Clients’ Basic Human Needs Developed by: Dede Carr, BS, LDA Karen Neu, MSN, CNE, CNP 1.

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Awareness & Sensitivity to Client’s Health Care Needs

Clients’ Basic Human Needs

Developed by:Dede Carr, BS, LDA

Karen Neu, MSN, CNE, CNP

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Clients’ Basic Human NeedsCompetencies:1. Describe the major stages of human

development and the basic health needs of humans1A. Describe 5 common characteristics of

growth and development. 1B. Describe human needs theory

regarding human actualization

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Clients’ Basic Human NeedsCompetencies:2. Describe the needs of clients across the

lifespan and how those needs can affect behaviors and attitudes.2A. Describe the 3 different types of needs that

humans have across the lifespan2B. List the basic needs of infants, children, and

adolescents.2C. List the developmental needs of young adults

and older adults.

Growth

Growth: Physical change & increase in size Indicators of Growth

Height, Weight, Bone Size, & Dentition, Sensory Adaptation, & Development of sexual organs & characteristics

Although physical growth is similar for all people, growth rates vary during different stages of growth & development

Growth is rapid during prenatal, neonatal, infancy, & adolescence, but slows during childhood & is minimal during adulthood

(Ramont & Niedringhaus) 5

DevelopmentDevelopment: An increase in complex functions & progression of skills

Development refers to a person’s capacity & skill to adapt to the environment

Development is the behavioral aspect of growth & includes abilities to walk, talk, & run, speak, etc. (Ramont & Niedringhaus)

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Principles of Growth &

Development

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5 Characteristics of Growth & Development1.Occurs in an orderly pattern from simple to

complex: one task must be completed before the next one is attempted.

2.Continuous processes characterized by spurts of growth and periods of slow, steady growth: after infancy the rate of growth slows down until adolescence

3.Affects all body systems but at different time periods for specific structures.

4.Progresses at highly individualized rates that vary from person to person.

5.Form a total process that affects the person physically, mentally and socially

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Principles of Growth & DevelopmentGrowth & development take place in an organized way, but do not progress at same rate with all individuals

Cephalocaudally: Growth & development progresses from the head (cephalo) to tail ((caudal); for example an infant gains head control before control of extremities

Proximal to Distal: Growth & development progress from the center of the body outward-body’s midline to extremities (infant rolls before grasp is perfected)


Principles of Growth & DevelopmentGeneral to Specific: Walking is learned before running or skipping

Growth & development are independent, interrelated processes: Muscles, bones, & nervous system must grow to certain point before one can walk (Ramont & Niedringhaus)

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Growth & Development PrinciplesGrowth & Development Continuous, orderly, & sequential processes influenced by maturity (age), the environment, & genetic factors

Each stage is predictable, although the time of onset, length of stage, & effects of each stage varies with persons

Each developmental stage has its own characteristics

Development proceeds from simple to complex or from single acts to integrated acts


Growth & Development PrinciplesDevelopment becomes increasingly differentiated (advance from general response to skilled specific response) Example: An infant’s response to a stimulus involves the whole body while a five year old might respond with laughter

(Ramont & Niedringhaus)

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Growth & Development PrinciplesCertain stages are more critical than others (1st 10-12 weeks after conception most critical—risks for defects from exposure to viruses, chemicals, & drugs

Uneven pace of growth & development (ex. Rapid spurts of growth during prenatal, neonatal, infancy, & adolescence periods) (Ramont & Niedringhaus)

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Sequence of Development--Order for Infants

2 Months Able to lift head up on his own

3 Months Can roll over

4 Months Can sit propped up without falling over

6 Months Able to sit up without support

7 Months Begins to stand while holding onto things for support

9 Months Can begin to walk, still using support

(All Psych & Heffner Media Group, Inc., )

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Sequence of Development--Order for Infants10 Months

Able to momentarily stand on her own without support11 Months

Stand alone with more confidence12 Months

Begin walking alone without support14 Months

Walk backward without support17 Months

Walk up steps with little /no support18 Months

Manipulate objects with feet while walking, such as kicking a ball

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Factors that Influence Growth & Development

Genetic inheritance—remains unchanged throughout life & determines characteristics: sex, physical stature, & race

(Ramont & Niedringhaus) (www.saintbarnabas.com, n.d.)

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Factors that Influence Growth & Development

EnvironmentalFamilyReligionSchoolsClimateCultureCommunity Nutrition

(Ramont & Niedringhaus) (www.saintbarnabas.com, n.d.)

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Growth & Development: Why is it important in health care?

Knowledge of growth & development is essential when working in health care occupations because it is necessary to identify needs & problems (varies with age & developmental stage)

& necessary to decide what & how to provide the appropriate health promotion/care needed.

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Growth & Development: Why is it important in health care?

It encompasses the prenatal period throughout the lifespan (fetus to neonate to old adult including physiological, psychosocial, cognitive, moral, & spiritual aspects of each life stage

Remember how you care for someone will depend on their age, size, mental, physical, & emotional abilities—(growth & development) (Ramont & Niedringhaus)

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Maslow’s Hierarchy of Needs Theory

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Human Needs TheoryObjectiveDescribe the basic health needs of

humans with a focus on Self-Actualization

Describe the human need’s theory: Maslow’s Hierarchy of Needs

(www.leansignateam.hotpromo.us, n.d.)

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Human Needs TheoryThe human needs theory gives healthcare

workers a holistic overview of health promotion for the individual and families across the life span

Its purpose is to promote the health of the individuals & families

Nurses & healthcare workers use the human needs theory: Maslow’s Hierarchy of Needs

Human needs are ranked on an ascending (upward) scale according to how essential the needs for survival are (Berman et al., p. 273)

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Maslow’s Hierarchy of NeedsAccording to Maslow's theory, if basic needs are not

met then a person will find a way to try to satisfy them Higher needs such as social needs & esteem are not

felt until one has met the needs basic to one's bodily functioning (physiologic & safety & security needs)

Individuals change & develop over time & do not remain at one level until every need at that level is met, instead they may move up & down levels depending on the situation & need

Life is a dynamic process that involves movement up & down the hierarchy in response to events & experiences & in an ongoing effort to satisfy various needs. (Juliar, p. 291)

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Maslow’s Hierarchy of NeedsAbraham Maslow (1970) ranks the five levels of human needs as follows:

(www.entrepreneursuperstar.com, n. d.)

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Maslow’s Hierarchy of NeedsNeeds are generally

met in the following order from the base of the pyramid upward

1. Physiological2. Safety3. Love/Belonging4. Esteem 5. Self-Actualization


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Maslow’s Hierarchy of NeedsOne way to think of the ongoing movement

among the levels of needs is to consider the following scenario:

A high school student spent a late night out with friends. The student got 5 hours of sleep & after over-sleeping rushed to catch a ride to school missing breakfast & arriving just in time for a one-hour course review & the mid-term test.

What level of needs is this student at? Why?Which level do you think his teacher expects

him to be at? Why?

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Maslow’s Hierarchy of NeedsPhysiologic Needs: Air/Oxygen, Water, Maintain pH balance, Food, Protein, Salt, Sugar, Calcium Eliminate wastes Maintain body temperature, Be active, Rest, Sleep, Sex, Shelter Avoid pain (Berman et al. pp. 273-274)

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Maslow’s Hierarchy of NeedsSafety & Security Needs: Feel safe, secure & free from threat of physical &

emotional harm Finding safe circumstances Stability Protection A need for structure, order, limits Be concerned with fears & anxieties

Home in a safe neighborhood, Good retirementMedical insurance Job security Financial reserves (Berman et al. pp. 273-274)

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Maslow’s Hierarchy of Needs

Love & Belonging Needs: Social Needs:Social needs relate to interaction with other peopleGive & receive affectionAttain a place in a groupMaintain a feeling of belongingFeel the need for a friend, a lover, children, a sense

of community, a need to belongExhibit through our need to marry, have a family, be

part of a gang or softball team, a church, a community

If unmet: Become vulnerable to loneliness & social anxieties (Berman et al. pp. 273-274)

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Maslow’s Hierarchy of NeedsEsteem Needs: Need to feel important; Classified as Internal esteem needs relate to self-esteem such as

self respect, achievement, confidence, independence, freedom, mastery

External esteem relate to social status & recognition Self-respect Self respect is harder to lose Achievement than respect of others Attention Recognition Reputation

Fame, Glory (Berman et al. pp. 273-274)

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Maslow’s Hierarchy of NeedsSelf-Actualization Needs:When all of the foregoing needs are satisfied,

then & only then are the needs for self-actualization activated

Self-actualization: the summit of Maslow's Hierarchy of Needs

Quest of reaching one's full potential as a person

Unlike lower level needs, this need is never fully satisfied; as one grows psychologically there are always new opportunities to continue to grow

(Berman et al. pp. 273-274)

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Maslow’s Self-Actualization NeedsTruth OrderPlayfulness MeaningGoodness BeautySimplicityUnity Wholeness AlivenessUniqueness PerfectionCompletion

Richness Justice Wisdom Growth motivationBeing needed Self-actualizationNeeds do not involve

balanceSelf-actualization will

become stronger as we “feed” the needs

Fulfill potentials---”be all that you can be”

(Berman et al., pp. 273-273)

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Maslow’s Hierarchy of NeedsSelf-actualized persons have frequent

occurrences of peak experiences, which are energized moments of profound happiness and harmony.

According to Maslow, only a small percentage of the population reaches the level of self-actualization

(Schmutte)

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Basic Human NeedsMajor types of

human needsPhysicalPsychosocial

(Emotional)Spiritual

May describe the types as Mind/Body/Spirit

Note Maslow’s Hierarchy of Needs

(www.sneogical.edu.ms, n.d.)

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Clients’ NeedsPersons of all ages have basic needs of physical,

psychosocial, & spiritual aspects of growth & development

[Mind/Body/Spirit]

Age determines the rate of physical, psychosocial, or spiritual growth & development

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Basic Needs of Clients&

Milestones in

Growth & Development

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Infant’s NeedsInfants & children experience a rapid &

marked rate of development and have major milestones in growth

Infants & small children have a high priority for physical comfort, such as food, rest, warmth, safety & security, & emotional needs, & depend on their caregivers to help meet their needs (Erikson’s psychosocial development of trust versus mistrust)

(Ramont & Niedringhaus)

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Infant’s NeedsPhysiologic Must provide for physical needs

of infantNutrition: Breastfeeding to 12 months;

breast-feeding & bottle feeding techniques; Formulas; Introduction of foods; need for iron supplementation @ 4-6 months;

Rest & Sleep: Establish routine patternsSecurity: Immunizations; well-child exams;

prompt attention for illnesses; appropriate skin hygiene & clothing

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Infant’s NeedsSafety: Importance of supervision; car seat,

crib, playpen, bath, & home environment safety measures; Feeding measures-no propping of bottles; provide toys without small parts; eliminate toxins in environment: chemicals, radon, lead, & mercury

Love/Belonging-Sensory Stimulation: Touch: cuddling, rocking; Vision: colorful, moving toys; Hearing: soothing voice tones, music, singing; Play: appropriate toys for development

(Ramont & Niedringhaus, p. 214)

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Infant’s Needs: Maslow’s

Love & Belonging

Safety & Security

Physiologic Needs (www.entrepreneursuperstar.com, n. d.)

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Toddler’s MilestonesPhysical DevelopmentDemonstrates growth in height, weight, & head

circumference with normal range for age (WNR)Motor DevelopmentPerforms gross & fine motor milestones WNR:

by 3 yr. child can: Walk without assistance, balance on one foot, jump, walk on toes; copy a circle; build bridge from blocks, ride a bike

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Toddler’s MilestonesPsychosocial Expresses like & dislikes; display

curiosity & asks questions; accepts separation from mother for short time periods; begins to communicate with others outside immediate family; understands words such as “up, down, cold, hungry”

Imitate religious ritual within the familyActivities of Daily Living: Feed self; eats &

drinks variety of foods, begins to develop bowel & bladder control; exhibits sleep pattern appropriate for age; dresses self (Berman et al., p. 377)

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Toddler’s MilestonesSpiritual: May repeat short prayers @

bedtime conforming to ritual, because praise & affection result—caregiver’s responses enhances the child’s sense of security

Sense of Love/Belonging (Maslow’s) Praise & affection;

Moral Learn attitudes that parents hold about moral matters

(Berman et al., p. 377)

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Toddler’s Needs-MaslowEsteem

Love/Belonging

Safety & Security

Physiological


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Preschooler’s MilestonesPhysical growth weight, height WNR for ageMotor Development: Gross & fine motor WNR

for ageBy 5 years able to: jump rope & skip; climb

playground equipment, ride a bicycle with training wheels, print letters & numbers

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Preschooler’s MilestonesPsychosocial [Erikson’s Initiative versus Guilt]:

By 5 years is able to separate easily from parents; display imagination & creativity, enjoy playing with peers in cooperative play; understand right from wrong & respond to other’s expectations; identify 4 colors, exhibit increasing vocabulary using complete sentences & all parts of speech; cooperate in doing simple chores (putting toys away); demonstrate awareness of sexual difference

Activities of Daily Living: Demonstrate development of toilet training; perform simple hygienic measures, dress & undress self; engage in bedtime rituals & demonstrate ability to put self to sleep


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Preschooler’s MilestonesMoral Fear of punishment & egocentric focus; Capable of pro-

social behavior (kind & sharing, helping, protecting, giving aid, befriending, showing affection & giving encouragement)

Some internal controls learned by modeling parents initially, then significant others;

Usually behaves well in social settings; usually controls behavior because they want love & approval from parents (if perceive parents as strict, child may become resentful or overtly obedient)

Spiritual: Enjoy social interaction in faith-oriented/Sunday school classes; faith result of teaching of significant others; learn to imitate religious behavior (bowing head in prayer) although do not understand meaning; use imagination to visualize angels or devil (Berman et al., pp. 379-380)

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Preschooler’s NeedsPhysiologic: Well-child check every 1-2 yearsNutritious meals/snacks; Elimination: teach proper hygiene (washing hands after using

bathroom); Sleep/Rest: dealing with sleep disturbances (night terrors,

sleep-walking);

Safety (Maslow’s): Educate about simple rules (crossing street; playing safely (bicycle & playground safety); to prevent poisoning & exposure to toxic materials

Security (Maslow’s): Immunizations, vision, hearing, & dental screenings; fluoride treatment

Psychosocial: Provide time for group activities; teach games requiring cooperation & interaction; toys & dress-ups for role-playing (Ramont & Niedringhaus, p. 209-210)

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Preschool Needs-MaslowEsteem

Love/Belonging

Safety & Security

Physiological (www.entrepreneursuperstar.com, n. d.)

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School-Age MilestonesPhysical Development: Weight/height WNR for

age & male or female pre-pubertal changes WNR for age

Motor: Coordinated motor skills, by age 12 years, can do tricks on a bike, climb a tree, shinny up a rope; throw & catch a small ball; play a musical instrument

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School-Age MilestonesPsychosocial By 12 years is able to make friends of

same sex & establish peer group; less dependent on family & ventures from them; interacts well with parents; controls strong & impulsive feelings; articulates an understanding of right & wrong; participates in organized competitions; reads, prints, & manipulates letters & numbers easily; expresses positive feelings about school & school activities; exhibits concept of money; expresses logical manner & talks through problems; enjoys riddles & reads & understands comics; invests in hobby or collection; likes to help others; thinks of self as likable & healthy


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School-Age MilestonesMoral Stage #1: Punishment & obedience: Child acts to

avoid punishment Stage #2: Instrumental-relativist orientation:

Child does things to benefit self; fairness-everyone gets a chance or fair share

(10-13 years)Stage #3 Interpersonal concordance: good

boy/nice girlStage #4 Law & order orientation: Child shifts

from concrete interests of individuals to interests of groups [Motivation for moral action to live up to what significant others think of child] (Berman et al., 382)

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School-Age MilestonesActivities of Daily Living: Demonstrates

concern for personal cleanliness & appearance; expresses need for privacy

Spiritual: Children learn to distinguish fantasy from fact; spiritual facts are beliefs accepted by religious groups; fantasy are thoughts & images formed in child’s mind

Child still influenced by parents & minister, priest or rabbi more than peers in spiritual matters (Berman et al., p. 382)

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School-Age NeedsPhysiologic: Nutrition-Importance of not skipping

meals; eating a balanced, nutritious diet; experiences with foods that may lead to obesity

Elimination: Use positive approaches to bedwettingSafety [Maslow’s]: Use proper protective equipment

when participating in physical activities (helmets, pads); encourage child to take responsibility for own safety (participation in safety classes: bicycle, water)

Security [Maslow’s]: Immunizations; periodic screenings for vision, hearing, dental; fluoride treatment; provide accurate information about sexual issues (reproduction, AIDS, STI’s) (Ramont & Niedringhaus, pp. 210-211)

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School-Age NeedsPlay & Social Interactions NeedsProvide opportunities for variety of

organized group activities; accept realistic expectations of child’s abilities; act as role models in acceptance of other persons who may be different; provide home environment that limits TV viewing, video games, & computer & encourage completion of homework & healthy exercise/activity (Ramont & Niedringhaus, p. 209-210)

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School-Age Needs-Maslow’sEsteem

Love/Belonging

Safety & Security


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Adolescent’s MilestonesPhysical Development: weight/height for age & genderDemonstrate male or female sexual development consistent

with standards

Psychosocial: Interacts well with parents, peers, teachers, siblings, & persons in authority; likes self, thinks & plans for the future (college/career); chooses a lifestyle & interests that fit one’s own identity; determines own beliefs & values; begins to establish a sense of identity in the family; seeks help from appropriate persons about problems

Activities of Daily Living: Demonstrates knowledge of physical development, menstruation, reproduction, & birth control; exhibit healthy lifestyle practices in nutrition, exercise, recreation, sleep patterns, & personal habits; demonstrates concerns for personal cleanliness & appearance (Berman et al., p. 387)

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Adolescent’s MilestonesMoralMost still accept Golden Rule & abide by social order &

existing lawsExamine their values, standards, moralsDiscard values adopted from parents in favor of values

they feel are more suitabledolescents start to question rules & laws of societyRight thinking & right action become matter of

personal values (which conflict with social laws) & consider to possibility of changing the law & emphasize individual rights

Not all adolescents or adults proceed to the post-conventional level (Berman et al., p. 386)

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Adolescent’s MilestonesSpiritual Adolescents are exposed to wide varieties of

opinions, beliefs, & behaviors regarding religious matters, so they reconciles differences by: Deciding the differences are wrongCompartmentalize the differences (example friend

cannot go to dance on Friday night because of religious observances, but will share activities on another day)

Obtaining advice from significant others (parents/ministers)

Often adolescents believe that there are more similarities rather than differences (Berman et al., p. 388)

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Adolescent’s NeedsPhysiologic: Nutrition & Exercise: Healthy snacks of

appropriate food intake & exerciseAware of factors that can lead to nutritional

problems(obesity, anorexia nervosa, bulimiaBalancing sedentary activities with regular

exercise

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Adolescent’s NeedsSafety: Responsible for using motor vehicles

safely (driver’s ed., wear seat belts, helmets,)Proper precautions during athletic activities

(medical supervision, proper equipment)Keep open lines of communication with parents

—alert to sign/symptoms of substance abuse, emotional disturbance, risky sexual behaviors)

Security: Immunizations, periodic screenings for vision, hearing, dental, tuberculosis; obtain & provide accurate information about sexual issues (Berman et al., p. 388)

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Adolescent’s NeedsPsychosocial Social InteractionsEncourage & facilitate success in schoolEncourage the establishment of relationships that

promote discussion of feelings, concerns, & fearsParents encourage adolescent peer group activities

that promote appropriate moral & spiritual valuesParents should role model for appropriate social

interactionsProvide a comfortable home environment for

appropriate adolescent peer group activities Parents can expect adolescents to participate in &

contribute to family activities (Berman et al., p. 388)

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Young Adult (20-40 years)

Physical Development: Prime physical years; human body functions-most efficient at about age 25 years

Well coordinate musculoskeletal system (athletic)

Physical changes @ minimum although weight & muscle mass change as result of diet & exercise

Extensive physical & psychosocial changes with pregnancy & lactation (Berman et al., p. 388)

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Young Adult Milestones (20-40 years)

Psychosocial: Energy directed toward attaining a mature sexual

relationshipDevelopmental tasksSelect a mate Take on civic responsibilityLearn to live with a partner Find a congenial social

groupStart a family Separate from parentsRear children Explore identities for selfManage a home Personal & self-discoveryGet started in an occupation High risk behavior (Berman et al., p. 388)

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Cognitive Development Ability to think abstractly & employ logicIdentify strong values & norms of their

social group & act in ways consistent with them

Screativity, intuition, & ability to consider information in relationship to other ideas (Murray & Zentner, 2001, as cited in Berman et al., p. 395)

)

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Cognitive Development possess an understanding of the temporary

or relative nature of knowledge Able to comprehend & balance arguments

created by logic and emotionOnly about 10% of adults reach this stage,

but these adults are marked by greater tolerance & skills of noticing & resolving complex problems (Pfaffenberger, 2005, as cited in Berman et al., p. 395)

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Moral Development Adults who mastered previous stages, enter

post-conventional levelPerson able to separate self from expectations &

rules of others & to define morality in terms of personal principles

When individual perceives a conflict with society’s rules & laws, they judge according to their own principles

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Moral Development Example: One may intentionally break the law &

join a protest group to stop hunters from killing wild animals, believing that the principle of wildlife conservation justifies the protest action (Type of reasoning –principled reasoning)

Men often use ethic of justice & define moral problems in terms of rules & rights

Women define moral problems in terms of obligation to care & to avoid hurt (Berman et al. p. 395)

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Spiritual Asks philosophical questions regarding

spirituality & may be self-conscious about spiritual matters

Religious teachings that young adult had as a child may not be accepted or redefined

Young adults depend on spirituality & seek guidance from a Higher Power (Berman et al.)

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Young Adult’s Needs (20-40 Years)

Physical: Routine physical exams: Females every 1-3 years, including professional breast exams, Pap smears, males every 5 years with testicular exams every year; ); skin exam every year; dental exam every 6 months; No smoking,

Nutrition & Exercise: Adequate iron intake, Nutritious diets & physical activity

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Psychosocial Needs: Personal relationships that promote discussion of feelings, concerns, & fears

Set short- & long-term goals for work & career choices

Safety [Maslow’s]Motor vehicle safety ( wear seat belts, no

drinking & driving, maintenance of breaks & tires on vehicle); Workplace & water safety measures; Sun protection

Security [Maslow’s] Safe home environment, Immunizations (Berman et

al.)

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Health ProblemsInjuries primarily motor vehicle crashesSuicideHigh blood pressureSubstance abuseSexually transmitted infectionsEating disordersViolenceAbuse of womenCancers with malignancies

Men – TesticularWomen – Breast, Cervical cancer (Berman et al., p. 388)

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Young Adult Needs (20-40 Years)

Self-Actualization

Esteem

Love/Belonging

Safety & Security

Physiological(www.entrepreneursuperstar.com, n. d.)

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Middle-Aged Adult Milestones (40-65 Years)

Stability & Consolidation YearsPhysical changes begin to occurHair & skin change; fatty tissue is

redistributed (fat in abdominal areaSkeletal muscle bulk decreases @ about 60

years-loss of height of about 1 inch; muscle loss according to disuse

Visual acuity decreases; hearing loss, Metabolism slows, weight gain, & hormonal

changes


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Middle-Aged Adult (40-65 Years)

Psychosocial Achieve adult civic & social responsibilityEstablish & maintain an economic standard of livingAssist teenage children to become responsible & happy adultsEnjoy new freedom of being independentAccept changes in family rolesDevelop adult leisure-time activities; expand previous

interestsRelate oneself to one’s spouse as a personAccept & adjust to physiologic changes of middle-ageAdjust to aging parentsActivities of Daily LivingFollow preventative health practices (Berman et al., p. 399)

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Middle-Aged Adult Milestones(40-65 Years)

Cognitive DevelopmentVery little change in cognitive development for this

age groupCognitive processes include reaction time, memory,

perception, learning, problem-solving, & creativityExperiences of professional, social & personal life

will be reflected in their cognitive performanceThus, approaches to problem-solving & task

completion vary considerably in a middle-aged group


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Middle-Aged Adult Milestones (40-65 Years)

Moral [Kohlberg’s Conventional]Few reach Kohlberg’s Post-Conventional level before 40

years of age & few individuals actually reach this level in a life time

Those that achieve Stage #5 a Social Contract Orientation must give rights of others a precedence

Spiritual [Fowler’s Paradoxical-Consolidative Stage]Not all adults progress to Fowler’s 5th stage At this stage an individual can view “truth” from a

number of viewpointsMost people in this age group rely on spiritual beliefs to

help them deal with illness, death, & tragedy (Berman et al., p. 401)

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Middle-Aged Adult Needs (40-65 Years)

Physical: Regular physical exams & screeningNutrition & Exercise: Importance of adequate

protein, calcium, & vitamin D in diet; exercise program that emphasizes skill & coordination; Nutrition-Exercise factors may lead to obesity, heart disease, diabetes, stroke)

Psychosocial: Social InteractionsPossibility of mid-life crisis, encourage discussion of

feelings, concerns, fearsRetirement planning (financial & diversional

activities) with partner if appropriate (Berman et al., p. 401)

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Health ProblemsCancerInjuries: work-related, motor vehicle collisions, falls, burns,

poisonings, & drowningObesityAlcoholism Mental Health Alterations

Developmental stressors: menopause, aging, impending retirement, & situational stressors: divorce, unemployment, death of a spouse,

Cardiovascular diseaseContributing factors: smoking, obesity, high blood pressure,

high cholesterol, diabetes, sedentary life style, family history(Berman et al., p. 401)

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Self-Actualization

Esteem

Love/Belonging

Safety & Security


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Older Adult Milestones (65 years & older) Physical Development: As a person ages, a

number of physical changes occur, some are visible, some are not.

Adjust to decreasing physical strength & health; safe guard mental health

Maintain independence, try to remain mobile & function as much as possible

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Older Adult Milestones (65 years & older) Psychosocial Adjust to retirement & reduced income;

establish a comfortable routineMeet social & civic obligationsEstablish satisfactory living arrangements (may

need to relocate to an apartment, assisted living facility, or nursing home

Maintain marital & family relationAdjust to death of spouse (Ramont &

Niedringhaus, p. 219)

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Older Adult Milestones (65 years & older) Cognitive Development Intellectual capacity includes perception

(interpretation of environment), cognitive agility, memory, & learning

Perception: Depends on acuteness of senses (how well persona can see, hear, touch) so if senses are impaired, person may not react appropriately (may be due to aging body systems)

Memory: Most elderly have more problems with short-term memory compared to long-term memory (most forgetfulness can be improved with use of memory aids, lists or notes, placing items in consistent locations


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Older Adult Milestones (65 years & older) Cognitive changes: Most occur in speed of action

or response time;Most maintain intelligence, problem-solving

abilities, & other well-practiced skills;Intellectual loss reflects a disease processMost older adults do not experience cognitive

impairmentsTo maintain cognitive ability, one should continue

with lifelong mental activities, particularly verbal activity (also help long-term memory) (Ramont & Niedringhaus, p. 221)

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Older Adult Milestones (65 years & older) Moral Development Important value & belief patterns to older adult

are cultural background, life experiences, gender, religion, & socioeconomic status

Spiritual Many older adults attend religious meetings &

servicesEven though the “old-old” are unable to attend

services, they will participate in a more private manner


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Older Adult Needs (65 years & older)

Physical: Regular physical exams & screeningNutrition & Exercise: Importance of adequate

protein, calcium, & vitamin D in diet; exercise program that emphasizes skill & coordination;

Be alert for symptoms of depression, risk factors for suicide, abnormal bereavement, changes in cognitive function, medications that increase risk of falls, signs of physical abuse & neglect, skin lesions, & tooth decay & gingivitis, loose teeth (Ramont & Niedringhaus, p. 221)

Safety: Environment that prevents falls & injury

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Older Adult Needs (65 years & older)

Self-Actualization

Esteem

Love/Belonging

Safety & Security


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References All Psych & Heffner Media Group,Inc. (1999-2003).

Psychology 101: Personality development. Retrieved from http://allpsych.com/psychology101/development.html

Berman, A., Snyder, S.J., Kozier, B., & Erb, G. (2008). Concepts of growth & development. In A. Berman, S.J. Snyder, B. Kozier, & G. Erb (Eds.). Kozier & Erb’s Fundamentals of nursing: Concepts, process, and practice (8th ed.) (pp. 348-365). Upper Saddle River, NJ: Prentice Hall

Berman, A., Snyder, S.J., Kozier, B., & Erb, G. (2008). Health promotion. In A. Berman, S.J. Snyder, B. Kozier, & G. Erb (Eds.). Kozier & Erb’s Fundamentals of nursing: Concepts, process, and practice (8th ed.) (pp.270-293). Upper Saddle River, NJ: Prentice Hall

89

ReferencesJuliar, K. (2003) Minnesota Healthcare Core Curriculum (2nd ed.).

Clifton Park, NY: Delmar Publishers Ramon, P.R. & Niedringhaus, D. M. (2008). Life span

development. Fundamental nursing care (2nd ed.) (pp. 197-223). Upper Saddle River, NJ: Person Prentice Hall

Schmutte, D. L. (2011). Maslow’s Hierarchy of Needs. Retrieved from http://www.enotes.com/nursing-encyclopedia/maslow-s-hierarchy-needs

Simons, D.J., Drinnien, I. & Drinnien B.A. (1987). The search for understanding. Retrieved from http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/maslow.htm

United States Army. (2004-2008). Categories of basic human needs. Retrieved from http://www.free-ed.net/sweethaven/MedTech/NurseFund/default.asp?iNum=2&fraNum=010102

Clients’ Basic Human Needs Developed by: Dede Carr, BS, LDA Karen Neu, MSN, CNE, CNP 1.

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