Age-Related Care

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Age-Related Care
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General Communication

• Allow caregiver to remain whenever possible
• Observe childs LOC, activity level, interaction,
  position of comfort, skin color, resp.
  rates/effort, degree of discomfort before
  touching the child
• Ask caregiver about childs normal behavior

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General Communication

• Address child by name
• Use a kind, firm, direct approach- demonstration
  can be helpful
• Be honest with child and caregiver
• Remember all ages are capable of experiencing
  pain, but show differently

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Infants

• PSYCHOSOCIAL
• Understand and experience the world through their
  bodies
• Being held, cuddled, rocked or comforted with
  familiar touch and smells soothes
• Common fears- separation, stranger anxiety

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Infants

• A P CHARACTERISTICS
• Obligate nose breathers for first several months,
  blocked or partially blocked nasal passages may
  cause resp. distress
• Breathe predominately using abdominal muscles
• Faster metabolic rate increases O2 need

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Infants

• APPROACH
• Slowly, gently, calmly
• Assess while caregiver is holding, when possible
• Up to about 7 months old can be comforted by
  strangers as long as basic needs are met
• If calm, start with resp. rate and end with
  touching

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Toddlers

• PSYCHOSOCIAL
• Common fears include separation from caregiver
  and loss of control
• Tend to cling to caregiver when apprehensive
• Strongly sensory based Seeing is believing
• Will demonstrate strong positive and negative
  behaviors

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Toddlers

• A P CHARACTERISTICS
• Babinskis reflex normally present until walking,
  after 2 years should have plantar reflex
• Still uses abdominal muscles for breathing
• May still develop cold stress when critically
  ill/injured and exposed for extended periods of
  time

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Toddlers

• APPROACH
• Gradually, with quiet, soothing voice, keep
  physical contact minimal
• Incorporate play, let touch equipment
• Prepare immediately before procedure, tell when
  completed

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Preschoolers

• PSYCHOSOCIAL
• Do not have a well-developed concept of time
• Big imagination, take words literally
• Common fears include body mutilation, loss of
  control, death, darkness and being left alone

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Preschoolers

• A P CHARACTERISTICS
• Continues to use abdominal muscles for breathing

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Preschoolers

• APPROACH
• Allow to handle equipment
• Prepare immediately before procedure, in simple,
  concrete terms- delays can increase anxiety
• Tell to still sit, but its ok to cry

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School-aged Children

• PSYCHOSOCIAL
• Logical thought process is beginning, but
  misinterpretation is still common
• Starting to understand simple anatomy and body
  functions
• Starting to hide thoughts and feeling
• Common fears include separation from friends,
  loss of control, physical disability

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School-aged Children

• A P CHARACTERISTICS
• By about 8 years old, resp. A P is
  approximately that of an adult

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School-aged Children

• APPROACH
• Let older child choose if caregiver is present
  during assessment- privacy needs are changing
• Explain procedures simply and ask for feedback
• Reassure that procedure/illness/injury is not a
  punishment

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Early and Middle Adolescents

• PSYCHOSOCIAL
• Acutely aware of body appearance
• Psychosomatic complaints are common
• May experience mood swings, depression, eating
  disorders, suicidal ideation, violent behavior-
  normal vs. poss. problem?
• May regress to earlier stages of dev. For comfort
• Need concrete explanations

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Early and Middle Adolescents

• A P CHARACTERISTICS
• Rapid growth and heightened emotions, usually
  associated with hormonal changes

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Early and Middle Adolescents

• APPROACH
• Introduce self to child and family
• Sit down and talk to them
• Be honest, nonjudgmental, dont talk down to
• Respect privacy and confidentiality
• Provide with concrete information

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Erikson's Stages of Psychosocial Development

• Infancy (birth to 18 months)
• Trust vs. Mistrust
• Children develop a sense of trust when
  caregivers provide reliability, care, and
  affection. A lack of this will lead to mistrust.

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Erikson's Stages of Psychosocial Development

• Early Childhood (2 to 3 years)
• Autonomy vs. Shame and Doubt
• Children need to develop a sense of personal
  control over physical skills and a sense of
  independence. Success leads to feelings of
  autonomy, failure results in feelings of shame
  and doubt.

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Erikson's Stages of Psychosocial Development

• Preschool (3 to 5 years)
• Initiative vs. Guilt
• Children need to begin asserting control and
  power over the environment. Success in this stage
  leads to a sense of purpose. Children who try to
  exert too much power experience disapproval,
  resulting in a sense of guilt.

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Erikson's Stages of Psychosocial Development

• School Age (6 to 11 years)
• Industry vs. Inferiority
• Children need to cope with new social and
  academic demands. Success leads to a sense of
  competence, while failure results in feelings of
  inferiority.

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Erikson's Stages of Psychosocial Development

• Adolescence (12 to 18 years)
• Identity vs. Role Confusion
• Teens need to develop a sense of self and
  personal identity. Success leads to an ability to
  stay true to yourself, while failure leads to
  role confusion and a weak sense of self.

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Erikson's Stages of Psychosocial Development

• Young Adulthood (19 to 40 years)
• Intimacy vs. Isolation
• Young adults need to form intimate, loving
  relationships with other people. Success leads to
  strong relationships, while failure results in
  loneliness and isolation.

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Erikson's Stages of Psychosocial Development

• Middle Adulthood (40 to 65 years)
• Generativity vs. Stagnation
• Adults need to create or nurture things that will
  outlast them, often by having children or
  creating a positive change that benefits other
  people. Success leads to feelings of usefulness
  and accomplishment, while failure results in
  shallow involvement in the world.

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Erikson's Stages of Psychosocial Development

• Maturity(65 to death)
• Ego Integrity vs. Despair
• Older adults need to look back on life and feel a
  sense of fulfillment. Success at this stage leads
  to feelings of wisdom, while failure results in
  regret, bitterness, and despair.

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Resources

• Erikson's Stages of Psychosocial Development
• http//psychology.about.com/library/bl_psychosocia
  l_summary.htm
• http//www.ebmedicine.net/topics.php?pactionshowT
  opicSegtopic_id149seg_id3000