The Long Term Care

Resident

Module 13
Basic Human Needs and Interventions for the
Elderly Resident

A. Environmental/physical

1. Safety
a. More light for better vision.
b. Freedom from hazards.
c. Support (adaptive devices).
d. Good personal hygiene.
Basic Human Needs and Interventions for the
Elderly Resident

2. Shelter
a. Appropriate living situation
b. Environmental control (heating, air conditioning).

3. Nourishment
a. Balanced nutrition.
b. Adequate fluids
Basic Human Needs and Interventions for the
Elderly Resident

B. Psychological

1. Maintain self-esteem
a. Respectful treatment.
b. Recognition of individual differences.
Basic Human Needs and Interventions for the
Elderly Resident

B. Psychological

1. Maintain self-esteem
a. Respectful treatment.
b. Recognition of individual differences.

2. Adjustment to role change and loss of independence

a. Respect privacy.
b. Give choices.
c. Encourage activities.
Basic Human Needs and Interventions for the
Elderly Resident

C. Social

1. Social interactions
a. Encourage family involvement.
b. Encourage social/community activities.

2. Adjustment to losses
a. Death of spouse/friends.
b. Encourage verbalization, such as reminiscing.
c. Encourage new social contacts.
Basic Human Needs and Interventions for the
Elderly Resident

3. Financial

a. Changes in income interfere with meeting basic needs of

security, love, belonging and self-esteem.
b. Refer to social service.
Basic Human Needs and Interventions for the
Elderly Resident

D. Recreational

1. Diversion
a. Encourage hobbies.

b. Involve in facility/community events.

c. Encourage family involvement.

Basic Human Needs and Interventions for the
Elderly Resident

2. Self-esteem

a. Encourage involvement.

b. Give compliments

c. Reinforce positive traits or abilities.

Basic Human Needs and Interventions for the
Elderly Resident

E. Spiritual

1. Provide respect for individual choices.

2. Provide opportunities to participate in religious activities.

Developmental and Mental Conditions Found in the Long
Term Care Population

A. Organic brain syndrome – dementia

1. Dementia; any disorder of the brain that causes deficits in thinking,

memory and judgment.
Developmental and Mental Conditions Found in the Long
Term Care Population

2. Causes
a. Alzheimer’s disease (most common); caused by plaques
and tangles in the brain. Brain decreases in size as cells
are lost. Progressive and incurable.

b. Multi-infarction dementia (multiple Transient Ischemic

Attack; TIAs)
.
c. Parkinson’s disease.

d. Syphilis.
Developmental and Mental Conditions Found in the Long
Term Care Population

e. AIDS.

f. Nutrition problems.

g. Medication problems.

h. Depression.

i. Metabolic disorders
Developmental and Mental Conditions Found in the Long
Term Care Population

B. Schizophrenia

1. Mental disorder characterized by paranoia, hallucinations, delusions,

bizarre behavior and distortions of reality.
Developmental and Mental Conditions Found in the Long
Term Care Population

2. Nurse Assistant duties and responsibilities.

a. Notify licensed nurse if behavior worsens or becomes dangerous.

b. Do not “feed in” to delusions, but do not try to convince

them of reality.

c. Be aware of suicide precautions.

d. Keep resident involved in reality activities.

Developmental and Mental Conditions Found in the Long
Term Care Population

e. Report and document observed responses to medication

and psychotherapy.

f. Monitor nutrition and fluid balance - these residents often refuse to

eat or drink out of a fear of poisoning.

g. Find ways of reducing resident’s fear and anxiety.

Developmental and Mental Conditions Found in the Long
Term Care Population

C. Hypochondriasis

1. Resident imagines or magnifies each physical ailment.

2. Nurse Assistant duties and responsibilities
a. Be supportive, some authorities feel this disorder stems from
depression.
b. Do not overlook real illness; report all complaints.
c. Do not judge.
Developmental and Mental Conditions Found in the Long
Term Care Population

D. Depression

1. Most common functional disorder in older people

2. Signs and Symptoms

a. Feeling of sadness.
b. Lack of interest in and withdrawal from environment.
c. Feelings of worthlessness.
d. Negative outlook on the future.
Developmental and Mental Conditions Found in the Long
Term Care Population

3. Nurse Assistant duties and responsibilities

a. Notify licensed nurse if resident displays loss of appetite, weight
loss, severe fatigue, crying, or sleeplessness.

b. Notify licensed nurse if resident makes statements such as “I

wish I could just die.”
Developmental and Mental Conditions Found in the Long
Term Care Population

c. Remain non-judgmental.

d. Listen with empathy.

e. Encourage activities with others.

f. Encourage aerobic activity, as well as outdoor activities (releases

endorphins).
Developmental and Mental Conditions Found in the Long
Term Care Population

E. Suicidal resident

1. The elderly are at risk of suicidal behavior, especially white males

over the age of 65 who live alone, and the very old (75 years and
above).
Developmental and Mental Conditions Found in the Long
Term Care Population

2. Nurse Assistant duties and responsibilities

a. Report clues of suicide attempts to licensed nurse.
b. Give constant care.
c. Monitor activities.
d. Work to preserve self-esteem.
e. Help resident find support network; friends, clergy, family
and support groups.
f. Never ignore the person’s statements or threats about
suicide.
Developmental and Mental Conditions Found in the Long
Term Care Population

F. Developmentally Disabled

1. Significant sub-average intellectual function and low adaptive ability.

Developmental and Mental Conditions Found in the Long
Term Care Population

2. Nurse Assistant duties and responsibilities

a. Provide an environment as normal as possible
(normalization).
b. Emphasize individual strengths.
c. Encourage independence, self-care.
d. Treat with dignity at age appropriate level.
e. Respect privacy.
f. Provide safe, structured environment.
Developmental and Mental Conditions Found in the Long
Term Care Population

G. Cerebral Palsy

1. Group of disorders characterized by motor dysfunctions.

Developmental and Mental Conditions Found in the Long
Term Care Population

2. Nurse assistant duties and responsibilities

a. Provide safe, structured environment.
b. Apply appropriate assistive devices.
c. Emphasize individual strengths.
d. Encourage independence.
e. Treat with dignity.
f. Respect privacy.
Developmental and Mental Conditions Found in the Long
Term Care Population

H. Alcoholism/Drug Abuse

1. Abuse of alcohol or drugs when healthy coping mechanisms

have failed.

2. 15% of elderly suffer from alcoholism.

Developmental and Mental Conditions Found in the Long
Term Care Population

3. Often triggered by
a. Retirement.
b. Loss of self-esteem.
c. Loneliness.
d. Chronic pain.
e. Decline in health.
f. Stress.
Developmental and Mental Conditions Found in the Long
Term Care Population

4. Nurse Assistant duties and responsibilities

a. Report to the licensed nurse any sign that the resident is under the
influence of alcohol or drugs.

b. Be sure alcohol/drugs are not available (alcohol can be in products

such as aftershave, perfume, cooking extracts,
cleaning products).

c. Watch for mental impairment; loss of coordination, poor

judgment.
Developmental and Mental Conditions Found in the Long
Term Care Population

d. Be careful when feeding, gag reflex may be impaired.

e. Set boundaries, avoid being manipulated.

f. Be aware of support groups such as Alcoholics

Anonymous or the Mental Health Association.
Developmental and Mental Conditions Found in the Long
Term Care Population

g. Notify licensed nurse if signs of withdrawal

1) Alcohol: tremors, shaking, agitation, seizures.
2) Drugs: runny nose, depression, headache, pacing,
poor coping mechanisms, agitation.

h. Follow resident’s care plan.

i. Be aware of dangerous behavior

Developmental and Mental Conditions Found in the Long
Term Care Population

I. The Agitated Resident

1. Uses inappropriate verbal, vocal, or motor activity due to causes

other than disorientation or real need.
Developmental and Mental Conditions Found in the Long
Term Care Population

2. Nurse Assistant duties and responsibilities

a. Report to the licensed nurse any signs of agitation
including aimless wandering, pacing, cursing, screaming,
spitting, biting, fighting, arguing, demanding, and talking to self.

b. Maintain quiet, calm atmosphere.

c. Encourage distracting activities.

Developmental and Mental Conditions Found in the Long
Term Care Population

d. Check for constipation or other sources of

discomfort/pain.

e. Realize that resident may become more agitated due to

feelings of loss of control.

f. Avoid restraints.

g. Allow resident to walk, or rock in chair to diffuse energy.

Developmental and Mental Conditions Found in the Long
Term Care Population

h. Listen with empathy.

i. Make sure you stay safe - maintain area to escape (don’t

let resident get between you and the door.)

j. Call for help if resident gets violent.

k. Do not attempt to control resident if they become violent.

l. Redirect.
Changes in Body Systems Associated With Aging.

A. Integumentary System

1. Skin becomes thin, fragile, dry and wrinkled.

2. Blood supply to fingers and toes decreases; sensitivity to hot and
cold decreases.
3. Hair loses color.
4. Nails thicken.
5. Bruises easily due to fragile blood vessels.
Changes in Body Systems Associated With Aging.

B. Respiratory System

1. Lung strength decreases.

2. Air sacs become less elastic and decrease in number.
3. Airways become stiff and less elastic.
4. Lung capacity decreases.
5. Cough reflex is less effective.
6. Cough becomes weaker.
7. Gas exchange in lungs is less effective.
Changes in Body Systems Associated With Aging.

C. Cardiovascular System

1. Blood flow decreases leading to less efficient circulation.

2. Blood vessels narrow and lose elasticity.
3. Longer recovery to normal pulse after exercise.
4. Heart is a less effective pump.
Changes in Body Systems Associated With Aging.

D. Musculoskeletal

1. Muscles weaken and lose tone.

2. Loss of elasticity in muscles.
3. Loss of muscle mass causes weight loss.
4. Less flexible.
5. Bones lose minerals, become porous and brittle (easily
broken).
Changes in Body Systems Associated With Aging.

6. Height is gradually lost due to space between vertebrae

shrinking; posture slumped.
7. Joints are less flexible and stiffer, slows normal body
movement.
8. Degenerative changes in joints.
9. Decreased reflexes: prone to injury and falls.
Changes in Body Systems Associated With Aging.

E. Endocrine System
1. Decrease in sex hormones (estrogen and progesterone)
signals menopause; testosterone levels decrease.
2. Insulin production decreases.
3. Metabolism and body functions slow.
4. Body is less able to handle stress.
5. Body less able to handle sugar.
6. Metabolism and body functions slow.
Changes in Body Systems Associated With Aging.

F. Nervous System

1. Slowing nerve transmission results in delayed reaction time,poor

coordination and balance.
2. Less effective temperature regulation.
3. Decreased sensitivity to pressure and temperature changes.
4. Decreased blood flow to brain resulting in memory loss and
confusion.
5. Deep sleep is shortened, naps are needed.
Changes in Body Systems Associated With Aging.

G. Gastrointestinal System

1. Decreased saliva production causing dysphagia.

2. Taste buds not as sensitive.
3. Decreased gag reflex leading to chance of choking.
4. Slowed peristalsis leading to indigestion and constipation.
5. Increased flatulence.
Changes in Body Systems Associated With Aging.

6. Decreased digestive enzymes, avoid dry, fried and fatty foods.

7. Decreased ability to absorb nutrients.
8. Medication related to side effects.
9. Sensitivity to sensation of full bowel.
10. Urgency is exaggerated with the bowel.
Changes in Body Systems Associated With Aging.

H. Urinary System

1. Kidneys decrease in size and are less efficient.

2. Bladder loses tone, leading to retention and infection