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Instructor’s Resource Manual
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Sorrentino: Mosby’s Essentials for Nursing Assistants, 3rd Edition
Instructor’s Resource Manual
Chapter 5: Understanding the Person
Instructor’s Preparation
Read Chapter 5 in the textbook.
Review chapter objectives, key terms, and review questions for Chapter 5 in the text- book.
Read the outline and classroom activities in Chapter 5 of this Instructor’s Resource Manual.
Review the student assignment and the quiz in Chapter 5 of this Instructor’s Resource
Manual.
V.
Review the PowerPoint slides for Chapter 5.
VI.
Review Electronic Images for Chapter 5.
VII.
If you are using the accompanying Student Workbook, review the activities for Chapter 5.
VIII.
Collect all necessary supplies and equipment for the classroom activities and student
assignments.
A. Collect PowerPoint slides.
B. Prepare appropriate flip charts.
C. Prepare index cards.
D. Collect correct TA.
E. Collect colored markers.
F. Collect any other items that will be needed for classroom activities.
G. Assemble items in the order they will be used.
IX.
Make sure that the necessary equipment is available and in good working order.
X.
Contact the guest speaker to confirm the day, date, time, and location that he or she is
expected.
A. Ask the speaker if he or she requires any special equipment or supplies. Make sure these
are available.
I.
II.
III.
IV.
Objectives
 Define the key terms listed in this chapter
 Identify the parts that make up the whole person and basic needs
 Explain how culture and religion influence health and illness
 Describe the American Hospital Association’s The Patient Care Partnership: Understanding
Expectations, Rights, and Responsibilities
 Describe the feelings and needs of nursing center residents
 Explain how to deal with behavior issues
 Identify the elements needed to communicate
 Describe how to use verbal and nonverbal communication
 Explain the methods for and barriers to good communication
 Explain why family and visitors are important to the person
 Identify the courtesies given to the person and visitors
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Key Terms
body language
culture
need
nonverbal communication
optimal level of function
religion
verbal communication
Outline and Classroom Activities
I. INTRODUCTION
A. The patient or resident is the most important person in the agency.
1. Each person has value.

Ask students: “Who is the most important person in the agency?”
o Ask them to discuss why the patient or resident is the most important person.
 Write the reasons students give on the chalkboard or flip chart.
II. CARING FOR THE PERSON
A. The whole person has physical, social, psychological, and spiritual parts.
1. The parts are woven together and cannot be separated.


Refer students to Figure 5-1 on p. 51 in the textbook. (Electronic Image 11.)
Display TA 3
2. Each part relates to and depends on the others.
B. Hospital patients
1. In April 2003, The American Hospital Association (AHA) adopted The Patient Care
Partnership: Understanding Expectations, Rights, and Responsibilities.
a. The document explains the person’s rights and expectations during hospital stays.
C. Nursing center residents
1. Fears and anxieties about living in a nursing center are common.
a. The resident’s behavior may reflect fear and other emotions.
2. You can help residents feel safe, secure, and loved.
a. Protect their rights (Chapter 7).
b. Take an extra minute to visit, to hold a hand, or to give a hug.
c. Treat each person with respect and dignity.
3. You can help maintain optimal level of function (the person’s highest potential for
mental and physical performance).
a. Encourage as much independence as possible.
b. Focus on the person’s abilities, not disabilities.
c. Help each person regain or maintain as much physical and mental function as
possible.
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D. Quality of life
1. Patients and residents have the right to quality of life.
2. Before giving care you must extend the following courtesies:
a. Knock before entering the person’s room.
b. Address the person by name.
c. Introduce yourself by name and title.
d. Explain the procedure to the person before beginning and during the procedure.
e. Protect the person’s rights during the procedure.
f. Handle the person gently during the procedure.
III. NEEDS
A. A need is something necessary or desired for maintaining life and mental well-being.
B. According to psychologist Abraham Maslow, basic needs must be met for a person to
survive and function.

Refer students to Figure 5-2 on p. 52 in the textbook
o Discuss lower level and higher level needs.
o Ask students to discuss how Maslow’s theory relates to the care they provide.
1. Lower-level needs must be met before the higher-level needs.
C. Basic needs, from the lowest level to the highest level, are:
1. Physical needs
a. Oxygen, food, water, elimination, rest, and shelter are needed for life.
(1) They are needed to survive.
2. Safety and security needs
a. Relate to feeling safe from harm, danger, and fear
(1) People feel safer and more secure if they know what will happen.
(a) For every procedure, they should know:
(i) Why it is needed
(ii) Who will do it
(iii) How it will be done
(iv) What sensations or feelings to expect
3. Love and belonging needs
a. Relate to love, closeness, and affection
(1) They also involve meaningful relationships with others.
b. Some people become weaker or die from the lack of love and belonging.
4. Self-esteem needs
a. Self-esteem:
(1) Means to think well of oneself, and to see oneself as useful and having value
(2) Relates to being thought well of by others
b. People often lack self-esteem when ill, injured, older, or disabled.
5. Self-actualization needs
a. Self-actualization means experiencing one’s potential.
b. This is the highest need.
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(1) Rarely, if ever, is it totally met.
IV. CULTURE AND RELIGION
A. Culture is the characteristics of a group of people.
1. They are passed from one generation to the next.
2. The person’s culture influences:
a. Health beliefs and practices
b. Behavior during illness



Review the “Caring About Culture: Health Care Beliefs” box on p. 53 in the textbook
with students.
Review the “Caring About Culture: Sick Care Practices” box on p. 53 in the textbook
with students.
o Allow time for questions and discussion.
o Discuss how cultural considerations affect how care is given.
Ask students to discuss their personal, cultural, and religious beliefs and practices
o Ask them:
 How these beliefs and practices influence their health habits
 How they would want their religious and cultural beliefs included in their care
plan
c. Family practices and food choices
d. Hygiene habits and clothing styles
e. Language and communication
f. Beliefs about what causes and cures illness
g. Beliefs and rituals about dying and death (Chapter 27).
B. Religion relates to spiritual beliefs, needs, and practices.

Ask students to share the religious practices and rituals that are important to them.
o Ask them how they would want these included in their care plans if they were in a
hospital or nursing center.
1. Many people find comfort and strength from religion during illness.
a. Assist the person to attend services as needed.
2. The care plan includes the person’s cultural and religious practices.
3. You must respect and accept the person’s culture and religion.
4. A person may not follow all beliefs and practices of his or her culture or religion.
5. Some people do not practice a religion.
V. BEHAVIOR ISSUES
A. A person who is ill, injured, or disabled may feel angry, frustrated, or useless.
B. Some patients, residents, and families have the following behaviors.

Write the following behaviors on a flip chart. Leave space after each.
o Anger
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o
o
o
o
o
Demanding behavior
Self-centered behavior
Aggressive behavior
Withdrawal
Inappropriate sexual behavior
 Call on students to describe each behavior.
 Write correct answers on the flip chart.
 Allow time for students to discuss how to meet the needs of persons with each
behavior.
1. Anger
a. Anger is a common emotion.
b. Causes include:
(1) Fear and pain
(2) Dying and death
(3) Loss of function and loss of control over health and life
(4) A symptom of diseases that affect thinking and behavior
(5) Some people are generally angry.
c. Anger is shown verbally and nonverbally.
(1) Nonverbal signs include:
(a) Rapid movements, pacing, clenched fists, and a red face
(b) Glaring and getting close to you when speaking
d. Violent behaviors can occur.
2. Demanding behavior
a. Nothing seems to please the person.
b. The person is critical of others.
c. Causes include:
(1) Loss of independence
(2) Loss of health
(3) Loss of control of life
(4) Unmet needs
3. Self-centered behavior
a. The person cares only about his or her own needs.
(1) The needs of others are ignored.
b. He or she may become impatient when needs are not met.
4. Aggressive behavior
a. The person may swear, bite, hit, pinch, scratch, or kick.
b. Fear, anger, pain, and dementia (Chapter 25) are causes.
c. Protect the person, others, and yourself from harm (Chapter 8).
5. Withdrawal
a. The person has little or no contact with others.
(1) This may signal physical illness or depression.
(2) Some people are not social and like to be alone.
6. Inappropriate sexual behavior
a. These behaviors may be:
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(1) On purpose
(2) Due to disease, confusion, dementia, or drug side effects
C. A person’s behavior may be unpleasant.
1. You cannot avoid the person or lose control.
2. Good communication is needed.
3. Follow the care plan and the guidelines in Box 5-1 on p. 53 in the textbook.

Review the contents of Box 5-1 on p. 53 in the textbook with students.
o Allow time for questions and discussion.
VI. COMMUNICATING WITH THE PERSON
A. For effective communication between you and the person, you must:
1. Follow the rules of communication (Chapter 4).
2. Understand and respect the patient or resident as a person.
3. View the person as a physical, psychological, social, and spiritual human being.
4. Appreciate the person’s problems and frustrations.
5. Respect the person’s rights.
6. Respect the person’s religion and culture.
7. Give the person time to process (understand) information.
8. Repeat information as often as needed.
a. Repeat exactly what you said.
9. Ask questions to see if the person understood you.
10. Be patient.
a. People with memory problems may ask the same question many times.



Call on students to define:
o Verbal communication
o Nonverbal communication
Ask students to discuss how they use verbal and nonverbal communication in their
daily lives.
Give examples of how verbal and nonverbal communication are used in the classroom.
B. Verbal communication
1. Words are used in verbal communication.
a. Words are spoken or written.
2. Follow these rules for spoken verbal communication.
a. Face the person.
b. Control the loudness and tone of your voice.
c. Speak clearly, slowly, and distinctly.
d. Do not use slang or vulgar words.
e. Repeat information as needed.
f. Ask one question at a time.
(1) Wait for the answer.
g. Do not shout, whisper, or mumble.
h. Be kind, courteous, and friendly.
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3. The written word is used if the person cannot speak or hear.
a. The nurse and care plan tell you how to communicate with the person.


Refer students to Figure 5-3 on p. 54 in the textbook.
Invite a speech-language pathologist to visit the class.
o Ask the person to:
 Discuss communication techniques used for hearing- and speech-impaired
persons
 Bring communication tools to show to students
 Allow time for questions and discussion
C. Nonverbal communication
1. Nonverbal communication does not use words.
a. Gestures, facial expressions, posture, body movements, touch, and smell send
messages.
2. Nonverbal messages more accurately reflect a person’s feelings than words do.
3. Touch is a very important form of nonverbal communication.
a. It conveys comfort, caring, love, affection, interest, and reassurance.
b. The meaning of touch depends on age, gender experiences, and culture.
(1) See “Caring About Culture: Touch Practices” box on p. 55 in the textbook.


Review the contents of the “Caring About Culture: Touch Practices” box on p. 55 in the
textbook.
Ask students to discuss what touch means to them.
o Ask them what they would want in their care plans about the use of touch.
(2) Some people do not like to be touched.
(3) Touch can show caring and warmth.
(4) Touch should be gentle; not hurried, rough, or sexual.
c. To use touch, follow the person’s care plan.
4. Body language.
a. People send messages through:
(1) Facial expressions
(a) See “Caring About Culture: Facial Expressions” box on p. 55 in the
textbook.

Review the “Caring About Culture: Facial Expressions” box on p. 55 in the textbook
with students.
o Allow time for questions and discussion.
(2) Gestures
(3) Posture
(4) Hand and body movements
(5) Gait
(6) Eye contact
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(7) Appearance
b. Your body language should show:
(1) Interest and enthusiasm
(2) Caring and respect for the person
c. Often you will need to control your body language.
D. Communication methods




Write each of the following communication methods on separate index cards.
o Listening
o Direct question
o Open-ended question
o Clarifying
o Silence
 Divide students into five groups. Give each group one card. Ask students to:
Define the communication method on their card
Explain when they would use the method
Give an example of the method
 Allow 5 minutes. Then have one person from each group report to the class.
1. Certain methods help you communicate with others.
2. Listening
a. Listening means to focus on verbal and nonverbal communication.
(1) You use sight, hearing, touch, and smell.
(2) You focus on what the person is saying.
(3) You observe nonverbal clues.
(4) Follow these guidelines:
(a) Face the person.
(b) Have good eye contact with the person.
(i) See “Caring About Culture: Eye Contact Practices” box on p. 56 in
the textbook.

Review the contents of the “Caring About Culture: Eye Contact Practices” box on p. 56
in the textbook with students.
o Allow time for questions and discussion.
(c) Lean toward the person.
(d) Respond to the person.
(e) Avoid the communication barriers on p. 57 in the textbook.
3. Direct questions
a. Direct questions focus on certain information.
4. Open-ended questions
a. Open-ended questions lead or invite the person to share thoughts, feelings, or
ideas.
(1) The person chooses what to talk about.
5. Clarifying
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a. Clarifying lets you make sure that you understand the message.
(1) You can:
(a) Ask the person to repeat the message
(b) Say you do not understand
(c) Restate the message
6. Silence
a. Silence is a powerful way to communicate.
(1) Just being there shows you care.
b. Silence is useful when the person is upset and needs to regain control.
c. See “Caring About Culture: The Meaning of Silence” box on p. 57 in the
textbook.

Review the contents of the “Caring About Culture: The Meaning of Silence” box on p.
57 in the textbook with students.
o Allow time for questions and discussion.
E. Communication barriers
1. Communication barriers prevent sending and receiving messages.
a. Language
(1) You and the person must use and understand the same language.
b. Cultural differences
(1) The person may attach different meanings to verbal and nonverbal
communication
(a) See “Caring About Culture: Communicating With Persons From Other
Cultures” box on p. 57 in the textbook.

Review the “Caring About Culture: Communicating With Persons From Other
Cultures” box on p. 57 in the textbook with students.
o Allow time for questions and discussion.
c. Changing the subject
d. Giving opinions
(1) Opinions involve judging values, behavior, or feelings.
e. Talking a lot when others are silent
f. Failure to listen
(1) Pretending to listen
(a) Shows lack of interest and caring
(b) Can cause you to miss complaints that you must report to the nurse
g. Pat answers
(1) These make the person feel that you do not care about his or her concerns,
feelings, and fears.
h. Illness and disability
F. The person who is comatose
1. The person cannot respond to others.
a. Often the person can hear and feel touch and pain.
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(1) Assume that the person hears and understands you.
(2) Use touch and give care gently.
2. Practice these measures:
a. Knock before entering the person’s room.
b. Tell the person your name, the time, and the place every time you enter the room.
c. Give care on the same schedule every day.
d. Explain what you are going to do and what you are doing step by step.
e. Tell the person when you are finishing care.
f. Use touch to communicate care, concern, and comfort.
g. Tell the person what time you will be back to check on him or her.
h. Tell the person when you are leaving the room.
VII. THE FAMILY AND VISITORS
A. Family and friends:
1. Help meet safety and security, love and belonging, and self-esteem needs
2. Offer support and comfort
3. Lessen loneliness
4. Often help with the person’s care
a. See “Caring About Culture: Family Roles in Sick Care” box on p. 58 in the
textbook.


Review the contents of the “Caring About Culture: Family Roles in Sick Care” box on
p. 58 in the textbook with students.
o Allow time for questions and discussion.
Call on students to share any personal experiences they may have had with illness or
injury. Ask them to answer these questions:
o How important were family and friends to you?
o How do you feel about having family and friends around when you are ill?
o Does everyone feel the same way?
B. The person has the right to visit with family and friends in private and without
unnecessary interruptions.
1. Do not expose the person’s body in front of visitors.
a. Politely ask them to leave the room.
b. Show them where to wait.
c. Promptly tell them when they can return.
2. If the person gives consent, a partner or visitor may help with the person’s care.
C. Treat family and visitors with courtesy and respect.
1. Do not discuss the person’s condition with them.
a. Refer their questions to the nurse.
D. Visiting rules depend on agency policy and the person’s condition.
E. A visitor may upset or tire a person.
1. Report your observations to the nurse.
Homework Assignment
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Ask students to answer the questions at the end of Chapter 5 in the textbook. Tell them the date
and time this assignment must be completed and turned in.
If the accompanying Student Workbook is being used, assign the Chapter 5 workbook exercises.
Tell students the date and time this assignment must be completed and turned in.
Assign each student a culture or religion to write a one-to two-page essay about. They should
include dietary, social, and health practices. Tell them the date and time the assignment must be
completed and turned in.
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Chapter 5 Student Assignment
Name: ____________________
Date: ____________________
Understanding the Person
Fill in the Blanks
1. List three measures that can help a resident feel safe, secure, and loved.
A. ________________________________________________________________.
B. _________________________________________________________________.
C. _________________________________________________________________.
2. According to Abraham Maslow, the need for ______________________________
____________________________________________________is the highest need.
3. Culture is __________________________________________________________.
4. Religion relates to ___________________________________________________.
5. Describe the following behaviors:
A. Demanding behavior ________________________________________________
B. Self-centered behavior _______________________________________________
6. List 5 causes of inappropriate sexual behaviors.
A.______________________________________________________________
B. ______________________________________________________________
C. ______________________________________________________________
D. ______________________________________________________________
E. ______________________________________________________________
7. Mr. Grant can hear, but cannot speak or read. How would you communicate with him?
________________________________________________________________
8. Your body language should show and__________________________________.
9. Touch means different things to different people. To use touch, you need to
__________________________________________________________________.
10. Listening requires that you ______ and ___________________________________.
11.____________________________________________________________ lead or invite the
person to share thoughts, feelings, or ideas.
12. ____________________________________________________________lets you make sure
that you understand the message.
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13. ____________________________________________________________is a powerful way
to communicate. It is used in sad times and when a person is upset and needs time to regain
control.
14. Explain why language can be a communication barrier.________________________
____________________________________________________________________
15. Discuss how the presence or absence of family and friends can affect recovery and quality of
life.
____________________________________________________________________
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Chapter 5 QUIZ
Name: ____________________
Date: ____________________
Understanding the Person
True or False
Mark T for true or F for false.
1._______ Self-esteem needs are the most important for survival.
2. _______ Family and friends are allowed to visit in private.
3. _______ Listen and use silence when dealing with an angry person.
4. _______ Inappropriate sexual behaviors are always on purpose.
5. _______ Verbal messages more accurately reflect a person’s feelings than nonverbal messages
do.
6. _______ Everyone likes to be touched.
7. _______ Open-ended questions lead the person to share thoughts, feelings, or ideas.
8. _______ Giving your opinion promotes effective communication.
9. _______ The person will feel safer and more secure if you explain what you are doing and
why.
Multiple Choice
Circle the BEST answer.
10. The following statements relate to basic needs. Which is false?
A. Physical needs must be met for survival.
B. Higher level needs must be met before lower level needs.
C. The need for self-actualization is rarely totally met.
D. The need for self-esteem is affected by illness.
11. The characteristics of a group of people passed from one generation to the next is:
A. Self-actualization
B. Religion
C. Culture
D. Holism
12. Which of the following statements about anger is false?
A. Anger can be a symptom of disease.
B. Loss of function can cause anger.
C. Anger is always expressed verbally.
D. Anger is a common emotion.
13. Which of the following does not promote effective communication?
A. Speaking clearly, slowly, and distinctly
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B. Controlling the loudness and tone of your voice
C. Asking several questions at once
D. Repeating information as needed
14. Communication that uses the written or spoken word is:
A. Nonverbal communication
B. Focusing
C. Body language
D. Verbal communication
15. Which does not promote effective listening?
A. Facing the person
B. Sitting back in the chair with your arms crossed
C. Having good eye contact
D. Asking questions
16. Direct questions are used to:
A. Show the person that you care
B. Make sure you understand what was said
C. Focus on specific information
D. Allow the person time to think
17. You are caring for Mr. John Smith. He is comatose. You must:
A. Assume that he hears and understands you.
B. Spend as little time in his room as possible.
C. Provide his care as quickly as you can.
D. Avoid talking to him when providing care.
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