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Robert Havighurst’s Developmental Theory(Middle Age)

Growth and development are both referred to as dynamic processes. They areindependent yet interrelated terms that possess factors that enable a person to achieve

a state wherein he is capable and equipped to cope and deal with the existing

circumstances surrounding him. It is influenced by genetic and environmental aspects.

The former is established by the individual even at conception, which remains

unchanged throughout life and determines most of his dominant physical attributes.

Whereas the latter involves the family, religion, climate, school, community and

nutritional provisions, which seem to be auxiliary details however truly poses a great

impact upon the progress and maturity upon each individual.

A developmental task is a task which arises at or about a certain period in the life

of the individual, successful achievement of which leads to his happiness and to

success with later tasks, while failure leads to unhappiness in the individual, disapproval

by the society, and difficulty with later tasks.

evelopmenta

Tasks

Description Achieved

or Not

Achieved

Justification

Assisiting

eenage

hildren to

ecome

esponsible

nd happy

dults

The primary charge of any parent is

to raise their children to become

independent, responsible adults.

Human experiences are continuous.

They are what ultimately define

everyone, including teens who build

on the lessons their parents teach

them over the years. Parents should

help their teen flush out and discuss

Our client is a mother of two, and

she says that she never forgets to

guide her children especially about

life’s challenges and things they

must do in order to become

successful in life, assist them on

how to socialize and involve in their 

community.

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Achieving

dult Social

nd Civic

esponsibility

citizens should work towards the

betterment of their community 

through economic participation,

public , volunteer work, and other 

such efforts to improve life for all

citizens

Our client is member in GKK in their 

community.By doing this, she

participates in the spiritual

development of their community

Reaching

nd

maintaining

atisfactory

erformance

one’sccupational

areer 

involved in preparing for work in

which one will gain personal

satisfaction and find enrichment

in one's life through work.

Occupational development is

related to one's attitude aboutone's work.' Traveling a path

toward your occupational

wellness, you'll contribute your 

unique gifts, skills and talents to

work that is personally meaningful

and rewarding.

Our client is a packer in banana

plantation.she states that she loves

her work but because of her 

condition her husband want him to

stop.

Developing

dult leisure

me activities

a period of time spent out of work 

and essential domestic activity. It

is also the period of recreational 

and discretionary time before or 

after compulsory activities such

as eating and sleeping, going to

work or running a business,

attending school and doing

homework, household chores,and day-to-day stress.

Since the client stayed only at

home, she says that she do

activities such as cleaning their 

house, do cooking foods and

sometimes watching television

together with her family.

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Relating Oneself to

ne’s spouse as a

erson

It is evident that the best

spouse relationships

survive on love and

respect.

Our client states that she and her 

partner have conflicts at times, but

she says that it is just natural for 

couples to have quarrels. She states

that without this quarrels you will

never know the real attitude of your 

partner. she also states that she

really cares for her husnband.

To accept and adjust

o the physiological

hanges of middle age

While the adult years are

generally a time of vitality

and good health, their are

health concerns. Themain health problems of 

middle adulthood are

cardiovascular disease,

cancer, and menopause.

Another major problem

that effects health and

behavior is stress.

Overall this is a time of 

major change and

development physically

and mentally.

Our client states that he accepts that

as we grow old, we also feel some

illnesses and weakness in the body.

she says that this is just naturalbecause we are just humans and all

of us get sick in different ways like

her. She says that to stay healthy he

really eats vegetables and fruits.

7. Adjusting to aging

parents

Becoming a caregiver to

parents involves

major changes for all

concerned -

physically,

emotionally, socially

and financially.Learning to cope

with the changes in

a healthy way is

important to ensure

you and your aging

parents can live in a

mutually loving and

giving relationship.

Our client states that when her 

parents got old she did not live with

them. But even with the distance,

she really tries to visit her parents

and to check if they are well, and she

also gives support for their needs.

She says that we should never forgeto go back to the people who made

us who we are right now especially

our parents.

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Legend:

Achieved –

 

Not Achieved -

Not Applicable -

Eric Erikson’s Psychosocial Development:

Generativity vs Stagnation (40 – 65 years old)

Generativity is the concern of establishing and guiding the next generation.

Socially-valued work and disciplines are expressions of generativity. Simply having or 

wanting children does not in and of itself achieve generativity.

During middle age the primary developmental task is one of contributing to

society and helping to guide future generations. When a person makes a contribution

during this period, perhaps by raising a family or working toward the betterment of 

society, a sense of generativity- a sense of productivity and accomplishment- results. In

contrast, a person who is self-centered and unable or unwilling to help society move

forward develops a feeling of stagnation- a dissatisfaction with the relative lack of 

productivity.

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As for the client, she is categorized under the 7 th stage, which is the Middle

Adulthood Stage that is confronted with the crisis of generativity vs stagnation.

Achieved

Our client states that she is contended with what she has right now. She says

that his family is a very big gift of God to her because this is what makes her go forward

in life and continue. She also states that even if there are conflicts in her family at times

she knows that this will all be solved and that this is a way wherein the y will know each

other better. She states that she is really glad that he was successful in guiding his

children in their studies and their behavior towards them as parents. She is also glad

that she is able to function well in their community especially in the spiritual activities

that they have. He also states that as we grow old, we also have limitations especially in

our health. And he is also glad that even if she is far from her parents, she never forgets

to look back and support them in their needs as aging parents.

If we take a closer look at all the essential data we’ve gathered and correlate it with

Robert Havighurst ‘s developmental theory and Erik Erikson’s developmental tasks, the

group concludes that the client is doing well as she continues to perform his tasks laid

out for an individual belonging to the same age group. We cannot say that she isalready fulfilled with his development since he is still in the process of accomplishing it.

However, as we can see, she is very much comfortable and at ease with the

present set-up. With this, we hope that he may eventually accomplish all his task with a

feeling of contentment and happiness.

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A. GENERAL SURVEY

The patient was lying on bed, conscious and coherent and on respiratory

distress. The patient is mesomorphic. She was wearing a clean hospital gown. She has

O2 inhalation @ 1liter per minute via nasal cannula and has an intravenous fluid of 

D5W500 regulated at KVO rate infusing well at left metacarpal vein at 300 cc level. She

doesn’t have any foul-odor smelling. She was cooperative, alert and responses

appropriately to our questions.

.

B. VITAL SIGNS

VITAL SIGNS RESULT NORMAL VALUES

Blood Pressure 100/90 90/70- 130/90

Temperature 35.8 35.6 – 37.5°C

Cardiac Rate 96 70 – 80 bpm

Pulse Rate 90 70 – 80 bpm

Respiratory Rate 26 16 – 20 cpm

I. SKIN, HAIR, NAILS

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Upon inspection, skin was tan in complexion and not uniform in color.

Upon palpation, skin was oily on lower extremities. Skin was rough and warm to

touch. The body’s temperature is uniform all throughout the body and is within the

normal range. Skin turgor was good. No edema and ulceration noted.

Hair is black in color. Infections or infestations were not noted upon inspection.

Body hair is variable in amount.

Upon inspection, nails are clean and well trimmed. Nail beds are slightly pinkish

in color. After performing the blanch test of capillary refill, there is return of usual color in

3 seconds.

II. HEENT

A. HEAD

Upon inspection, head is normocephalic. Hair was black in color. Facial features

are symmetrical, palpebral fissures equal in size and symmetrical nasolabial folds are

present. Facial movements are symmetrical as patient elevates and lowers the

eyebrows, close the eyes tightly, puff the cheeks and smile.

Upon palpation, nodules, masses were not noted.

B. EYES

Upon inspection, eyebrows are black, evenly distributed and symmetrically

aligned.. Eyelashes are equally distributed and slightly curled outward. There is icteric

sclera in both eyes. The bulbar conjunctiva is transparent. The palpebral conjunctiva is

smooth and pale. Lesions are absent.

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No edema or tenderness noted upon palpation on the lacrimal gland. No edema

or tearing on the lacrimal sac and nasolacrimal duct. No lesions were noted.

The pupils are black in color, equal in size of about 2mm in diameter. The iris

appears brown in color. The pupils constricts when looking at near objects, dilate when

objects are far and converge when near object is moved towards the nose.

When looking straight ahead, the patient can see objects in periphery. Upon

performing the extraocular muscle test, both eyes are coordinated and move with

parallel alignment (six ocular movements). She was also able to read newsprint with the

use of her eyeglasses.

C. EARS

 Upon inspection,the ears have the same color as that of facial skin, symmetrical

and aligned with the outer canthus of the eye. It is mobile and not tender. After the

pinna is folded, it recoils. No presence of cerumen noted. Skin lesions, pus or blood

were not noted. Normal voice tones are audible and able to hear ticking in both ears

during the watch tick test.

D. NOSE

Upon inspection, external nose is uniform in color and no discharge noted.

Tenderness, masses, displacement of bone and cartilage and lesions are absent. Both

nasal cavities are patent. The nasal septum is intact and in midline. The maxillary and

frontal sinuses are not tender upon palpation.

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E. MOUTH

The lips are brown in color.Texture is smooth, and patient is able to purse lips.

The oral mucosa has a uniform pink color and moist. The gums are also pink. Upon

inspection, teeth are incomplete, there is cavities noted.The tongue is positioned

centrally, pink in color, moves freely, and lesions, tenderness, or palpable nodules were

not noted. Tongue base is smooth with prominent veins. The frenulum is in midline.

The hard palate is lighter pink The uvula is positioned in midline. The tonsils are pink

and not inflammed. Discharges are not noted. Gag reflex is present.

 

III. NECK

Upon inspection, the neck muscles are equal in size. She was capable of turning

her neck from right and left lateral without any discomfort. Jugular vien is distended at

left side.

Upon palpation, lymph nodes are not palpable.. No bruit heard upon auscultation.

IV. CHEST AND LUNGS

The anteroposterior diameter of the chest has a ratio of 1:2. The skin is intact,

warm to touch, and no masses noted. Chest wall expansion is symmetrical with

crackles heard upon auscultation on both lungs..

V. BREAST & AXILLAE

The skin on breasts is uniform in color, smooth and intact. Areolas are oval and

bilaterally the same color and is dark brown. Nipples are round, equal in size, soft and

smooth. Discharges are absent. No tenderness, masses or nodules noted on axillary

area.

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VI. HEART

Upon inspection, no bulges were noted. Whooshing cardiac sounds heard upon

auscultation.

VII. ABDOMEN

The skin color is uniform. Abdominal movements caused by respirations are

symmetrical. Audible bowel sounds of 16soundsper minute are heard and absence of 

arterial bruit and friction rub upon auscultation. No areas of tenderness noted upon

palpation. She has abdominal girth of 93 cm.

VIII. EXTREMITIES

No nodules or deformities observed on shoulders, arms and elbows. Forearms

can be flexed, extended, or put to supine and prone position. Contractures, redness,

bone enlargements, nodules, atrophy and tremors were not observed. No pain or 

tenderness, deformities on hip joints and thigh. No lesions or deformities noted.Lesions, edema, inflammation and deformities are absent.

IX. GENITALS AND RECTUM

The patient refused to be assessed in her genital area.

X. NEUROLOGIC SYSTEM

Mental Status

o Language

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There was no notable defect or loss of power to express his self by speech. she

was able to answer the questions asked to her. Her answers are relevant and

comprehensible.

o Orientation

The client was able to recognize other persons such as her relatives, nurses on

duty and her physician. She is oriented of the time of the day and was aware of where

she is at the present moment.

o Memory

The patient was able to recall the foods he had taken for the whole day. He also

remembered some of the hospital personnel that were assigned to him.

Level of Consciousness

Glasgow Coma Scale (GCS)

Eye Opening 4 - Spontaneous

Best Verbal Response 5 - Oriented

Best Motor Response 6 - Obeys commands

Eye opening was spontaneous; reactive to any stimuli. Pupil size were

both 2mm brisk in movement and reactive to light accommodation. Verbal

response was oriented; she was able to know the person, place and time

appropriately. Moreover, motor response was assessed through asking the

patient to move both upper and lower extremities. She was able to follow

commands without difficulty.

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Reactive Level Scale

Patient was alert and was able to respond spontaneously. A score of 1/15

was given to the neurological assessment of the patient.

 

Cranial Nerves

Cranial

NerveName Functions Findings

I Olfactory Smell Identified the source of odor as

patient closes her eyes.

II Optic Purely sensory; carries

impulses for vision

Patient can see objects in a

distance and can read

newsprints.

III Oculomotor Extraocular Movement

and sphincter of pupil;

ciliary muscles of lens

movements

The patient can see objects in

periphery. When the pupil is

illuminated, it constricts (direct

response) and the non-

illuminated pupil also constricts

(consensual response)

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IV Trochlear Moves eyeball

downward and laterally

Patient can see objects in

periphery and can gaze

laterally.

V Trigeminal Sensation of cornea,

skin of face and nasal

mucosa; sensation of 

anterior oral cavity;

muscles of mastication

Patient was able to elicit blink

reflex. The patient was able to

open her mouth at the widest

and can move tongue from

side to side

VI Abducens Supplies motor fibers

to the lateral rectus

muscle, which rolls the

eye laterally

Patient can see objects in

periphery and can gaze

laterally.

VII Facial Activates the muscles

of facial expression

and the lacrimal and

salivary glands; carries

sensory from the taste

buds of anterior tongue

Facial movements are

symmetrical as patient

elevates and lowers the

eyebrows, close the eyes

tightly, puff the cheeks and

smile.

VIII Vestibulocochlear Purely sensory;

vestibular branch

transmits impulses for 

the sense of balance

and cochlear branch

transmits impulses for 

the sense of hearing

Normal voice tones are audible

and able to hear ticking in both

ears during the watch tick test

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IX Glossopharyngeal Supplies motor fiber to

the pharynx that

promote swallowing

and saliva production;

carries sensory

impulses from taste

buds of the posterior 

tongue and from

pressure receptors of 

the carotid artery

Gag reflex is present. Our 

client can move her tongue in

and out, up and down, side to

side a little slowly. she could

determine different tastes.

X Vagus Sensation of pharynx

and larynx; swallowing;

vocal cord movement

Gag reflex is present. The

uvula is positioned in midline of 

soft palate. Client’s speech

was not hoarse and there is no

difficulty to talk.

XI Accessory Most motor fibers that

activate

sternocleidomastoid

and trapezius muscles;

head movement and

shrugging of shoulders

She can shrug both of his

shoulders with ease; if applied

with resistance from hands, still

he can move her shoulders.

She can turn his head slowly

on both sides; when asked to

turn to side against resistance,

still she can move her head.

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XII Hypoglossal Motor fibers control

tongue movements;

sensory fibers carry

impulses from the

tongue

Gag reflex is present. The

uvula is positioned in midline of 

soft palate. She can protrude

her tongue at midline and can

move it side to side without

difficulty