1. Chapter 6: Those We Care For
Nursing Assistant III
Chapter 6: Those We Care For

2. Objectives Recognize that health care is a people-focused service
Discuss why people need health care intervention
Differentiate between acute, chronic, and terminal conditions, and give example of each
Describe how the health care industry classifies people, and list the types of people you might have the opportunity to work with
List and briefly describe the stages of human growth and development
Understand the developmental changes are common throughout the life span of a person
Draw Maslow’s hierarchy of basic human needs, and explain each level
Describe the ways that a nursing assistant helps patients and residents to meet their needs
Understand the difference between sex and sexuality and discuss how a person’s sexuality can be affected by illness

3. Patients, Residents, and Clients
Receiving care in a hospital, clinic, or extended care facility
Resident
Receiving care in a long-term care or assisted living facility
Client
Person receiving care in his/her own home

4. Patients, Residents, and Clients
Three general types of illness
Acute illness
Characterized by rapid onset and a relatively short recovery time
Usually unexpected
Pneumonia, appendicitis, broken bone, labor and delivery
Chronic illness
Condition that is ongoing
Generally needs continuous medication
Diabetes, asthma, arthritis, high blood pressure

5. Patients, Residents, and Clients
Three general types of illness
Terminal illness
Recovery is not expected
Some types of cancer, end-stage emphysema, and some heart conditions

6. Patients, Residents, and Clients
Group people according to age, illness, or medical condition
Surgical patients
Need to have illness or condition treated by surgery
Inpatient or outpatient
Medical patients
Treated with interventions other than surgery
Medications, physical therapy, or radiation

7. Patients, Residents, and Clients
Group people according to age, illness, or medical condition
Obstetrical patients
Pregnant or have just given birth
Continues for about 8 weeks after delivery
Pediatric patients
Children and adolescents
Are at risk for some diseases adults are not
Child’s body does not function exactly the same way and adult’s does

8. Patients, Residents, and Clients
Group people according to age, illness, or medical condition
Geriatric patients
Elderly people
Changes associated with the aging process
Psychiatric patients
People with impaired mental health
Combination of counseling and medication

9. Patients, Residents, and Clients
Group people according to age, illness, or medical condition
Rehabilitation patients
Undergoing therapy to restore highest level of physical, emotional, mental, or occupational functioning
Inpatient and outpatient
Subacute or extended-care patients
Usually recovering from an acute illness or condition
Do not need total care, but not ready to return home

10. Patients, Residents, and Clients
Group people according to age, illness, or medical condition
Intensive care patients
Needing very specialized care
Usually nurse has 1 or 2 patients

11. Growth and Development
Changes that occur physically
Height, weight, and physical maturation of the body and organ systems
Development
Changes that occur psychologically or socially
Behavior and way of thinking

12. Growth and Development
Both occur in an orderly fashion
Progress from simple to complex
Process is divided into stages of normal progression
Not everyone progresses through the stages at the same rate
A person cannot progress to the next stage without completing the tasks/milestones
Stages may be defined differently based on psychologist you study

13. Growth and Development
Infancy (Birth to 1 Year)
Stage when changes occur most rapidly
Neonate (newborn to 28 days old)
New tasks completed on a weekly to monthly basis
Smile and laugh
Recognize parents
Play peek-a-boo,
Say simple words
Eating solid foods

14. Growth and Development
Toddlerhood (1 to 3 years)
Physical growth slows down
Become quite active
walk, run, climb, jump
Safety becomes a concern
Greater control of bladder and bowels
Learns words to express emotion
Short complete sentences

15. Growth and Development
Toddlerhood (1 to 3 years)
Increasing independence
Usually play alone or along side another child without many interactions
Do not tolerate separation from parent or caregiver easily
Medical procedures requiring separation may be very frightening

16. Growth and Development
Preschool (3 to 5 years)
“an adventure waiting to happen”
Physical coordination improves a great deal
Dress self
Independent toileting
Plays with other children
Active imaginations

17. Growth and Development
Preschool (3 to 5 years)
Aware of gender differences
Ask questions
Develop a conscience
More easily follows rules

18. Growth and Development
School-Age (5 to 12 years)
Several major physical growth spurts
Fine motor skills develop
Play with groups of same-sex friends
Increased ability to follow society’s rules
Seek approval from authority figures and peers
Logical thinking patterns develop

19. Growth and Development
School-Age (5 to 12 years)
Learn to incorporate other people’s perspectives in their own thinking
Feel very strongly about right and wrong with no grey area
Spiritual and religious beliefs also take root

20. Growth and Development
Adolescence (12 to 20 years)
Ages of this stage vary considerably
Begins at the onset of puberty
Reproductive organs begin to function
Girls usually between 10 and 14
Boys usually between 12 and 16
Physical growth and development is considerable

21. Growth and Development
Adolescence (12 to 20 years)
May be self conscious about changing bodies
Aware of own sexuality
Experiment with new styles of dress and hair
Follow very closely with friends
Begin dating
Question authority figures

22. Growth and Development
Adolescence (12 to 20 years)
May experiment with sex, drugs, alcohol
May take jobs
Plans for future education and beginning of career

23. Growth and Development
Young Adulthood (20 to 40 years)
Typically have stable supporting friendships
Good health
Complete education
Starting a career
Finding a partner and marrying
Learn to be successful on their own

24. Growth and Development
Young Adulthood (20 to 40 years)
Children
Very little physical change

25. Growth and Development
Middle Adulthood (40 to 65 years)
Many at the height of their careers
Caretaker to children
Caretaker to aging parents
“sandwich generation”
More time to travel and leisure
Many become grandparents

26. Growth and Development
Middle Adulthood (40 to 65 years)
Shows signs of aging
Wrinkles
Grey hair
Women experience menopause
Chronic illness
Hypertension
diabetes

27. Growth and Development
Later Adulthood (65 to 75 years)
Physical changes of aging become more prevalent
Strength diminishes
Decreased hearing and sight
Retirement
Many have to cope with loss of friends and or spouse due to death

28. Growth and Development
Older Adulthood (75 years and beyond)
Primary task is preparing for one’s own death
Adjust to failing health
Enjoy sharing wisdom with younger people

29. Basic Human Needs
Primary mission of health care is to tend to the physical and emotional needs of those we care for
What are needs?
What are wants?

30. Basic Human Needs Maslow’s Hierarchy of Human Needs
Need is something essential for a person’s physical and mental health
Abraham Maslow defined what he thought to be basic human needs
Believed that the more basic needs must be met before the higher-level needs can be met
Many people can meet their own needs with little or no outside help
People who are ill, injured, or disabled, rely on help of healthcare team to meet needs

31. Basic Human Needs

32. Basic Human Needs Physiologic Needs Most basic level of needs
Essential for survival
Highest priority
Nursing Assistant Interventions
Assisting with meals
Toileting
Ambulation
Providing a relaxing environment

33. Basic Human Needs Safety and Security Needs Physical Emotional
Follow safety procedures
Infection control
Emotional
Call lights
Rounding
explanations

34. Basic Human Needs Love and Belonging Needs
All people need to feel loved, accepted, and appreciated
Family life
When not met, loneliness and isolation develop
Babies and children don’t grow
Older people can actually die of loneliness

35. Basic Human Needs Love and Belonging Needs
Nursing Assistant Interventions:
Take interest in residents
Smile
Kind words

36. Basic Human Needs Self-Esteem Needs How a person perceives themselves
How they think other people perceive them
Things that effect self-esteem in health care
Having to wear a hospital own
Having surgery that might change physical appearance
Having to depend on others for something they used to do themselves

37. Basic Human Needs Self-Esteem Needs Nursing Assistant Interventions
Provide for privacy
Allowing residents to wear own clothing when possible
Assisting with grooming
Allowing as much independence as possible

38. Basic Human Needs Self-Actualization Needs
A person must reach his or her fullest potential
Most try to meet this need throughout entire life
Constantly setting new goals
Nursing Assistant Interventions
Help resident set small, realistic goals for positive outcome
Help meet basic needs first

39. Culture and Religion Culture
Made up of the beliefs (includes religious or spiritual beliefs), values, and traditions that are customary to a group of people
A view of the world that is handed down from generation to generation
Can be shared by people of the same race or ethnicity
Shared by people in the same geographic area, or speak the same language
Race
General characterization that describes skin color, body stature, facial features, and hair texture

40. Culture and Religion Culture United States is very culturally diverse
Lake County??
As a healthcare worker it is important to learn as much as possible about other cultures or ethnic groups
Cultural differences will affect how healthcare is delivered
Attitudes toward sickness and death
Avoid generalizations

41. Culture and Religion Culture Religion Food preferences
A person’s spiritual beliefs
Often closely linked to culture
Certain rituals
May be different than yours

42. Culture and Religion Religion
If a resident asks to see a spiritual leader or clergy, grant the request promptly
Respect another person’s values

43. Quality of Life
Sometimes we get so focused on a patient or resident’s problems we forget to consider the desires of the individual
Use a humanistic approach
Allow patients or residents to make decisions about their care
What if a person decides not to follow treatment recommendations?
Quality of life
Getting satisfaction and comfort from the way we are living
Must respect decisions related to quality of life issues

44. A Person’s Family
You must consider the impact of a person’s illness or disability on their family members
Families may be very diverse
Many family members feel “guilty”
Feel they have failed their loved one

45. A Person’s Family
Some family members will question you and second guess your care
Family members may be involved in care decisions if the patient allows