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AGE SPECIFIC COMPETENCIES. Caring for patients at every stage of life

Presented by,Deepa S Madhu,MSN,RN

ADH

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To increase the awareness among nurses about age specific competencies as a part of JCAHO standards!

To ensure that the quality care providing to different age groups are co ordinated.

To ensure that all age groups are treated with dignity and respect.

Discussing about patient care and communication barriers.

Objectives

ADH

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"Age-specific competencies" means the ability to communicate with each patient, resident or client in a way that is appropriate to his or her particular age, capabilities or disabilities, temporary impairments, emotions, stresses, culture, and individual station. that you use to give care, that meets each patient’s unique needs.

WHAT ARE AGE-SPECIFIC COMPETENCIES ?

ADH

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Communication Safety & Security Health Recognition of Common Illnesses

SKILLS

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Help Ensure Quality Care: With age-specific competencies, each patient gets the individual care that he or she needs and deserves. He or she also becomes a partner in his or her own health care plan.

Improve Job Performance and Satisfaction: Putting age-specific competencies into practice can be a challenge. But the rewards, improved patient care, relationships and teamwork, are great!

Meet JCA Standards: Age-specific competencies are a key area of focus for the JCA (Joint Commission on Accreditation of Healthcare Organizations) survey. They’re essential to gaining and retaining accreditation.

AGE-SPECIFIC COMPETENCY BENEFITS

ADH

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INFANTS(BIRTH TO 1 YEARS) ARETRUSTING

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Fear of strangers (begins 6-8 months of age)Communicate discomfort by crying, facial

expressions, body movementPrefer to be held in familiar positionsLike established routines, verbal repetitionUnderstand simple commands, respond well to

consistencyAre fearless, choke easily, accident prone,

require constant supervisionNeed to consistently have needs met to develop

sense of trust (feeding, changing)

CHARACTERISTICS

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Talk to baby before touchingInvolve parents in procedure if possibleImitate how parent holds babyExplain procedure to parents beforehandRemove unnecessary equipmentKeep infant clothed as much as possibleDo not leave infant unattendedAllow parent to hold infant while waiting Ask parents about immunization record

NURSING IMPLICATIONS

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TODDLERS (1 TO 3 YEARS) ARE CURIOUS

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Views hospitalization as punishmentNeeds security objectsCurious, unaware of dangerComprehension greater than ability to verbalizeShort attention spanFrequently says “NO” trying to demonstrating

independenceCan be cooperative if trust is won

CHARACTERISTICS

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COMMON FEARSSeparation . Loss of Control . Altered rituals . Pain

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Reassure that treatment is not a punishment

Simple explanations

Give one direction at time

Demonstrate equipment

Speak at eye level, maintain eye contact

Remove unnecessary equipment

Use distraction techniques

Involve parents, allow to be present during procedures

. Nursing Implications

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YOUNG CHILDREN (AGES 4 TO 6 YEARS) ARE ACTIVE

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Seek explanations “Why?” By age 5 speaks in 8 word sentencesIncreased speech skills, attention span and

memory Fear, bodily injury, separation, death, punishmentDifficulty expressing needsPrivacy importantAccident prone

CHARACTERISTICS

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Use simple explanationAdapts to changes in environment more easily

than toddlerBe truthful about pain, discomfortEncourage questions regarding fears Show caregiver location of restroomsInclude parents in teaching Plan procedure to minimize waiting time

Nursing implications

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ADOLESCENTS (AGE 13 TO 20 YEARS) ARE IN TRANSITION

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Developing greater sense of selfStart to negotiate for independenceNeed to fit in with peersRules very importantNeed respect for privacyFear mutilation, loss of control

CHARACTERISTICS

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Encourage questions Treat more as adult, avoid authoritarian

approach Allow maintenance of control Talk directly to them, not through

parents, and offer explanations Maintain privacy Establish trust to gain cooperation

NURSNG IMPLCATIONS.

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YOUNG ADULTS (AGES 21 TO 39 YEARS) BUILD CONNECTIONS

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Sets career goals, chooses lifestyle

May start own family, building connections

Developing responsible attitude

Need to establish healthy lifestyle

Nutrition needed for maintenance not growth

Mental abilities peak during 20s

CHARACTERISTICS

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Respect personal values, be honest & supportive

Consider significant others, impact on jobEncourage to pursue healthy lifestyleTeach & encourage testicular & breast self-

examMaintain privacyEncourage creating Advance Directive

NURSING IMPLICATIONS

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MIDDLE ADULTS (AGES 40 TO 64 YEARS) SEEK PERSONAL GROWTH

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May develop chronic health problems

Decrease in bone and muscle mass, short term memory, loss of skeletal height and calcium, skin elasticity, dry skin, wrinkles

Women experience menopause

“Sandwich generation”

Use life experiences to learn, solve problems

Future oriented, has specific goals

CHARACTERISTICS

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Encourage regular check-ups & preventative exams

Assist person to recognize risk factors related to health

Focus on their strengths

Address worries about children & aging parents

Treat with respect

Provide explanations and educate.

Nursing implications cont.

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OLDER ADULTS (AGES 65 YO 79 YEARS) ENJOY NEW OPPORTUNITIES

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Continue to be active learner/thinker

Takes on new roles, balances independence v. dependence

Most elderly are not depressed

May become isolated

Some decline in physical abilities, senses, memory skills (short term memory, attention span shortens)

CHARACTERISTICS

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Promote mobility & ADL

Consider needs related to diminished sight, hearing (may need to read information to patient, face person when talking to them)

Allow reminiscing about the past Promote physical, mental, social activities

to prevent isolationAllow more time for processing new

informationEducate about safety measures

Nursing implications cont.

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Give the person your full attention -

listen and observe.

Remember:

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ADULTS AGES( 80 AND OLDER )MOVE TO ACCEPTANCE .

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Decline in physical ability, increased risk for chronic illness

Decline in memory & learning skillsMay need assistance in ADLMay have diminished appetite, fluid intake

Healthy growth and development

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Encourage as much mobility & ADL as possible.

Encourage healthy eating & adequate fluid intake, monitor bowel function.

Avoid treating older adult like a child.Respect & support end of life decisions.

NURSING IMPLICATIONS

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Assess every patient you deal with for the possibility of the following: Physical Impairments Learning Difficulties Cultural Differences Emotional Stresses Language. Barriers •

RECOGNIZE BARRIERS TO COMMUNICATION

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Age Specific Competency Post Test

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1. When performing any procedure on an infant, it is important to:A. Move as quickly as possibleB. Talk to the baby while performing the procedureC. Avoid eye contactD. Allow mother to hold infant while waiting

2. It is important to always speak to the infant before a touch:

A. True B. False

3. To help the newborn feel secure, caregivers can:A. Hold the infant only when he criesB. Imitate how the parent holds the newbornC. Encourage friends and neighbors to be involved in care

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4. As a healthcare provider, one of the most important parts of the infant's history is:A. Favorite mealsB. Likes and dislikesC. Favorite toysD. Immunization record

5. The toddler who is having blood drawn:A. Will usually want a parent presentB. Will be concerned with privacyC. Will require a detailed explanation of the procedure

6. Use of the word "No" by a toddler indicates:A. He has limited vocabularyB. He is showing his independenceC. He is not friendly towards strangersD. He hasn't learned how to say "Yes"

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7. Preschoolers have increased speech skills, attention span and memory. This helps them to:A. Manipulate their environmentB. Sleep better without their parentsC. Change their routines more easilyD. Understand what is happening to them

8. School-aged children have a need to:A. Gain independence from their friendsB. Fit in with peersC. Be separated from siblings in a stressful situation

9. When doing procedures with children, it is important to let them:A. Know they can cryB. Become separated from their parentsC. Know your first nameD. Leave them alone to gain control of their emotions

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10. During the adolescent period, it is normal to be concerned with:A. Current eventsB. Childhood memoriesC. The same things as adultsD. Body image

11. It is important for staff working with adolescents to:A. Assume the patients will ask if they have any questionsB. Talk to the parents since an adolescent is unable to really

understand fullyC. Talk directly to the adolescent and offer explanationsD. Tell them as little as possible so they will not be frightened

12. The hospitalized adolescent patient :A. Is not affected by the hospital stayB. Continually strives for independence and controlC. Is not concerned with assisting with plan of care, and encourages

parents adviceD. Is too immature to understand or care about the changes

occurring in their bodies

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13. The adolescent population is usually characterized by:A. Rapid growthB. Awkwardness on gross motor skillsC. Beginning of development of occupational identityD. All of the aboveE. None of the above

14. For the young adult, it is important to involve the individual and significant other in the plan of care. A. TrueB. False

15. Which statement about young adults is NOT true: A. Nutritional needs are for growth, not maintenanceB. Seeks closeness with others & may start own familyC. Makes lifelong decisionsD. Needs to be encouraged to have regular checkups

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16.Young adults like others to make decisions for them and to control their lives.A. TrueB. False

17. Which of the following physical change(s) occur in middle adulthood?A. Loss of skin elasticity, dry skin and an

increase in wrinklesB. Decrease in muscle strength and massC. Decrease in bone massD. Loss of skeletal height and calciumE. All of the above

18. During middle adulthood, short-term memory or recall increases.A. TrueB. False

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19. We should be patient with the middle-aged adult who is part of the “sandwich generation” (caring for aging parents and their own children).A. TrueB. False

20. Which of the following intervention(s) should we do with middle-aged adults?A. Treat them with respect and explain everything to

themB. Encourage as much dependency as possibleC. Make decisions for them instead of allowing them

choicesD. All of the above

21. The middle-aged adult is future-oriented and has specific goals.A. TrueB. False

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22. Which of the following statement(s) is true, related to the elderly? Select all that apply.A. They do not like to talk about the pastB. They may have difficulty hearing and/or seeingC. They tend to be depressedD. They need more time to process new information

23. When giving an elderly person instructions, it is important to:A. Shout in the earB. Treat the person as you would a person of any ageC. Face the person so he/she can see your lipsD. Wait until a family member is present

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24. Identify the appropriate change for visual impairment in the elderly.A. No change in lighting is neededB. With glasses, no changes in lighting neededC. Staff may need to read information to the patientD. The family is responsible for the accommodations

25. When educating a person over 65, the following changes in cognitive functioning need to be considered:A. Short-term memory may be impairedB. More time is needed to process informationC. Attention span shortensD. All of the above

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