Download Developmentally Appropriate Care of the Adult Patient

HealthStream Regulatory Script
Developmentally Appropriate Care of the Adult Patient
Version: May 2007
Lesson 1:
Lesson 2:
Lesson 2:
Lesson 3:
Lesson 4:
Lesson 5:
Introduction
Age-Specific Competencies
Young Adults
Middle Adults
Older Adults
Development and Assessment of Competencies
Lesson 1: Introduction
1001
Introduction
Welcome to the introductory lesson on developmentally
appropriate care of the adult patient. This lesson gives the
course rationale, goals, and outline.
IMAGE: 1001.JPG
As your partner, HealthStream strives to provide its customers with excellence
in regulatory learning solutions. As new guidelines are continually issued by
regulatory agencies, we work to update courses, as needed, in a timely
manner. Since responsibility for complying with new guidelines remains with
your organization, HealthStream encourages you to routinely check all relevant
regulatory agencies directly for the latest updates for clinical/organizational
guidelines.
If you have concerns about any aspect of the safety or quality of patient care in
your organization, be aware that you may report these concerns directly to The
Joint Commission.
Point 1 of 11
2
1002
Course Rationale
Healthcare professionals should be committed to providing
quality patient care. In order to do so, they must understand a
patient’s age-specific:
• Characteristics
• Needs
• Challenges
FLASH ANIMATION: 1002.SWF/FLA
Understanding these features will allow you to better meet your
patient’s needs.
Point 2 of 4
1003
Course Goals
After completing this course, you should be able to:
• Define the term “competency”
• Discuss needs, characteristics, and medical care
practices for the:
o Young adult
o Middle adult
o Older adult
• Explain how age-specific competencies are acquired
and assessed
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Point 3 of 4
1004
Course Outline
Lesson 1 provided the course rationale and goals.
FLASH ANIMATION: 1004.SWF/FLA
Lesson 2 will discuss age-specific competencies.
Lesson 3 will focuse on young adults.
Lesson 4 will focuse on middle adults.
Lesson 5 will focuse on older adults.
Lesson 6 will describe development and assessment of
competencies.
Point 4 of 4
Lesson 2: Age-Specific Competencies
2001
Introduction & Objectives
Welcome to the lesson on age-specific competencies.
FLASH ANIMATION: 2001.SWF/FLA
After completing this lesson, you should be able to:
• Define competency
• Recall age-specific competencies
• Understand the importance of age-specific
competencies
Point 1 of 10
2002
What Is a Competency?
A “competency” is a set of:
• Knowledge
• Skills
• Abilities
IMAGE: 2002.JPG
This skill set allows a person to perform a task.
Healthcare staff must develop and demonstrate competencies
related to patient care.
Point 2 of 10
2003
What Are Age-Specific Competencies?
Age-specific competencies are one type of competency.
IMAGE: 2003.JPG
Caregivers must be able to provide care according to a
patient’s:
• Chronological age
• Developmental age
• Maturity level
Point 3 of 10
2004
Why Develop Age-Specific Competencies?
Age-specific competencies:
• Improve the quality of patient care
• Enable your facility to meet accreditation requirements
IMAGE: 2004.GIF
Let’s take a closer look at each of these goals.
Point 4 of 10
2005
Importance of Age-Specific Competencies: Quality Patient Care
At each stage of life, human beings exhibit predictable:
• Characteristics
• Needs
• Developmental challenges
• Milestones
IMAGE: 2005.JPG
This knowledge will allow you to provide developmentally
appropriate care. This will better meet your patient’s needs.
Point 5 of 10
2006
Importance of Age-Specific Competencies: The Joint Commission Standards
The Joint Commission believes that age-specific competency is
important. They require accredited institutions to:
• Develop age-specific competencies
• Evaluate competencies
IMAGE: 2006.JPG
Competency training and assessment must be documented.
Point 6 of 10
2007
The Joint Commission Standards: Assessment of Age-Specific Competencies
An employee is competent if they understand how human
beings grow and develop.
IMAGE: 2007.JPG
They can demonstrate this knowledge by:
•
•
•
Utilizing patient data to determine a patient’s status
Interpreting patient information to identify needs
Providing appropriate care according to a patient’s age
and developmental needs
Point 7 of 10
2008
Adult Age Groups
Adults can be divided into three age categories:
• Young adult (ages 18 to 44)
• Middle adult (ages 45 to 65)
• Older adult (over age 65)
IMAGE: 2008.JPG
Remember, characteristics presented in this course are not
absolutes. They are guidelines to consider when providing care
to adult patients of different ages.
Point 8 of 10
2009
Review
The Joint Commission believes that age-specific care is
important. However, they do not require employees to
demonstrate age-specific competencies.
a. True
b. False
MULTIPLE CHOICE INTERACTION
Correct answer: B
Feedback for A. Incorrect. The Joint Commission requires staff
to demonstrate age-specific competencies. Institutions must
train and assess staff.
Feedback for B. Correct. The Joint Commission requires staff
to demonstrate age-specific competencies. Institutions must
train and assess staff.
Point 9 of 10
2010
Summary
You have completed the lesson on age-specific competencies.
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Remember:
• A competency is a set of knowledge, skills, and abilities
needed to perform a task.
• Age-specific competencies:
o Improve patient care
o Allow an institution to meet accreditation
requirements
Point 10 of 10
Lesson 3: Young Adults
3001
Introduction & Objectives
Welcome to the lesson on the young adult (ages 18 to 44).
FLASH ANIMATION: 3001.SWF/FLA
After completing this lesson, you should be able to:
•
•
Describe the young adult’s:
o Characteristics
o Needs
o Cognitive abilities
Detail care practices for the young adult
Point 1 of 13
3002
Physical Characteristics and Changes
During the young-adult years, patients:
• Reach physical and sexual maturity
• Continue to experience growth of the skeletal system
(until age 30)
• Reach peak muscular strength (between the ages of 20
and 30)
• Achieve adult lab values
IMAGE: 3002.JPG
Toward the end of this stage:
• Physical functions slow gradually
• Tissues lose some capacity to regenerate
• Degenerative changes such as arthritis may develop
• The skin begins to lose moisture and elasticity
• The reproductive system begins to atrophy
• Diseases of the reproductive system may develop
Point 2 of 13
3003
Physical Characteristics and Changes: Developmentally Appropriate Care
Important care practices include:
• Monitoring for sexually transmitted diseases
• Assessing for degenerative changes
IMAGE: 3003.JPG
Point 3 of 13
3004
Nutritional Needs and Related Care
The nutritional needs of young adults shift from growth to
maintenance.
IMAGE: 3004.JPG
Explain proper nutrition and diet to maintain:
• Health
• Normal weight
Note: Nutritional needs of adults depend upon activity levels.
Point 4 of 13
3005
Psychosocial and Developmental Characteristics
Young adults face the primary challenge of intimacy vs.
isolation.
IMAGE: 3005.JPG
Those who develop intimate relationships can maintain:
• Friendships
• A primary love relationship
Those who do not, show signs of isolation:
• Poor self-esteem
• Withdrawal
Other characteristics of the young adult are given on the next
screen.
Point 5 of 13
3006
Psychosocial and Developmental Characteristics: Table
IMAGE: 3006.JPG
Point 6 of 13
3007
Psychosocial and Developmental Challenges: Developmentally Appropriate Care
Encourage the young adult patient to think realistically about
commitments and challenges. These include:
• Relationships
• Family
• Career
• Community
IMAGE: 3007.JPG
Provide help with family planning. Provide prenatal information.
Discuss changes that may be stressful.
Demonstrate respect for the young adult’s personal values.
Allow the young adult to verbalize concerns. Encourage
questions related to fear. Help the patient explore any fears
about how their condition will affect their work, relationships, or
family.
Point 7 of 13
3008
Cognitive Abilities
Mental abilities peak during the twenties. These abilities
include:
• Reasoning
• Creativity
• Memory
• Verbal skills
IMAGE: 3008.JPG
Young adults begin to:
• Form their own opinions
• Make independent decisions
• Learn from life experiences
Point 8 of 13
3009
Cognitive Abilities: Developmentally Appropriate Care
Respect the cognitive abilities of young-adult patients. Explain
all medical procedures.
IMAGE: 3009.JPG
Ask the patient if he or she prefers to:
• Discuss the procedure
• Look through written materials with you
• Use other learning techniques
Each patient learns differently. Adjust your explanation
accordingly.
Involve young-adult patients in decision-making and planning.
Allow for as much self-care as possible.
Point 9 of 13
3010
Safety Needs and Related Care
Major causes of death among young adults are related to:
• Age-specific stressors
• The impact of unhealthy lifestyle choices
FLASH ANIMATION: 3010.SWF/FLA
To help promote safety:
• Encourage the use of stress-reduction techniques
• Encourage healthy lifestyle choices:
o Proper nutrition and weight control
o Regular exercise
o Other practices for reducing long-term risk
• Emphasize the importance of regular checkups and
screenings
• Encourage attention to safety hazards
Point 10 of 13
3011
Review
During some or all of the young-adult years:
a. The skeletal system continues to grow.
b. The skin begins to lose moisture and elasticity.
c. Degenerative changes such as arthritis may develop.
d. All of these are correct.
MULTIPLE CHOICE INTERACTION
Correct answer: D
Feedback for A: Not quite. The correct answer is D. All of
these physical changes take place.
Feedback for B: Not quite. The correct answer is D. All of
these physical changes take place.
Feedback for C: Not quite. The correct answer is D. All of
these physical changes take place.
Feedback for D: Correct. All of these physical changes take
place.
Point 11 of 13
3012
Review
FLASH INTERACTION: 3012.SWF/FLA
Psychosocial and Developmental Characteristics of the Young Adult
•
Establishment of personal identity
•
Acceptance of self
•
Finding a career and working up
Major achievements
the career ladder
Major stressors
•
Establishing a family
•
Balancing roles and
responsibilities at home, work,
school, and in the community
Most significant relationships
•
Spouse
•
Children
•
Coworkers
•
Loss of work
•
Loss of social relationships
Greatest fears
Point 12 of 13
3013
Summary
You have completed the lesson on young adults.
NO IMAGE
Remember:
•
•
•
•
•
•
•
During the young-adult years, patients reach their physical
and sexual peak. They then begin to experience
degenerative changes. Physical functions slow.
The nutritional needs of young adults shift to maintenance of
a healthy body.
Young adults work to develop intimacy. If they do not, they
may show signs of isolation.
Major stressors and fears are related to personal identity,
career, family, and relationships.
Mental abilities peak during the twenties. Young adults form
their own opinions. They make independent decisions.
Causes of death are related to stressors and unhealthy
lifestyle choices.
Consider these factors when caring for a young adult.
Point 13 of 13
Lesson 4: Middle Adults
4001
Introduction & Objectives
Welcome to the lesson on the middle adult (ages 45 to 65).
FLASH ANIMATION: 4001.SWF/FLA
After completing this lesson, you should be able to:
•
•
Describe the middle adult’s:
o Characteristics
o Needs
o Cognitive abilities
Detail appropriate care practices for the middle adult
Point 1 of 12
4002
Physical Characteristics and Changes
During the middle adult stage:
• Physical functions continue to slow
•
Basal metabolic rate [glossary] declines
•
Tissues continue to lose the ability to regenerate
•
Degenerative changes may continue
•
Other chronic conditions may develop
•
The skin continues to lose moisture and elasticity
•
Atrophy of the reproductive system continues
IMAGE: 4002.JPG
Point 2 of 12
4003
Physical Characteristics and Changes
•
Women typically experience menopause (may be
IMAGE: 4003.JPG
accompanied by depression)
•
Bone changes may occur (especially in women, because of
menopause). These changes include:
o
Decalcification [glossary] and reabsorption of bone
o
Diminished bone density (may lead to osteoporosis)
•
Farsightedness tends to develop
•
Other senses may begin to diminish
Point 3 of 12
4004
Physical Characteristics and Changes: Developmentally Appropriate Care
Obesity can develop during this stage.
IMAGE: 4004.JPG
Emphasize the importance of checkups and screenings to:
• Monitor risk factors for disease
• Screen for chronic conditions
Counsel women regarding menopause:
• Discuss the use of estrogen
• Provide tips for minimizing the risk of osteoporosis
• Depression
Discuss sensory changes and how these changes may affect
activities such as driving.
Point 4 of 12
4005
Psychosocial and Developmental Characteristics
Middle adults face the primary challenge of productivity vs.
stagnation.
IMAGE: 4005.JPG
To stay productive, middle adults may:
• Reevaluate their priorities
• Make new decisions
Productive adults engage in tasks that nurture and nourish:
• Managing a household
• Raising children
• Contributing to the health and welfare of future generations
Those who fall into stagnation tend to be self-absorbed.
Other characteristics of the middle adult are summarized on the next
screen.
Point 5 of 12
4006
Psychosocial and Developmental Characteristics: Table
IMAGE: 4006.JPG
Point 6 of 12
4007
Psychosocial and Developmental Characteristics: Developmentally Appropriate Care
Middle adults may experience self-doubt and midlife crisis.
IMAGE: 4007.JPG
To provide encouragement:
• Focus on the patient’s strengths
• Acknowledge the patient’s abilities and contributions
• Maintain a hopeful attitude
• Be alert for signs of depression
You should also:
• Allow the patient to express concerns about growing
children and/or aging parents
• Encourage the patient to express any worries about the
future
• Help him or her plan for an active, healthy retirement
• Encourage the patient to verbalize any fears about
illness/treatment/hospitalization
Point 7 of 12
4008
Cognitive Abilities
The middle adult uses extensive life experience to:
• Learn
• Create
• Solve problems
IMAGE: 4008.JPG
Middle adults:
• Form their own opinions
• Make independent decisions
Point 8 of 12
4009
Cognitive Abilities: Developmentally Appropriate Care
Explain all medical procedures to middle-adult patients. Provide
teaching based on learning style.
IMAGE: 4009.JPG
Involve patients in decision-making and healthcare planning. Allow
for as much self-care as possible.
As with all patients, respect the middle adult’s cultural and religious
beliefs.
Point 9 of 12
4010
Review
FLASH INTERACTION: 4010.SWF/FLA
Drag and drop terms from the word bank to complete the following table
of physical changes characteristic of the middle adult.
System/Organ
Skin
Bones
Reproductive system
Sense
Related Change
Loss of moisture and elasticity
Loss of density
Menopause
Farsightedness
Point 10 of 12
4011
Review
When caring for a middle-adult patient, focus on the patient’s
strengths, and acknowledge the patient’s abilities and contributions.
a. True
b. False
TRUE / FALSE INTERACTION
Correct answer: A
Feedback for A: Correct. Focus on the patient’s strengths.
Acknowledge the patient’s abilities.
Feedback for B: Incorrect. Focus on the patient’s
strengths. Acknowledge the patient’s abilities.
Point 11 of 12
4012
Summary
You have completed the lesson on middle-adult patients.
NO IMAGE
Remember:
• The middle adult experiences many degenerative physical
changes.
They may develop chronic conditions such as diabetes or
cardiovascular disease.
Middle adults often reevaluate their priorities and make new
decisions to remain productive. If they are not productive,
they may show signs of self-absorption.
Major stressors and fears are related to the sandwich
phenomenon.
The middle adult uses extensive life experience to learn,
create, and solve problems. Middle adults form their own
opinions and make independent decisions.
• Consider these factors when caring for a middle adult.
Point 12 of 12
Lesson 5: Older Adults
5001
Introduction
Welcome to the lesson on the older adult (over age 65).
FLASH ANIMATION: 5001.SWF/FLA
After completing this lesson, you should be able to:
• Describe the older-adult patient’s:
o Characteristics
o Needs
• Recall care practices that are appropriate for the older
adult, based on:
o Developmental challenges
o Milestones
o Characteristics
o Needs
Point 1 of 16
5002
Physical Characteristics and Changes
Older adults experience diminished function in every system of the
body.
IMAGE: 5002.GIF
Many of these changes are summarized in the table to the right.
Point 2 of 16
5003
Physical Characteristics and Changes: Developmentally Appropriate Care
Monitor the physical health of older adults closely. Encourage
good health.
IMAGE: 5003.JPG
Ensure that immunizations are kept up-to-date.
The Joint Commission’s 2007 National Patient Safety Goals
includes reducing the risk of influenza and pneumococcal disease
in older adults.
To achieve this goal,,develop and implement protocols for:
• Administration and documentation of vaccinations
• Identification and management of outbreaks such as
influenza and pneumococcal.
Point 3 of 16
5004
Physical Characteristics and Changes: Developmentally Appropriate Care
As a health care professional you should:
• Encourage patients to remain as active as possible
• Suggest ways of dealing with physical impairments
IMAGE: 5004.JPG
Finally, when examining, treating, or caring for an older adult:
•
•
•
•
Provide for warmth if heat regulation is poor
Have the patient change positions slowly, to compensate
for decreased cardiovascular force
Speak distinctly
Focus light directly on objects
Point 4 of 16
5005
Nutritional Needs
Older adults require fewer calories than younger adults.
IMAGE: 5005.GIF
The nutritional status of older adults may be poor. This is due to
factors such as:
• Income
• Overall state of health
• Dental health
• Changes in taste
• Physical limitations, such as difficulty chewing,
swallowing, etc.
• Lack of transportation to and from the grocery store
• Lack of appetite
• Psychological factors, such as depression
• Chemical dependency, such as alcoholism
Point 5 of 16
5006
Nutritional Needs: Developmentally Appropriate Care
Assess the nutritional status of all older-adult patients.
IMAGE: 5006.JPG
For older-adult patients who take care of themselves, encourage:
• Healthy eating
• Adequate fluid intake
To help improve food intake in patients with compromised
nutritional status, suggest:
• Physical support while eating
• Smaller, more frequent meals
• Food intake appropriate for the patient’s activity level
• Pureed foods
• Nutritional supplements
Point 6 of 16
5007
Psychosocial and Developmental Characteristics
Older adults tend to be introspective. They review their lives.
They face the primary challenge of ego integrity vs. despair.
FLASH ANIMATION: 5007.SWF/FLA
Those who achieve ego integrity display:
• Wisdom and skills
• Satisfaction with their lives
Those who do not show signs of despair:
• Remorse
• A sense that life is meaningless
Other characteristics of the older adult are summarized in the
table on the next screen.
Point 7 of 16
5008
Psychosocial and Developmental Characteristics: Table
IMAGE: 5008.JPG
Point 8 of 16
5009
Psychosocial and Developmental Challenges: Developmentally Appropriate Care
Encourage older adults to accept the realities of aging. Also
encourage them to remain as active and independent as possible.
IMAGE: 5009.JPG
Listen to the older-adult patient. Give patients the opportunity to
express their:
• Feelings about life accomplishments
• Grief concerning the death of family and friends
• Fears and concerns
Finally, help guard against depression and isolation by
encouraging:
• Social activities
• A positive attitude
• Sense of humor
Point 9 of 16
5010
Cognitive Abilities
Older adults may remain active learners and thinkers.
IMAGE: 5010.JPG
However, many older adults eventually experience significant
declines in:
• Memory
• Learning
• Communication skills
Point 10 of 16
5011
Cognitive Abilities: Developmentally Appropriate Care
Involve competent older-adult patients in decision-making and
healthcare planning.
IMAGE: 5011.JPG
Allow for as much self-care as possible. Encourage the completion
of advance directives [glossary].
For those with a limited ability to understand:
• Involve a designated healthcare representative
• Present information slowly
• Keep sessions short
• Avoid distractions
• Use large print materials and simple pictures or drawings
Preserve patient dignity. Promote autonomy. This should be done
even in patients with dementia.
Point 11 of 16
5012
Safety Needs and Related Care
Patients in this age group have increased safety needs:
• Older adults are at increased risk for falls. They also are
more likely to be injured in a fall.
• Sensory changes may put drivers at increased risk.
• Confused patients may be unable to recognize dangers.
IMAGE: 5012.JPG
Related healthcare practices include:
• Assess patients for fall risk
• Assess patients for confusion
• Discuss how sensory changes can affect activities
• Suggest environmental changes to help prevent falls
Point 12 of 16
5013
Medical Needs and Related Care
Older adults may take many medications.
IMAGE: 5013.JPG
Provide aids (dose calendars, daily pillboxes, etc.) to help the
patient remember to take their medications.
Age-related changes can affect drug absorption, metabolism, and
excretion.
Medications can have unexpected and unpredictable effects.
Therefore, dosages should follow the “start low, go slow” rule.
Point 13 of 16
5014
Review
Older adults should avoid physical activity as much as possible.
a. True
b. False
TRUE / FALSE INTERACTION
Correct answer: B
Feedback for A: Incorrect. This statement is false. Older
adults should remain as active as possible.
Feedback for B: Correct. Older adults should remain as
active as possible.
Point 14 of 16
5015
Review
Older adults who fail to achieve ego integrity tend to display:
a. Despair
b. A sense that life is meaningless
c. Remorse about ways in which they could have lived life
differently
d. All of these
MULTIPLE CHOICE INTERACTION
Correct answer: D
Feedback for A: Not quite. The correct answer is D. Older
adults who do not achieve ego integrity show signs of
despair and remorse.
Feedback for B: Not quite. The correct answer is D. Older
adults who do not achieve ego integrity show signs of
despair and remorse.
Feedback for C: Not quite. The correct answer is D. Older
adults who do not achieve ego integrity show signs of
despair and remorse.
Feedback for D: Correct. Older adults who do not achieve
ego integrity show signs of despair and remorse.
Point 15 of 16
5016
Summary
You have completed the lesson on older adults.
NO IMAGE
Remember:
• Older adults experience diminished function in every
system of the body.
• Older adults require fewer calories than younger adults.
However, they may not maintain adequate dietary intake.
• Older adults tend to be introspective. They face the
challenge of ego integrity vs. despair.
• Major stressors and fears for the older adult are related to
new roles, decline, decreasing independence, dealing with
death, security, and status.
• Many older adults will experience declines in memory,
learning, and communication skills.
• Safety issues for older adults are related to fall risk,
sensory changes, and confusion.
• Older adults may take many medications. They may have
unexpected and unpredictable effects.
• Consider these factors when caring for the older adult.
Point 16 of 16
Lesson 6: Development and Assessment of Competencies
6001
Introduction & Objectives
Welcome to the lesson on development and assessment of agespecific competencies.
FLASH ANIMATION: 6001.SWF/FLA
After completing this lesson, you should be able to:
• Detail the facilities requirements concerning age-specific
competencies
• Describe methods used to assess age-specific
competencies
Point 1 of 9
6002
Developing Age-Specific Competencies
Your facility must:
• Define age-specific competencies
• Educate and train staff members
• Assess employee competencies
FLASH ANIMATION: 6002.SWF/FLA
Let’s take a closer look at each responsibility.
Point 2 of 9
6003
Defining Age-Specific Competencies
Each healthcare facility must define the exact competencies to be
achieved by its employees.
FLASH ANIMATION: 6003.SWF/FLA
Exact definitions are important. All employees need a clear idea of
the knowledge and skills they are expected to have.
Your facility competencies may differ slightly from those presented
in this course.
Point 3 of 9
6004
Defining Age-Specific Competencies: Documentation
Age-specific competencies may be documented in:
• Position or job descriptions
• Addenda to position or job descriptions
• Unit or departmental policies
• Departmental scope-of-service documents
• Peer review standards
• Contracts between employers and provider groups
FLASH ANIMATION: 6003.SWF/FLA
Ask your supervisor where to find documentation if needed.
Point 4 of 9
6005
Education
Your facility also should offer training:
• Orientation programs
• In-services
• Videos and other self-learning materials
• Computer-based programs
• Hospital-wide education programs
FLASH ANIMATION: 6005.SWF/FLA
Completion should be documented in your employee record.
Point 5 of 9
6006
Assessment
Your facility also must assess age-specific competencies. Specific
criteria must be used.
FLASH ANIMATION: 6006.SWF/FLA
Point 6 of 9
6007
Assessment
Assessment methods may include:
•
•
•
•
•
Direct observation
Return demonstration
Medical record review
Peer evaluation
Patient satisfaction survey
Click on each method to learn more.
CLICK TO REVEAL
Direct observation
A supervisor watches a staff member provide care to a
patient. Developmentally-appropriate care (or lack of) is
noted by the supervisor.
Return demonstration
A staff member observes a supervisor teach the proper
way to care for a patient. The staff member then
demonstrates the care procedure. This shows that he or
she has acquired the competency.
Medical record review
A supervisor checks the medical records of patients.
Developmentally-appropriate care (or lack of) is noted.
Peer evaluation
Coworkers assess the knowledge and ability of a staff
member. They are in the best position to view performance
on an ongoing basis.
Surveys
Surveys provide information about patient perceptions of
the quality of age-specific care.
Point 7 of 9
6008
Review
The direct observation method is used to assess age-specific
competencies. A supervisor watches as a staff member provides
care or services to a patient of a particular age group.
a. True
b. False
TRUE / FALSE INTERACTION
Correct answer: A
Feedback for A: Correct. A supervisor watches as a staff
member provides care or services to a patient.
Feedback for B: Incorrect. This statement is true. In direct
observation, a supervisor watches as a staff member
provides care or services to a patient.
Point 8 of 9
6009
Summary
You have completed the lesson on acquisition of age-specific
competencies.
NO IMAGE
Remember:
• Your facility must define age-specific competencies.
Age-specific competencies may be documented in a
variety of places.
Your facility must provide education and training. It must
be documented.
Your facility is responsible for assessing age-specific
competencies.
Point 9 of 9
[Developmentally Appropriate Care of the Adult Patient]
Course Glossary
#
Term
Assess
Psychosocial
Cognitive
Basal metabolic rate (BMR)
Decalcification
Advance directive
Definition
To determine the importance, size, or value of through official evaluation
"Psychological + social" - the emotional portions of thought plus the
relationship to human society, life and community
A term that describes the process people use for remembering, reasoning,
understanding, problem solving, evaluating and using judgment.
A measurement of the energy required to keep the body functioning at rest
Loss of calcium from bones or teeth
Written document that describes how you want medical decisions to be made if you lose
the ability to make decisions for yourself
[Developmentally Appropriate Care of the Adult Patient]
Pre-Assessment
1. Jill Smith is a 27-year-old accountant. She recently married. She is considering starting a family, but also enjoys her work. She wonders how a
new baby would affect her marriage. She is also concerned about her friendships with non-mothers. You should:
a. Encourage her to pursue both family and career, while she is still young and energetic
b. Advise her to establish her career more firmly before having children
c. Encourage her to think realistically about the commitments and challenges related to relationships, family, and career
d. Reassure her that children will not affect her other relationships or her ability to pursue her career
Correct answer: C
Rationale: Balancing roles and responsibilities can be a major stressor for young adults. Encourage patients in this age group to think realistically
about the challenges and commitments of relationships, family, and career.
2. Amy Peters is a 24-year-old college graduate looking for a job. She dates casually, but has never been in a serious relationship. She has no
children. Jane Joseph is a 52-year-old stay-at-home mother of three. Her youngest child recently started college. Which of the following
statements reflect best practices for BOTH patients?
a. Explain all necessary medical procedures to Jane, including the rationale for each procedure. Discuss Amy’s treatment with her parents.
b. Screen Jane for depression related to mental and physical decline. Screen Amy for depression related to midlife crisis.
c. Monitor Jane for risk factors related to conditions such as cancer, heart disease, and diabetes. Monitor Amy for sexually transmitted
diseases.
d. Acknowledge Jane’s abilities and contributions. Give Amy the opportunity to express feelings related to life achievements.
Correct answer: C
Rationale: Monitor middle adults for risk factors. Monitor young adults for sexually transmitted diseases.
3. The primary psychosocial challenge for older adults is:
a. Intimacy vs. isolation
b. Productivity vs. stagnation
c. Ego integrity vs. despair
d. Dependence vs. independence
Correct answer: C
Rationale: The primary challenge for older adults is ego integrity vs. despair. Those who achieve ego integrity display wisdom, skills, and
satisfaction with their lives. Those who fail to achieve ego integrity display signs of despair: remorse about what might have been, and a sense
that life is meaningless.
4. Medication dosages for older adults should follow the:
a. “Start low, go slow” rule
b. “Aim high, retry” rule
c. “Stop and drop” rule
d. “Wait and watch” rule
Correct answer: A
Rationale: Age-related changes can affect drug absorption, metabolism, and excretion. In some cases, medications can have unexpected and
unpredictable effects on older patients. To help guard against this, medication dosages should follow the “start low, go slow” rule.
5. Each healthcare facility is responsible for defining and describing the exact competencies to be achieved by its employees. All of the following
statements are true EXCEPT:
a. Exact definitions are important so that all employees have a clear idea of the knowledge and skills they need to provide quality, ageappropriate care.
b. Descriptions of age-specific competencies are often documented in job descriptions or unit/departmental policies.
c. Once a facility has defined and documented its competency expectations, it has no further responsibilities with regard to the age-specific
competencies of its employees.
d. Clear definitions and descriptions provide reliable guidelines for patient care, but do not give hard-and-fast rules.
Correct answer: C
Rationale: In addition to defining age-specific competencies, facilities are responsible for training and assessing their employees with regard to
established competencies.
6. The term “competency” refers to a set of knowledge, skills, and abilities that allow a person to perform a specific task.
a. True
b. False
Correct answer: A
Rationale: This is an accurate definition of competency.
7. You are evaluating an institution’s compliance with The Joint Commission’s National Patient Safety Goals. The institution has initiated a
program to increase flu and pneumococcus vaccination program among older adults. They also have methods in place to document how many
older patients are vaccinated. To be fully compliant, they also need to:
a. Develop protocols to vaccinate middle adults as well
b. Develop protocols to vaccinate older patients against Rubella as well
c. Develop protocols to identify and manage influenza and pneumococcus outbreaks
d. No other measures are needed. The institution is fully compliant.
Correct answer: C
Rationale: The Joint Commission also expects accredited institutions to identify and manage influenza and pneumococcus outbreaks.
8. Developmentally-appropriate care uses age as a guideline for providing patient care. This is an advantage because care is standardized by
age. A 30-year-old man with Down syndrome will receive the same care as a 30-year-old man without Down syndrome.
a. True
b. False
Correct answer: B
Rationale: Age is used only as a guideline. Care must also depend on other factors. In this example, the developmental stage of the patient with
Down syndrome must be considered. The two patients will have different characteristics and needs. Each must be addressed appropriately.
9. Rich is 30-years-old. He is living with his parents while attending graduate school. Chris is a 30-year-old student who lives off campus and has a
full-time job. You should challenge the personal values of ____ in order to encourage his independence.
a. Chris
b. Rich
c. Both Chris and Rich
d. Neither Chris or Rich
Correct answer: D
Rationale: Never challenge the personal views of a patient.
10. When caring for a menopausal woman:
a. Discuss the use of estrogen
b. Provide tips for minimizing the risk of osteoporosis
c. Screen for depression
d. All of these should be done
e. None of these are necessary at this stage
Correct answer: D
Rationale: Menopausal women need information about the use of estrogen. Because bone changes take place after menopause, they also need
information about osteoporosis. Finally, menopause can be accompanied by depression.
11. Which of the following patients is most likely to experience the sandwich phenomenon?
a. A 23-year-old woman
b. A 45-year-old woman
c. A 69-year-old woman
d. All of these
Correct answer: B
Rationale: Middle adults typically experience the sandwich phenomenon. They are often caring for their children and aging parents at the same
time.
Final Exam
1. The term “competency” refers to a set of knowledge, skills, and abilities that allow a person to perform a specific task.
a. True
b. False
Correct answer: A
Rationale: This is an accurate definition of competency.
2. Age-specific competencies are assessed for accreditation by The Joint Commission. Each employee must be able to:
a. Determine a patient’s status by assessing patient data
b. Identify an individual patient’s needs by interpreting patient information
c. Provide care appropriate to a patient’s age and developmental needs
d. All of these abilities must be demonstrated
e. None of these abilities must be demonstrated
Correct answer: D
Rationale: To be considered competent under The Joint Commission standards, an employee must demonstrate all of these abilities.
3. The sandwich phenomenon and empty nest syndrome are most common among:
a. Young adults
b. Middle adults
c. Older adults
d. All of these
e. None of these
Correct answer: B
Rationale: The sandwich phenomenon describes caring for both growing children and aging parents. Empty nest syndrome describes parental
feelings of depression after children leave home. Both are most common among middle adults.
4. Older adults rarely have problems related to inadequate dietary intake.
a. True
b. False
Correct answer: B
Rationale: Although older adults require fewer calories, their nutritional status is often poor, due to inadequate income, overall state of health,
dental health, changes in taste, and other factors.
5. Developmentally appropriate care uses age as a guideline. Other factors don’t need to be taken into account.
a. True
b. False
Correct answer: False
Rationale: Age is used as a guideline, not a rule. Other factors need to be considered when caring for a patient.
6. Learning styles differ from patient to patient. Even individuals among a single age group differ.
a. True
b. False
Correct answer: A
Rationale: Learning styles differ from person to person.
7. Which of the following statements is (are) true?
a. The middle years can be a time of doubt.
b. The middle years can be a time of crisis.
c. The middle years can be a time of nurturing.
d. All of the above
e. None of the above
Correct answer: D
Rationale: All of these can characterize the middle years.
8. When caring for patients, you must consider:
a. Chronological age
b. Developmental age
c. Maturity level
d. All of the above
e. None of the above
Correct answer: D
Rationale: All of these factors are important to consider.
9. One the Joint Commission’s National Patient Safety Goals is to reduce the risk of influenza in:
a. Young adults
b. Middle adults
c. Older adults
d. All adults
Correct answer: C
Rationale: The Joint Commission requires accredited institutions to reduce the risk of influenza in older adults.
10. Age-related changes can affect drug absorption, metabolism, and excretion. However, these changes are predictable.
a. True
b. False
Correct answer: B
Rationale: Drug effects in older patients are unpredictable.
11. Which assessment method gathers information about patient perceptions about the quality of age-specific care?
a. Direct observation
b. Medical record review
c. Peer evaluation
d. Surveys
Correct answer: D
Rationale: Patient surveys collect information about the patient’s perceptions of care.
12. Monitoring for sexually transmitted diseases is an important care practice for the ____ patient.
a. Young adult
b. Middle adult
c. All adults
d. Both A and B
Correct answer: A
Rationale: Young adults should be monitored for sexually transmitted diseases.
13. The primary psychosocial challenge for the older adult is
a. Ego integrity vs. despair
b. Intimacy vs. isolation
c. Productivity vs. stagnation
d. Independence vs. dependency
Correct answer: A
Rationale: Older adults face the challenge of ego integrity versus despair.
14. Which of the following patients is most likely to experience the sandwich phenomenon?
e. A 23-year-old woman
f. A 45-year-old woman
g. A 69-year-old woman
h. All of these
Correct answer: B
Rationale: Middle adults typically experience the sandwich phenomenon. They are often caring for their children and aging parents at the same
time.
15. Which of the following statements is NOT true?
a. It is important to encourage stress reduction among young adults
b. Unhealthy lifestyle choices are a major safety risk for young adults
c. Older adults are at increased risk for falls
d. Confused older adults recognize dangers but are unable to avoid them
Correct answer: D
Rationale: Confused adults often do not recognize dangers.