Middle Adulthood (40-50 years of age)

Introduction 

• Middle aged starts at the age of 40 and ends at 50 years.
• This is the period of physiological changes that are gradual and inevitable; although physical growth has stopped he/she continue to mature emotionally.
• In this period he or she has obtained personal achievements and socioeconomic stability.
• He or she enjoys the role in assisting other young people or children. That is the time of helping aging parents progress through the later years of life.
• The middle aged adults use his leisure time in creative work and get satisfaction from his/her own work.
• This is the time when a person prepares for retirement. 

Physiological Development 

• Major physiological changes occur between 45-65 years of age.
• The changes in physical appearance and functions vary from person to person.
• The most visible changes are grey hair, loss of hair, wrinkling, body metabolism which begins to slow down due to lack of excess fat deposition especially around waist and abdomen.
• Presbyopia ( blurred vision at close range ) is common in middle adulthood. 
• The impact of physiological changes has an effect on the person's self concept and body image.

Cognitive Development 

• Middle aged adults are able to learn new skills and information.
• Some adults prepare themselves for new education, career and vocational training.
• The cognitive function changes when they are seriously ill or have trauma.

Psychological Development 

1. The psychological changes in the middle aged are due to children moving away from home, divorce and death of spouse.

• The changes may cause stress and affect the health of an individual .

Sexuality 

• During this period sex hormone begins to decline such as estrogen and progesterone in the female. Therefore most of the women experience menopause between the age of 45-60 years of age.
• There is decreased level of androgen which may cause climacteric changes in both male and females, middle aged adult experience changes in the erection and decreased repeated orgasm. Therefore some may experience emotional distress and for this reason, both male and female clients need more information about menopause and climacteric changes.

Physiological Needs and Developmental tasks 

Physiological needs of Middle Aged are :

1. Adaptation to changing sexuality.
2. Promotion of adaptive health maintenance measures.
3. Monitoring for and treatment of chronic illness.
4. Early detection of loss of perception.

Seven Development tasks have been Described by "Havighurst" 

1. Achieving adult civic social responsibility.
2. Establishing and maintaining as standard of living.
3. Helping teenage children become responsible and happy adults.
4. Developing leisure activities.
5. Relating to one's spouse as a person.
6. Accepting and adjusting to physiological changes of middle age.
7. Adjusting to aging parents.

Central tasks of middle adulthood 

1. Express love through more than sexual contacts.
2. Maintain healthy life patterns.
3. Develop a sense of unity with mate.
4. Help growing and grown children to be responsible adults.
5. Relinquish central role in lives of grown children.
6. Accept children's mates and friends.
7. Create a comfortable home.
8. Be proud of accomplishments of self and mate/spouse.
9. Reverse roles with aging parents.
10. Achieve mature, civic and social responsibility.
11. Adjust to physical changes of middle age.
12. Use leisure time creativity.

Major Health Problems of Middle adulthood

Common health problems in middle adulthood include:

1. Diabetes
2. Accidents
3. Heart diseases
4. Stroke
5. Hypertension
6. Cancer
7. Alcoholism
8. Degenerative joint disease, Gout
9. Gallbladder disease 
10. Coronary artery disease 
11. Varicose veins
12. Gl disorders: peptic ulcer disease 
13. Obesity 
14. Dental problems 
15. Visual changes 
16. Reproductive/menopausal problems
17. Anxiety/stress
18. Accidents/injuries.

Many of these diseases are preventable wholly or in part through behavior changes . Middle aged adults can influence their own health as well as their children's through healthier life styles.

Nursing consideration in middle adulthood 

1. Encouraging regular medical check up 
2. Teaching self breast examination to females and self testicular examination to males.
3. Encouraging to have pap smear test done for females.