Age Specific Competency Kaiser Permanente San Diego

Why Do We need to be Age Specific Aware So we can better understand the patient’s needs Communicate at an appropriate level with the patient Understand and respond to a patient’s concerns Assess their educational needs and teach accordingly Kaiser Permanente San Diego

Neonates (0-1mo) & Infants (1mo-1yr) Characteristics Fear of strangers (begins 6-8 mos of age) Communicate discomfort by crying, facial expressions, body movement Prefer to be held in familiar positions Like established routines verbal repetition Understand simple commands, respond well to consistency Are fearless, choke easily, accident prone, require constant supervision Need to consistently have needs met to develop sense of trust (feeding, changing) Caregiver Implications Talk to baby before touching Involve parents in procedure if possible Imitate how parent holds baby Explain procedure to parents beforehand Remove unnecessary equipment Keep infant clothed as much as possible Do not leave infant unattended Allow parent to hold infant while waiting Ask parents about immunization record Kaiser Permanente San Diego

Toddlers (1yr -3yr) Characteristics Views uncomfortable procedures as punishment Needs security objects Curious, unaware of danger Comprehension greater than ability to verbalize Short attention span Frequently says “NO” trying to demonstrating independence Can be cooperative if trust is won Caregiver Implications Reassure that treatment is not a punishment Simple explanations Give one direction at time Demonstrate equipment Speak at eye level, maintain eye contact Remove unnecessary equipment Use distraction techniques Involve parents, allow to be present during procedures Kaiser Permanente San Diego

Preschoolers (4yr -6yr) Characteristics Seek explanations “Why?” By age 5 speaks in 8 word sentences Increased speech skills, attention span and memory Truth important Fear bodily injury, separation, death, punishment Difficulty expressing needs Privacy important Accident prone Caregiver Implications Use simple explanation Adapts to changes in environment more easily than toddler Be truthful about pain, discomfort Encourage questions regarding fears Show caregiver location of restrooms Include parents in teaching Plan procedure to minimize waiting time Kaiser Permanente San Diego

School Age (7yr -12yr) Characteristics Developing greater sense of self Start to negotiate for independence Need to fit in with peers Rules very important Need respect for privacy Fear mutilation, loss of control Caregiver Implications Allow child to exercise some control Allow to handle equipment as learning tool (as appropriate) Respect privacy Include parent in teaching Reassure child it is okay to cry Guide in making choices that are healthy and safe Kaiser Permanente San Diego

Adolescents (13yr -20yr) Characteristics Transition stage (developing identity) & stress filled Continually striving for independence and control Appreciate being treated as adults Self-conscious about appearance (body image) Need respect of privacy Risk takers, strong sense of immortality Rapid growth, awkwardness on gross motor skills, development of occupational identity Kaiser Permanente San Diego Caregiver Implications Encourage questions Treat more as adult, avoid authoritarian approach Allow maintenance of control Talk directly to them, not through parents, and offer explanations Maintain privacy Establish trust to gain cooperation

Young Adult (21yr -39yr) Characteristics Sets career goals, chooses lifestyle May start own family, building connections Developing responsible attitude Need to establish healthy lifestyle Nutrition needed for maintenance not growth Mental abilities peak during 20s Caregiver Implications Respect personal values, be honest & supportive Consider significant others, impact on job Encourage to pursue healthy lifestyle Teach & encourage testicular & breast self-exam Maintain privacy Encourage creating Advance Directive Kaiser Permanente San Diego

Middle Adult (40yr -64yr) Characteristics May develop chronic health problems Decrease in bone and muscle mass, short term memory, loss of skeletal height and calcium, skin elasticity, dry skin, wrinkles Women experience menopause “Sandwich generation” Use life experiences to learn, solve problems Future oriented, has specific goals Caregiver Implications Encourage regular check-ups & preventative exams Assist person to recognize risk factors related to health Focus on their strengths Address worries about children & aging parents Treat with respect Provide explanations and educate Kaiser Permanente San Diego

Older Adult (65yr -79yr) Characteristics Continue to be active learner/thinker Takes on new roles, balances independence v. dependence Most elderly are not depressed May become isolated Some decline in physical abilities, senses, memory skills (short term memory, attention span shortens) Caregiver Implications Promote mobility & ADL Consider needs related to diminished sight, hearing (may need to read information to patient, face person when talking to them) Allow reminiscing about the past Promote physical, mental, social activities to prevent isolation Allow more time for processing new information Educate about safety measures Kaiser Permanente San Diego

Adult 80 & Older Characteristics Decline in physical ability, increased risk for chronic illness Decline in memory & learning skills May need assistance in ADL May have diminished appetite, fluid intake Caregiver Implications Encourage as much mobility & ADL as possible Encourage healthy eating & adequate fluid intake, monitor bowel function Avoid treating older adult like a child Respect & support end of lie decisions Kaiser Permanente San Diego