People of different ages have unique personal and health needs, all of which must be recognized by the medical professional who treats them. This involves nurses or physicians customizing the care they provide to ensure their patient gets the best possible outcome.
Part of this will be adapting their interactions, in terms of their behavior and communication techniques. The way they carry out assessments and the tools they use will also be adapted, depending on the age of their patients. In doing so, they gain a patients’ trust and encourage them to participate in their recovery. Most US hospitals group patients into four age groups, these are neonatal and infant, child and adolescent, adult and elders.
Learning to serve each section of the population
As lifelong learning is embedded into their profession, clinicians will always have opportunities for further study in this field. Ambitious working nurses who plan to move into a more responsible role can take the Post-Master’s Certificate — Family Nurse Practitioner course at Spring Arbor University. The program prepares students to care for patients at every stage of life and is highly flexible, so busy nurses can complete the certification at their own pace.
Nursing students learn that patients of all ages can expect the same standards of safety, comfort and confidentiality. Patients should also have an appropriate level of pain relief and involvement from their family, should they so wish. Experienced nurses consider a patient’s age when responding to these needs, ensuring their approach is appropriate and respectful.
Caring for the youngest patients in neonatal and infant nursing
As very young patients are small, have less mature body systems and are not capable of cooperating in their care, nurses have to be extra vigilant in giving medication. Children may have reactions to safe drugs, as their tolerance levels vary, but also because they may have allergies that are not yet known. Furthermore, as infant veins can be fragile, nurses need to be vigilant when placing an IV. Unlike almost all other patients, young babies need to be cuddled to feel reassured and to develop feelings of trust for the nurse who is caring for them.
This age group has specific safety risks, such as sudden infant death syndrome (SIDS), which nurses can address by placing them on their back to sleep. They should also be positioned correctly for feeding, as younger children are at higher risk of choking. Furthermore, they can be more reactive to heat and cold, as they cannot regulate their body temperature in the same way as older patients. That means a static environmental temperature must be maintained.
For this age group, nurses will often limit the number of unfamiliar adults who are present in the hospital room and encourage the parent or parents to stay close. Many young children are nervous about adults they do not know and fearful of separating from their parents. Assessment of neonatal patients can be difficult, as they are unable to respond verbally and can become distressed quickly. Nurses will speak with the parents to learn more about the child’s behavior and gain insight into how their current condition is affecting them.
As children move into the toddler years, they are more communicative and will respond well to attention and praise. However, at this stage, children can also have tantrums, be fond of saying no and will respond swiftly to pain. Nurses need to respond firmly but gently, but it can help to prepare a toddler in advance and use play to describe a treatment. Using the least intrusive methods of assessment and giving medication is always best, as toddlers can find these unfamiliar experiences quite threatening.
As their immune system is still immature, toddlers often contract respiratory and gastrointestinal bugs. Therefore, nurses use infection-control practices to provide a safe environment and lower this risk. Finally, toddlers can experience even more separation fear than babies, so the entire medical team will work to keep parents close and lessen the impact of long stays or invasive treatments.
Respecting the needs of older children and adolescents
By the time children are of school age, they are often keen to become active participants in their care. Nurses respond to this natural curiosity by answering their questions in an age-appropriate way and teaching them about the equipment that is used in the ward or office. They will often seek out other children to play with, so an area of the ward can be set aside for this, which also gives them a chance to burn off energy. Between the ages of five and 10, children are better able to understand that their parents can leave for a while and be trusted to return. They are also happy to chat with trusted adults, like nurses, and will ask for help when they need it.
This age group understands the concept of independence and will want to do things for themselves, nurses ensure this can happen within limits. However, there will also be times when children try to conceal their feelings of fear and anxiety because they hope to appear ‘grown up’. Nurses are sensitive to this and remind children that it is ok to share feelings and seek reassurance. Part of this will involve giving information about the child’s condition and asking them to repeat back what they understand. This helps the child to feel more confident in their treatment and understand why certain procedures are needed. As children of this age have a good grasp of time, nurses can explain to them how long a treatment will last. This can be reassuring because the child gains a deeper understanding of when they might start feeling better.
Young adolescent adults are coping with body changes, and this can make them more self-conscious than younger children. Nurses may have to support this age group when it comes to body image, as they can be vulnerable to feeling different or flawed. Moreover, although they are often unsure of the facts about their treatment, they could be too shy to ask for help, so nurses are always very clear and informative, to pre-empt this from becoming a problem. Unlike younger children and older adults, they can often feel more supported by their peers than their family, so nurses will often allow friends to visit when a young adolescent adult is staying in the hospital.
Being advocates for young and middle-aged adult patients
Between the age of 20 and 40, most people have taken on an adult role in their family, as well as at work, in education and in their community. However, not everyone matures at the same rate, so nurses will assess each young adult individually. People in this age group understand why they need treatment and are usually very cooperative, but nurses may need to provide support with other areas of their care. For instance, some may have trouble attending meetings or agreeing to a long course of treatment, because they have childcare responsibilities.
As people enter middle-age — between 40 and 65 years old — they are often very independent, both emotionally and financially. Furthermore, many people of this age are in a position of authority at home, as a parent of adult children, and at work, as their career has progressed. Therefore, the transition to being a patient and relying on a nurse for their care could feel distressing. Even after elective surgery, middle-aged people may be disappointed in their sudden lack of mobility and overly keen to return home. Nurses will take this on board while caring for middle-aged patients, by keeping them involved and informed at every stage of their care.
All adults of this age are prone to obesity as their metabolic rate decreases. Nurses may need to broach this subject if a person’s weight is impacting their health. Providing education on healthy lifestyle choices can help — this could involve assessing and then giving advice on nutrition and exercise. Women in this age group are often affected by their menopausal status and they may be at risk of broken bones. Therefore, nurses will offer guidance on how to relieve symptoms, such as hot flushes, or help them to access hormone replacement therapy.
Middle age is often the onset of minor conditions, such as short-sightedness, which can impact patient care significantly if the patient does not have their glasses with them. Nurses will ensure they can read the materials a facility provides, from menus to educational materials or consent forms. For women, screenings begin for conditions such as breast cancer and bone density tests will also be offered. For men, prostate cancer screening is the norm. Nurses remind or inform middle-aged patients about the importance of these tests, as a part of their standard care.
Protecting and healing our elders
‘Elder’ and ‘elderly’ are terms that the healthcare profession uses to describe people who are over 65. The population is ageing, and in 2020 more than one in six Americans were over the age of 65. This has been enabled, in part, through advances in healthcare. Now, older people often put off retiring and may even choose to pursue a new career altogether.
Therefore, nurses must take into account the considerable variations in elderly people’s cognitive and physical powers. Some people have a high level of competency, others will need more thoughtful communication techniques. Nurses may have to speak slowly and more loudly, face the patient when they explain something and give adequate time for a response. If appropriate, nurses can help patients get around the communication barriers they experience. They could advise on hearing aids or offer a magnifier if their patient is struggling to read.
Some elderly people feel patronized by terms such as ‘dear’ or ‘sweetheart’ and prefer a more formal tone from medical professionals. Nurses can manage this by asking the patient how they like to be addressed and acting on their advice. Furthermore, people in this group have experienced extensive loss through the death of loved ones. They may also have less independence and less mobility. Therefore, nurses remain cognizant of the need to be respectful and to maintain the patient’s dignity, especially when they feel vulnerable or have additional needs. The families of elderly patients are often involved in their lives and may help with their day-to-day care. Therefore, nurses involve relatives in their relation’s care plan, provide instructions and offer information that could help when the patient is back home.
Routine procedures such as IVs and taking blood can be more difficult in this age group. Older people often have fragile veins and are vulnerable to both dehydration and fluid overload. Like young children, they can be over-sensitive to medication and dosages must be carefully monitored. Furthermore, their skin can tear easily, even when tape is being removed or a patient is being transferred into bed. Nurses are constantly aware of these multiple risks and will carefully assess each patient before any procedure takes place.
These risks are amplified because some elderly people may not reveal the full extent of their condition or any pain they are suffering. They may have been experiencing discomfort for some time before they seek help and often consider pain to be a natural part of getting older. Nurses can tackle the issue and gain a better understanding of a patient’s health by focusing on detailed assessments. They order tests and screenings, as well as look at the patient’s body language and facial responses. This helps them to make an informed diagnosis and implement an effective treatment plan as soon as possible.
Delivering patient-centered care to Americans of all ages
Nurses do not take a one-size-fits-all approach to treating or advocating the rights of patients, because their needs change between ages — as well as between other demographics. By providing age-appropriate care, they can help to manage the patient’s emotional needs, as well as their physical treatment. This leads to better experiences in the health system, improved medical outcomes and satisfied patients.