1. Understanding the Person Chapter 8

2. For effective care you must consider the whole person PhysicalSocialPsychologicalSpiritual Caring For The Person

3. Basic Human Needs

4. Describe Basic Human Needs n Basic Human needs are needs all persons have. However individuals meet these needs in different ways. Most residents in long term facilities will need some assistance to meet their basic needs.

5. Ways to assist Residents with Physical Needs n Food –making meal time as pleasant as possible –assist resident to eat, feed resident when possible –prepare foods such as cutting meats, opening cartons n Oxygen/Air –elevate HOB for resident with breathing problems or SOB –position in bed and chairs to allow lung expansion –assist resident to ambulate –assist nurse with oxygen therapy.

6. Meeting Resident Physical needs n Water: –Offer fluids frequently –keep water containers within reach –Keep water fresh, other liquids at correct temperatures. n Elimination: –Assist resident in toileting needs –provide privacy –be matter of fact in response to incontinent residents

7. Meeting Physical Needs n Rest: –Assist in preparation for sleep –recognize changes in patterns for sleep n Activity and Exercise –Encourage ROM in ADL’s –ambulate, transfer and move properly –Encourage activity n Stimulation –Encourage resident to participate in activities –Encourage residents to talk and listen carefully –Do not isolate resident. Place in area where they can observe activity.

8. Ways to Assist Resident with Safety and Security Needs n Safety –Keep area safe and free of hazards –Show residents how to do activities safely –keep call light within reach –know how to do tasks –be alert to safety. Use TB and brakes n Security –respect residents belongings –orient resident to new surroundings –reassure resident –welcome family and friends –provide privacy, knock on doors

9. Ways to Assist Love and Belonging Needs n Caring about someone –listen to resident, encourage talk of past –show interest in residents family –encourage contact with other residents –read social histories in resident charts –some residents may have significant others who are not family members –take time with resident, pay attention

10. Love and Belonging Needs n Being cared about –Show interest in resident –touch residents in a kind and gentle manner –be kind and friendly to visitors –inform family and residents of activities offered –be patient and understanding –treat residents as you would like to be treated

11. Ways to Meet Self Esteem Needs n Sense of Identity –call resident by preferred name –include resident and family in discussions concerning resident care –give and respect choices made by residents –respect differences in culture, heredity, interests and values

12. Meeting Self- Esteem Needs n Feeling Important, worthwhile –praise accomplishments of residents –acknowledge residents at all times –respect resident property –talk to resident as an adult –encourage resident to do as much as abble for themselves –Give residents simple responsibilities and tasks to feel important

13. Meeting Self- Actualization Needs n The extra’s in life –encourage hobbies –praise accomplishments and strengths n Spirituality –respect religious beliefs –provide privacy for clergy visit. –Handle with care religious symbols –refer clergy requests to Nurse in Charge

14. Describe Developmental Tasks n Theorists suggest that as one matures from infancy to old age, persons pass through several stages. During each stage developmental tasks must be accomplished in order to mature in a healthy way. Developmental tasks are social, emotional, and psychological growth experiences.

15. RESPECT CULTURAL DIVERSITY n CLAS stands for culturally and linguistically appropriate services. n Developed in 2000 by the Dept of health and human services. n Clas focuses on health care organizations, and also standards for how health care should be delivered.

16. Personal guidelines n Think about your personal belief system n Examine how personal culture influences your own behavior n Don’t stereotype n Ask patients about their culture n Attend staff development activities and develop cultural awareness.

17. Cultural influences n Personal space –Some cultures will not permit members of the opposite sex to provide cares –Some prefer distance during cares n Gestures/ eye contact –Gestures may have different meanings –Eye contact may be offensive

18. Cultural influences n Clothing: –Men may cover their heads –Women may cover their heads and only have face and hands in view n Health Practices: –May want cultural remedies –May want herbs, spices, teas or wraps –Check to see if this interferes with treatment

19. Cultural Influences n Pain: –Some demonstrate pain by being very emotional –Some view displays of pain as being weak n Personal hygiene: –Bathing may not be done routinely/ or may be very frequent –Women may not want body hair removed

20. Family n A family is a group of people tied together by common interests and concern about the well being and needs of members. “Traditional Family” usually refers to a married man and women and children. Today there are many family units containing single parents, extended families, and groups of unrelated friends.

21. Family Dynamics n The way individuals in a family relate to and interact with each other is known as family dynamics –Each family has individual needs. –Families have their own rules related to how they operate as a group. –Each person has a role in the group, or several roles. –Usually roles are learned from older family members. There may not be a role model for healthy development –In a stressed family children may have an adult role.

22. Describe Needs of Family n Definition of Family: –Two or more people have chosen to live together and share interest, roles, resources commitment and love. n Family emotions include, anxiety, fear, sadness, anger, relief, confusion

23. Remember….. n Nursing assistants need to acknowledge family members, have a non judgmental attitude, be patient, be sensitive, quietly listen, include family when appropriate in cares. BE PLEASANT!!!

24. Developmental Disabilities n Any condition which interferes with normal growth and development is a disability. –May interfere with the way a person speaks, learns, or completes ADL’s –Usually as a result of heredity, or birth injury. (cerebral palsy, fetal alcohol,MR.) –Places stress on family due to health care costs and special services needed.

25. Untypical Behaviors n Child may become over dependent on others and demanding n May not follow normal routines, such as nap time. n Regresses to earlier stage.(incontinent) n Physical complaints

26. Integumentary system n Results –skin is less resistant to injury –skin bruises easily –skin is drier –skin is slow to heal –body temperature regulation is difficult –decreased sensations occur n Nursing Assistant responsibilities: –use lotion and other skin care products –prevent pressure areas and other injuries –select appropriate clothing

27. Musculo-Skeletal (bones and muscles) n Changes –bones become porous and brittle –muscles reduce in size –joints and ligaments become less flexible n Results –muscles lose strength –fractures occur –Range of Motion is decreased n NAR responsibilities –encourage exercise and good nutrition –balance activity and rest

28. Digestive (Stomach and Intestines) n Changes –Slowing down of system –decrease in taste –saliva reduced –teeth missing (poor fitting denture) n Results –decrease in appetite –difficulty chewing and swallowing –constipation n NAR responsibilities: –watch for choking –encourage fluids, small bites, and to eat slower

29. Circulatory (Heart -blood vessels) n Changes –heart does not pump as effectively –blood vessels become less elastic –heart disease is common in elderly n Results –tires easily –elevated blood pressure –dizzy when changing positions n NAR responsibilities –provide rest times –encourage exercise –change positions

30. Respiratory n Changes –decreased exchange of oxygen and carbon dioxide –lungs lose elasticity –cough reflex is weak n Results –deep breathing more difficult –susceptible to infections –tires easily and SOB n NAR Responsibilities –pace activities –prevent infections

31. Urinary ( Kidney - bladder) n Changes –kidney function reduced –bladder elasticity lessened –females have stress incontinence –males have prostate enlargement n Results –susceptible to UTI’s –more urgent need to void –difficulty and incontinence in voiding n NAR responsibilities –encourage fluids –follow B&B program –good peri care

32. Nervous System n Changes –nerve cells decrease in number –blood flow to brain is decreased –diseases may cause abnormalities and personality changes n Results –slower reaction to stimuli –forgetfulness n NAR responsibilities –Provide adequate time to complete activities –be alert to safety needs

33. Sensory (eyes and ears) n Changes –gradual slowing down of all senses –tears and earwax reduced n Results –reduced vision and hearing –eyes dry, irritated –impacted ear wax –problems with glare n NAR responsibilities –speak clear, slowly –face resident –be alert to safety

34. Digestive (Stomach and Intestines) n Changes –Slowing down of system –decrease in taste –saliva reduced –teeth missing (poor fitting denture) n Results –decrease in appetite –difficulty chewing and swallowing –constipation n NAR responsibilities: –watch for choking –encourage fluids, small bites, and to eat slower

35. REPRODUCTIVE SYSTEM Changes: Females: Menstrual cycles ceases, vaginal wall become thinner and drier Males: scrotum is less firm, prostate gland may enlarge. NAR responsibility: Clean Perineums, watch for signs of infections.

36. Endocrine system (glands) n Changes: –Less insulin produced, may result in diabetes –Weight gain/loss –Increased feeling of nervousness n Nar’s should report any behavior or physical changes to nurse.