6.2.3: Care Needs

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Erin O'Hara-Leslie, Amdra C. Wade, Kimberly B. McLain, SUNY Broome

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Remember that a disability is not an illness, although it may lead to increased care needs of the person. People with disabilities, whether they are physical, cognitive, learning, or social impairments of functioning have the same basic needs as other people. We discussed Maslow’s Hierarchy of Needs in Module 2. Let’s explore how these apply to working with patients who have a developmental disability.

Physical Needs

In working with a patient with a developmental disability, Home Health Aides/Personal Care Aides may be asked to provide or assist with self-care. This includes bathing, skin care, dressing, toileting, and feeding. Taking vital signs, shopping for and preparing food for their patient, and measuring intake and output are other important tasks Home Health Aides/Personal Care Aides do to help patients meet their patient’s physical needs. Promote independence in the patient being able to meet their own physical care needs whenever possible. Home Health Aides/Personal Care Aides may have to be their patient’s voice if they are unable to communicate their needs. Be aware of things you can do to promote comfort, such as provide fluids, extra pillows to support an arm the patient is not able to physically control, turn and position an immobile patient, and provide food throughout the shift. A patient depends on their HHA/PCA to meet their physical needs, even if they are unable to tell them what these needs are.

Safety and Security Needs

A person who has a developmental disability may be reliant on others, including Home Health Aides/Personal Care Aides, to protect them from harm. Keeping the patient’s home clean and free from dirt by completing tasks such as laundry, vacuuming, and cleaning maintains a safe environment for the patient. Ensuring that patients properly use assistive devices such as canes, walkers, and wheelchairs also ensures their safety. Remember to always lock brakes on chairs that can roll during patient transfer. Be cautious of trip and fall hazards. Be proactive in preventing accidents.

Teach the patient to be as independent as possible within safety constraints. If something is not safe for them to do alone, Home Health Aides/Personal Care Aides should discuss this with them and help them complete the task. Maintaining good personal hygiene and washing hands is also an important part of the tasks Home Health Aides/Personal Care Aides complete to provide for the safety and security needs of their patient. Observing for signs of abuse or harm that may be going on in the home is a very important part of providing for the safety and security needs of a patient. Report any signs of abuse to a supervisor immediately.

Love and Belonging Needs

A person with a developmental disability has the same need for love and belonging as anyone else. By promoting involvement with the family and community, Home Health Aides/Personal Care Aides can help them meet this crucial need. Find opportunities for the patient to socialize with others, including people with and without disabilities. Encourage patients to be involved with spiritual and religious practices they and their family believe in. Support their belief in prayer before meals and bedtime if this is something they choose. Home Health Aides/Personal Care Aides can promote a feeling of love and belonging by being respectful, nonjudgmental, and having the attitude that everyone has strengths and can make unique contributions to their family, community, and society.

Self-Esteem Needs

It is important to help promote positive self-esteem in all patients. People who have a disability may at times feel guilty, embarrassed, or that they are not a valued part of their family or community due to having a disability. Home Health Aides/Personal Care Aides can support development of their patient’s self-esteem by being nonjudgmental, helping them to find and utilize their strengths and talents, and by promoting independence. They can demonstrate to their patients that they accept them for who they are and that they are not defined by their disability.

Remember to always talk to and not about a person with a disability. Treat them with respect and use positive communication methods, taking care to be conscious of nonverbal communication. Be sensitive to their feelings and recognize that the person may have many different feelings about their situation. Never assume that you know what these are. Encourage them to talk about their feelings and thoughts and help them to develop healthy coping strategies. Always maintain the dignity of a person who has a disability, even if they are totally dependent on others for their care. They may be very vulnerable and rely on their Home Health Aides/Personal Care Aides to provide their privacy and confidentiality.

Self-Actualization Needs

To help a person with a disability meet Maslow’s highest level of the Human Needs Hierarchy, self-actualization, Home Health Aides/Personal Care Aides should work with the patient to help them set goals and dreams for the future. Don’t be judgmental about the goals they have for themselves. Even if the goal may seem to be unachievable to you, never make a person feel hopeless about their future or their dreams. Encourage the patient to take small steps to reach larger goals and provide praise and support along the way. Support the person in making decisions and choices whenever possible.

Self Check Activity \(\PageIndex{1}\)

1. What are some of the tasks Home Health Aides/Personal Care Aides can do to help a person with a disability meet their needs? Select all that apply.

a). Help them learn to tie their shoelaces.

b). Ask their opinion about what clothes they would like to wear.

c). Calling them by the name they prefer.

d). Providing skin care.

e). Changing their bed linens.

f). Reporting suspected abuse.

g). Promoting involvement in family activities.

h). Encouraging the person to have future goals and dreams.

i). Preparing lunch for the patient.

j). Locking wheelchair brakes before transferring the patient from the wheelchair to the toilet.

k). Arranging for the patient to attend a church social.

Answer

1. All of these are tasks you can do to help a person with a disability meet their needs.

FEEDBACK: Assisting a patient to learn to tie their own shoelaces is good way to promote independence, which is an important patient need. Providing the patient with choices, using the name they prefer for which to be called, and encouraging involvement in family activities and church activities are also important ways to help a patient meet their self-esteem, love and belonging, and self-actualization needs. Providing skin care, changing bed linens, and preparing meals for a patient are ways to help patients meet physical needs. Reporting suspicions of abuse and locking wheelchair brakes are ways to help patients meet their safety needs.