Care Needs

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 developmentally disabled patients.

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 and Self-Actualization Needs

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 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.

 Role of the Home Health Aide/Personal Care Aide

The role of a Home Health Aide/Personal Care Aide will vary depending on the needs of the patient with a developmental disability and their family. For many patients, Home Health Aides/Personal Care Aides will assist with providing or assisting to provide self-care. The personal care skills covered in previous modules and in future modules in this course will all be used to work with a patient with a developmental disability. This includes bathing, skin care, dressing, toileting, feeding, and assisting with ambulation.

Home Health Aides/Personal Care Aides will monitor their patient’s health as directed by the Care Plan. They may be asked to measure intake and output. They may assist with housekeeping and meal preparation for their patient. They may provide respite for the family and assist with supervision and child care while the family is busy with another task or to allow them some respite.

As with all patients, using good communication skills is important and essential in doing their job well and meeting the needs of their patient. It will also be part of the job to help teach patients who need help learning effective communication skills. As with all patients, an important part of the job is to always be observing and documenting changes in physical, mental, emotional, or social health. Report any issues of concern to a supervisor immediately. Always document any observations and tasks that you completed. Be watchful of issues of concern in the home such as domestic violence, substance abuse, or child abuse. Report any concerns to a supervisor immediately.

Performance Standards

Health Aides/Personal Care Aides will use all of the basic skills they have learned in working with people with developmental disabilities.

Remember the following:

• Speak to all people respectfully and politely.
• Include the patient in conversations.
• Speak with and not about them.
• Do not assume they cannot understand what is being said about them.
• Use positive verbal and nonverbal communication skills.
• Avoid negative communication.
• Explain things in a way the patient will understand.
• Observe how they receive information and make adjustments to how you communicate based on their understanding.
• Encourage the patient to think by asking questions rather than just giving commands to them.
• Allow them a chance to respond and to make choices.
• Encourage independence by allowing the patient to do as much as they can rather than doing for them.
• Be patient and allow extra time for task completing.
• Give praise and encouragement.
• Never be negative or criticize the patient when they try to complete a task.
• Include the patient in decisions and provide choices to them whenever possible.This promotes self-determination and independence.
• Always respect differences and individual desires, needs, and values.
• Consider others’ feelings and concerns, even if they are different from your own.
• We are all different, and will have differences in opinion and values.
• Never be judgmental.

Follow these basic guidelines with all patients, including those who have developmental disabilities. While Home Health Aides/Personal Care Aides may need to make adjustments in how they complete tasks or how they communicate, the basic set of skills and performance standards are required for work with every patient. Following these will allow Home Health Aides/Personal Care Aides to provide the best care they can and to allow their patient to become as independent as possible.