Age Specific Guidelines

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Medical Staffing.
Any duplication or use by anyone other than an
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Age Specific Competency: Growth andAge Specific Competency: Growth and
Development Through the Life-SpanDevelopment Through the Life-Span
Adapting Patient care Relating to Age-Related
Changes
JCAHO Mandatory
Annual Competency
Chesapeake Medical Staffing

Medical Staffing.
Although every person is unique, all humans growAlthough every person is unique, all humans grow
and develop in similar patterns. Knowing thesesand develop in similar patterns. Knowing theses
patterns allows healthcare professionals to:patterns allows healthcare professionals to:
• make objective predictions about individual patient’s response
to pain, sickness, body image disturbances, and hospitalizations
• proactively plan post-hospitalization care
• utilize the most effective teaching strategies
• relieve common fears
• provide appropriate safety precautions
• utilize effective interventions.

Medical Staffing.
What Are Age-Specific Competencies?What Are Age-Specific Competencies?
Age-specific competencies are skills that you use to give care that
meets each patient’s unique needs. Every patient is an individual
and each has his or her own likes, dislikes, feelings, thoughts and
beliefs. They also each have their own limitations, abilities, and life
experiences. However, everyone grows and develops in a similar
way. Experts generally believe that people grow and develop in
stages that are related to their age and they share certain qualities
at each one of those stages. Understanding these stages of life is
the key to age-specific competencies.

Medical Staffing.
Knowledge of Age-Specific CompetenciesKnowledge of Age-Specific Competencies
Benefit You and Your PatientsBenefit You and Your Patients
Competencies Help Ensure Quality Care:
With age-specific competencies, each patient gets the individual
care the he or she needs and deserves. He or she also
becomes a partner in his or her own
health care plan.
Competencies Improve Job Performance and Satisfaction:
Putting age-specific competencies into practice can be a
challenge. But the rewards, improved patient care, relationships
and teamwork, are great!
Competencies Meet JCAHO Standards:
Age-specific competencies are a key area of focus for JCAHO
standards. They’re essential to gaining and retaining
accreditation.

Medical Staffing.
DefinitionsDefinitions
GrowthGrowth: An increase in size, function, or complexity which occurs
incrementally over time.
DevelopmentDevelopment: The orderly pattern of lifelong changes in structure,
thought, or behavior that evolves as a result of maturation,
experience, and learning.
As you read, keep in mind that everyone develops at his or her own
rate. The age groupings, or stages, in this presentation are just one
of many ways to divide human growth and development. They are
intended only as a general guideline.

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Infant/Toddler YearsInfant/Toddler Years
A sick infant or toddler can create high levels of stress for parents
and caregivers. Understanding the unique physical characteristics,
psychosocial needs, and safety and wellness issues of infants and
toddlers will help you to provide appropriate care for your young
patients and their families. It is important to be aware of the
physical changes, psychosocial development, safety/wellness
issues, and possible interventions related to infants and toddlers.

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Infants (Birth to 1 Year) Are TrustingInfants (Birth to 1 Year) Are Trusting
Healthy Growth & Development ParametersHealthy Growth & Development Parameters
• Physical: grows at a rapid rate, especially brain size. Birth
weight doubles at 6 months and triples by 1 year.
• Begins to roll, sit unassisted, crawl, stand, and walk. Begins to
grasp – fine motor skills enhanced.
• Mental: learns through senses, exploring, playing; Learning
develops along with rapid physical development.
• Communicates by crying, babbling. Begins to vocalize – say
one or two words.
• Social/emotional: seeks to build trust in others; dependent;
begins to develop a sense of self.
• Communications: provide security, physical closeness; promote
healthy parent-child bonds.

Medical Staffing.
Infant Health & Safety IssuesInfant Health & Safety Issues
• Health: keep immunizations/checkups on schedule; provide
proper nutrition, sleep, skin care, oral health, routine screenings.
• Safety: ensure a safe environment for exploring, playing,
sleeping.
• Supervision of infants: do not leave unattended.
• Fall precautions: keep side rails up; use safety belts in high
chairs & infant seats
Common FearsCommon Fears
• Needs not being met
• Stranger anxiety (starts around 6 months)

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Adverse Effects of Infant HospitalizationAdverse Effects of Infant Hospitalization
Infants gradually learn to accept delayed gratification if caregivers
do not always meet infants needs before they signal readiness.
This is how infants learn to test environments. Mistrust develops
when needs are not met. Tactile stimulation (touch) is important in
acquiring trust. At approximately 6 months of age, stranger anxiety
becomes evident. Sleep disturbances can occur and inactivity
delays motor development. Separation of parents/caregivers, who
the infant has formed strong attachment, can be devastating.

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Infant DisordersInfant Disorders
• Infants are susceptible to stress imbalances, especially, of fluids
and electrolytes.
• Infants have tiny, delicate respiratory systems so it is necessary
to:
 maintain humidified air at all times
 use appropriately sized diagnostic tools
 use appropriate interventions to keep their breathing passages
clear.

Medical Staffing.
Immature Infant Immune SystemImmature Infant Immune System
Infant immunological system is very immature, therefore: Wash
your hands between infants and after dirty procedures. Protect
infants from airborne disease: use masks and other protective
equipment appropriately.

Medical Staffing.
Age-Specific Care for InfantsAge-Specific Care for Infants
to Minimize Adverse Effectsto Minimize Adverse Effects
• Speak to babies in quiet, light, calm voices.
• Encourage continued breastfeeding.
• Involve child and parent(s) in care during feeding, diapering,
bathing.
• Be aware of stranger anxiety in older infants (>6 months of age).
Have family members with infant as much as possible
• Provide safe toys and opportunities for play.
• Encourage infant to communicate – smile, talk softly to him or
her, etc. Provide the family uninterrupted time for cuddling and
fun.
• Help parent(s) learn about proper childcare. Involve parents and
grandparents in daily care and medical treatments.

Medical Staffing.
Understanding Unique Patterns ofUnderstanding Unique Patterns of
Growth & Development in ChildrenGrowth & Development in Children
While children’s abilities, cognitive, and emotional skills at various
ages differ, all children go through similar stages and patterns of
growth and development. By understanding these patterns of
growth and development, healthcare workers can better provide
appropriate and quality care to children and adolescents. It is
important to consider the physical changes, psychosocial
development, safety/wellness issues, and potential interventions
related to preschoolers, school age children, and adolescents.
Young children feel a deep desire to be in control of their
environment and want to be seen as individual beings. In their
search for control, rituals and routines become very important.

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Toddlers (1 TO 3 Years) Are CuriousToddlers (1 TO 3 Years) Are Curious
• Physical: growth slows. Usually begins to run by about 2 years. Jumps in
place. Likes to explore the environment. Very possessive of toys. Enjoys
toys which are musical, ring, can turn or push/pull.
• Mental: learning occurs by use of senses. Imitates behaviors of others;
plays pretend games. Understands that objects and events continue to
exist even when they cannot be seen, heard, or touched. Short attention
span, relates cause and effect, but has no concept of danger.
• Social/emotional: egocentric- unable to distinguish between own
perspective and that of someone else
• Communications: provide security, physical closeness; promote healthy
parent-child bonds.
• Begins behaviors that represent attempts to control their environment.
Saying “No” in response to requests; relying on routines; refusing to
follow commands; responding slowly and offering excuses.

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Toddler Health & Safety IssuesToddler Health & Safety Issues
• Health: keeps immunizations/checkups on schedule; promote
healthy habits (good nutrition, personal hygiene, etc).
• Vital signs range: BP 80-100 systolic; HR 90-120; RR 24-40
• Begins potty training
• Safety: fall precautions, climbing
• Keep all objects that the toddler may put in his mouth, out of
reach.
• Ingestion of foreign and toxic substances is very common at this
age.
• Promote injury prevention strategies to parents concerning,
childproofing, poison control, car seats, pool safety, helmets, etc.

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Common Toddler FearsCommon Toddler Fears
• Separation
• Loss of Control
• Altered rituals
• Pain

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Adverse Effects of Toddler HospitalizationAdverse Effects of Toddler Hospitalization
A toddler may have increased dependence on parents. Separation
anxiety is common and regressive behavior may be exhibited. Such
as delayed toilet training, may need diapers, bottle, special stuffed
animal or blanket from home,etc.
Age-Specific Care for ToddlersAge-Specific Care for Toddlers
• Minimize separation from parents, involve parents in care Keep
security objects close (favorite blanket, toy, pacifier).
• Provide continuity in familiar routines of eating, toileting, and
sleeping.
• Provide safe toys and opportunities for play.

Medical Staffing.
Age-Specific Care for ToddlersAge-Specific Care for Toddlers
• Use play as a technique. Let child handle medical equipment
before procedures whenever possible.
• Prepare toddler for any procedure within a reasonable time
frame. Do this no more than 30 minutes prior to the procedure,
too far in advance may increase level of anxiety.
• Recognize that any intrusive procedure (example: rectal temp)
may provoke an intense reaction which is most likely a reaction
due to fear, not pain.
• Keep explanations simple choose words carefully.

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Pre-School Children (Ages 4 – 6) are ActivePre-School Children (Ages 4 – 6) are Active
• Physical: grows at a slower rate; improving motor skills; dresses
self; toilet-trained.
• Walks up and down stairs, throws ball, rides tricycle.
• Mental: begins to use symbols; improving memory; vivid
imagination, fears, likes stories. Has difficulty establishing
between reality and fantasy.
• Social/emotional: develops social behaviors, begins to share.
• Communication – give praise, rewards, clear rules.
• Identifies with parent(s); becomes more independent; sensitive
to other’s feelings.

Medical Staffing.
Pre-Schooler Health & Safety IssuesPre-Schooler Health & Safety Issues
• Health: keep immunization/check-ups on schedule; promote
health habits (good nutrition, personal hygiene, etc).
• Safety: promote safety habits – use of appropriate car seats;
bike helmets, water safety, etc.
• Supervise at all times while out of bed.
• Discuss with parents, as appropriate, behavior with strangers,
potential sexual abuse, increasing exposure to others outside
family members.

Medical Staffing.
Common Pre-Schooler FearsCommon Pre-Schooler Fears
• Bodily injury
• Loss of control
• Unknown, dark, being left alone

Medical Staffing.
Adverse Effects of HospitalizationAdverse Effects of Hospitalization
on a Pre-School Childon a Pre-School Child
The young child strives to master the environment using initiative to
gain a sense of accomplishment from successfully completing such
tasks as dressing unassisted and helping around the house. The
young child may attribute illness to his/her own “bad” behavior.
Regressive behavior, bed wetting, eating and sleeping problems
may develop. Due to the illness and/or hospitalization parents often
become overprotective which can affect the young child’s need for
accomplishment and control of their environment.

Medical Staffing.
Age-Specific Care for Pre-SchoolersAge-Specific Care for Pre-Schoolers
• Use play as a teaching technique as much as possible. Use
toys, games, etc., to teach child & reduce fear.
• Be honest. Allow child to make simple choices, whenever
possible, in care, food, etc.
• Encourage playtime. Enjoys toys like puppets, books, puzzles
(5-20 pieces), simple board games, and coloring sets.
• Encourage child to ask questions, play with others and talk about
feelings, expression of fear and anger.
• Reinforce that the child has not done anything wrong to cause
illness.
• Prepare several hours in advance for major events. Emphasize
the child will wake up after surgery.
• Help parent(s) teach child safety rules.

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School Aged Children (Age 7–12 years) Are “Doers”School Aged Children (Age 7–12 years) Are “Doers”
• Physical: grows slowly until a “spurt” at puberty.
• Is active physically, activities serve to refine motor skills.
• Visible signs of reproductive maturity may become evident
between 9-12years, self conscious.
• Mental: active, eager learner; understands cause and effect; can
read, write and do math. Has personified concept of death,
begins logical thought processes.
• Has tendency to nod with understanding when in reality no
understanding has occurred, reluctant to ask questions.
• Social/emotional: develops greater sense of self; focuses on
school activities, “fitting in” with peers; negotiates for greater
independence.
• Communication – help child to feel competent, useful.
• Needs parental support in times of crisis but also requires
privacy. Easily influenced by peer activities

Medical Staffing.
School Aged Child Health & Safety IssuesSchool Aged Child Health & Safety Issues
• Health: keeps immunizations/checkups on schedule; give
information on alcohol, tobacco, other drugs, and sexuality.
• Safety: promote safety habits (playground safety, resolving
conflicts peacefully, etc.)
• Needs to be reminded of dangerous situations (bicycle safety,
use of helmets, water safety, safe sex, etc.)
Major FearsMajor Fears
• Loss of control
• Bodily injury
• Death
• Not being able to live up to the expectations of important others

Medical Staffing.
Adverse Effects of HospitalizationAdverse Effects of Hospitalization
on a Pre-School Childon a Pre-School Child
The older age child strives to become industrious while overcoming
a sense of inferiority. A child wants to learn how to do and make
things with others. In learning to accept instruction and to win
recognition by producing “things”, he or she opens the way for
capacity of work enjoyment. The danger in this period is the
development of a sense of inadequacy and inferiority in a child who
does not receive recognition for his/her efforts. The child becomes
increasingly peer oriented. Possible adverse effects of
hospitalization may include insomnia, nightmares, or bedwetting
due to fear of the unknown. A loss of body control and feelings
regarding missing school and other important activities is also
common.

Medical Staffing.
Age-Specific Care for School-Aged ChildrenAge-Specific Care for School-Aged Children
• Use games to teach whenever appropriate.
• Involve child in planning of care as much as possible. Involve
parents in education along with child.
• Allow child to make some care decisions (“In which arm do you want
the vaccination?”) for an increased sense of control.
• Give a choice of whether or not to have parents present during
exams and procedures.
• Prepare child in advance for major event or surgery.
• Use body diagrams, pictures and models. Ask child to explain what
s/he understands about situation.
• Build self-esteem – ask child to help you do a task, recognize his or
her achievements, etc.
• Emphasize the “normal” things the child can and will be able to do.
Guide child in making lifestyle choices that are healthy and safe.

Medical Staffing.
Adolescents (Age 13 – 20 years) Are in TransitionAdolescents (Age 13 – 20 years) Are in Transition
• Physical: grows in spurts; rapid growth changes in height,
weight, body proportions
• Matures physically; able to reproduce.
• Little understanding of the structure and workings of their bodies.
• Mental: becomes an abstract thinker (goes beyond simple
solutions, can consider many options, etc.); chooses own values.
• Fairly mature level of reasoning
• Social/emotional: develops own identity; builds close
relationships; tries to balance peer group with family interests;
concerned about appearances; self-conscious; challenges
authority.
• Communication: provide acceptance, privacy; build teamwork,
respect.

Medical Staffing.
Adolescent Health & Safety IssuesAdolescent Health & Safety Issues
• Health: encourage regular checkups; promote sexual
responsibility; advise against substance abuse; update
immunizations.
• Safety: discourage risk taking (promote safe driving, violence
prevention, etc).
• Still needs to be reminded of dangerous situations, risk
behaviors and consequences.
Major FearsMajor Fears
• Loss of Control
• Altered body image
• Separation from peer group

Medical Staffing.
Adverse Effects of Adolescent HospitalizationAdverse Effects of Adolescent Hospitalization
Develops identity by defining self favorably in relation to others.
Role confusion occurs if the adolescent has continued conflicts
with
the family and society over the current role and anticipated future
role of the individual. Individual may fluctuate in participation in own
care due to dependence vs. independence. May be preoccupied
with bodily functions due to anxiety about illness, and concerns
about illness/procedure/surgery affecting his/her appearance.
Fewer opportunities to be part of peer group, wants to be like other
adolescents. Fear of not being “normal”, want to fit in with peers.
Fears about ability to function in school or on the job. May
experience a sense of isolation, resents loss of control, relationship
with parents and healthcare providers may become hostile.

Medical Staffing.
Age-Specific Care for AdolescentsAge-Specific Care for Adolescents
• Treat more as an adult than a child. May physically look like
adults but they are not.
• Explain treatments and procedures carefully. Explain physical
activity limitations carefully and what risks are involved.
• Avoid authoritarian approaches. Negotiate learning outcomes
with the patient.
• Encourage participation in self-care activities.
• Allow choices about care whenever possible. Collaborate in
developing an effective pain management program.
• Show respect – be considerate of how procedures, treatments,
etc., may affect appearances, relationships.

Medical Staffing.
Additional Age-Specific Care for AdolescentsAdditional Age-Specific Care for Adolescents
• Encourage social interaction with peers, continuing contact in
school activities, hobbies, and interests.
• Guide teen in making positive lifestyle choices – for example,
correct misinformation from teen’s peers.
• Be honest. Encourage open communication between parent(s),
teen, and peers.
• Discuss plans for future and how illness may affect it.

Medical Staffing.
Introduction to AdulthoodIntroduction to Adulthood
Varying age groups within the adult population will have different
physical needs, priorities, life goals, and approaches to life and the
future. These differences can have an impact on their needs and
desires when it comes to healthcare. It is important to consider the
physical changes, psychosocial development, safety/wellness
issues,and potential interventions related to early adulthood, middle
adulthood, and older adulthood. Young and middle adulthood is
usually a time of enduring stability of physical and mental health,
however hospitalization is a major crisis due to economic and family
needs. Young adults are involved in establishing careers, families,
and general lifestyles. Middle aged adults typically are economically
responsible for other family members are making major decisions
for families, workplaces, and the community.

Medical Staffing.
Young Adults (Ages 21 – 39) Build ConnectionsYoung Adults (Ages 21 – 39) Build Connections
• Physical: reaches physical and sexual maturity; nutritional needs
a maintenance, not growth.
• Muscular efficiency is at its peak between 20-30.
• Growth of skeletal systems continues until age 30.
• GI system decreases secretions after age 30.
• Some loss in hearing, especially high tones.
• Mental abilities reach their peak during the twenties; reasoning
skills, information recall, verbal skills; used to solve problems.
• Social/emotional: seeks closeness with others; sets career
goals; chooses lifestyle, community, may start own family.
• Communication: be supportive and honest; respect personal
values.
• Watch body language as a cue for feelings.

Medical Staffing.
Young Adulthood Health & Safety IssuesYoung Adulthood Health & Safety Issues
• Health: encourage regular checkups; promote healthy lifestyle
(proper nutrition, exercise, weight control, etc); inform about
health risks (heart disease, cancer, etc); update immunizations.
• Safety: provide information on hazards at home, work.

Medical Staffing.
Age-Specific Care for Young AdultsAge-Specific Care for Young Adults
to Minimize Adverse Effects of Hospitalizationto Minimize Adverse Effects of Hospitalization
Young adults seek companionship, love, and intimacy with another
person or can become isolated from others. Initiating a career,
finding a mate, developing loving relationships, marriage,
establishing a family, parenting. Searching for and finding a place
for self in society, achievement oriented, working up career ladder.
Begins to express concerns for health. Actual, or perceived
anticipation of harm, anxiety and/or fear of the unknown. Threats to
physical self image, such as pain or change in physical
appearance. Threats to psychosocial self-image, change in role as
provider, becoming dependent vs. independent, powerlessness or
loss of control.

Medical Staffing.
Additional Age-Specific Care for Young AdultsAdditional Age-Specific Care for Young Adults
• Assess barriers to learning and readiness to learn.
• Ask the individual, based on their past experiences, how they
learn best (visual aids, written material, demonstration, hands-
on, etc.) then use the method(s) identified by the patient.
• Assess current knowledge of the individual regarding their
disease/test/procedure.
• Involve individual and significant other in plan of care.
• Support the person in making health-care decisions.
• Assess and manage pain based on patient need and response
to current pain management techniques.
• Encourage health and safe habits at work and home.
• Explore impact of hospitalization/illness to work/job and family.
• Recognize commitments to family, career, community (time,
money, etc).

Medical Staffing.
Middle Adults (Ages 40 – 64) Seek Personal GrowthMiddle Adults (Ages 40 – 64) Seek Personal Growth
• Physical: beginning to age; experiences menopause (women);
may develop chronic health problems.
• Slowing of reflexes and prolonged response to stress.
• Visual changes, especially farsightedness, noticeable loss of
hearing and taste.
• Muscles and joints respond more slowly. Decreased balance
and coordination.
• Bone mass begins to decrease. Loss of skeletal height; calcium
loss, especially after menopause.
• Decreased muscle strength and mass; without regular exercise,
endurance declines.
• Loss of skin elasticity, dry skin, and increased appearance of
wrinkles.
• Receding hairline, occipital baldness in males and increased
facial hair in females.

Medical Staffing.
Healthy Growth & Development Parameters (cont)Healthy Growth & Development Parameters (cont)
• Mental: uses life experiences to learn, create, and solve
problems.
• Synthesis of new information is decreased. Decrease in mental
performance and speed.
• Decreased short-term memory or recall.
• Social/emotional: hopes to contribute to future generations;
stays productive, avoids feeling “stuck” in life; balances dreams
with reality; plans retirement; may care for children and parents.
• Mood swings: re-evaluation of current lifestyle and value
system.
• Communications: keep a hopeful attitude; focus on strengths,
not limitations.

Medical Staffing.
Middle Adulthood Health & Safety IssuesMiddle Adulthood Health & Safety Issues
• Health: encourage regular checkups and preventative exams;
address age-related changes; monitor health risks; update
immunizations.
• Decreased renal function and metabolic rate, heat and cold
intolerance.
• More prone to infections.
• Safety – address age-related changes (effects on senses, reflexes,
etc).
• Although memory loss, especially of short term events, is normal in
the elderly, dementia is NOT a normal occurrence. Signs of
confusion or significant changes in mental abilities may signal an
underlying health problem and should be assessed in detail. Most
elderly will take longer to learn new content, have difficulty making
quick decisions, and may need frequent reinforcement of
instructions.

Medical Staffing.
Adverse Effects of Hospitalization forAdverse Effects of Hospitalization for
Middle Aged AdultsMiddle Aged Adults
Middle-aged adults strive to be productive, performing meaningful
work versus becoming stagnant and inactive. They continue
working up career ladder becoming future-oriented or possibly self-
absorbed. The empty nest syndrome may be expressed negatively
or positively. This is the potential “mid-life” crisis, measuring
accomplishments against goals or the recognition of limitations.
Adverse effects include anxiety for an unidentified threat or fear of
a known threat. Threats to physical image; loss of body part;
change in functional ability; need for prosthetic device. Threats to
psychosocial image; loss of control; insecurity; perception of aging;
losing independence; fear of death.

Medical Staffing.
Age-Specific Care for Middle Aged AdultsAge-Specific Care for Middle Aged Adults
• Assess barriers to learning and readiness to learn.
• Provide teaching in the form the adult patient learns best.
• Address worries about future – encourage talking about feelings, plans,
etc.
• Progress at the individual’s desired speed and ability to assimilate
information.
• Allow choices and decision-making concerning schedule and plan of
care whenever possible.
• Encourage as much self-care as possible.
• Recognize the person’s physical, mental and social abilities, and
contributions.
• Provide information and instruction regarding pain, disease, treatments,
interventions and expectations.
• Help with plans for a healthy, active retirement.

Medical Staffing.
Older Adults (Ages 65 – 79 years) Enjoy NewOlder Adults (Ages 65 – 79 years) Enjoy New
Opportunities -Opportunities - Healthy Growth & DevelopmentHealthy Growth & Development
ParametersParameters
• Physical: ages gradually; natural decline in some physical
abilities, senses.
• Mental: continues to be an active leaner, thinker; memory skills
may start to decline.
• Social/emotional: takes on new roles (grandparent, widow/er,
etc); balances independence, dependence, reviews life.
• Changes in role or status, changes in financial situation
• Loss of significant others, depression and/or isolation
• Loss of health, reduced autonomy and self-determination
• Communications: give respect; prevent isolation; encourage
acceptance of aging.
• Introduce yourself to the patient, ask how they wish to be
addressed (Mr., Ms., Mrs., first names, etc.).

Medical Staffing.
Older Adulthood Health & Safety IssuesOlder Adulthood Health & Safety Issues
• Health: monitor health closely; promote physical, mental, social
activity; guard against depression, apathy; update
immunizations.
• Teach stress reduction strategies
• Safety: promote home safety, especially preventing falls.
Common Fears of Older AdultsCommon Fears of Older Adults
• Loneliness
• Becoming a burden for loved ones
• Pain

Medical Staffing.
Adverse Effects of Hospitalization of the Older AdultAdverse Effects of Hospitalization of the Older Adult
Integrity results when the older person derives satisfaction from an
evaluation of his/her life. Disappointment with life and the lack of
opportunities to alter the past brings despair. Coping with life
adjustments can be the biggest challenge to the elderly. Many
changes are perceived as losses, which affect the person’s “coping”
ability.

Medical Staffing.
Age-Specific Care for Older AdultsAge-Specific Care for Older Adults
• Encourage the person to talk about feelings of loss, grief, and
achievements.
• Assess learning barriers and readiness to learn.
• Allow extra time to absorb verbal or written material.
• Present information that is factual and straightforward.
• Emphasize the application of knowledge and experience.
• Provide information, materials, etc., to make medication use, home
safer.
• Use large print for written materials.
• Encourage the use of organizing aids.
• Provide support for coping with any impairment. (Avoid making
assumptions about loss of abilities.)
• Make arrangements for support of religious practices. Encourage
social activity with others, peers, as a volunteer, etc.

Medical Staffing.
Adults Ages 80 and Older Move to AcceptanceAdults Ages 80 and Older Move to Acceptance
• Physical: continues to decline in physical abilities; at increasing risk
for chronic illness, major health problems.
• Arteries lose their elasticity, accumulate calcium deposits, resulting
in narrowed arteries and higher blood pressure.
• Increased incidence of chest pain if preexisting cardiovascular
disease is present.
• Calcification of rib cage, and loss of elasticity of alveoli often results
in less effective gas exchange, hypoxia and an increased risk for
developing respiratory infection.
• Renal mass becomes smaller with age. Bladder muscles weaken
and capacity decreases. Voiding becomes more difficult and an
increase in bladder infections may result.
• Bone and mineral mass are reduced, contributing to the brittleness
of the bones, especially women. Fractures are a serious risk to the
older adult. The deterioration of cartilage surface of joints limit
activity and motion.

Medical Staffing.
Healthy Growth & Development Parameters (cont)Healthy Growth & Development Parameters (cont)
• Mental: continues to learn; memory skills and/or speed of
learning may decline; confusion often signals illness or a
medication problem.
• Social/emotional: accepts end-of-life and personal losses; lives
as independently as possible.
• Reduced autonomy and self-determination, loss of health and
significant others.
• Loneliness and becoming a burden for loved ones are common
fears and concerns.
• Communications: encourage the person to express feelings,
thoughts, avoid despair; use humor, stay positive.
• Introduce yourself to the patient, ask how they wish to be
addressed (Mr., Ms., Mrs., first names, etc.)

Medical Staffing.
Health & Safety Issues for Older Adults > 80 yearsHealth & Safety Issues for Older Adults > 80 years
• Health: monitor health closely; promote self-care; ensure proper
nutrition, activity level, rest; reduce stress; update
immunizations.
• Poor dental care can contribute to GI problems by poor
mastication of food.
• Each of the five senses becomes less efficient with age,
interfering in varying degrees with safety, normal activities of
daily living and general well being.
• Safety: prevent injury; ensure safe living environment.
• Clearly visible markings on stove and other appliances.

Medical Staffing.
Additional Health & Safety Issues forAdditional Health & Safety Issues for
Older Adults > 80 yearsOlder Adults > 80 years
• Adequate, non glaring lighting, access to light before getting out
of bed
• Remove throw rugs or highly polished floors, cords, clutter or
other obstacles in pathways
• Grab bars in bathroom, toilet, tub/shower Sturdy, non-skid
shoes. Encourage and make sure individuals use aids
(eyeglasses, hearing aids, canes, etc.)
• Daily/Weekly medication trays if needed for individuals with
visual impairments
• Ensure individual has adequate clothing and blankets, when
cold.

Medical Staffing.
Adverse Effects of Hospitalization of theAdverse Effects of Hospitalization of the
Older Adult > 80 YearsOlder Adult > 80 Years
One of the most important functions of any individual is the ability to
interact with both the internal and external environment. Effective
interaction with the environment depends largely on the ability to
receive accurate information. With aging comes a general slowing
of a person’s response to sensory stimuli. Long term memory can
be slowed especially if the information is not used or needed on a
daily basis. Although learning itself is not slowed in older adults,
other factors may contribute such as decreased attention span,
difficulty in hearing, and decreased visual acuity.

Medical Staffing.
Age-Specific Care for Older AdultsAge-Specific Care for Older Adults
• Assess learning barriers and readiness to learn.
• Use learning methods that are meaningful to the individual.
• Don’t try to teach too much new information at one time.
• Speak slowly, deliberately and distinctly while facing person(s)
with hearing impairment.
• Encourage independence – provide physical, mental, social
activities.
• Support end-of-life decisions, advanced directives– provide
information, resources, etc.
• Make arrangements for support of religious practices.
• Assist the person in self-care – promote medication safety;
provide safety grips, ramps, etc.
• Provide comfort, physical contact and frequent interventions.

Medical Staffing.
ConclusionConclusion
Each patient is unique. Always keep in mind that:Each patient is unique. Always keep in mind that:
• Growth & development follow general patterns, but every
individual grows & develops in his or her own unique way.
• Not every member of a cultural group may share all of its values,
beliefs or practices.
• A patient may appear similar to you, but still be different from you
in certain ways.
• Avoid stereotyping a patient – consider all the factors that may
affect his or her care needs.

Age Specific Guidelines

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Age Specific Guidelines