Developmental Task

Geriatric people
Prepared by
Pooja Prakash
Lecturer
 Developmental Task
• Refers to a skill, knowledge or behaviour that individuals are expected to
acquire at specific stages of life, with successful achievement leading to
happiness and future success, while failure can lead to unhappiness and
difficult in later stages.
• Developmental task concept occupies middle ground between two opposed
theories of education i.e. theory of freedom and constraint
Theory of Freedom: the child will develop best if left as free as possible
Theory of Constraint: the child must learn to become a worthy, responsible
adult through restraints imposed by his society
* Developmental task is defined as a physical or cognitive skill that a person
must accomplish during a particular age period to continue development.
Erik-Erikson’s Psychosocial development
(1964)
Expression of Integrity and Despair by Elderly

Expression of Integrity Expression of Despair and Distrust

Proud, content with self and life Despair
Deep Resentment
Still activity thinking about the future Nothing left, uselessness

Healthy Interaction with self Low self esteem

Self-approving Anger at self, other, world, society

Comfortable giving and sharing with others Closed to others

Likes being an example to others Complaints, irritable

Accepts aging process gracefully and death as part of Anger at aging, feels cheated
life cycle
 Robert Peck’s Developmental Tasks
1. Ego Differentiation Vs Role Preoccupation: to find
satisfaction with oneself instead of satisfaction through parental or
occupational roles.

2. Body Transcendence Vs Body Preoccupation: to enjoy

life instead of being consumed by age-related physical changes

3. Ego- Transcendence Vs Ego Preoccupation: to reflect

positively on time past rather than obsessing about the limited time
remaining
Havinghurust: Developmental Task
• Adjust to decreasing physical strength and declining health
• Adjust to retirement and fixed income
• Adjust to death of spouse of companion
• Establish social relationship with persons of same age and with
younger persons
• Establish appropriate living arrangements
• Make arrangements for care, if needed
• Accept one’s own mortality
• Find satisfaction in one’s own mortality
• Accept oneself as an aging person
 Moral Development
• Is the process by which people develop the distinction between
right and wrong (morality) and engage in reasoning between the
two (moral reasoning)
• Is the process of developing an understanding of right and wrong,
encompassing moral reasoning and the internalization of values
and norms, which typically progress through stages from childhood
to adulthood.
• Moral development refers to the changes in an individual’s
understanding of morality, encompassing thoughts, behaviours
and feeling related to right and wrong.
• Moral development refers to the process through which children
develop the standards of right and wrong within their society,
based on social and cultural norms and laws.

• MD as a process of discovering universal moral principles and is

based on a child’s intellectual development
Lawrence Kohlberg

• conceptualizes moral development as a constructive process,

whereby the interplay of action and thought builds moral
concepts. Piaget
 Piaget’s Theory
• Piaget’s (1932) was principally interested not in what children do
but in what they think, as was interested in children's moral
reasoning.

• Children’s ideas regarding rules, moral judgements and

punishment tended to change as they got older.

• As there is stages of cognitive development so there is also stages

to their moral development
 Two main types of Morale Thinking
• Heteronomous Morality (5-9yrs): Known as
Moral Realism – morality imposed from the
outside. Morality is obeying as other people’s
rules and laws, which can not be changed.
They accept all the rules made by authority
figure. Breaking Rules lead to immediate and
Heteronomous Autonomous severe punishment.
Morality Morality

• Autonomous Morality (9-10yrs): is known as

moral relativism, based on own rules. People
recognize there is no absolute right or wrong
and that morality depends on intentions not
consequences.
 Research Finding
Piaget (1932) told the children stories that embodied a moral theme and then
asked for their opinion. Here are two examples:

• There was once a little girl who was called Marie. She wanted to surprise her
mother and cut out a piece of sewing for her. But she didn’t know how to use
the scissors properly and cut a big hole in her dress.

A little girl called Margaret went and took her mother’s scissors one day when
her mother was out. She played with them for a bit. Then, as she didn’t know
how to use them properly, she made a little hole in her dress.

• The child is then asked, “Who is naughtier?”

• they tend to judge naughtiness in terms of the severity of the consequence

rather than in terms of motives
 LAWRENCE KOHLBERG
• American Psychologist, developed best theory exploring the concept of
Moral Development as expanded and modified work of Jean Piaget.

• “Moral Development is a Continual Process that occurs throughout the

lifespan. Kohlberg’s theory outlines six stages of moral development within
three different levels.

• Kohlberg theory is based on a series of moral dilemmas presented to his

study subjects. Participants were also interviewed to determine the
reasoning behind their judgements in each scenario.
 Research Finding
"Heinz Steals the Drug."
a woman has cancer and her doctors believe only one drug might save her. This drug
had been discovered by a local pharmacist and he was able to make it for $200 per
dose and sell it for $2,000 per dose. The woman's husband, Heinz, could only raise
$1,000 to buy the drug. He tried to negotiate with the pharmacist for a lower price
or to be extended credit to pay for it over time. But the pharmacist refused to sell it
for any less or to accept partial payments. Rebuffed, Heinz instead broke into the
pharmacy and stole the drug to save his wife. Kohlberg asked,

"Should the husband have done that?"

 Stages of Moral Development
Levels of MD Age Stages

Preconventional 0-9 Stage1: Stage 2:

Morality Obedience and Individualism and
punishment Exchange
Conventional Early Stage 3: Stage 4:
Morality Adolescence Developing good Maintaining Social
to adulthood interpersonal Order
relationships stages
Postconventional Some adults, Stage 5: Stage 6:
Morality rare Social Contract and Universal
individual rights stage Principles
 SPIRITUAL DEVELOPMENT
• World Health Organization: (1998)
Health professions have largely followed a medical model which seeks
to treat patients by focussing on medicines and surgery and gives less
importance to beliefs and to faith. This reductionist or mechanistic
view of patients as being only a material body is no longer
satisfactory. Patients and physicians have begun to realise the value
of elements such as faith, hope and compassion in the healing process.
The value of such 'spiritual elements in health and quality of life has
led to research in this field in an attempt to move towards a more
holistic view of health that includes a non-material dimension,
emphasising the seamless connections between mind and body'.
• Spiritual Development can occur throughout an individual’s lifespan.

• Spiritual Theories is a complex and unique to each person.

• Is the process of examining beliefs that transcend the realm of the

material world.
• During the development, an individual becomes aware of the interior
world, the world of thoughts and beliefs.

Theologian James W. Fowler developed Stages of Faith Development

He argues that the development of people’s spiritual awareness runs
parallel to other aspects of human development. Seven primary stages of
faith development.
• Stage O: Undifferentiated Faith : learns to trust the goodness or badness of the world
based on the way the child is treated
• Stage 1: Institutive- Projective Faith: are very self-centered and tend to take ideas
about right and wrong very literally
• Stage 2: Mythic-Literal Faith: information is organized into stories and together with moral
rules are concretely understood
• Stage 3: Synthetic –Conventional Faith : young adults’ identification with a religious
institution, belief system, or authority, Personal religion or spirituality
• Stage 4: Individuative- Reflective Faith : fear and struggle as the person takes
responsibility for his or her beliefs and feelings.
• Stage 5: Conjunctive Faith: also known as the time of the midlife crisis. A person at this
stage recognizes that there are paradoxes and mysteries attached to the transcendent values and norms of
faith.. a person goes beyond the traditional beliefs that he or she has inherited from the earlier stages of
faith development..
• Stage 6: Universalizing Faith : is also known as the enlightenment stage, or later maturity.
This stage is only reached by a limited number of people. A person in this stage is not limited by differences
in religious movements or spiritual beliefs between people in the world. He or she views all beings as
humans who can show compassion and understanding. Example: mahatma Gandhi and Mother Teresa.
Misconception about Old Age
Ethical and Legal issues Affecting the Older
Adults
1. Restraints
- Physical Restraints or Chemical Restraints
2. Do not Resuscitate Orders (DNR)
3. Withholding and Withdrawing Treatment
4. Assisted Suicide and Euthanasia
5. Medical Decision Making for a Potentially Incomplete Patient
6. Informed Consent
7. Enteral feeding
8. Patient Opposition to Placement
Common Ethical Issues Confronting to Elder
Care Providers
Decision Making
Actual Colflicts of
Capacity
interest

Ethical Dilemas
Potential, Future or
Perceived Conflicts
of Interest

Autonomy

Confidentiality
 Patient’s Medical Condition Patient’s preferences
Indication for and against the Cultural, ethnic and age related
intervention differences
Reflects the goals of care

The Four- box method

Quality of life
Other contextual features
Evaluation of prior QOL
Social, legal, economic and institutional
Expected QOL with and without circumstances
treatment
Legal issues that affect the Older Adults
1. Act of Negligence, Malpractice and Omission
2. Intentional Torts : Assault and Battery
3. Defamation: Libel and Slander
4. Invasion of privacy
5. Elder Abuse and Neglect
6. Abandonment
7. Advancement Directives
Thank you ☺