Chapter 3

Understanding ResidentsChapter 3

Basic Human NeedsMaslows Hierarchy of NeedsPhysicalSafety and SecurityNeed for loveNeed for self-esteemNeed for self-actualization (to learn, realize ones potential)

Sexual needsThey are still present in old age, must be respected, not judged

GuidelinesSexual needsKnock, 2 consenting adults, provide privacy and leaveMust watch for abuse, mandatory reportingHolistic CareCaring for the whole personHave a conversation while bathing someoneMeets physical, as well as psychosocial needsTreating with dignity and respectPromoting Independence and self-care

Cultural Diversity and needsMany cultures in the U.S.You will care for people from many cultures.Be sensitive to each persons:Food preferencesComfort with touchReligious practicesTraditionsFeelings about family Respect residents choices and beliefs.* * Always treat residents as you would like to be treated, if you were in their place.

ActivityActivity is essential to physical and mental health.Promotes independence, wellness, and quality of life.

Improves body functionGI, muscles, energyStress, moodInactivityDepressionConstipationWeight gainBlood clots

Family and FriendsPlay a very important supportive role.Different types of support groups, must be recognized a essential people in the residents life.Must be respectful to friends and family and allow for privacy during visits.Pay attention to interactions between family membersMust report abusive behavior.

Human developmentInfancy Birth to 12 monthsDeveloping physicallyGaining control over their bodiesLearning to feed themselvesEntirely dependent on their family, at first.Toddler 1 3 yearsBecoming more independent.TantrumsGain control of bowel and bladder.

Human Development (continued)Preschool Age (3 6 years)Learning words and language skills.More physically coordinated.Learn right from wrong.School Age (6 10 years)Development of cognition (thinking processes)Social DevelopmentDevelopment of conscience and morals.

Human Development (continued)Preadolescense (10 13 years) Very social.Need to feel trust in the attention and care of parents.Adolescence (13 19 years)PubertyPeriod of change in bodies and emotions.Still need parents but are trying to establish independence.May be a very stressful time for both child and parents.

Human Development (continued)Young Adult (19 40)Continued social and psychological developmentCareerFamilyMiddle Adult hood (40 65)More stablePhysical changes r/t aging occur.Diseases develop, may become chronic

Human Development (continued)Late adulthood (65 and older)Adjusting to effects of aging.Lets read list on page 67

Developmental DisabilitiesPresent at birth, chronic conditionAffects language, mobility, learning, ability to care for selfIntellectual disabilityDifficulty with learning, communicatingPossess the same emotions and needs as anyone else, but limited in how those are expressed.Guidelines for CareTreat with dignity and respect, encouragement for tasks done wellPromote independence when able, assist when needed

More on Mental IllnessSome diagnoses:DepressionApathy, loss of appetite, withdrawalBipolarAnxietyPhobiasOCDPTSDSchizophrenia

Treatment for Mental IllnessPsychotherapyMedicationsECT

Death and DyingHospice careStages of GriefDenialAngerBargainingDepressionAcceptance

Advance DirectivesLegal Documents

Living will Medical Directive

Durable Power of Attorney

DNR Do not resuscitate No CPR if not breathing or heart not beating.

Care of dying patientDiminished sensesCare of mouth and noseSkin careComfortEnvironment comfortable, call light within reachEmotional and Spiritual SupportListen to residentExplain what you are doing, even though may seem like residents is unconscious.Hearing is the last sense to go.

Rights of the dying patientThe right to refuse treatmentThe right to have visitorsThe right to privacy.More rights listed on page 72.

Approaching DeathUnfocused eyesVS decreasing..BP, HRCheyne-Stokes breathingRattling or gurgling sound when breathingMottled skinDisorientation

Post-Mortem CareAfter death care:Bathe bodyPlace clean gown on.Do not remove any tubes or other equipment, nurse will do.Close eyesPlace arms folded across abdomenRigor Mortis sets in, so body must be positioned soon after death.

Special Services for End of LifeHospice care6 months or less to liveFocus is on pain and anxiety reliefNo longer on Cure.

Palliative CareAllow resident to have as much control over life as possible.Be a good listener.Be supportive of resident and family.