Chapter 8

Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.

Chapter 8Chapter 8

UnderstandingUnderstanding

the Residentthe Resident


Caring for the PersonCaring for the Person

For effective care, you must consider the For effective care, you must consider the whole person.whole person.

The whole person has physical, social, The whole person has physical, social, psychological, and spiritual parts.psychological, and spiritual parts. These parts are woven together and cannot be These parts are woven together and cannot be

separated.separated. Each part relates to and depends on the others.Each part relates to and depends on the others.

Disability and illness affect the whole person.Disability and illness affect the whole person.

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Addressing the personAddressing the person Call residents by their titles.Call residents by their titles. Do not call residents by their first names unless Do not call residents by their first names unless

they ask you to.they ask you to. Do not call residents by any other name unless Do not call residents by any other name unless

they ask you to.they ask you to. Do not call residents Grandma, Papa, Sweetheart, Do not call residents Grandma, Papa, Sweetheart,

Honey, or other names.Honey, or other names.

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Basic NeedsBasic Needs

According to Abraham Maslow:According to Abraham Maslow: Basic needs must be met for a person to survive Basic needs must be met for a person to survive

and function.and function. The needs are arranged in order of importance.The needs are arranged in order of importance. Lower-level needs must be met before the higher-Lower-level needs must be met before the higher-

level needs.level needs.

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Basic needs, from the lowest level to the Basic needs, from the lowest level to the highest level, are:highest level, are: Physiological or physical needsPhysiological or physical needs Safety and security needsSafety and security needs Love and belonging needsLove and belonging needs Self-esteem needsSelf-esteem needs The need for self-actualizationThe need for self-actualization

People normally meet their own needs.People normally meet their own needs.

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Culture and ReligionCulture and Religion

Culture is the characteristics of a group of Culture is the characteristics of a group of people passed from one generation to the people passed from one generation to the next.next. The person’s culture:The person’s culture:

• Influences health beliefs and practicesInfluences health beliefs and practices

• Affects behavior during illness and when in a nursing Affects behavior during illness and when in a nursing centercenter

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Religion relates to spiritual beliefs, needs, Religion relates to spiritual beliefs, needs, and practices.and practices. A person’s religion influences health and illness A person’s religion influences health and illness

practices.practices. Many people find comfort and strength from Many people find comfort and strength from

religion during illness.religion during illness. The nursing process reflects the person’s The nursing process reflects the person’s

culture and religion.culture and religion. Do not judge the person by your standards.Do not judge the person by your standards.

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Effects of Illness and DisabilityEffects of Illness and Disability

Sickness and injury have physical, Sickness and injury have physical, psychological, and social effects.psychological, and social effects.

Anger is a common response to illness and Anger is a common response to illness and disability.disability. To help the person feel safe, secure, and loved:To help the person feel safe, secure, and loved:

• Take an extra minute to “visit,” to hold a hand, or to give Take an extra minute to “visit,” to hold a hand, or to give a hug.a hug.

• Show that you are willing to help with personal needs.Show that you are willing to help with personal needs.

• Respond promptly.Respond promptly.

• Treat each person with respect and dignity.Treat each person with respect and dignity.

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Optimal level of functionOptimal level of function Residents are helped to maintain their optimal Residents are helped to maintain their optimal

level of function.level of function. Encourage the person to be as independent as Encourage the person to be as independent as

possible.possible. Always focus on the person’s abilities.Always focus on the person’s abilities.

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Nursing Center ResidentsNursing Center Residents

Alert, oriented residentsAlert, oriented residents Confused and disoriented residentsConfused and disoriented residents Complete care residentsComplete care residents Short-term residentsShort-term residents Life-long residentsLife-long residents Mentally ill residentsMentally ill residents Terminally ill residentsTerminally ill residents

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Behavior IssuesBehavior Issues

People who do not adjust well have some of the People who do not adjust well have some of the following behaviors:following behaviors: AngerAnger Demanding behaviorDemanding behavior Self-centered behaviorSelf-centered behavior Aggressive behaviorAggressive behavior WithdrawalWithdrawal Inappropriate sexual behaviorInappropriate sexual behavior

A person’s behavior may be unpleasant.A person’s behavior may be unpleasant. You cannot avoid the person or lose control.You cannot avoid the person or lose control. Good communication is needed.Good communication is needed. Follow the care plan.Follow the care plan.

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For Effective CommunicationFor Effective Communication

Use words that have the same meaning for you and Use words that have the same meaning for you and the person.the person.

Avoid medical terms and words not familiar to the Avoid medical terms and words not familiar to the person.person.

Communicate in a logical and orderly manner.Communicate in a logical and orderly manner. Give facts and be specific.Give facts and be specific. Be brief and concise.Be brief and concise. Understand and respect the resident as a person.Understand and respect the resident as a person. View the person as a physical, psychological, social, View the person as a physical, psychological, social,

and spiritual human being.and spiritual human being.

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Appreciate the person’s problems and Appreciate the person’s problems and frustrations.frustrations.

Respect the person’s rights.Respect the person’s rights. Respect the person’s religion and culture.Respect the person’s religion and culture. Give the person time to process the information Give the person time to process the information

that you give. that you give. Repeat information as often as needed.Repeat information as often as needed. Ask questions to see if the person understood Ask questions to see if the person understood

you.you. Be patient.Be patient. Include the person in conversations when others Include the person in conversations when others

are present.are present.

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Follow these rules for spoken communication:Follow these rules for spoken communication: Face the person.Face the person. Position yourself at the person’s eye level.Position yourself at the person’s eye level. Control the loudness and tone of your voice.Control the loudness and tone of your voice. Speak clearly, slowly, and distinctly.Speak clearly, slowly, and distinctly. Do not use slang or vulgar words.Do not use slang or vulgar words. Repeat information as needed.Repeat information as needed. Ask one question at a time.Ask one question at a time. Do not shout, whisper, or mumble.Do not shout, whisper, or mumble. Be kind, courteous, and friendly.Be kind, courteous, and friendly.

The written word is used when the person cannot speak or The written word is used when the person cannot speak or hear but can read.hear but can read.

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Communication barriers include:Communication barriers include: Using unfamiliar languageUsing unfamiliar language Cultural differencesCultural differences Changing the subjectChanging the subject Giving your opinionGiving your opinion Talking a lot when others are silentTalking a lot when others are silent Failure to listenFailure to listen Pat answersPat answers Illness and disabilityIllness and disability AgeAge

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Residents with DisabilitiesResidents with Disabilities

A person may acquire a disability any time A person may acquire a disability any time from birth through old age.from birth through old age.

People with disabilities have the:People with disabilities have the: Same basic needs as you and everyone elseSame basic needs as you and everyone else Right to dignity and respect just like you and Right to dignity and respect just like you and

everyone elseeveryone else

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The person who is comatose is unconscious.The person who is comatose is unconscious. The comatose person cannot respond to The comatose person cannot respond to

others.others. The person often can hear and can feel touch The person often can hear and can feel touch

and pain.and pain. Knock before entering the person’s room.Knock before entering the person’s room. Tell the person your name, the time, and the Tell the person your name, the time, and the

place every time you enter the room.place every time you enter the room. Use touch and give care gently.Use touch and give care gently.

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Family and FriendsFamily and Friends

Help meet safety and security, love and Help meet safety and security, love and belonging, and self-esteem needsbelonging, and self-esteem needs

Offer support and comfortOffer support and comfort Lessen lonelinessLessen loneliness Often help with the person’s careOften help with the person’s care The presence or absence of family or friends The presence or absence of family or friends

affects the person’s quality of life.affects the person’s quality of life.

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Quality of LifeQuality of Life

The resident is the most important person in The resident is the most important person in the nursing center.the nursing center.

Learn as much as you can about a person’s Learn as much as you can about a person’s religious and cultural beliefs and practices.religious and cultural beliefs and practices.

Illness and disability affect quality of life.Illness and disability affect quality of life. Always focus on the person’s abilities.Always focus on the person’s abilities.

Always treat family and visitors with respect.Always treat family and visitors with respect.

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Chapter 8