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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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?

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

Basic Human Needs

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

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

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

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

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

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

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

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

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

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

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

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

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

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