copyright 2008 Cheryl K. Hosken, BSN, MS Psych.
Basic Human Needs Influence Behavior
Mrs. Ryan is 90 years old. Her health is good and she eats well, drinks enough fluids, uses the bathroom regularly, gets lots of fresh air, and rests and sleeps well. She dresses and grooms herself every day, socializes with the other persons in the nursing home, and likes visits from her relatives. She reads a number of books each month, and does handwork.
On the other hand, Josie Miller, who is nine years younger than Mrs. Ryan, is frail. Some days, she refuses to eat because she says she is too tired. Yet, at night, she does not sleep well. Because she is frail and often tired, she doesn't exercise much and seldom goes outside for fresh air. She spends much of her time in her room or dozing off in the living room. She doesn't socialize with the other residents as she once did, except for one other woman. Her relatives don't come as often as usual because she falls asleep when they visit longer than 10 minutes.
To live and be healthy and content, people need certain things, such as food, sleep and air. These are called basic human needs. How these needs are met vary from person to person. For example, both Mrs. Ryan and Mrs. Miller need food, but each of them responds differently when they eat a meal. Mrs. Ryan smiles, says, "Thank you", and begins to eat. Mrs. Miller turns her head away and says, "I just want to sleep". Mrs. Ryan eats her meal completely, but Mrs. Miller eats only a few bites. Both are responding to their need for food, but in different ways.
We can use Maslow's hierarchy of needs in caring for our clients. People usually need to have the lower levels of needs met before they can move to self-fulfillment. When people struggle to have their physical needs met, the higher-level needs are not important. Many of our clients are at this level of need. For example, you may come to class feeling very tired. If the need for sleep is great enough, you might fall asleep. You may be somewhat concerned about whether your action upsets others in the class, but your basic physical need is more important than your social need at that time.
Meditate Word By Word On These Verses:
Acts 2:44-47.
Physical Needs
The people we will work with have physical needs. They too, do not concern themselves with higher level needs until their physical needs are met. For example, a person who needs to go to the toilet immediately may not worry about being polite to others. A person who feels nauseated probably does not care about physical exercise program. As we meet the physical needs of persons, they can begin to think about their emotional and self-fulfillment needs.
Question:
1. Do all persons have the same physical needs? Why or why not?
yes /
no.
Physical needs are a person's most basic bodily needs to be able to live. Everyone needs sleep, exercise, elimination of body wastes, and human touch. If you stay awake late for several days in a row, you know how much you need sleep and rest. And if you have ever been sick in bed for a week or more, you know how hard it is for a person to begin to move around and exercise when he gets better. As health care providers, our clients need exercise, rest, and sleep. You are the one who determines what persons need by making sure that they exercise daily, participate in activities during the day, and giving them a quiet time in the evening. You can provide a person with a special blanket or pillow, a backrub or special positioning. A favorite stuffed animal may help a child to sleep easier. Physical environment is also important and this includes limited noise, turning lights down or off, or even quiet music. Elimination of body wastes cannot be put off for longer than a day.
Question:
2. What type of exercise would you give a person who is confined to bed or a wheelchair?
(One or more of the following answers may be correct.)
Move each arm and each leg 10 times through its full range of motion.
Walk the length of the corridor and return. Do this 5 times.
Lift both arms and inhale, then lower both arms and exhale.
Sit up for a few minutes so the dizziness goes away before trying to move.
Being touched by another person is also a physical need. Think of a time when you had a very bad day. Nothing was right. Then a friend came by your house and gave you a hug or a pat on the shoulder. How did you feel then? This physical need is often one that we forget about. To live and be well, persons need the touch of others. If healthy babies get enough food, water, rest, and exercise, they eventually get sick and die without the holding and touching of another person. Sick persons in hospitals and at home also need touch. They get well and stay healthier when they are touched by other people.
Question:
3. What are physical needs? Does it follow that if we meet physical needs the person will begin to think about his spiritual needs?
However, touch is personal. Some people do not like to be touched by anyone outside their families or close friends. People from certain cultures may have strong feelings about being touched. For example, in Southeast Asia, if a child is touched on the head, that is a demeaning act. But in other parts of the world it is a sign of affection. When we are working with people, we need to ask them how they feel about being touched and we need to know what kind of touch is acceptable. For example, sometimes in the nursing home, older people may want a hug and a kiss at bedtime. This is not true for most men, but I have been asked to give my patients a hug or kiss at times.
Question:
4. Have you ever used touch to calm or encourage a person?
yes /
no.
How did he respond?
Security Needs - People whose basic physical needs are reasonably well met begin to ask about security needs. For most people, security means feeling safe and comfortable. We all need shelter, clothing, safety, and someone who can help when assistance is needed. You must find out what makes each person in your care feel secure. For example, a person may want a door shut so that he has privacy or another person may want a door open so that someone hears him when he calls for help. Each person feels more secure when you provide what that person needs. When you help a person meet his need for security that person begins to trust you.
Question:
5. What would make you feel more secure in your own life?
Some examples of meeting security needs are the following:
- Safety need - make sure that a person wears his eyeglasses if he needs them.
- Protection need - check on a person frequently if he cannot move around by himself.
- Clothing need - make sure a person wears the right clothes for the weather or the temperature of his room and make sure they are without wrinkles and securely fastened.
- Shelter need - if a person has no heat in his home, report the situation to the proper authority.
- Help need - arrange the telephone or other device a person may need to call for help.
Question:
6. Please give an example of how you provided security for a patient or a sick friend.
Social Needs
What are social needs? Think for a moment about the people in your life. Think about family members, friends, a special person you love, and people you work with. What things so you need from them to fell good? Most people need to be liked, loved, and accepted by other individuals and groups. No one wants to be ignored or feel left out, or to feel unloved or lonely. When you care for a person, you can be helpful when friends or family cannot be with him.
Here are some examples of meeting social needs are:
- Need for approval - show interest when a person talks about what he has accomplished;
- Acceptance- introduce people to one another, listen to what people say, talk to people with interest;
- Need for Affection - give people smiles or hugs;
- Family and friends - encourage a person's family to visit when they are able, help a person spend time with another person he likes, help with telephone communication.
Question:
7. What are social signs of affection in your culture? Do you smile at someone or hug him?
smile at him /
hug him.
Esteem Needs
Esteem means a high regard for someone. A person needs to feel good about himself and that others respect him as well. What do you do to make you feel good about yourself? What do you do so that others respect you?
Some people who are old, sick, or disabled feel they are no longer wanted by others. They cannot do what they once did and thus feel worthless. What did James say about the poor and sick? In James 1:27 he says, "Religion that our God and Father accepts as pure and faultless is this: to look after the widows and orphans in their distress." Jesus' life gives us many examples of how He changed the lives of many by healing them from blindness, paralysis, and other physical and spiritual disorders.
People who are ill, disabled or old do not have the opportunity to feel successful because of their limitations. We can help them feel better about themselves if we notice the small accomplishments they make and talking about them.
Question:
8. See Jn. 4:5-30. How did Jesus show esteem to the woman He met?
(Only one of the following answers is correct.)
He called her a filthy prostitute.
He talked normally to her, although Jewish men wouldn't talk to Samaritan women.
He condemned her for sleeping with five men.
Here are some examples of meeting needs for esteem:
- Rewards - Give a person recognition by congratulating him on his success - even if it is a very small deed.
- Respect - Use a person's correct name and title when speaking to him. Listen to what a person has to say because it is important to him.
- Self-respect - Help a person do whatever he can for himself so that he can be independent. Talk about when the person was valued for who he was.
- Success - Praise a person if you notice improvement in what he is trying to do.
- Possessions - Compliment a person when he has something new to wear or has medals of achievement.
Question:
9. How do people show affection inside the church and outside the church?
Self-Fulfillment Needs
People whose basic four needs are met satisfactorily can seek self-fulfillment. Self-fulfillment means that a person feels satisfied with himself. When people satisfy their self-fulfillment needs, they believe they are doing what they are best suited to do for their abilities and age. For example, a person may have self fulfillment by writing a book, becoming a good parent, by finding a cure for a disease, or by working to provide good care for the disabled and elderly. Because each person excels in one area of his life, each person's self fulfillment will be different.
When you work with different people, they have many different needs. When you understand the levels of needs, you can give better care. For example, Mrs. Ryan likes to dress every day. If she says that she doe not want to get dressed today, this statement is a clue to you that something maybe wrong. A change in a person's usual behavior may mean that one or more of her other needs has not been met.
Human Sexuality and Its Effects on Behavior
What you think of when you hear the word sexuality? As with most people, the word "sex" is most familiar to us, and this means having sexual intercourse. But "sex" is only part of the word "sexuality". Sexuality includes sensuality, intimacy, sexual identity and reproduction.
Sensuality means that people feel pleasure from the way their bodies look, feel, and behave. Sensuality enables people to feel good about their appearance as they look at themselves in the mirror. It allows them to experience pleasure when their bodies are touched or enjoy sexual intercourse.
Sensuality is also the feeling one has about others' bodies. For example, a body of an Olympic athlete is beautiful to see as they practice their sport. Sensuality is also attraction to another person and receives touch by a special person. It also makes people want to be touched and held by people they know, not just in a sexual way, but in loving, caring ways.
As you work with others, you help persons with personal care. People may behave differently depending on how they feel about themselves. Part of a person's healthy sexuality is having a good body image. When you work with a person, it is important that you:
- Notice some small difference - a new shirt or hair cut - and comment on it, complimenting a person on his appearance.
- Ask the person what he wants to wear, encouraging him to make choices.
- Focus on the positive things about a person's appearance - his smile or the color of his eyes - things that do not degenerate with age.
You must also be sensitive to someone who does not feel comfortable with his body image because of disease, disability, disfigurement, or age. You help the person by looking beyond the physical features and seeing the person inside. For example, a person may have crippling arthritis, but can tell stories and history of his country for hours.
Question:
10. What kind of body image do you have? (Any of the following answers may be correct. It depends on you!)
I have an excellent body. It's almost perfect!
I have a few problems in my body, but that's normal. I like my body.
I have so many problems with my body, but I'll get along somehow.
I hate my body. I'm ugly, nobody loves me. I want to die.
There may be times when a person who is in your care may be physically or sexually attracted to you. You may even be attracted to someone in your care. Feeling of sexual attraction, even for a person in your care, can happen. It is alright to acknowledge the feelings you have to yourself, but it is not right to act on these feelings or comment on these feelings when you are with the person. Likewise, if a person is attracted to you, he or she should not act on those feelings. If a person in your care makes sexual advances to you, you refuse them gently and firmly. You can say something such as: "I really like you as a person, but I don't like you to touch me in that way." "I really enjoy giving care to you, but I feel uncomfortable when you talk to me in that way. Please do not talk to me in that way again."
Intimacy is the need and ability of a person to feel close to another human being and to have that closeness returned. Intimacy are all those good feelings that people have for one another - sharing, caring, loving, and liking. To express their feelings of intimacy, people may hug, kiss, touch, hold hands, or simply be with one another and talk. Intimacy may include a sexual relationship or may not.
Intimacy affects our work in that we work closely with another person. If we want to fully understand that person, we must be willing to show how much we care for him. This does not mean that we become sexually involved, but we listen and try to understand the needs of a person.
The way a person feels about who he is sexually is called sexual identity. This may seem like a complicated concept, but it has three aspects:
- recognizing that we are male or female,
- learning how males or females are expected to behave,
- knowing that we are attracted to the other sex or not.
People learn how men or women should behave by watching the groups in which they grow up. Families and cultures have strong rules about what men and women can and cannot do. Perhaps women with children should stay at home or men should not cry, whether women can play certain sports or whether men should become nurses.
Question:
11. What types of behaviors are traditional for women and men in your culture? Are there many opinions?
Cultural Influences on Behavior
Culture is a combination of what you believe (faith), what you consider acceptable social forms (behavior and values), and how you express yourself through material things (food, clothing, art, and music). As a family or group repeats these cultural expressions, they become customs. As families or groups pass these customs from one generation to another, they become traditions. The culture that people are born into is their heritage, or inherited customs. All people have a national, racial, or tribal heritage, that connects them by a shared ancestry, religion, and often by physical characteristics to others of the same heritage.
Our inherited culture helps us to understand who we are and how we fit into our society. Together, with our environment, it tells us how to think about being male or female, being young, growing up, marrying, aging, becoming ill, and dying. Theses ways of thinking feel natural, comfortable, and right to us. Problems arise when we experience the differences of other people's inherited culture. We sometimes fear these differences and decide that our way is right and their way is wrong.
Imagine that you are in a foreign country where people dress differently and eat strange-looking food. You do not understand what people are saying to you, and they do not understand you. If you get sick and need medical treatment, how might you feel? Some people in hospitals feel as if they are in a foreign country. Their problems are not fully explained in simple terms they understand. They must wear gowns that reveal more of their bodies than their customs permit.
Question:
12. What role does the church play in helping men and women understand their sexual identity? Are there Biblical examples for us to follow?
Others' inherited culture may be different from yours, but that does not necessarily make one culture right and the other culture wrong. Your culture seems right to you, and another's culture seems right to him. Everyone is different, and even people from the same culture often have different beliefs. You have the opportunity to learn about different cultural practices, a person's personal wants, needs, and desires. This knowledge enriches your own life and helps you to understand how you can meet the needs of another person. We need to remember that God made many diverse cultures in the world and that each culture and persons in it are important to God. As you care for others, you learn your own values and feelings better. You may also reduce the stress people and their families may be feeling about illness, disability, and old age.
It is not always easy to accept what other people believe. In fact, you do not have to. What we must do is respect people's beliefs while helping them learn what they need to learn to get better or adapt their lives to a lifelong illness.
Here are some questions for you to think about when you care for others:
- What do you believe about being healthy?
- Why do people get sick? How would someone you know answer this question differently?
- How do people in your family respond to pain? How do others you know respond to pain?
- What are your personal health practices?
- What are your beliefs about food and health?
- What are your beliefs about medical care?
- What do you believe about family? What is your family culture like? Is there a Christian family culture?
- What beliefs about birth and death have you heard about that are different than yours?