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| Job Specific Quizzes | ||
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Age-Specific Care
Introduction
As healthcare workers we offer our care and our experience to people at all stages of life, from infants to older adults. They are all individuals with their own feelings and abilities; But they grow and develop in similar ways. At each stage in life there are certain qualities and needs that are shared, and by understanding what these are, we can provide better, more appropriate care at each stage. Age specific-competencies address the different needs people have at different ages.
By incorporating age-specific considerations with each patient, you help identify and provide the care that particular patient needs at that time of life you help the patient become an active partner in health decisions.
Age-specific competencies have also become a major focus of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Healthcare staff needs to be trained on how the age of each patient can impact assessment, delivery of care, and health education needs for the patient. There may be special health considerations to be aware of at each stage of life, and the JCAHO feels all healthcare staff should understand and apply these age-specific considerations. Being able to apply age-specific are often depends on using age-appropriate communication skills to understand the patient's needs. We will address this issue first.
BARRIERS TO COMMUNICATION
At just about any age there may be barriers to communication that you should look for. Give the person your full attention and observe closely. You may not be able to fully do away with any barriers you find, but you can be aware of them and minimize them.
You should assess the patient's primary language and whether communication might be clearer if you brought in a translator. Check for any speech or hearing impairments, and check whether any confusion or depression might be a sign of physical or mental illness. Find out if the patient is under stress or worried if healthcare decisions might affect their schooling, job or family.
With children and adults, check if there are any apparent learning disabilities and if the person appears to understand instructions at an age-appropriate level. Be aware of cultural differences and how eye contact and gestures that seem ordinary to you might be misinterpreted. Some people from Asian cultures, for example, are much less comfortable with being touched than those from cultures. Make an effort to understand the patient's family structure and support system, and try to incorporate family caregivers into treatment suggestions. Clear communication with the patient can be the key to providing age-specific care.
NEONATES: BIRTH - 28 DAYS
Age-specific care begins at the beginning; with neonates. The first 28 days of life are a time when the neonate's body functions, such as digestion, temperature regulation and sleeping, become established. Neonates can focus on faces, smile in response to a smile, and lift their heads. Neonates are in a state of total dependency. The startle or Moro reflex is one of several reflexes neonates are born with to help cope with life outside the womb.
Normal reflexes such as grasping, gagging and startling are key healthcare issues for the neonate. Other important concerns are for good APGAR scores, age-appropriate vital signs (temperature, pulse and respiration) steady weight gain, and in some cases, blood glucose levels.
Age-specific care for neonates
Always handle the neonate in a gentle, comforting and soothing manner. Avoid over-stimulation. Speak to the neonate in a soft, comforting voice. Help parents learn proper childcare skills, including feeding, diapering and bathing. Be sure parents understand a neonate has immature heat regulation and needs to be kept warm.
With changes in the healthcare system, neonates are going home earlier these days and sometimes with potential healthcare problems that haven't been identified. New parents should be taught about issues of jaundice, breasting feeding and nutrition, cord care, fever and avoid sleeping positions associated with Sudden Infant Death Syndrome.
Help parents understand the importance of safety devices such as car seats. In most states, they are required by law. The current stand is to use a child seat in the back seat of the car and fasten it in place with both the lap and shoulder belt.
INFANTS/TODDLERS: 0-3 YEARS
Infants and toddlers are in a period of rapid growth and learning. They explore the world through direct sensory contact; by tasting, touching, looking, listening and smelling. And they progress in their efforts to communicate, moving from crying, through babbling to using simple words. They are very dependent, but are beginning to develop a separate self.
Key emotional and health and safety issues at this age are to foster good child-parent bonds; keep immunizations and checkups on schedule, and help parents ensure a safe environment for playing and sleep.
Age-specific care for infants
When infants and toddlers are brought in, ask the parents how feeding is progressing, ask if the infant seems to be developing motor skills normally, and if they have noticed any hearing or vision problems. Remind the parents that children develop at different speeds and if the infant seems slow to crawl or walk, remind them it may be perfectly normal.
Look for and ask the parents about any signs of colds or flu and remind the parents that these conditions are very common, especially among children who attend daycare. Hand washing as a way to prevent disease transmission should be emphasized to children, and parents should be aware of its importance for themselves and anyone providing care.
Check the toddler's teeth and help the parents understand the essentials of basic tooth care, even for one or two teeth. You will probably see the infant or toddler before any dentist does.
Encourage the child to communicate, and encourage hugging, cuddling and touch by staff and parents. All this will promote healthy bonds and good parenting. Be aware of the problem of "stranger anxiety" and try to limit the number of staff workers assigned to each infant.
Keep a safe environment, as well as helping parents learn how to care for the child safely at home.
There are many safety tips such a supporting an infant's head that may not be obvious to all parents, especially new parents.
YOUNG CHILDREN: 4-6 YEARS
Next we will discuss some of the common characteristics of young children from about ages 4 to 6. This is a period where growth slows a little but motor skills increase, and children learn many new skills including things like dressing and toilet training. Their minds begin to use symbols and they play with imagination and fears and stories. They identify with their parents but grow more independent and begin to become sensitive to others' feelings.
Key emotional and health and safety issues at this age are for praise and clear rules to provide a secure set of boundaries, to keep immunizations and checkups on schedule, and learn healthy habits for nutrition and grooming. In addition parents may need help teaching about safety equipment, such a bike helmets and elbow and knee pads for skateboarding. Match safety and pool safety can also be issues.
Age-specific are for young children
The healthcare worker should work to involve both parents and children in healthcare choices. Always explain what you are going to do in a firm and direct way before you start. Don't lie to the child about whether something will hurt, but reassure them that it won't hurt for long.
Injury and disease can be very upsetting to children. Children at this age tend to weave fantasies, so a minor wound may suggest that the whole limb is about to fall off. Explain healthcare issues clearly and reassure the child. Explain grooming and hygiene issues and point out to the parents that it's not just to look good, but an important infection control technique. And try to allow the child to make some reasonable choices, too. This will foster a growing sense of independence. It is important to incorporate the child's home routines as much as possible.
Use toys and games to help teach the child and reduce fear of health issues. Use talking, singing, and distractions like colorful stickers to divert attention from frightening procedures. Encourage the child to ask questions, talk about feelings, and play with other children to encourage both growing independence and social skills.
OLDER CHILDREN: 7-12 YEARS
Now we will discuss some of the common characteristics of older children from about ages 7 to 12. This is a period where growth continues slowly until there is a spurt at puberty. Children this age became mentally active, eager learners and love to share their knowledge. They learn about cause-and-effect, and they perfect their reading and writing and learn math skills.
While they are developing a greater sense of self, there is also a great need to fit in with their peers. School activities become very important and they may start negotiation with their parents for greater independence.
Key emotional and health and safety issues at this age are to learn to feel competent and useful, to continue immunizations and check-ups, and to begin to learn honest information about alcohol, drugs and sexuality. It is also time to begin learning playground safety habits and how to resolve conflicts peacefully.
Age-specific-care for older children
At this age vital signs approach the norms of adult parameters. Some questions may arise about the development of secondary sexual characteristics and should be dealt with honestly. The healthcare worker should explain procedures in straightforward terms, using correct terminology, and invite the child to make some healthcare choices. If equipment is needed, allow the child to explore the equipment ahead of time. You should allow longer training and teaching sessions. Provide privacy if necessary, and build into your teaching rewards and praise. Do your best to guide the child toward healthy lifestyle and safety choices. Habits formed at this age may last a lifetime. It's not too soon to begin to discuss exercise and nutrition and maintaining a healthy lifestyle. And help the parents talk to the child about crucial issues of peer pressure around smoking, sexuality and all kinds of substance abuse. It can be very hard for parents to know how to initiate these discussions and an outside authority such as a healthcare worker can be a big help in getting the ball rolling.
ADOLESCENTS: 13-20 YEARS
Now we will discuss some of the common characteristics of adolescents from about ages 13 to 20. This is a period where growth spurts upward and the body transforms into an adult, sexually mature body, and physical appearance becomes increasingly important.
At this age adolescents are able to entertain complex moral thinking, and they begin to make up their own minds and choose their own values. Adolescents need to balance developing their own identity with the need for very close relationships. Peer groups can come into conflict with family demands, and it can become a time of challenging authority.
Key emotional and health and safety issues at adolescence are for privacy and respect, and to find ways to foster teamwork. Checkups should continue and adolescents must learn about sexual responsibility, and ways to resist vastly increased temptations to substance abuse. Risk-taking, particularly in driving and risky sports needs to be addressed, and adolescents should be helped to learn ways to peacefully handle violent situations.
Age-specific care for adolescents
At adolescence, you should begin looking for signs of common adolescent health problems such as nutritional disorders, obesity, anorexia, bulimia, acne problems, STDs, substance abuse, pregnancy and any stress-related problems. This is a stress-filled age. Reassure adolescents about the normality of the changes they are going through. When working with adolescents, remember their self-consciousness about their bodies and provide for privacy.
The healthcare worker should begin treating as an adult and avoid authoritarian approaches. Talk directly to the adolescent, not through the parents. Always explain why something is being done. Be considerate of how any treatment may affect the adolescent's appearance and relationships, because these are very sensitive issues at this stage. Encourage questions about their fears. And respect any expressed or implied religious or cultural beliefs.
Adolescents with family histories of genetic-related diseases, such as cardiovascular disease, diabetes, or sickle cell trait, should be screened as appropriate. Adolescent girls should be taught breast self-examination. And boys should be taught testicular self-examination. Peak age for testicular cancer is 20-35. Guide the teen-ager toward positive lifestyle choices, and pay particular attention to misinformation that is common at this age and help correct it. Realize that there may be some resistance to taking advice from an adult. Encourage the teen and parents and peers to have open communication on any issues of concern. As an outside authority, you can often play a powerful role in opening up channels of communication.
YOUNG ADULTS: 21-39 YEARS
Now we will discuss some of the common characteristics of young adults from about ages 21 to 39. This is an age when young people finally reach physical and sexual maturity, and nutritional needs shift away growth toward maintenance of a healthy body.
Young adults are still acquiring the new skills that will help them at home and at work. They are seeking closeness and partnership. And they are making decisions that may last all their lives on careers, communities and starting a family.
Key emotional and health and safety issues for young adults are for support and honesty and respect for their personal values. They need to have regular health checkups and updated immunizations. They should be encouraged to pursue healthy lifestyles, including good nutrition, exercise and weight control. There is a need to begin to be aware of long-term health-risks for issues like heart disease and cancer. They also need to be guided to give their attention to safety hazards at home and at work.
Age-specific care for young adults
Young adults need to be monitored for STDs. Testicular and breast self-exam should be taught and encouraged. Discuss questions of stress in their lives, as this can be a time of great change, marriage, and beginning families, starting new jobs.
The healthcare worker should encourage young adults in making positive fitness and health care choices. Help the young adults recognize the new reality of their time and financial commitments to family, career and community. Explore the impact of hospitalization or illness on the patient's job or family. This is a time when most couples become parents and they need help considering the long-term commitments and challenges this brings. They may also need help with family planning and prenatal information.
Explain the specifics of a healthy physical workout, including warm-up and stretching exercises, and if necessary explain proper nutrition and diet to encourage a healthy lifestyle. Explain risk factors and signs to watch for chronic conditions such as heart disease because young adults often feel invulnerable and tend to ignore or deny early signs of disease.
MIDDLE ADULTS: 40-64 YEARS
Now we will discuss some of the common characteristics of middle adults from about ages 40 to 64. Adults of this age have had tremendous life experiences and continue to use them to learn and create and solve problems. They often reach a point where priorities are reevaluated and new decisions are made about their lives to stay productive and avoid feelings of being stuck in a rut in life. Many start to think of retirement and start to plan for it. Some may begin to develop chronic health problems and women experience the life change of menopause.
Key emotional and health and safety issues for middle adults are to focus on strengths and keep a hopeful attitude. Checkups and preventive exams must continue to address age-related issues and monitor any risks, and immunizations should be updated. Women, for example, should be encouraged to continue having breast exams even after menopause. Some middle adults need to be made aware of age-related changes in their senses, such as reduced visual and auditory acuteness and slower reflexes and how this may affect activities such as driving.
Age-specific care for middle adults
Middle adults should be screened for chronic conditions that often develop at this age, such as diabetes, prostate disorders and breast cancer. Women should be counseled bout menopause issues, such as taking estrogen or methods of minimizing the risks of osteoporosis.
The healthcare worker should encourage middle adults to express freely any worries about the future, and encourage them to plan for a healthy and active retirement. Be sure to acknowledge their abilities and contributions throughout life. This can be a time mid-life crisis when come people begin to doubt themselves and their contributions and they need encouragement. Some may need specific psychiatric interventions so be alert for signs of depression or other mental illness.
Be alert for any worries they have about their children or older parents. This as an age where many become the "sandwich generation," caring for both older and younger family members at the same time. This can also be a positive stage of life, with more time available to fulfill lifelong dreams of travel and leisure, and to pursue new interests or volunteer work that had been put off.
OLDER ADULTS: 65-79 YEARS
Now we will discuss some of the common characteristics of older adults from about ages 65 to 79. An older adult continues to be an active learner and thinker and can now pass on skills and wisdom to other generations.
There is some decline in physical abilities and senses that need attention. Often new roles will be taken on, such as grandparent or the return to single lie after the death of a husband or wife. There is a tendency now to review one's life, and to find new balances between independence and dependence.
Key emotional and health and safety issues for older adults are to remain respected and prevent isolation. Aspects of aging need to be accepted and extra effort made to remain active. Nutritional needs are changing and there are still needs for regular checkups, breast and prostate exams, and immunizations, particularly against influenza, which can be much more, serous at later ages. It's important to promote physical, mental and social activities and guard against depression. Home safety needs attention, especially guarding against falls, and changes in skills may make driving risks much greater.
Age-specific care for older adults
Stay alert for signs and complaints of the more common chronic conditions at this age, such as arthritis, hypertension, hearing impairment, and heart disease, and conduct regular screening for these conditions. Also be alert for digestive and esophageal problems such as reflux, and bladder and bowel problems, which become more common at this age. The healthcare worker should encourage the older adults to express freely their feelings about their accomplishments in life, but also their feelings of loss and grief. As they age, they will lose friends and family and grief counseling can be very important.
Often medication use, with multiple medications can become quite complicated, and it is important to help an older adult work out a manageable schedule. Explain any procedure using appropriate terms. Provide for warmth if necessary because of the possibility of decreased heat regulation. Be alert for the development of any impairment that may inhibit mobility or activities of daily living.
And also point out ways to make the environment safer, such as removing slick throw rugs. You should also suggest practical ways of dealing with any impairment that exist, but do not assume impairments exist just because of age. Offer contacts to support services. To keep an older adult busy and engaged, you can encourage social activities with peers or volunteer activity to give something back to the community. The sense giving back and staying active can make all the difference in a person's outlook at this age.
AUDLTS 80 AND OLDER
Last we will discuss some of the common characteristics of adults 80 or older. There is no reason to think a person this age is in mental decline. Some great writers and artist continued to create until well past this age. While you should be alert for signs of confusion, they may just signal an illness or depression that might be treatable. Many people this age begin to accept that the end of the life is approaching and begin to prepare for it.
Key emotional and health and safety issues for adults over 80 are to encourage expression of feelings and thoughts, encourage humor and stay positive to help prevent depression. Health should be monitored closely, and proper nutrition, exercise, and health rest and avoidance of stress should all be encouraged. Immunizations should be updated, particularly against influenza which can be more serious, even life threatening, for older adults. The environment should be monitored to prevent any hazards, particularly falls, which can be devastating at this age. Safety grips, ramps and similar aids may become crucial at this age, either at home or in a nursing home.
Age-specific care for adults 80 and over
There is an increased risk of chronic illnesses and major health problems that need to be watched. The healthcare worker should encourage as much independent living in older adults as possible. Physical, mental and social activities should be encouraged. An active mind and a sense of humor can often support a person's spirits.
Medications for those over 80 can become even more complicated and may require you to work out very detailed plans. You may need to include helps like color-coding and timed reminders to help the person follow the schedule. Encourage healthy eating and adequate fluid intake. Be alert to the fact that changes in tastes or ability to chew may result in decreased intake. You may need to monitor bowel function daily. It is important to avoid treating an older adult like a child. Almost anyone will sense and resent being patronized.
Support any end-of-life decisions, offering access to appropriate information such as advance directives, and encourage the preparation of trusts and living wills. Offer any assistive devices that can keep the person adept at his own activities of daily living, and make sure he has access to all necessary safety ramps and other equipment. The more independence the person can maintain, the better the quality of life.
CONCLUSION
People grown and learn and change all their lives. Each person is an individual with his or her own special needs and feelings, and thoughts and dislikes. But we all share the human condition, too, and there is so much that we share with one another at every step of the journey.
This program has been a guideline for the age-specific competencies that will help you work with patients at all stages of their life. It will help you learn what you can offer them at just that moment in their journey when they need it most.
