Chapter 6 Understanding the Resident Revised by Christie Minor, RN

CARING FOR THE PERSON For effective care, you must consider the whole person. This is known as Holism. Mind , Body, And Soul. Disability and illness affect the whole person.

Why consider holistic care for a woman with a mastectomy? What Physical care will you have to provide? What Psychological/Mental care may be needed? What could be some of the spiritual concerns she needs addressed?

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 Grandma, Papa, Sweetheart, Honey, or other names.

BASIC NEEDS Abraham Maslow Lower needs are met first

Basic Needs Consider the woman going through the chemo treatments and loses her hair – she may not have her self-esteem needs being met Consider the man in the nursing home who’s family never visits – he does not have love & belonging needs met Consider the COPD patient who feels like their smothering from lack of oxygen – can he even think about eating lunch

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

Religion relates to spiritual beliefs & practices Some residents may ask to see their spiritual leader, report this to the nurse Some may receive communion on Sundays Some may have religious objects in their rooms

Remember…. You Are Not Being Pressured to Accept and Adopt Others Beliefs, but You Must Respect Each Individual and Their Beliefs It is impossible to understand all the beliefs of different religions and cultures, but try to be sensitive and learn about their beliefs and practices, this will help you give better care.

EFFECTS OF ILLNESS AND DISABILITY Define Disability Anger is a common response to illness and disability. To help the person feel safe, secure, and loved: Take an extra minute to “visit,” to hold a hand, or to give a hug. Show that you are willing to help with personal needs. Respond promptly. Treat each person with respect and dignity.

Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. 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, not disabilities! Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

Types of NURSING CENTER RESIDENTS Most are older Alert, oriented residents Confused and disoriented residents Complete care residents Short-term residents Life-long residents Residents with Mental Health disorders Terminally ill residents

Behavior Issues Anger Demanding behavior Self-centered behavior Aggressive behavior Withdrawal Inappropriate sexual behavior See page 84 for ways to deal with issues

Effective Communication Avoid medical terms that residents may not understand Repeat information as often as needed Ask questions to see if the person understood Be patient, especially with people with memory problems

Verbal Communication Can be spoken or written Communicating with dementia residents can be difficult Call them by name Choose simple short sentences Use a gentle, calm voice Keep distractions to a minimum Allow the person time to respond

Nonverbal communication does not use words. Touch is a very important form of nonverbal communication. Body language involves: Facial expressions Gestures Posture Eye contact You may need to control your body language (like to offensive odors) Remember, touch ,gestures & eye contact can be different in other cultures. (see boxes at top of page 87)

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 lead or invite the person to share thoughts, feelings, or ideas. Clarifying lets you make sure that you understand the message. Focusing is dealing with a certain topic. Silence is a very powerful way to communicate.

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

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 Have the right to dignity and respect just like you and everyone else

The person who is comatose is unconscious. The person cannot respond to others. The person often can hear and can feel touch and pain. Assume that the person hears and understands you. Knock before entering the person’s room. Tell the person your name, the time, and the place every time you enter the room. Tell them when you leave. Explain what you are going to do, step by step.

FAMILY AND FRIENDS Family and friends: Help meet safety and security, love and belonging, and self-esteem needs Lessen loneliness Often help with the person’s care The presence or absence of family or friends affects the person’s quality of life.

QUALITY OF LIFE The resident is the most important person in the nursing center. Always treat family and visitors with respect. TIME TO REFLECT: Read the box, How would you respond?