Age-Specific Considerations for Pediatric Patients
Children are very special people… not just miniature adults! As a child grows older and changes, they move through stages. Everyone grows and develops in a similar way. The stages are related to their age and therefore, share certain qualities at each stage.
Important! Even though children go through stages, everyone develops at his/her own RATE! Every patient is an individual with his or her own… Likes and dislikes Feelings, thoughts & beliefs Limitations and abilities Life experiences
As caregivers, we must… Know enough about the different stages of childhood development that we interact with the children in a way that is positive and helpful for them. Understand that the hospitalized child requires sensitivity and special actions.
Infancy (Birth through 1 year) Parental involvement when appropriate Stay in infants line of vision Place familiar object with baby (stuffed animal, etc.) Pacifier, talk softly, touch Cuddle, hug after procedure Adequately restrain Model desired behavior (opening mouth)
Infancy Stable, caring relationships Verbal, auditory, visual and tactile stimulation Reduction and control of negative stimuli Satisfaction through pleasurable stimuli (sucking, stroking) Opportunities for motor development and neuromuscular control Recognition of the individuality of the infants responses Appreciation of individual patterns Consistency in care Support, preparation and teaching for parents
Toddlers (1 year – 3 years) Continuing relationships with parents Space for mobility and exploration Consistency in daily routine Opportunity for play Continuity of familiar routines of eating, toileting, and sleeping Acceptance of regression under the stress of hospitalization Continued contact with security objects
Toddlers Opportunity to express independence Detailed preparation for parents and brief preparation for the child Reassurance and brief explanations of procedures or treatments
Toddlers Involve child in procedure by allowing him/her to play with equipment when appropriate. Use play; demonstrate on doll, stuffed animal Consistency with daily routines Explain procedure in relation to what child sees, hears, etc. Emphasize being still Let them know – “It’s okay to cry” Give one direction at a time
Preschoolers _(3 years-6 years) Identification of fears, misconceptions, fantasies, and offering appropriate support and clarification Recognition of the importance of parental involvement Opportunity for play and mobility More detailed explanations and preparations for procedures Recognition of individuality Continued contacts with security objects
Preschoolers Explain in simple terms Demonstrate procedure Allow to play with equipment/dolls Encourage child to talk; let them ask questions to clarify Tell them “this is not punishment”- “you haven’t done anything wrong”
School Age (6 years-12 years) Use of intellectualization as a coping mechanism More detailed preparation and explanation of procedures Increased participation in self care and treatment Continuation of school and age- appropriate educational activities Opportunity to play and continue with interests and hobbies Involvement with peers Continuing need for parents’ presence
School Age Explain using correct terms Explain reasons – use simple diagrams Allow to ask questions Prepare in advance Tell what is expected Suggest breathing, counting, etc. Include in decision (where to get injection, etc.) Encourage participation Provide privacy
Adolescents (12 years-19 years) Contact and involvement with peers Opportunities for increasing independence and responsibility Recognition of concerns about body image Need for privacy Continuation of activities such as schooling, music, telephoning, eating and sleeping patterns
Adolescents Detailed preparation and explanations Opportunity to talk about concerns with staff and peers Appropriate parental involvement
Adolescents Explain and give reasons Encourage questions Provide privacy Discuss “after effects”- scars, etc. Involve in decision making and planning Accept regression and resentment of authority
Adults to age 64 years Involve these patients in their care, treatment, diagnosis, and procedures Family support and visitors are necessary to their improvement\ Allow them to verbalize fears, anxiety, and concerns related to their care
Geriatrics 65 + It is crucial to maintain a safe environment for these patients (side rails up, falls prevention, mobility needs, and communication) Prior to performing any treatments or procedures, explain fully to the patient and allow time for questions Provide for sensory losses such as visual impairment and hearing loss Involve the family in the patients care and decision making
In summary… Know developmental levels and stages. Keep in mind the importance of family- centered care Remember to address both the physical and emotional needs of the patient.