Chapter 6 Understanding the Resident All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Caring for the Person   For effective care, you must consider the whole person.   The whole person has physical, social, psychological, and spiritual parts.   These parts are woven together and cannot be separated.   Each part relates to and depends on the others.   Disability and illness affect the whole person. 2 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Address the Resident Properly   Addressing the person   Call residents by their titles.   Do not call residents by their first names unless they ask you to.   Do not call residents by any other name unless they ask you to.   Do not call residents Grandma, Papa, Sweetheart, Honey, or other names. 3 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Basic Needs   According to Abraham Maslow:   Basic needs must be met for a person to survive and function.   The needs are arranged in order of importance.   Lower-level needs must be met before higher- level needs. 4 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Maslow’s Basic Needs for Life   Basic needs, from the lowest level to the highest level, are:   Physiological or physical needs   Safety and security needs   Love and belonging needs   Self-esteem needs   The need for self-actualization   People normally meet their own needs. 5 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Culture and Religion   Culture is the characteristics of a group of people passed from one generation to the next.   The person’s culture: Influences health beliefs and practices Affects behavior during illness and when in a nursing center 6 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Religion   Religion relates to spiritual beliefs, needs, and practices.   A person’s religion influences health and illness practices.   Many people find comfort and strength from religion during illness.   The nursing process reflects the person’s culture and religion.   Do not judge the person by your standards. 7 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Effects of Illness and Disability   Sickness and injury have physical, psychological, and social effects.   Anger is a common response to illness and disability.   To help the person feel safe, secure, and loved: Take an extra minute to “visit,” hold a hand, or give a hug. Show that you are willing to help with personal needs. Respond promptly. Treat each person with respect and dignity. 8 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Highest Potential   Optimal level of function   Residents are helped to maintain their optimal level of function.   Encourage the person to be as independent as possible.   Always focus on the person’s abilities. 9 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Nursing Center Residents   Alert, oriented residents   Confused and disoriented residents   Complete care residents   Short-term residents   Life-long residents   Mentally ill residents   Terminally ill residents 10 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Behavior Issues   People who do not adjust well have some of the following behaviors:   Anger   Demanding behavior   Self-centered behavior   Aggressive behavior   Withdrawal   Inappropriate sexual behavior   A person’s behavior may be unpleasant.   You cannot avoid the person or lose control.   Good communication is needed.   Follow the care plan. 11 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

For Effective Communication   Use words that have the same meaning for you and the person.   Avoid medical terms and words not familiar to the person.   Communicate in a logical and orderly manner.   Give facts and be specific.   Be brief and concise.   Understand and respect the resident as a person.   View the person as a physical, psychological, social, and spiritual human being. 12 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

For Effective Communication (Cont’d)   Appreciate the person’s problems and frustrations.   Respect the person’s rights.   Respect the person’s religion and culture.   Give the person time to process the information that you give.   Repeat information as often as needed.   Ask questions to see if the person understood you.   Be patient.   Include the person in conversations when others are present. 13 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Verbal Communication   Follow these rules for spoken communication:   Face the person.   Position yourself at the person’s eye level.   Control the volume and tone of your voice.   Speak clearly, slowly, and distinctly.   Do not use slang or vulgar words.   Repeat information as needed.   Ask one question at a time.   Do not shout, whisper, or mumble.   Be kind, courteous, and friendly.   The written word is used when the person cannot speak or hear but can read. 14 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Nonverbal Communication   Messages are sent with gestures, facial expressions, posture, body movements, touch, and smell.   Touch means different things to different people.   People send messages through their body language: Facial expressions and eye contact Posture and gait Gestures, hand and body movements Appearance (dress, hygiene, and so on) 15 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Communication Methods   Listening means to focus on verbal and nonverbal communication.   Paraphrasing is restating the person’s message in your own words.   Direct questions focus on certain information.   Open-ended questions invite the person to share thoughts, feelings, or ideas.   Clarifying lets you make sure you understand the message. 16 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Communication Methods (Cont’d)   Focusing is dealing with a certain topic.   Silence is a very powerful way to communicate. 17 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Communication Barriers   Communication barriers include:   Using unfamiliar language   Cultural differences   Changing the subject   Giving your opinion   Talking a lot when others are silent   Failure to listen   Pat answers   Illness and disability   Age 18 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Residents with Disabilities   A person may acquire a disability any time from birth through old age.   People with disabilities have the:   Same basic needs as you and everyone else   Right to dignity and respect just like you and everyone else 19 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Care of the Comatose Person   The person who is comatose is unconscious.   The comatose person cannot respond to others.   The person often can hear and can feel touch and pain.   Knock before entering the person’s room.   Tell the person your name, the time, and the place every time you enter the room.   Give care on the same schedule every day. 20 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Care of the Comatose Person (Cont’d)   Explain what you are going to do. Explain care measures step-by-step as you do them.   Tell the person when you are finishing care.   Use touch to communicate care, concern, and comfort.   Tell the person what time you will be back to check on him or her.   Tell the person when you are leaving the room. 21 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Family and Friends   Help meet safety and security, love and belonging, and self-esteem needs   Offer support and comfort   Lessen loneliness   Often help with the person’s care   The presence or absence of family or friends affects the person’s quality of life. 22 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Quality of Life   The resident is the most important person in the nursing center.   Learn as much as you can about a person’s religious and cultural beliefs and practices.   Illness and disability affect quality of life.   Always focus on the person’s abilities.   Always treat family and visitors with respect. 23 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.