Chapter 3

1. Understanding
Residents
Chapter 3

2. Basic Human Needs
 Maslow’s Hierarchy of Needs
 Physical
 Safety and Security
 Need for love
 Need for self-esteem
 Need for self-actualization (to learn, realize one’s
potential)
 Sexual needs
 They are still present in old age, must be respected, not
judged

3. Guidelines
 Sexual needs
 Knock, 2 consenting adults, provide privacy and
leave
 Must watch for abuse, mandatory reporting
 Holistic Care
 Caring for the whole person
 Have a conversation while bathing someone
 Meets physical, as well as psychosocial needs
 Treating with dignity and respect
 Promoting Independence and self-care

4. Cultural Diversity and needs
 Many cultures in the U.S.
 You will care for people from many cultures
. Be sensitive to each person’s:
Food preferences
Comfort with touch
Religious practices
Traditions
Feelings about family
Respect residents’ choices and beliefs.
* * Always treat residents as you would like to be
treated, if you were in their place.

5. Activity
 Activity is essential to physical and mental health.
 Promotes independence, wellness, and quality of
life.
 Improves body function
 GI, muscles, energy
 Stress, mood
 Inactivity
 Depression
 Constipation
 Weight gain
 Blood clots

6. Family and Friends
 Play a very important supportive role.
 Different types of support groups, must be
recognized a essential people in the resident’s
life.
 Must be respectful to friends and family and allow
for privacy during visits.
 Pay attention to interactions between family
members
 Must report abusive behavior.

7. Human development
 Infancy – Birth to 12 months
 Developing physically
 Gaining control over their bodies
 Learning to feed themselves
 Entirely dependent on their family, at first.
 Toddler – 1 – 3 years
 Becoming more independent.
 Tantrums
 Gain control of bowel and bladder.

8. 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 Development
 Development of conscience and morals.

9. Human Development (continued)
 Preadolescense (10 – 13 years)
 Very social.
 Need to feel trust in the attention and care of
parents.
 Adolescence (13 – 19 years)
 Puberty
 Period 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.

10. Human Development (continued)
 Young Adult – (19 – 40)
 Continued social and psychological development
 Career
 Family
 Middle Adult hood (40 – 65)
 More stable
 Physical changes r/t aging occur.
 Diseases develop, may become chronic

11. Human Development (continued)
 Late adulthood (65 and older)
 Adjusting to effects of aging.
Let’s read list on page 67

12. Developmental Disabilities
 Present at birth, chronic condition
 Affects language, mobility, learning, ability to care
for self
 Intellectual disability
 Difficulty with learning, communicating
 Possess the same emotions and needs as anyone
else, but limited in how those are expressed.
 Guidelines for Care
 Treat with dignity and respect, encouragement for
tasks done well
 Promote independence when able, assist when
needed

13. More on Mental Illness
 Some diagnoses:
 Depression
 Apathy, loss of appetite, withdrawal
 Bipolar
 Anxiety
 Phobias
 OCD
 PTSD
 Schizophrenia

14. Treatment for Mental Illness
 Psychotherapy
 Medications
 ECT

15. Death and Dying
 Hospice care
 Stages of Grief
 Denial
 Anger
 Bargaining
 Depression
 Acceptance

16. Advance Directives
 Legal Documents
 Living will – Medical Directive
 Durable Power of Attorney
 DNR – Do not resuscitate – No CPR if not breathing
or heart not beating.

17. Care of dying patient
 Diminished senses
 Care of mouth and nose
 Skin care
 Comfort
 Environment – comfortable, call light within reach
 Emotional and Spiritual Support
 Listen to resident
 Explain what you are doing, even though may seem
like residents is unconscious.
 Hearing is the last sense to go.

18. Rights of the dying patient
 The right to refuse treatment
 The right to have visitors
 The right to privacy.
 More rights listed on page 72.

19. Approaching Death
 Unfocused eyes
 VS decreasing..BP, HR
 Cheyne-Stokes breathing
 Rattling or gurgling sound when breathing
 Mottled skin
 Disorientation

20. Post-Mortem Care
 After death care:
 Bathe body
 Place clean gown on.
 Do not remove any tubes or other equipment, nurse
will do.
 Close eyes
 Place arms folded across abdomen
 Rigor Mortis sets in, so body must be positioned
soon after death.

21. Special Services for End of Life
 Hospice care
 6 months or less to live
 Focus is on pain and anxiety relief
 No longer on Cure.
 Palliative Care
 Allow resident to have as much control over life as
possible.
 Be a good listener.
 Be supportive of resident and family.