each of Fowler’s stages of spiritual development, new
patterns of thoughts, values, & beliefs are added to those
already held by the individual; (Berman et al., p. 361)
 Therefore the stages follow in sequence (order)
 Fowler’s spiritual stages evolve from a combination of
knowledge & values
(Berman et al., p. 361)
The following slides depict Fowler’s Stages of Spiritual
Development & give a general age range of when
individuals progress in developmental sequence.
Which stage of spiritual development do you find yourself?
Consider why you are at that stage.
77
Spiritual Development
Fowler’s Stages of
Development
 Stage #0:
Undifferentiated
 (0-3 years of age)
Description
 Infant is unable to
formulate concepts about
self & the environment
(Ramont & Niedringhaus, p. 209)
78
Spiritual Development Component
Stage #1
Intuitive-predictive
(3-7 Years)
 Egocentric, becoming aware
of time
 Combination of images &
beliefs given by trusted
others (parents), mixed
with child’s own experience
& imagination
 Will affect their later life
(Ramont & Niedringhaus, p. 209)
Stage #2
Mythical-literal
(6-12 Years)
 Private world of fantasy &
wonder; symbols refer to
something specific
 Dramatic stories & myths
used to communicate
spiritual meanings
 Aware of the stories & beliefs
of the local community &
 Uses these stories to give
sense to their experiences. 79
Spiritual Development Component
Stage #3
Synthetic-conventional
(12 Years to Adult)
 Extend faith beyond the
family & use this as a vehicle
for creating a sense of
identity & values
 World & ultimate
environment structured by
expectations & judgments
of others
 Interpersonal focus
Stage #4
Individuative-reflective
(Early Adults)
 Sense of identity & outlook
on the world are
differentiated & the person
develops explicit systems of
meaning
 Constructing one’s own
explicit system; high degree
of self-consciousness
 Takes personal responsibility
for his/her beliefs & feelings
(Ramont & Niedringhaus, p. 209)
80
Spiritual Development Component
Stage #5
Conjunctive or
Paradoxical-Consolidative
(Adult)
 Person faces up to the
paradoxes of experience &
begins to develop universal
ideas & becomes more
oriented towards other
people
 Awareness of truth from a
variety of viewpoints
Stage #6
Universalizing
(Adult)
 Person becomes totally
altruistic & they feel an
integral part of an allinclusive sense of being
 Become an incarnation of
principles of love & justice
 This stage is rarely achieved
(Ramont & Niedringhaus, p. 209)
(Ramont & Niedringhaus, p. 209)
81
References
All Psych & Heffner Media Group,Inc. (1999-2003). Psychology
101: Personality development. Retrieved from
http://allpsych.com/psychology101/development.html
Berman, A., Snyder, S.J., Kozier, B., & Erb, G. (2008). Concepts of
growth & development. In A. Berman, S.J. Snyder, B. Kozier, &
G. Erb (Eds.). Kozier & Erb’s Fundamentals of nursing:
Concepts, process, and practice (8th ed.) (pp. 348-365). Upper
Saddle River, NJ: Prentice Hall
Berman, A., Snyder, S.J., Kozier, B., & Erb, G. (2008). Health
promotion. In A. Berman, S.J. Snyder, B. Kozier, & G. Erb
(Eds.). Kozier & Erb’s Fundamentals of nursing: Concepts,
process, and practice (8th ed.) (pp.270-293). Upper Saddle
River, NJ: Prentice Hall
82
References
Juliar, K. (2003) Minnesota Healthcare Core Curriculum (2nd ed.). Clifton
Park, NY: Delmar Publishers
Lego Group. (2011). Your 12+ year old teens: Becoming an adolescent.
Retrieved from http://parents.lego.com/engb/ChildDevelopment/CD%2012+yrs.aspx
Ramon, P.R. & Niedringhaus, D. M. (2008). Life span development.
Fundamental nursing care (2nd ed.) (pp. 197-223). Upper Saddle River, NJ:
Person Prentice Hall
Schmutte, D. L. (2011). Maslow’s Hierarchy of Needs. Retrieved from
http://www.enotes.com/nursing-encyclopedia/maslow-s-hierarchy-needs
Simons, D.J., Drinnien, I. & Drinnien B.A. (1987). The search for
understanding. Retrieved from
http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/te
achtip/maslow.htm
United States Army. (2004-2008). Categories of basic human needs. Retrieved
from http://www.freeed.net/sweethaven/MedTech/NurseFund/default.asp?iNum=2&fraNum=0
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