CHAPTER 5 :

DEVELOPMENTAL
STAGES OF THE
LEARNER
 GROUP MEMBERS

FUTALAN GUTIERREZ LAGOS GALELIAGA

KATIGBAK GUILING ISLA

 OBJECTIVES
Identify the characteristics of learners that
influence learning at various stages of growth and
development.
Recognize the role of the nurse as educator in
assessing stage-specific learner needs according
to maturational levels.
Determine the role of the family in patient
education at various stages of development.
Discuss appropriate teaching strategies effective
for learners at different developmental stages
CHAPTER HIGHLIGHTS
DEVELOPMENTAL
8 CHARACTERISTICS

DEVELOPMENTAL
10 STAGES OF CHILDHOOD

DEVELOPMENTAL
37 STAGES OF ADULTHOOD

THE ROLE OF THE FAMILY IN

59 PATIENT EDUCATION
DEVELOPMENTAL STAGES
OF THE LEARNER
Nurses must plan, design, implement, and evaluate educational programs
considering learners' developmental stages in life.
Individuals' developmental stages significantly impact learning abilities.
Pedagogy, andragogy, and geragogy are orientations used in childhood,
young and middle adulthood, and older adulthood to meet health-related
educational needs.
Developmental psychologists study behavior patterns at different stages,
impacting instruction.
Research shows that chronological age is not the sole predictor of learning
ability, as there is a wide variation in abilities related to physical, cognitive,
and psychosocial maturation.
DEVELOPMENTAL STAGES
OF THE LEARNER

Age ranges are used as approximate reference points, not

perfect age-strata reference points. Human growth and
development are sequential but not age-related, as individuals
progress through these stages at varying rates.
Development is influenced by three key contextual factors:
chronological age, biological changes over time, and the dynamic
relationship between a person's biological makeup and
environment.
 THREE IMPORTANT
CONTEXTUAL INFLUENCES

Normative age-graded influences : are strongly related to

chronological age and are similar for individuals in a specific
age group.
Normative history-graded influences : are common to
people in a certain age cohort or generation.
Normative life events : are the unusual or unique
circumstances, positive or negative, that are turning points
in individuals lives that causes them to change direction.
 DEVELOPMENTAL
CHARACTERISTICS
The relative indicator of someone's physical, cognitive, and
psychosocial stage of development is their actual chronological
age. In this chapter, each developmental stage will be briefly
described.
Age can have a significant impact on learning readiness, but it
should never be looked at in isolation. The aptitude and
willingness to learn of an individual is influenced by growth and
development, which also interact with experience, background,
physical and emotional health status, and personal motivation.
Numerous contextual elements, such as stress, the
environment, and the presence of support networks are also
important.
Musinski (1999) describes three phases of learning dependence,
independence, and interdependence. These passages of
learning ability from childhood to adulthood, labeled by Covey
(1990) as the "maturity continuum," are identified as follows.
 DEVELOPMENTAL
CHARACTERISTICS
An infant and young child, who are fully reliant on others for
guidance, support, and nourishment from a physical, emotional,
social, and intellectual viewpoint, are characterized by dependence.
Children become independent when they can take care of
themselves physically, cognitively, socially, emotionally, and by
making their own decisions, including taking charge of their
education.
Interdependence happens when a person has sufficiently matured to
develop self-reliance, a feeling of self-worth, the capacity to give and
receive, and when that person exhibits a certain amount of respect
for other people.
The learner must be acknowledged as a significant source of
information on their health if the nurse is to inspire students to take
charge of their own health. The major question underlying the
planning for educational experiences is: When is the most
appropriate or best time to teach the learner? The answer is when
the learner is ready. The teachable moment, as defined by Havighurst
(1976)
 DEVELOPMENTAL STAGES
OF CHILDHOOD
Pedagogy is the art and science of helping children to learn
(Knowles, 1990. Knowles et al., 2020). According to what
developmental theorists and educational psychologists
identify as certain patterns of behavior observable in clear
phases of growth and development, the various stages of
childhood are categorized into these categories:
Infancy and Toddlerhood
Early Childhood
Middle and Late Childhood
Adolescence
INFANCY (FIRST 12 MONTHS OR LIFE) AND
TODDLERHOOD (1-2 YEARS OF AGE)

In this stage, the field of growth and development is highly complex.

The physical, cognitive, and psychosocial maturation are so
changeable during this stage.
The focus of instructions for health maintenance is the parent, who
are considered the primary learner rather than the very young
child.
During this stage, physical maturation is so rapid.
According to Polan and Taylor (2019), patient education in
this stage must focus on teaching parents the importance of
stimulation, nutrition, safety measures to prevent illness or
injury, and health promotion.
TEACHING STRATEGIES:
In this stage, it is devoted to teaching parents about child
development, safety, health promotion, and disease prevention.
In cases of developmental delay, such as autism or congenital
disorder like cerebral palsy, our role is to support parents to
determine their child strength and to facilitate their child optimal
cognitive and motor development.
When the child becomes ill or injured, the first priority for
teaching intervention would be to assess the parents and child's
anxiety levels and help them cope with their feelings of stress
related to uncertainty and guilt about the cause of illness or
injury.
TEACHING STRATEGIES:
Separation anxiety is the characteristic of this stage of development
and particularly evident when a child feels insecure in an unfamiliar
environment.
In this stage, it is important for a nurse to establish a relationship or
rapport with parents and child to have a successful teaching-learning
process and to reduce the child's fear of strangers , as well as to
make them participate actively.
Health teaching should be at a place familiar to a child (such as
home or day care center) and it should be safe and secure
(such as the bed or play room) to feel protected.
 TEACHING STRATEGIES:

The following teaching strategies are recommended for children's natural

tendency to play and their need for active participation or sensory
experience:
For Short-Term Learning
Read simple stories from books with lots of pictures.
Use dolls and puppets to act out feelings and behaviors.
Use simple audiotapes with music and video tapes with cartoon
characters.
Role-play to bring the child's imagination closer to reality.
Give simple, concrete, non-threatening explanations to accompany
visual and tactile experiences.
Perform procedures on a teddy bear or doll first to help the child
anticipate what an experience will be like.
 TEACHING STRATEGIES:
For Short-Term Learning
Allow the child something to do-squeeze your hand, hold a Band-Aid, sing
a song, cry if it hurts-to channel their response to an unpleasant
experience.
Keep teaching sessions brief (no longer than about 5 minutes each)
because of the child's short attention span.
Cluster teaching sessions close together so that children can remember
what they learned from one instructional encounter to another.
Avoid analogies and explain things in straightforward and simple terms
because children take their world literally and concretely.
Individualize the pace of teaching according to the child's responses
and level of attention.
 TEACHING STRATEGIES:
For Long-Term Learning
Focus on rituals, imitation, and repetition of information in the form
of words and actions to hold the child's attention
Use reinforcement as an opportunity for child to achieve
permanence of learning through practice.
Employ the teaching methods of gaming and modeling as means by
which children can learn about the world and test their ideas over
time.
Encourage parents to act as role models, because their values and
beliefs serve to reinforce healthy behaviors and significantly
influence the child's development of attitudes and behaviors.
 EARLY CHILDHOOD
(3-5 YEARS OF AGE)
In this stage, children continue with the development skills learned
in the earliest years of growth.
Their sense of identity becomes clearer and their world expands to
encompass involvement in the surrounding.
In this stage, children acquire new behavior that gives them
independence from their parents and allows them to care for
themselves.
Learning in this stage occurs through interaction with others or by
following the behavior of playmates and adults.
Supervision is still required because they lack judgment in carrying
out skills they develop
As they begin to understand and appreciate the world around
them, their span of attention (ability to focus) starts to lengthen.
(Santrock, 2019)
 TEACHING STRATEGIES
The nurse should take every opportunity to teach parents
about health promotion, disease prevention measures, and to
offer instructions about medical recommendations related to
illness or disability.
In this stage, parents can be a great asset to the nurse in
working with children, and they should be included in all
aspects of educational plan and actual teaching experience.
Explanation of the purpose is beyond the young child's level
of reasoning, so any explanation must be kept simple.
In this stage, children's fear of pain and bodily harm is
uppermost in their minds, whether they are well or ill.
(Egocentric Causation is children's attribution of the cause of
illness to the consequences of their own transgressions)
 TEACHING STRATEGIES

Nurses should allow them to express their fears,

since young children have fantasies and active
imagination.
Nurses should carefully choose their words and use
less threatening words.
 TEACHING STRATEGIES
The following specific teaching strategies are recommended:
For Short-Term Learning
Provide physical and visual stimuli because language ability
is still limited, both for expressing ideas and for
comprehending verbal instructions.
Keep teaching sessions short (no more than 15 minutes) and
scheduled sequentially at close intervals so that information
is not forgotten.
Relate information needs to activities and experiences
familiar to the child.
Encourage the child to participate in selecting between a
limited number of teaching-learning options, such as playing
with dolls or reading a story, which promotes active
involvement and helps to establish nurse-client rapport.
 TEACHING STRATEGIES
For Short-Term Learning
Arrange small-group sessions with peers to make teaching less
threatening and more fun.
Give praise and approval through both verbal expressions and,
nonverbal gestures, which are real motivators for learning.
Give tangible rewards, such as badges or small toys, immediately
following a successful learning experience to encourage the
mastery of cognitive and psychomotor skills.
Allow the child to manipulate equipment and play with replicas or
dolls to learn about body parts. Special kidney dolls, ostomy dolls
with stomas, or orthopedic dolls with splints and tractions provide
opportunities for hands-on experience.
Use storybooks to emphasize the humanity of healthcare
personnel; to depict rela- tionships between the child, parents, and
others; and to help the child identify with certain situations.
 TEACHING STRATEGIES

For Long-Term Learning

Enlist the help of parents, who can play a vital role in
modeling a variety of healthy habits, such as
practicing safety measures and eating a balanced
diet, offer them access to support and follow-up as
the need arises.
Reinforce positive health behaviors and the
acquisition of specific skills
MIDDLE AND LATE CHILDHOOD
(6-11 YEARS OF AGE)

A period of great change.

They approach learning with enthusiastic anticipation, and minds are
open to new and varied ideas.
They are motivated to learn because of their natural curiosity and their
desire to understand more.
They have developed the ability to concentrate for extended periods,
can tolerate delayed gratifications, are responsible for independently
carrying out activities of daily living, have a good understanding of the
environment around them, and can generalize from experience.
Illness and disability is a thought of in terms of social consequences and
role alterations.
MIDDLE AND LATE CHILDHOOD
(6-11 YEARS OF AGE)

Nurses role as an educator:

Health promotion and health maintenance is most likely to occur in the
school system through the school nurse but the parents as well as the
nurse outside the school setting should be informed of what their child
is being taught.
Explain illness, treatment plans, and procedures in concrete terms with
step-by-step instructions. It is imperative that the nurse observe
children’s reactions and listen to their verbal feedback to confirm that
information shared has not been misinterpreted or confused.
Teaching parents directly is encouraged; siblings and peers are also
considered as sources of support.
MIDDLE AND LATE CHILDHOOD
(6-11 YEARS OF AGE)

Objectives of health promotion:

healthy eating
weight status (exercise)
sleep
prevention of injuries
avoidance of tobacco, alcohol, and drug use
MIDDLE AND LATE CHILDHOOD
(6-11 YEARS OF AGE)

To achieve positive health outcomes:

Identify individual learning styles.
Determine readiness to learn.
Accommodate special learning needs and abilities.

Factors in how health is viewed:

Individual circumstances surrounding the child, along with their experiences. Concepts
of illness in children vary depending on socioeconomic status and ethnicity.
Systematic differences exist in children’s reasoning skills with respect to understanding
body functioning and the cause of illness resulting from their experiences with illness.
Causality - the ability to grasp a cause-and-effect relationship between two paired,
successive events.
 TEACHING STRATEGIES:

Children must be invited to participate, to the extent

possible, in planning for and carrying out learning
activities.
Children in middle and late childhood are used to the
structured, direct, and formal learning in the school
environment; consequently, they are receptive to a
similar teaching–learning approach when hospitalized
or confined at home.
 TEACHING STRATEGIES:

Short-Term Learning:
Allow school-aged children to take responsibility for
their own health care.
Teaching sessions can be extended to last up to 30
minutes. However, lessons should be spread apart.
Use instructional tools as adjuncts to various teaching
methods (both spoken and written).
Provide time for clarification (esp., scientific
terminology and medical jargon), validation, and
reinforcement of what is being learned.
Use analogies.
 TEACHING STRATEGIES:

Short-Term Learning:
Use one-to-one teaching sessions as a method to
individualize learning .
Select individual instructional techniques that provide
opportunity for privacy.
Employ group teaching sessions with others of similar
age and with similar problems or needs.
Prepare children for procedures and interventions well in
advance.
Encourage participation in planning for procedures and
events.
Praise and rewards help motivate and reinforce learning.
 TEACHING STRATEGIES:

Long-Term Learning:
Help school-aged children acquire skills that they
can use to assume self-care responsibility on an
ongoing basis with minimal assistance.
Assist them in learning to maintain their own
well-being and prevent illnesses from occurring.
ADOLESCENCE (12-19 YEARS OF AGE)

Marks the transition from childhood to adulthood.

Potential threats:
Significantly facing many healthcare issues and
known to be among the nation’s most at-risk
populations.
An estimated 20% teenagers have at least one serious
health problem, such as asthma, learning disabilities,
eating disorders (e.g., obesity, anorexia, or bulimia),
diabetes, a range of disabilities resulting from injury, or
psychological problems resulting from depression,
anxiety, or physical and/or emotional maltreatment.
ADOLESCENCE (12-19 YEARS OF AGE)

Potential threats:
Considered at high risk for teen pregnancy, the effects of
poverty, drug or alcohol abuse, and STDs such as
venereal disease and AIDS.
The 3 leading causes of death in this age group are
accidents, homicide, and suicide.
More than 50% of all adolescent deaths are a result of
accidents, most of these accidents involve motor
vehicles.

Adolescent Egocentrism - a characteristic of teenagers

that become obsessed with what they think as well as what
others are thinking.
ADOLESCENCE (12-19 YEARS OF AGE)

Types of social thinking:

Imaginary Audience - a type of social thinking in which
they begin to believe that everyone is focusing on the
same things they are – namely, themselves and their
activities.
Personal Fable - a type of social thinking in which they
can identify health behaviors, although they may reject
practicing them or begin to engage in risk-taking
behaviors because of their brain development, the social
pressures they receive from peers, and their feelings of
invincibility. 15 years of age and older are not susceptible
to the personal fable.
 TEACHING STRATEGIES

Despite these potential threats to their well-being, adolescents use medical

services the least frequently of all age groups. Thus, the educational needs
of adolescents are broad and varied. The potential topics for teaching are
numerous, ranging from sexual adjustment, contraception, and venereal
disease to accident prevention, nutrition, substance abuse, and mental
health.

Develop a mutually respectful, trusting relationship (Brown et al., 2007).

They need privacy, understanding, an honest and straightforward
approach, and unqualified acceptance in the face of their fears of
embarrassment, losing independence, identity, and self-control (Ackard
& Neumark-Sztainer,2001; Lipstein et al., 2013).
The important factors in providing education effectively are availability,
visibility, quality, confidentiality, affordability, flexibility, and coordination
(American Academy of Pediatrics Committee on Adolescence (2016).
 TEACHING STRATEGIES

Short-Term Learning:
Use one-to-one instruction, peer-group discussion
sessions, face-to-face, or computer group discussion.
Employ adjunct instructional tools, which can be used
competently by many adolescents.
Clarify any scientific terminology and medical jargon
used.
Share decision making whenever possible in
formulating teaching plans related to teaching
strategies, expected outcomes, and determining what
needs to be learned and how it can best be achieved.
Suggest options.
 TEACHING STRATEGIES

Short-Term Learning:
Give a rationale for all that is said and done.
Approach them with respect, tact, openness, and flexibility
to elicit their attention and encourage their
responsiveness.
Expect negative responses and avoid confrontation and
acting like an authority figure.

Long-Term Learning:
Accept adolescents’ personal fable and imaginary audience
as valid, rather than challenging their feelings of
uniqueness and invincibility.
Allow them the opportunity to test their own convictions.
THE DEVELOPMENTAL STAGES OF
ADULTHOOD

Andragogy
The term used by Knowles (1990) to describe his theory
of adult learning. It is the art and science of teaching
adults.
Education within this framework is more learner
centered. It has served for years as a useful framework
in guiding instruction for patient teaching and for
continuing education of staff.
THE FOLLOWING BASIC ASSUMPTIONS ABOUT KNOWLES' FRAMEWORK
HAVE MAJOR IMPLICATIONS FOR PLANNING, IMPLEMENTING, AND
EVALUATING TEACHING PROGRAMS FOR ADULTS AS THE INDIVIDUAL
MATURES:

1. The adult's self-concept moves from one being a dependent personality to

being an independent, self-directed human being.
2. The adult accumulates a growing reservoir of previous experience that serves
as a rich resource for learning.
3. Readiness to learn becomes increasingly oriented to the developmental task
of social roles.
4. Adults are best motivated to learn when the information being offered is
needed to improve or support their life situation.
5. Adults learn for personal fulfillment such as self-esteem or an improved
quality of life.
 CHILD VS. ADULT LEARNERS

(child)
A child's readiness to learn depends on physical, cognitive and psychosocial
development.
Subject-centered
Enjoy learning for the sake of gaining an understanding of themselves and
the world.
Dependent on authority figures for learning.

(adults)
Adults have essentially reached the peak of their physical and cognitive
capacities.
Problem-centered
Adults must clearly perceive the relevancy of acquiring new behaviors or
changing old ones for them to be willing and eager to learn.
The adult is much more self-directed and independent in seeking information
Three categories describe the general
orientation of adults toward continuing
education (Knowles et al., 2020; Miller &
Stoeckel, 2019):
Goal-oriented learners engage in
educational endeavors to accomplish clear
and identifiable objectives.
Activity-oriented learners select educational
activities primarily to meet social needs.
Learning-oriented learners view themselves
as perpetual students who seek knowledge
for knowledge's sake.

THREE DEVELOPMENTAL STAGES OF

ADULTHOOD
Young Adulthood
Middle-aged Adulthood
Older Adulthood
YOUNG ADULTHOOD
(20-40 YEARS OF AGE)
- Young adulthood is a time for establishing long-
term, intimate relationships with other people,
choosing a lifestyle and adjusting to it, deciding
on an occupation, and managing a home and
family.

- Decisions made during this time lead to changes

in the lives of young adults that can be a
potential source of stress for them.

- It is a time when intimacy and courtship are

pursued and spousal and/or parental roles are
developed.
 TEACHING STRATEGIES

Allow them the opportunity for mutual collaboration in health education decision
01
making.
They should be encouraged to select what to learn (objectives), how they want material to be
02 presented (teaching methods and tools), and which indicators will be used to determine the
achievement of learning goals (evaluation).

It is important to draw on their personal experiences to make learning relevant, useful, and
03
motivating.

04 The new information, skills, knowledge, and attitudes should be relevant to their current lives
or anticipated problems.

05 They do well with written materials, audiovisual tools, online instruction, and group
discussion.

06 Health promotion and disease prevention; healthy eating habits, regular exercise, avoiding
drug abuse
MIDDLE-AGED ADULTHOOD
(41-64 YEARS OF AGE)
- Middle-aged adulthood is the transition period
between young adulthood and older adulthood.

- This stage is a time to reflect on the contributions

they have made to family and society, relish in their
achievements, and reexamine their goals and
values (Newman & Newman, 2021).

- Some may have had career interruptions or

failures due to economic recessions or find
themselves in the sandwich generation, which is
presented with challenges not faced by others in
their cohort.
 TEACHING STRATEGIES

01 If their past experiences with learning were minimal or not positive, their motivation
likely will not be at a high level to easily facilitate learning

02 Physical changes may impede learning.

03 The nurse must be aware of their potential sources of stress, the health risk factors
associated with this stage of life, and the concerns typical of midlife.

04 Adult learners need to be reassured or complimented on their learning competencies.

Teaching strategies for learning are similar in type to teaching methods and instructional tools
05 used for young adults. The content just differs to coincide with the concerns and problems
specific to this group.
OLDER ADULTHOOD
(65 YEARS OF AGE AND OLDER)
2020
- Filipinos 60 years old and above: 85% of the population
- Filipinos under 15 y/o: 30.7%
Report by: Philippine Statistics Authority (PSA)

Categories of Older Adults by Developmentalists

• Santrock's Three Groups of Older Adults

Young Old: 65-74 y/o

Old-old: 75-84 y/o
Oldest old: 85 y/o and older

• Barbara Newman and Philip Newman's Last Stages of

Aging

Later Adulthood: 60-75 y/o

Elderhood: 75 y/o till death
 Shift in health and productivity levels
according to biological and social trends
Chronic conditions
Multiple conditions
Hospitalized longer than other
persons in other age groups
Require more teaching of self-care
> more complex and greater patient
education needs
WHICH PROBLEMS ARE MOST
> benefits from education programs?
LIKELY TO OCCUR DURING OLDER
high compliance
ADULTHOOD?
improve health status
reduced morbidity
 GROWING OLDER
• normal, inevitable event
• biological, psychological, and social changes
• Nurses and nurse educators must recognize that these events are challenges rather than
defeats for older person

TEACHING STRATEGIES/ GERAGOGY

• to be effective, accommodate the normal physical, cognitive, and psychosocial changes
• few studies about the special learning needs of older study

LEARNING INFLUENCES IN THE OLDER ADULT

• sensory perceptions (hearing, seeing, touching), energy level, memory, affect, risk-taking ability,
response time, cultural bg, disability, stress
 MAXIMIZING LEARNING IN THE OLDER ADULT
• personalized goals, positive reinforcement, pacing with rest periods, rehearsing, time for
questions, relaxed environment, flexibility, provide purpose of teaching, establish rapport, easy to
read material

NURSES MUST BE AWARE OF THE:

• possibility that older patients may delay medical attention

• decreased cognitive functioning, sensory deficits, lower energy levels, and others may prevent
early disease detection and intervention
• a decline in psychomotor performance affects older adults' reflex responses and their ability to
handle stress
• difficulty in coping with simple tasks

>> Despite changes in cognition, most research shows that the ability of the older adults to learn
and remember is as good as
ever
Myths associated with the intelligence, personality traits,
motivation, and social relations of older adults

Myth 1: Senility - Aging causes mental decline

Myth 2: Rigid Personalities - Older adults are cranky, stubborn, and
inflexible
Myth 3: Loneliness - Dissatisfaction with life
Myth 4: Abandonment - Loss of contacts with significant others

Ageism: describes prejudice against the older adult

- not all older adults are unhealthy, unhappy, fearful, institutionalized, or

disengaged; dwell on their own morality; or find themselves in financial
straits
- stereotypes positively and negatively affect the older adults
>> Consider that abilities and needs of older adults differ from those of younger
persons
>> Assess each learner's physical, cognitive, and psychosocial functioning levels
before developing and implementing any teaching plan
>> Nurses educators must take steps to support older clients in making decisions
affecting their health to increase their participation
>> Interventions work best when they take place in casual, informal atmosphere

What influences the ability of older people to learn?

motivation, life experiences, educational background, socioeconomic status,

health or illness status, and motor, cognitive, and language skills

Helping Older Adults to Adapt in the Age of Computer

Nurses must:
• first assess technology skills in older adults
• provide non-computer-based learning materials
• refer older adults to expand their technology skills to programs offering
individualized instruction in a collaborative environment
• suggest adaptive devices
 PHYSICAL NEEDS:
1. To compensate for visual changes:

• bright lit environment

• large print, well-spaced letter, and with
primary colors visual aids
• wear bright colors and visible name tag
• use white or off-white, flat matte paper and
black print for posters, diagrams, and other
written materials
• avoid blue, blue-green, and violet hues
> color distortions
 PHYSICAL NEEDS:
2. To compensate for hearing losses:

• eliminate extraneous noise

• avoid covering mouth when speaking
• directly face the learner
• speak slowly with clear enunciation between
words
• low voices are heard best
• do not shout
• word speed should not exceed 140 words per
minute
• ensure that batteries of hearing aids are working
• when addressing a group, use microphones
• ask for feedback from the learner
• ask older person to repeat verbal instructions
 PHYSICAL NEEDS:
3. To compensate for musculoskeletal problems,
decreased cardiovascular system, and reduced
kidney function:

• keep sessions short

• schedule frequent breaks
• provide pain medication
• provide comfortable seating

4. To compensate for any decline in central nervous

system and decreased metabolic rates:

• set aside more time for the giving and receiving of

information
• do not assume that older adults have the psychomotor
skills to handle technological equipment
• do not interpret loss of energy and motor skills as lack
of motivation
 PHYSICAL NEEDS:
5. To compensate for the impact of hearing and
visual changes on computer base:

• be sure that speakers on the computer are working well

and use headphones to block background noise
• computer screen should be clean and free of glare
• teach alternative ways to use mouse for clients with
arthri
tis
 COGNITIVE NEEDS:
1. Two Kinds of Intellectual Ability

A. Crystallized intelligence
• absorbed over a lifetime such as vocabulary, general
information, understanding social interactions, arithmetic
reasoning, and ability to evaluate experiences
• increases with experience
• can be impaired by disease states, such as the dimentia
seen in Alzheimer's disease

B. Fluid Intelligence
• capacity to perceive relationships, to reason, and perform
abstract thinking
• declines as degenerative changes occur
• decrease in fluid Intelligence results in ff:
- slower processing and reaction time
- persistence of stimulus (afterimage)
- decreased short-term memory
- increased test anxiety
- altered time perception
 COGNITIVE NEEDS:
2. Be aware of the effects of medications and energy
levels on concentration, alertness, and
concentration.

3. Be certain to ask what an individual already

knows about a healthcare issue or technique before
explaining it.

4. Convince patients that the information or

technique they are teaching is correct.

5. Arrange for brief teaching sessions for shortened

attention span.

6. Conclude each teaching session with a summary

of information and allow for a Q&A
period.
 PSYCHOSOCIAL NEEDS:
1. Determine how dependent the older person
is on other members for financial and
emotional support. Explore the level of
involvement by family members in reinforcing
the lessons and in giving assistance with self-
care measures.

2. Determine availability of resources.

3. Encourage active involvement of older

adults to improve self-esteem.

4. Identify coping mechanisms

 ONE-TO-ONE INSTRUCTION

• provides a nonthreatening environment

• help older adults compensate for their special deficits and promotes their active
participation in learning

GROUP TEACHING

• for fostering social skills and maintaining contact with others through shared
experiences

>> Games, role-play, demonstration, and return demonstration can be used to rehearse
problem-solving and psychomotor skills. These teaching methods stimulate learning and
offer active learning opportunities to put knowledge into practice.

>> Written materials are excellent adjuncts to augment, supplement, and reinforce verbal
instructions.
 THE ROLE OF THE FAMILY IN
PATIENT EDUCATION

The role of the family is considered one of the

key variable influencing positive patient care
outcomes.

Sometimes the family members need more

information than the patient to compensate for any
sensory deficits or cognitive limitations the patient
may have. Anticipatory teaching with family
caregivers can reduce their anxiety, uncertainty,
and lack of confidence. What the family is to do is
important, but what the family is to expect also is
essential information to be shared during the
teaching- learning process (Haggard, 1989).
 STATE OF THE EVIDENCE
In an extensive review of the literature, a significant
number of studies, from both primary and
secondary sources, that were carried out by nurses
and other healthcare professionals were found to
support the application of teaching and learning
principles to the education of middle-aged and
older adult clients in various healthcare settings.
However, current nursing and healthcare research
focusing specifically on patient education
approaches applicable to the age cohorts of
children, ad-olescents, and the young adult
population, as well as instructional needs of family
members as caregivers, is lacking.
THANK YOU
QUIZ