Age-Related Care

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

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

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

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

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

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

Toddlers A & P CHARACTERISTICS: Babinski’s 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

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

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

Preschoolers A & P CHARACTERISTICS: Continues to use abdominal muscles for breathing

Preschoolers APPROACH: Allow to handle equipment Prepare immediately before procedure, in simple, concrete terms- delays can increase anxiety Tell to still sit, but it’s ok to cry

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

School-aged Children A & P CHARACTERISTICS: By about 8 years old, resp. A & P is approximately that of an adult

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

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

Early and Middle Adolescents A & P CHARACTERISTICS: Rapid growth and heightened emotions, usually associated with hormonal changes

Early and Middle Adolescents APPROACH: Introduce self to child and family Sit down and talk to them Be honest, nonjudgmental, don’t talk down to Respect privacy and confidentiality Provide with concrete information

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.

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.

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.

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.

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.

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.

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.

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.

Resources Erikson's Stages of Psychosocial Development http://psychology.about.com/library/bl_psychosocial_summary.htm http://www.ebmedicine.net/topics.php?paction=showTopicSeg&topic_id=149&seg_id=3000