Home » Employees » Educational Pieces » Age Specific Considerations


Age Specific Considerations


Age Specific Competency

Aspects of care should be modified according to age-based characteristics, such as communication and education techniques, ability to participate in one's own care, impact of illness and hospitalization, discharge planning, and inclusion of family/primary caregiver/significant other in care and education.

As a healthcare professional, you are required to be competent in understanding and modifying care for a specific patient population, including all age groups that apply. For example, a practitioner providing care to children from birth to age twelve must not only be competent in understanding the milestones, skills and development of children in that age group, but also the age-specific considerations of their parents or other primary caregivers. A healthcare professional working in the Emergency Department should be trained in the characteristics and needs of all age groups.

While sources vary in their opinion of exactly where one age group ends and another begins, it must be taken into account that human characteristics will vary, regardless of “age group”. Age groups should be considered and used as a guideline for assessment and the planning of patient care to attain the optimal outcome for the patient.

Infancy (Birth - 1 year)

Psychosocial Achievements and Normal Growth and Development:
  • Builds motor skills, such as grasping, rolling, sitting, crawling, standing, walking
  • Reflexive behaviors gradually replaced by voluntary movements
  • Develops trust and a sense of being loved and cared for
  • Simple communication such as crying and babbling
  • Birth weight triples during 1st year of life
  • Fears loss of support, loud noises, bright lights, sudden movements, strangers
Health Concerns:
  • Prematurity
  • Infection
  • Respiratory disease
  • Cardiovascular disease
  • Nutritional imbalances
  • Accidents
  • Disruption of family unit
  • Delay in bonding
  • Congenital malformations
Unique Challenges:
  • Weaning breast / bottle /cup
  • Separation anxiety
  • Teething
  • Safety/injury prevention
  • Parental/sibling adjustment
  • Introduction to solid food
  • Immature immune system

Age Specific Considerations for the Healthcare Professional:
  • Educate primary caregiver(s) regarding checkups, screening, and immunizations.
  • Include primary caregiver(s) in child's care to decrease separation anxiety
  • Provide emotional support to family
  • Use calm, soothing voice when caring for child
  • Place infant on back to sleep
  • Assess for developmental milestones
  • Assess for abuse/neglect, report when indicated
  • Cuddle, rock, swaddle to comfort a child when possible/appropriate

 

Toddler (1-3 years)

Psychosocial Achievements and Normal Growth and Development:

  • Physical growth: 5 lbs/year; 3 inches/year
  • Molars and cuspids emerge
  • Walks, runs, balance improves, climbs stairs, Draws, toilet training (may be mastered or continuing), plays alone and parallel with others
  • Can feed self (hold bottle, finger foods)
  • Acquires language
  • Developing autonomy, shame and doubt, magical thinking, object permanence
  • Actively explores and discovers but with a short attention span
  • Cannot discern danger
  • Seeks positive reinforcement and approval from caregiver(s)
  • Concept of time is immediate only
  • Ritualistic/routine behaviors
  • Fears separation from caregiver(s), but can tolerate short separation
  • Able to express emotions
Health Concerns:
  • Accidents
  • Nutritional disturbances
  • Contagious/infectious disease
  • Dental health
Unique Challenges:
  • Toilet training
  • Separation anxiety
  • Stranger anxiety
  • Communication (able to understand more than can communicate)
  • Asserting Independence
  • (temper tantrums), sibling rivalry
Age Specific Considerations for the Healthcare Professional:
  • Assess for developmental milestones
  • Involve and educate family/primary caregiver(s) in caring for child
  • Remind primary caregiver(s) regarding checkups, screening, and immunizations
  • Monitor for abuse/neglect. Report when indicated
  • Communicate with child at appropriate age level using appropriate learning materials (puppets, dolls, videos, storybooks)
  • Use firm, direct approach, distraction techniques, and give short, concrete instruction and explanations
  • Follow routines
  • Use oral routes for medication administration when possible
  • Keep medications out of child's reach
  • Be alert to pediatric medication doses (usually based on child's weight)
  • Use pediatric pain assessment tool
  • Use appropriately sized equipment ((pediatric BP cuff, electrodes, catheters, etc.)

Pre-school (4-6 years)

Psychosocial Achievements and Normal Growth and Development:
  • Gains less than 5 pounds/year; grows 2-2.5 inches/year
  • Begins to lose baby teeth
  • Develops coordination (e.g., runs, hops, throws, uses scissors)
  • Can dress self
  • Learns to use utensils, tie shoe laces, ride bike; can write name and copy letters of alphabet
  • Speech becomes more intelligible, speaks in sentences, vocabulary increases
  • Curious, imaginative and asks lots of question
  • Develops sense of privacy
  • Becomes aware of others' feelings
  • Develops sense of time
  • Active fantasy life
  • Fear of separation and the supernatural (monsters, ghosts, animals, the dark)
  • Health Concerns:
    • Communicable diseases of childhood
    • Accidents
    • Dental health
    • Poisoning
    • Hospitalization/illness may lead to regression
    • Nutritional Balance

    Unique Challenges:

    • Maintaining a safe environment for child
    • Promoting close contact between caregiver(s) and child
    • Maintaining a healthy diet. Children often have specific likes and dislikes at this age.
    Age Specific Considerations for the Healthcare Professional:
    • Reassure child that
    • illness and/or treatment are not punishment for misbehavior
    • Assess for developmental milestones
    • Monitor for abuse/neglect: report when indicated
    • Remind primary caregiver(s) regarding checkups, screening, and immunizations
    • Praise good behavior and offer small token rewards such as stickers
    • Encourage parental involvement and presence during hospitalization
    • Use clear, concise explanations that child can understand being attentive to vocabulary choices (e.g.. a child might believe they will be “stretched” if they have to go on a stretcher)
    • Give appropriate choices whenever possible (e.g. injection site)
    • Be alert to pediatric medication doses (usually based on child's weight)
    • Use appropriately sized equipment (pediatric BP cuff, electrodes, catheters, etc.)
    • Allow child some independence (self care, dressing, feeding) when appropriate
    • Use pediatric pain assessment tool

    School Age (7-12 years)

    Psychosocial Achievements and Normal Growth and Development:
    • Gains 4-7 pounds/year, height increases at age 9, arms long in proportion to body
    • Girls may begin menstruation and develop secondary sex characteristics
    • Has 10-26 permanent teeth
    • Improved balance and muscular strength, improved hand-eye coordination
    • Can read, write, do math, and memorize
    • Logical and deductive reasoning develop, understands past, present/future, can understand death and dying
    • Assumes responsibility for chores and school related tasks
    • Begins to understand anatomy, bodily functions and illness
    • Can articulate some degree of discomfort, but may be reluctant to ask questions
    • Need to develop a sense of adequacy about abilities involving social interaction and learning
    • Sex segregated “play” with peers (athletics), development of personal interests/hobbies
    • Coping skills include doing nothing, acting impulsively, problem solving
    • Other adults beginning to have significant impact on behavior (teachers, coaches), but parents still considered primary adult authority
    Health Concerns:
    • Communicable childhood diseases
    • Accidents
    • Dental health
    • Behavior disorders
    • Nutrition
    • Vulnerable regarding drugs, alcohol, and sexual activity
    Unique Challenges:
    • Peer pressure may lead to poor judgment
    • Prefers fast food dining with friends
    • Concerned with peer acceptance and appearance
    Age Specific Considerations for the Healthcare Professional:
    • Remind primary caregiver(s) regarding checkups, screening, and immunizations
    • Continue to assess for developmental milestones
    • Monitor for abuse/neglect; report when indicated
    • Educate patient and caregiver(s), and promote parental involvement
    • Use age appropriate teaching materials and language. Be direct, use correct terminology, and encourage child to ask questions, participate in care, and make own decisions regarding care when appropriate
    • Be supportive of need for control and privacy
    • Support coping mechanisms and independence (e.g. “Your job is to hold very still while I put these drops in your eye. It's OK if you're scared and want to grab your pillow”)
    • Address fears, such as loss of control, failure in school, and death
    • Provide for continued schooling
    • Educate in safe behaviors regarding drugs, alcohol, and sexual activity

    Adolescence (13-20 years)

    Psychosocial Achievements and Normal Growth and Development:
    • Secondary sex
    • characteristics develop
    • Adult weight is achieved, some awkwardness may occur because of rapid growth
    • Variable appetite
    • Dentition complete, many adolescents have wisdom teeth extracted
    • Gross and fine motor control increases
    • Heightened emotionality because of hormonal changes
    • Capacity for abstract, symbolic, deductive and analytical thinking.
    • Beginning thoughts of career options
    • Critical of appearance and mood changes
    Health Concerns:
    • Accidents
    • Eating disorders
    • Depression
    • Substance abuse
    • Acne
    • Reproductive system problems
    • Adolescent pregnancy
    • STDs
    Unique Challenges:
    • May participate in
    • impulsive and risk-taking behaviors
    • Is heavily influenced by peer opinion and judgments.
    • Attempts to identify factors necessary for self-growth
    • Identity, achievement, and autonomy
    Age Specific Considerations for the Healthcare Professional:
    • Emphasize the
    • continued need for checkups, screenings, and immunizations
    • Provide privacy for teaching and procedures
    • Provide increasingly more detailed information with the use of correct medical terminology
    • Know the age at which an adolescent can legally authorize own treatment.
    • Involve patient in treatment decisions and care
    • Encourage contact with family and friends while hospitalized
    • Reinforce knowledge of safe behaviors regarding drugs, alcohol, and sexual activity
    • Monitor for abuse
    • Assess for depression and encourage use of stress reduction
    • Refer to appropriate youth support groups, if needed
    • Provide for continued schooling

    Young Adult (21-39)

    Psychosocial Achievements and Normal Growth and Development:
    • Physical and motor development complete
    • At peak physical strength and prime reproductive capacity
    • Continued development of intellectual abilities
    • Develops intimate, long-term relationships
    • Struggles to form commitment without losing identity
    • Evaluates new information in terms of own experience
    Health Concerns:
    • Pregnancy and childbirth
    • Infertility
    • STDs
    • Accidents
    • Stress-related illness
    • Substance abuse
    Unique Challenges:
    • Fears the loss of work and social relationships
    • Most significant relationships are with spouse, children, and coworkers
    • Most stressors include career, establishing family, balancing numerous roles and responsibilities at home, work, school, community, and child rearing
    • Choice of alternative lifestyle (e.g., homosexuality)
    Age Specific Considerations for the Healthcare Professional:
    • Assess for physical and mental health, self-esteem, family roles, support system
    • Emphasize the continued need for checkups, screenings, and immunizations
    • Use teaching methods that won't challenge self-concept
    • Explain the importance of compliance by relating to patient's life
    • Encourage family participation in patient care and education
    • Encourage expression of feelings and concerns
    • Educate in accident prevention and healthy lifestyle (e.g. weight control, exercise, nutrition, stress reduction) and explain benefits
    • Monitor for abuse

    Middle Adult (40-64)

    Psychosocial Achievements and Normal Growth and Development:
    • Slow decline in body functions
    • Degenerative changes (hair loss, eyesight, bearing), atrophy of reproductive system
    • Menopause
    • Develops concern for next generation
    • May seek further education or career change
    • Reflects on life and accomplishments
    Health Concerns:
    • Chronic disease such as cardiovascular disease, arthritis, osteoporosis, diabetes, hypertension, lung disease
    • Cancer
    • Obesity may occur secondary to reduced metabolic rate
    • Depression
    • Substance abuse
    Unique Challenges:
    • Making adjustments to middle age's physical changes
    • Maintaining satisfactory employment, then preparing for retirement and leisure activities
    • Maintaining satisfying relationships, social and civic responsibilities
    • Maybe caring for aging parents as well as children
    • Empty nest issues
    • Adjusting to being a grandparent
    Age Specific Considerations for the Healthcare Professional:
    • Physical and mental health assessment to include physical changes/loss, family and social roles, career, self esteem
    • Continued monitoring for abuse
    • Encourage checkups, screenings, and immunizations
    • Promote as much self-care as possible and include significant other family in education and care when appropriate
    • Begin teaching about advance medical directives
    • Allow time to verbalize fears and concerns
    • Educate in accident prevention and healthy lifestyle (e.g. weight control, exercise, nutrition, stress reduction).
    • Educate on the safe use of medications
    • Assist in finding resources to meet healthcare needs and costs

    Older Adult (65-and older)

    Psychosocial Achievements and Normal Growth and Development:
    • Require more sleep
    • May feel isolated or upset by loss (friends, family, sensory abilities or financial)
    • Need for acceptance of their worth and satisfaction with accomplishments
    • May have reduced attention span and memory
    Health Concerns
    • Decreased mobility, joint pain, brittle bones
    • Greater risk for poor nutrition, dehydration, infections
    • Changes in skin, muscles, and sensory abilities
    • Recovery from illness takes longer
    • Despair/depression
    • Chronic diseases as mentioned previously, but also including Alzheimer's, glaucoma, cataracts, benign prostatic hypertrophy, and fractures
    • More prone to adverse drug reactions
    • May present with atypical or vague symptoms making diagnosis difficult
    Unique Challenges:
    • May lose self-confidence as abilities decline
    • Increased need for safety because of decreased cognition and mobility
    • May need smaller, more frequent meals
    • Maintaining leisure activities and social relationships
    • Coming to terms with death
    Age Specific Considerations for the Healthcare Professional:
    • Physical and mental health assessment to include screening for abuse and neglect, physical changes of aging, financial stability, loss & role changes, support system
    • May need to present information in a slower manner, in smaller segments, repeat a number of times, and avoid distractions
    • Use large print materials, simple pictures and medication dose calendars/aids
    • Ask questions to determine level of comprehension don't assume understanding
    • Involve family in education and care
    • Encourage checkups, screenings and immunizations
    • Ensure safety
    • Encourage physical and social activity and reminiscing
    • Encourage self-care and decisions



    Home » Employees » Educational Pieces » Age Specific Considerations