Care for the

Sick
Basic Needs

- Every person has certain basic needs that must be met to survive. A need is a
requirement for survival.
- Sometimes an individual can satisfy her/his own needs, and sometimes needs
he/she requires help.
- A person becomes your client when he/she is unable to satisfy all his/her needs
himself. Example, a person may need help with meals or to meet his need for
nourishment.
- As a homemaker/home health aide, you will help your client meet basic needs until
he/she can meet them without your help.
- It is always important to be sure that health care team actions are meeting client’s
needs. Your knowledge of these needs and your objective observations will help
your supervisor determine whether the plan of care meets all needs in a particular
home.
Basic Physical and Psychological needs

- Not all needs must be met completely each day, but more each person’s needs are
fulfilled, the better the quality of life.
- Psychological needs also must be satisfied to have a healthy emotions and social
outlook. As with Physical needs, these do not have to be met totally each day.
However, the more completely each day need is met, the better the person’s
emotional state will be.
- Needs can be met by family, by oneself, or by someone not a family member but
available on an intermittent.
Balancing needs

- Children’s needs are usually met by family members. During adult years, most
people are expected to meet some or most of their own needs.
- These physical and psychological needs overlap and affect each other. Each person
determines his or her particular balance.
- When one need is out of balance due to illness, the other needs are also affected.
Example: when a person is ill and requires more rest, food intake must meet this
change in activity. Clothing will change. Weight may change, and moods may later.
The client is often the one who knows how to restore balance. In such case, the
client might determine when to eat and what foods to decrease so that he does not
gain weight. By consulting the client, you will more likely to meet actual needs and
not guess what they are.
- Needs can change, so be alert.
Basic Physical Needs: Basic Psychological Needs:

1. Food 1. Love
2. Shelter 2. Trust
3. Clothing 3. Independence
4. Safety 4. Security
5. Rest 5. Acceptance
6. Activity 6. Affection
7. Avoidance of Pain 7. Socialization
Several Factors affect the way in which we balance a client’s needs:

1. Client Knowledge
2. Disease state
3. Family support
4. Mental state
5. Age
6. Available resources
7. Culture
8. Financial resources
Your needs as a Homemaker/Home Health Aide

- Homemaker/Home Health Aides have the same basic needs as their client. It is
important that you needs be met, too, but not at the expense of your client’s.
- Many times your needs will have to be put aside until you leave the client.
- Discuss with your supervisor both your Client’s needs and yours. Then a plan will
be made so that the needs of the client will be satisfied and you will not feel
slighted.
- Caregivers must be alert to the reasons they do and say things. As you care for
your clients, be alert and identify what basic need you are satisfying and whose it
is.
Family needs

- If your client is part of a family unit, his/her change in status will

affect all other members of the family. Remember that, although
you are in the home primarily to meet the needs of the client,
your observations about the family are important.
- The Family Unit will continue support when you are no longer
there. Every member of the family has a set of basic needs and
these needs must continue to be met even though one of its
members, your client, now has a changed status.
- Balancing all these requirements is difficult. Discuss with your
supervisor so a plan care can be established that will be useful
for the family and your client.
Reactions to Being Ill and Dependent

- Every person reacts to illness, being disabled and being dependent in a

different way.
- Individual reactions are determined by age, family, culture, emotional
health and all the other parts that make up a particular person.
- As a Home Health Aide, you must be aware of common behaviors so that
you will know what to expect while caring for your clients.
- It is important to remember that you bring certain feelings about illness
with you when you care for a client. These feelings are part of you.
Sometimes these feelings are helpful to you and your client. Sometimes
they are not.
- The most useful action you can take as a Home Health Aide is to involve
the client and his family in the plan of care.
The Difference between Illness and Disability

1. Illness - is the absence of good health. An Illness has pain and

discomfort associated with it. This absence of health may be acute
or it may be chronic. Acute illness starts suddenly and does not last
long. Chronic illness continues for a long time.
2. Disability - is a condition that produces a physical or mental
limitation that may or may not respond to adaptive aids. A disability
may be produced by an accident, an illness or a birth defect.
Reactions to Illness and Disability

- Reactions of families to illness, disability and crisis vary.

- Family Dynamics: The ways in which family members interact
and get along with each other.
- Support systems are people or actions that help a person adjust
to a new or difficult situation . Families may be able to make the
necessary adjustments in their functions and rally to the short-
term crisis or acute illness but fail to adjust if the illness is a long-
term or chronic situation.
- Other families make long-term adjustments. Still others fail to
make any changes in their structure and fail to cope with any
illness or disability.
Kinds of Support System:

1. Informal systems: people help one another because they want to

like church group, neighbors and friends.
2. Formal systems: people help because they are paid to do so
and/or they have a particular knowledge necessary and/or an
outside agency or government says they must do so like visiting
nurses, home health aide, case-workers.
3. Support group: people gather, usually with a leader or facilitator,
to discuss and share similar problems, help each other, and gain
knowledge from each other.
Denial

- Is used by some people when people meet a situation with which they cannot
cope at the time. It is difficult to help a person who denies that a problem
exists.
- Denial is a way people shield themselves from situations. A person may deny
an event or situation and then come to accept it later when she is emotionally
able to do so. Almost everyone uses denial at some time.
- Clients may use denial to feel more acceptable to themselves and their
families. Families use denial so they do not have to change their routines.
- When a person has illness, the family may wish to keep it from him. They will
deny the problem and ask your help in keeping the secret. You must ask your
supervisor to assist you with this charade.
- Remember, the family and the client have a right to deny a situation if that is
their method of coping and the client is not negatively affected. As the
caregiver, you must deliver the best possible care within that situation.
Abusive Words and Difficult Behavior

- Many clients can be impatient. A client may show his impatient to one
member of the family or only to you. It is important to remain calm and
not take the client’s words as personal insult.
- Often, they can be angry at the situation, not at you but you are the
closest person to whom they can react. A client may complain that the
medicine isn’t working, that the exercise aren’t working, and that he isn’t
getting better fast enough. They may complain that you are doing too
much or not enough. If you have difficulty doing this, speak to your
Supervisor.
- Working with an unpleasant client is difficult. Discuss the entire
situation with your supervisor and she will assist you in dealing with it.
Goals to keep in mind as you care for your Client

- All clients, whether they are ill, disabled, have a chronic condition, or are
having an acute attack, will have a plan of care. As a Home Health Aide,
you will be asked to follow this plan of care.
- A plan is carefully made up by the professional nurse, a supervisor, and
therapists who care for the client. This plan is formulated to meet both
short-term and long-term client needs. Maintenance of this routine is
really important and your careful observation and reporting to your
supervisor are also important.
- Each client has his individual care plan, certain broad goals are present
in all care plans: Promote self-care, self-respect, behavior appropriate to
the client’s condition and age, and a safe, clean environment.
Mental Health/Mental Disability

- Mental Health is the ability to functions effectively and

satisfactorily in a certain society. Mental Health is a condition of
the whole person. Our Mental Health is the basis for our behavior
and relationships with others.
- At times, everyone shows behavior that may be judged unusual.
The difference between a mentally healthy person and one with a
mental disability is that the person who is mentally disabled adopts
characteristics or behaviors that no longer enable him to function
within society.
Mentally Healthy people can:

1. Adopt to change
2. Give and receive affection and love
3. Tolerate stress to varying degrees
4. Accept responsibility for their own feelings and actions
5. Distinguish between reality and unreality
6. Form and keep relationship with people
Mental Disability

- The temporary or permanent disruption in ability of a person to

function satisfactorily in society.
- Mental disability often starts slowly, and people cannot tell you
when the problem started. They can, however, say when the
behavior became no longer acceptable.
- There are many levels of mental dysfunction. Do not try to label
a client. Just treat him respect, support him and his family, see to
his safety, and follow the plan of care.
Common Causes of Mental Disability are:

1. Isolation
2. Medication
3. High Fevers
4. Family and Interpersonal relationships
5. Environment
6. Chronic Stress
7. Alcohol/Substance Abuse
8. Specific traumatic event
9. Heredity
10. Circulatory Disease
 - People show their disability in different ways. One classic symptoms is a
marked change in the behavior patterns. If you notice any change in your
client’s behavior or his family tells that his behavior has changed, report
it to your Supervisor immediately.

Other symptoms of mental disability are:

1. Hallucinations
2. Sleeplessness
3. Fears
4. Decreased memory
5. Disorientation
6. Forgetfulness
7. Withdrawal
8. Mood Swings
Defense Mechanism

- A thought used unconsciously to protect oneself against painful or unpleasant

feelings.

Common Defense Mechanism:

1. Denial - is an outright refusal to admit or recognize that something has occurred.

2. Depression - causes feelings of sadness and/or loss of interest.
3. Regression - acting like a child or becoming very dependent.
4. Repression - acts to keep information out of conscious awareness.
5. Projection - involves taking our own unacceptable qualities or feelings and
ascribing them to other people.
6. Rationalization - explaining an unacceptable behavior or feelings in a rational or
logical manner, avoiding the true reasons for the behavior.
7. Aggression - behavior that attacks everyone regardless of cause.
Depression

- Means low spirits that may or may not cause a change of activity.
- Depression may be an illness, a way in which a person deals with illness, the result
of illness or a side effect of medications.
- The primary sign of depression is lack of interest in the present situation and
environment.

Other signs of depression are:

1. Poor Appetite
2. Disinterest in people and things previously of interest.
3. Statements like “I’m not up to that” and “What does it matter anyways?”
4. Being overappreciative of help
5. Lack of activity or social interactions
6. Lack of expression in face or voice
Your Role as a Home Health Aide

- Your observation of the client and family are important.

- Report your observations objectively
- Your friendly, understanding manner will show how you feel about the client. It will
encourage others to feel positively about the client.
- Be aware of your body language
- Encourage the client to take part in his own care as is appropriate
- Speak to the client in simple sentences. Do not shout or talk baby talk to him.