Age-Specific Patient Care

Age-Specific Patient Care

Every patient is different – and so is every age group. As a caregiver, you must be aware of certain considerations related to each age group and ways to effectively communicate with patients of various ages. It is important to understand patient needs and what they might be facing at certain times of their lives. This can help you identify issues such as speech or hearing impairments, stress, learning disabilities, depression, and much more. Educating yourself about these factors can help you deliver the best care possible to your patients. Age-Specific Patient Care

Purpose/Overall Goal

This module outlines age-specific care and best practices for nine different age groups, from birth to age 80 and beyond. The goal of this module is to provide healthcare workers with information on how to physical, emotional, social, spiritual, and other needs for different age groups, and how to adjust your patient care with age-specific needs in mind.

Course Objectives

After completing this module, the learner should be able to:

• Demonstrate appropriate communication skills for various age groups

• Describe appropriate healthcare practices for various age groups Age-Specific Patient Care

• Explain physical and emotional considerations for patients of different ages

• Describe common health conditions to assess in patients at various life stages

Communication Across the Ages

As a healthcare worker, clear communication with patients is key to providing good age- specific care. Each age group has unique physical, psychosocial, and cognitive needs, as well as unique fears and stressors. By understanding the age-specific needs usually associated with each stage of life, you can provide better, more appropriate care, tailored to the needs of each individual. For every patient across all age groups you should: Assess primary language Age-Specific Patient Care

• Check for speech or hearing impairments

• Check for confusion, depression, and signs of illness or stress

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• Be aware of possible learning disabilities

• Be mindful of cultural differences

• Understand family structure Age-Specific Patient Care

Regardless of a patient’s age, caregivers must respond to the need of each patient and family for:

• Safety

• Privacy

• Confidentiality

• Comfort

• Pain management

• Healthcare choices

Complex Communication Needs

Keep in mind that individuals with complex communication needs (CCN) who cannot communicate by natural speech alone have the same social, emotional, and physical needs as other individuals. Communication supports, also known as augmentative and alternative communication (AAC), can help these individuals express themselves. Examples of AACs include:

• Gestures and body language Age-Specific Patient Care

• Sign language

• Paper and pencil written communications

• Picture boards or books

• Devices that produce voice output (speech generating devices) or written output

• Electronic communication aids that use picture symbols, letters, and/or words and

phrases to create messages

Neonates: Birth-28 Days

The first 28 days of life are a time when neonates are in a state of total dependency and their basic body functions are being established. The following is a checklist of functions to test:

• Reflexes such as grasping, gagging, and startling Age-Specific Patient Care

• Vital signs (temperature, pulse, respiration)

• Steady weight gain

• Blood glucose levels when appropriate

Keep these practices in mind:

• Always handle the neonate in a gentle, comforting manner to avoid overstimulation.

• Swaddling increases feeling of security and comfort.

• Teach parents proper childcare skills for feeding, diapering, cord care, and bathing.

• Teach parents to always put the baby down on his or her back for sleeping, to help avoid

sudden infant death syndrome (SIDS).

• Make sure parents understand the importance of safety devices such as car seats.

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Infants and Toddlers: 0-3 Years

Infants and toddlers grow and learn rapidly. Although they are dependent, this is when they begin to develop a separate self. With infants:

• Limit the number of staff workers assigned to each one to avoid “stranger anxiety.”

• Always speak to an infant before a touch to avoid startling him or her.

When delivering care to toddlers:

• Keep in mind that toddlers are impulsive and their moods change quickly.

• Expect an exaggerated response to pain, frustration, and changes in the environment.

• Give one direction at a time, since toddlers have a short attention span.

• Speak at eye level with the child and maintain eye contact.

• Discuss procedures with toddlers immediately before they happen, not too far in

advance, since their sense of time is the immediate present. Age-Specific Patient Care

• Use play to prepare for and explain procedures.

• Provide support and comfort during procedures.

• Use the least intrusive procedures possible, such as axillary temperature and oral


When speaking with parents:

• Emphasize proper hand-washing as a way to prevent disease transmission.

• Encourage parents to communicate with the child, and to touch and cuddle.

In infants and young children, small veins may make inserting an intravenous (IV) line a challenge. Keep these facts in mind:

• Be aware that the child may want to play with the IV tubing. Age-Specific Patient Care

• Secure the site with a transparent dressing so you can see it easily.

• Inspect and palpate the site every hour.

• Avoid wrapping tape too tightly.

Young Children: 4-6 Years

For children ages 4 to 6 years, some common fears are the dark, being left alone, and bodily injury. It is important to advise parents to:

• Keep immunizations and checkups on schedule

• Teach the child healthy habits for nutrition and grooming

• Learn about safety equipment such as bicycle helmets, elbow pads, and kneepads Age-Specific Patient Care

• Enforce safety issues regarding fire and pools

When providing care:

• Explain the procedure to the child as well as the parents.

• Never lie to the child about whether something will hurt; instead, tell the child that it won’t

hurt for long.

• Preschoolers are beginning to explore their own bodies, so procedures involving the

genitalia can be especially anxiety-producing.

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• Explain when parents will return; preschoolers can understand this concept and can find

it comforting.

• Keep in mind that children of this age engage in magical thinking and may become

fearful based upon imagined threats. Age-Specific Patient Care

• Emphasize that the child will wake up after anesthesia.

Be extra careful when giving medications to infants and young children.

• Because of their small size and immature body systems, children are at a higher risk for

adverse effects.

• Medication errors are three times more common among pediatric patients as compared

to adult patients.

• Medication errors have 10 times the potential for harm in children. Age-Specific Patient Care

Older Children: 7-12 Years

For children ages 7 to 12, use these approaches:

• Talk, sing, or use distractions such as colorful stickers to divert attention from frightening


• Encourage the child to ask questions and talk about feelings.

• Respect the child’s need for privacy.

• Allow the child to make some care decisions (such as “In which arm do you want the


• Give permission to display fear or pain.


• Prepare the child for procedures ahead of time.

• Ensure that the child understands the healthcare information you provide. Age-Specific Patient Care

Keep these factors in mind for children at this age:

• They may have a great fear of the unknown, pain, death, loss of control, or disappointing


• They may resent forced dependence and lack of privacy.

• They may view illness or pain with guilt or as punishment.

• Living up to expectations is very important. Age-Specific Patient Care

Adolescents: 13-20 Years

Between ages 13 and 20, an adolescent’s body grows into sexually maturity, and complex thinking develops. Keep the following in mind when caring for adolescents:

• Adolescent patients should be treated as adults to foster an atmosphere of trust and


• Speak directly to adolescents instead of talking through their parents.

• Invite adolescents to participate in decision making and whether a parent should be


• Respect privacy and opinions.

• Encourage questions and verbalization of feelings.

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• Be honest.

• Explain treatments and procedures thoroughly.

• Be considerate of how procedures, treatments, etc., may affect appearances and


• Discuss plans for future and how illness may affect it. Age-Specific Patient Care

When working with adolescents:

• Check for signs of common adolescent health problems such as the nutritional

disorders, obesity, anorexia, bulimia, and sexually related health problems such as


• Adolescents with a family history of genetically related diseases should learn about their

family history and be screened appropriately.

• Adolescent girls should be taught breast self-examination; adolescent boys should be

taught testicular self-examination.

• Maintain an updated knowledge base about acne causes and treatments, since acne is

a major concern for this age group.

• Assess illicit substance use and sexual activity in private. Age-Specific Patient Care

• Seek follow-up referral or resources if you notice signs of depression or suicidal

thoughts; suicide is the third most frequent cause of death in this age group.

• Provide support, information, and encouragement related to threats to body image.

• Expect that adolescents may experience mood swings due to hormonal changes,

relationships with parents and peers, and identity adjustments.

• Adolescents may experience increased perception of pain.

Young Adults: 21-39 Years

Key concerns when caring for young adults age 21 to 39 are support, honesty, and respect for personal values. Stress can be a factor, since this stage of life usually includes major changes such as marriage, having children, and career adjustments. Age-specific care for young adults includes:

• Involve patients with their plan of care and in making decisions.

• Support their health care decisions, even if you disagree with them. Age-Specific Patient Care

• Explore the impact of their hospitalization or illness on work, family, and other


• Never use terms of endearment (such as honey, sweetie, darling).

• Acknowledge and respect their commitments to family and career.

• Acknowledge and address their worries about the future.

Middle Adults: 40-64 Years

Adults ages 40 to 64 are often reevaluating priorities and making plans for retirement. Respect the fact that most middle-aged adults are at the peak of their influence and authority, and they may be distressed by forced dependency in the patient role. Be alert for:

• Serious chronic conditions that often develop at this age, such as diabetes, breast

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cancer, and prostate disorders

• Stress from a midlife crisis that may result in depression or other mental issues

• Stress from being in the “sandwich generation” – the generation responsible for caring

for their parents as well as their children

Age-specific care for this age group includes:

• If appropriate, encourage talking about concerns, plans, finances.

• Keep a hopeful attitude and help patients concentrate on strengths, not limitations.

• Respect their decisions and give them as much control over their care as possible.

• Never use terms of endearment (honey, sweetie, darling). Age-Specific Patient Care

• Allow verbalization of fears and concerns.

• Provide privacy.

Check for the following conditions:

• Skin breakdown due to dryness and decreased subcutaneous tissue

• Hypertension and hyperlipidemia, which may not be the cause of hospitalization but may

be detected during hospitalization

• Sleep apnea

• Skeletal injury due to diminished bone density and osteoporosis, especially in women

• Obesity due to slower metabolism Age-Specific Patient Care

• Nutritional deficiencies

• Farsightedness, which is common in middle-aged patients; if the patient does not have

reading glasses or magnifiers, ensure that any important reading material (such as forms

requiring signature, menus, etc.) is printed in a larger type size, or read the materials

aloud for the patient Age-Specific Patient Care


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