1. Age Specific Competency
Kaiser Permanente San Diego

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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