No two people are the same. However, we all have certain common needs. These needs are part of our biology. They are what it means to be human. In institutional-style care, people were seen mainly as having just physical and medical needs. This meant that the role of a disability or aged worker was to help the person to stay clean, get some exercise, eat and drink, and have medical conditions treated where needed. The problem with this approach to care was that these physical needs are only a small part of what we need as humans. Many other areas of the person’s life were often neglected.
Our basic human needs include the following areas:
- Spiritual needs
- Intellectual needs
- Social needs
- Physical needs
- Psychological needs
- Cultural needs
- Sexual needs
Let’s look at each of these needs individually.
Example
An older person who has a hearing impairment is more likely to feel socially isolated from others because they cannot communicate in the same way. Other people may avoid having conversations with them. Because of this, the person’s social, emotional and intellectual needs may not be met. The person can find it more difficult to take part in cultural and spiritual practices that they have always followed. Stress and depression can be the result of these needs not being met. Depression can lead to further withdrawal and isolation. Stress can have a negative impact on the person’s health and physical wellbeing. Their appetite might be reduced. It can also lead to the person not attending to their physical needs such as hygiene.
The Aged Care Quality Standards
The Aged Care Quality and Safety Commission have a set of Quality Standards that refer specifically to the need of aged care services to meet the holistic needs of the older person you support.
Standard 1 (Consumer Dignity and Choice) is the central standard that underpins all of the other seven standards.
It requires you to:
- Recognise and respect individual differences
- Provide support that recognises the cultural, spiritual and social needs of the person
- Allow and provide choice and control.
- Allow dignity of risk
- Be given information about their care, so that they can make choices about how they want to be supported.
New Changes to the Aged Care Quality Standards
The Aged Care Quality Standards are changing from eight (8) to seven (7) Quality Standards. The strengthened Aged Care Quality Standards are more measurable, detailed and comprehensive. The Royal Commission into Aged Care Quality and Safety identified focus areas for improvement, including diversity, governance, food and nutrition, dementia and clinical care. To learn more about this you can access the link here.
Watch
Take a look at the following video series comprising of 3 videos from the Aged Care Quality and Safety Commission that further discusses the new implementation of the strengthened Aged Care Quality Standards.
Episode 1
Episode 2
Episode 3
Reading
The Department of Social Services also provide a set of National Standards for the disability sector.
Three of the six National Standards for Disability Services refer to individualised support and choice.
Standard 1. Rights:
The service promotes individual rights to freedom of expression, self-determination and decision-making and actively prevents abuse, harm, neglect and violence.
Standard 2. Participation and Inclusion:
The service works with individuals and families, friends and carers to promote opportunities for meaningful participation and active inclusion in society.
Standard 3. Individual Outcomes:
Services and supports are assessed, planned, delivered and reviewed to build on individual strengths and enable individuals to reach their goals.
Activity
Watch this video and reflect on the following question.
- What needs of the older person do you think are being met through this holistic approach?
- What needs of the young person can you see are being met?
Basic human needs are part of our biology. Where do these needs come from, and when do they develop?
Our individual needs and differences can change as we grow and mature. Our needs change at different times in our lifespan. The biggest differences between us in terms of our needs are often related to our age and stage of development. Some people need help and support in different ways and at different levels.
However, many of these needs are the same for all of us, including people who have intellectual disabilities, acquired brain injuries, mental health conditions or dementia. You must take the person’s age and stage of development into account when you are supporting any individual.
There are many theories that have been developed over the years regarding the human development lifespan, for instance; Erik Erikson theorised that there are eight (8) stages of development from infancy to late adulthood which include:
- Infancy
- Toddler
- Pre-school age
- School age
- Adolescence
- Young adulthood
- Middle age; and
- Older adulthood
Read
You can read about other Development Theorists such as Lawrence Kohlberg, Jean Piaget and a Sigmund Freud by reading the following Lifespan Theories article.
The tables below outline the way that we develop as we age, and the basic needs that change with age and development.
Infancy (Birth to 2yrs)
| Developmental Changes | Basic Needs | |
|---|---|---|
| Physical | The baby undergoes fast physical growth. A lot of this growth happens in the brain. The senses—sight, hearing, smell—develop and sharpen. The baby will learn to move their limbs, pick up objects, crawl (6- 11 months) and walk (9-16 months). The body systems, such as the digestive and immune systems are still developing. |
|
| Emotional | The baby begins to show through smiling and laughing when they feel pleasure. Pain, discomfort or fear can trigger extreme distress and the baby reacts by crying. |
|
| Intellectual | The baby’s cognitive development is amazing. They will learn the beginnings of understanding words and will begin to recognise people and objects. The brain is being constantly stimulated by new things, and intellect is being stimulated by music, language and social interactions. |
|
| Social | The baby tries to mimic language by cooing and babbling. They cry to let others know when they need help. In the beginning, this is a reflex, but crying for help becomes a conscious social action by the time the baby is a few weeks old. The baby begins to recognise the faces of the people they know, and often prefers those faces. Many babies do not like to be held by people they do not know. |
|
| Cultural and spiritual | The baby begins to observe and absorb cultural and spiritual rituals but is not an active participant in them. Culture can mean differences in parenting styles, and the baby begins to experience these effects. | N/A |
| Sexual | Apart from the genitals, there is little to no difference between genders at this age, and sexual development has not begun. |
|
Childhood (2 to 12 years)
| Developmental Changes | Basic Needs | |
|---|---|---|
| Physical | The child’s fast physical growth in infancy begins to slow down. They learn to control their movement and coordination. They learn to run, climb and use objects like cutlery. These are called the gross and fine motor skills. | To be protected from harm while they learn about their physical limits and try new things
|
| Emotional | The child begins to develop a sense of self-esteem. In the primary school years, this can affect their confidence. For some children, a sense of inferiority can begin to develop.
|
To be allowed to practice independence
|
| Social | Children start to recognise that other people have feelings, and that they can affect the way other people feel. This is the beginning of empathy. Play helps the child to interact with others, and helps them to learn communication, social rules and interactions. Attachment is strongest to their parents and family, especially in the younger years. It has been shown that too much use of smartphones and tablets in early childhood can limit the child’s social development. |
|
| Cultural and spiritual | The child develops a sense of security in routines and rituals, and these are often linked to the family’s cultural background. The child might begin to play pretend, in which they mimic the behaviours and rituals that they see acted out by others. |
|
| Sexual | The child is beginning to understand gender identities and body difference. They might develop a curiosity about sexual characteristics of the opposite sex. Around school age, children start to develop a sense of privacy. Unhealthy sexual development can lead to a sense of shame about themselves and their body. The gender roles that are given to the child are thought to affect their understandings of gender. Children often begin to have a strong preference for dressing and presenting in their preferred gender role. |
|
Adolescence
| Developmental Changes | Basic Needs | |
|---|---|---|
| Physical | The physical changes of growth and puberty are a major part of adolescence. Most teenagers can self-manage many different parts of their lives and are usually independent in self-care. The adolescent is often reaching their full potential in muscle strength and flexibility. Sport and formal exercise can take over from exercise gained from play. |
|
| Emotional | The sense of identity and feelings of self-confidence or insecurity can become firm. Many teenagers become self-centred and self- absorbed. They may experience mood swings or even depression. These can be caused by hormones but also because teenagers can feel a deeper sense of loss and grief than they did as children. Peer groups often become the centre of the child’s world, and they can feel a strong need to dress and behave in the way that their peers do. Not being accepted by their peers at this age can have a strong emotional effect, which can continue through their life. |
|
| Intellectual | Our brains reach their full development in our teens. We usually have the ability to use complex abstract thinking and reasoning. We learn full independence and life skills. Adolescents often begin to question things they once accepted. |
|
| Social | Puberty triggers sexual development and strong interest and curiosity in sex. The adolescent may begin to experiment with sex and develop sexual and gender preferences. Adolescents often have a strong interest in dressing and grooming to feel sexually and physically attractive, and to express their gender and personal identity. |
|
Early and middle adulthood
| Developmental Changes | Basic Needs | |
|---|---|---|
| Physical | In these years, most people have finished growing and achieve their peak physical fitness level. Pregnancy and childbirth can cause physical changes to the female body. Ageing begins to slowly lead to declines in muscular strength and energy levels. |
|
| Emotional | Many adults gain a strong sense of achievement from obtaining education and employment. A feeling of financial independence and security can be very important. Our need for a sense of purpose can become even stronger as we age. We often feel a strong need to provide for and protect our immediate family. Anxiety and stress can sometimes be a big part in the lives of many adults as responsibilities increase. Many adults mature emotionally, and learn from past mistakes, to understand more about themselves and about what makes them happy. We can feel strong opinions about a range of issues. |
|
| Intellectual | Our mental development and capacity for learning can continue to increase during adulthood. Transitioning from school to employment is a huge jump in our development of skills and learning. Adults can become more confident decision-makers as they age. Hobbies and sports can continue to be ongoing interests. |
|
| Social | Adults tend to have more intense social relationships with a narrower group of friends than in the past. Many people feel a strong drive to partner and have a family. Being an active part of the community can become increasingly important as we age. |
|
| Cultural and spiritual | Social behaviour is often strongly influenced by culture in adulthood. We can feel stronger ties to our background and begin to identify more strongly with our cultural identity. For many adults, spirituality can be a way to reduce anxiety and feel a sense of higher purpose. |
|
| Sexual | Intimate relationships in adulthood are an important part of life. Most adults seek out sexual relationships during adulthood, often with an intimate or life partner. |
|
Late adulthood
| Development changes | Basic needs | |
|---|---|---|
| Physical | As we age, we begin to show more significant declines in strength, fitness and health. Hearing and eyesight can deteriorate. Memory loss can become more common. We also become more likely to develop diseases and poor health. Some older people remain physically independent well into their nineties, but many will need help to care for themselves |
|
| Emotional | Ageing can be emotionally difficult for many older people. They can experience grief relating to the death and friends and partners, loss of home, poor health and loss of financial independence. Retirement can for many people lead to loss of identity and sense of purpose. For others, it is a time of freedom from work, and a time to pursue leisure interests. Familiarity and routine can often become more important as we get older |
|
| Intellectual | We can continue to learn as we age, although we may take longer to learn new skills. People who keep their brains active are thought to be less likely to develop dementia, or to develop it at a later age. If a person experiences cognitive changes, they may need to support to care for themselves. |
|
| Social | We continue to need meaningful social interactions with others as we age. Many older people become grandparents and can derive a great deal of satisfaction from this role. The death of spouse and friends can cause significant changes in the person’s social network. Older people are more likely to be socially isolated than younger adults. |
|
| Cultural and spiritual | search for meaning through spirituality can become stronger in later years. Our attachment to our cultural routines and rituals can also be a significant and important part of life. |
|
| Sexual | Menopause leads to physical changes in women. Changes in sex drive can happen as we get older, but most older people continue to have sexual needs. Sexual needs can often be expressed with intimacy and privacy. Gender identity continues to be important, and sometimes more important. This is still often expressed through dress and appearance, which continue to be important for many people. |
|
Activity
Reflect on what stage of the human development lifespan you are at and consider the following questions.
What needs do you have that are common to other people your own age? In a notepad, write down at least three examples.
Watch
The following video contains an overview of different theories of development
No two people are ever the same. We are all the product of complex factors that make us all uniquely individual. Our individual differences can stem from:
- Genetics
- Our upbringing
- Peer groups and acceptance
- Cultural, social and financial backgrounds
- Life experiences and opportunities
- Education
- Disability and physical differences
- The stage of life the person is at, as you have seen in the previous section. People with disabilities and older people are not different in this.
- Individual differences mean that the support you provide will be different for each person.
The way we interact socially with others can be one of the main differences between people. Some enjoy being in different types of social situations with all types of people. We sometimes call people who love the company of other extroverts. Other people prefer the company of a few people at a time or prefer to talk one on one to other people. They might feel shy around strangers, or they might find social interactions tiring. We tend to call these types of people introverts. Many of us are somewhere in between these two extremes. Many people need time between social interactions to recharge, even if they enjoy being with others. Some of us need to time to get to know someone before we feel comfortable around them. Older people and people with disabilities experience the same degrees of difference in these characteristics.
Social Differences
Social differences can refer both to our social background, such as the type of family we were raised in, and the differences we have in the way we socialise with others. Our social background can influence us in many ways. It can lead to differences in:
Their level and type of education
- How much money they have to spend?
- Whether they live in the city, regional or remote areas
- The type of house they live in
- The community groups they interact with
- Their political beliefs
- Their hobbies and interests
- The way that they dress and talk
- Social taboos and rituals.
Think
Do you consider yourself an introvert or an extrovert, or somewhere in between? How do you think this influences the way you mix with other people?
Example
You can show respect for a person’s social differences by:
- Not making judgements about the way the person talks, how they dress or what they believe
- Not expecting the people you support to want to socialise with others in the same way that you do.
Cultural and Spiritual Differences
Australia is a country with people from many different cultural backgrounds, and with wide religious and spiritual beliefs.
These include people:
- With different cultural or ethnic backgrounds and languages
- Who are from Aboriginal and Torres Strait Islander backgrounds
- Who have different cultural identities related to the part of Australia they live in, such as city dwellers or people who live in remote areas of Australia
- Who belong to groups that identify as having a unique culture, such as the LGBTIQ community
- Who practice a particular religion
- Who live a unique way of life, such as hippie communities.
Resource
Translating and Interpreting Service (TIS) is a national translating and interpreting service that provides free online and phone interpreting service to help services such as government schools to communicate with people from non- English-speaking backgrounds. They offer immediate phone interpreting on 131 450, along with onsite interpreting.
Case Study
Li is a Vietnamese lady who has recently entered aged care. She does not speak much English, and she feels anxious about how she will communicate with the staff and other residents. Veronica is one of the workers in the facility. Together with her manager, Veronica talks to Li’s family about how they can meet her cultural needs, and they help to translate the conversation with their mother. Veronica helps the family and Li to access written information about entering aged care in Vietnamese, from the My Aged Care Website. The family help Li to create signs and directions in Vietnamese, to help Li find her way around while she is new. They help Li to talk to the chef in the kitchen about how her meals could be prepared using traditional Vietnamese ingredients and spices. Li’s manager included these and other cultural needs on Li’s individual support plan.
These differences can mean that the person:
- Believes in different things than you
- Prays at certain times
- Goes to a religious service
- Speaks another language
- Wears certain clothing or dress
- Prefers to be cared for by someone of their own sex
- Uses different ways to communicate feelings
- Eats a certain diet
Note
You do not have to believe in what the person is doing to be able to support them well.
Case study - Harry
Harry comes from a Muslim background. He does not eat pork, bacon or ham. He does not drink alcohol. His food must be prepared and stored in certain ways. The aged care facility where he lives does not have the resources to prepare these foods in the correct way, so they outsource Harry’s main meals and have them delivered by a local Halal kitchen.
Case study – Lorraine
Lorraine is vegetarian. Her support worker Tony helps Lorraine to prepare her meals and respects her request to eat only vegetarian. He makes certain to ensure meat is not accidentally included, such as in stock cubes. He helps Lorraine to include other foods that help to provide the nutrients that she might miss in meat, such as iron. These include leafy green vegetables, mushrooms, nuts and grains.
Activity
Aged Care Quality Standards Guidance Read the following Aged Care Quality and Safety Commission resource: ‘Guidance and Resources for Providers to Support the Aged Care Quality Standards’ Standard 1, Requirement 3(b): ‘Care and Services are Culturally Safe’:
Guidance_&_Resource_V14.pdf (agedcarequality.gov.au)
Once you have read this section, answer the following questions.
- What is cultural safety?
- What suggestions do the standard make about how you can find out more about a person’s culture?
- What examples does the guidance material give about being proactive when providing cultural support?
Review Questions
- Describe the main differences between the way we supported people in disability and aged care settings in the past, and the way we aim to provide support today.
- Describe the major differences between a person’s needs in early childhood and in early adulthood.
- Give two examples of cultural differences.
- Explain what your service could do to increase cultural safety and awareness.
