FNP Treatment Approaches for All Ages: A Holistic Perspective
May 26th, 2023 by David Martin
Working in the medical industry is the dream of many a student, but not everyone knows exactly where in the system they want to work. More specifically, what kind of patients do they want to work with? If you find that you want to help everyone, or simply don’t have a strong feeling regarding one age group over another, then you could consider becoming a family nurse practitioner (FNP). These care providers work with patients at all stages of their lives, from infants to the elderly. As an FNP, you play a critical role in the lives of your patients and can help them attain and maintain excellent health.
In this article, we will examine the ways that FNPs can adapt their treatment style to complement the age group in question. We’ll do this by breaking down ages into eight different categories:
- Infants and toddlers
- Young children
- Older children
- Young adults
- Middle adults
- Older adults
Each of these age groups presents its own unique challenges. FNPs must be able to adapt their treatment approaches to the patients in each of them. The best way to do this is to complete an accredited nurse practitioner program at a qualified university. Rockhurst University, for example, provides students with a well-respected and well-established program designed to prepare them to care for their future patients.
If you are interested in becoming an FNP, here is what you need to know about each stage of life.
Infants and toddlers (0 to 3 years)
There are a few things to consider in regard to infants and toddlers. First, they experience rapid growth, both physically and mentally. Their social selves are also evolving quickly, with many toddlers already beginning to form social relationships as well as a sense of self. As you might imagine, children in this age bracket are easily frightened by visiting healthcare providers and will likely rely on their parents or other caregivers to determine when they should be scared or calm.
To suit these needs and provide a safe and secure place for infants and toddlers during their visit, FNPs should focus on acting calmly and interacting with the parents and/or caregivers. Communication with infants and toddlers is largely nonverbal, of course, which means that conversations with caregivers will typically be used to compose any treatment plans that might arise. Instead of asking the child directly for their input, FNPs will rely on their caregiver’s observations and objective medical measurements to determine the true health of the child in question.
While infants and toddlers are in your care, effective FNPs will provide a safe place for them to play with age-appropriate and clean toys. They might also gently hold the child while giving them immunizations or performing medical exams. All of this helps to reassure children that they are safe and builds rapport with you as a care provider.
Young children (4 to 6 years)
As children age, their growth begins to slow somewhat. Instead, older children begin to refine their existing abilities. Fine motor skills are developing during this age range, and young children also often dress themselves and communicate verbally. Social and emotional cues and interactions also become more complex during this age range, as they begin to grow more independent and identify with their parents and other people outside of their families. Remember that not all children are the same, however, and the way that patients interact with care providers at this age varies. Some might be fairly sociable and have little trouble communicating, while others might be more reserved and aloof. Both of these extremes are completely normal, but they do require FNPs to have specialized skills.
Children who are independent and interested in interacting with the care provider can be approached directly. From playing games to carefully explaining that any procedures they experience that day are not punishments, frank communication is often the best choice here. Children who are more reserved require a bit more finesse. Be aware that this kind of child is often especially observant and will be watching your behavior and actions closely. Make sure that you are predictable and gentle with your movements. Praise the child and give them rewards, and steer clear of overly familiar/dramatic communication.
Regardless of the child’s independence and confidence, providers should encourage children to ask questions as well as talk about their feelings. Playing with others, assuming that the setting is appropriate, is another good way to build strong relationships between provider and child as well as the child and other people. This helps reduce fear. FNPs working with patients in this age range can also begin to include the child in their health assessments, but will still primarily rely on the parents and other caregivers to ensure that health milestones are met. This is a good time to teach patients healthy nutritional habits and the importance of good personal hygiene. This includes reinforcing the need for frequent hand washing.
Older children (7 to 12 years)
Patients in this age range experience quick mental growth. They understand cause and effect, know how to write, and can read and do math. They are typically eager to learn and are beginning to consider where they fit socially. Many children will focus most of their attention on school and finding somewhere to ‘fit in’. This naturally leads to an increased sense of self and an increased demand for independence. It is a good idea for care providers to encourage healthy coping mechanisms for peer pressure and conflicts in addition to caring for the patient’s physical and mental health.
Toward the latter end of this age range, patients often become less willing to share the health problems they face, especially if they are ‘embarrassing’. Providers must be aware of this and gently steer the conversation toward potential health issues. Encourage these patients to make their health their top priority and not be too embarrassed to ask for help. Emphasize that as a care provider, nothing they need help with will surprise you. Also, reassure them that whatever the health concern might be, you can help them get through it.
Older children are both easier and more difficult to interact with than the earlier age groups described above. On the one hand, they can now communicate clearly and take some responsibility for their own health. On the other hand, they are now caught up in the throes of social angst and might hide medical concerns that they feel are ‘weird’. Providers must be able to meet the child on their own terms and adapt their communication style accordingly. Also, remember to keep parents involved! While older children can take part in their health decisions, their parents will also make important decisions, particularly at the younger ages in this age range.
Finally, FNPs should be ready to guide parents through uncomfortable conversations. While many families might wait until the next age group to have these conversations, some will start in this one. From sex to peer pressure and everything else, care providers must be knowledgeable enough to help parents effectively communicate with their children.
Adolescents (13 to 20 years)
Adolescents experience rapid development similar to what they experienced as infants and toddlers, though in spurts rather than a continuous stream. Patients in this age group mature physically and are technically able to reproduce, so frank conversations about sex and sexual health are not unusual. These patients are also still deciding who they are, especially in the younger ages in this range. It is not unusual for adolescents to struggle to balance social group commitments with familial requirements. As they grow, they might also begin to look into career choices and expand their interests.
Most importantly, adolescent patients want to have control over themselves. In a hospital or other medical setting, for example, they want to know the procedures they’re undergoing and the tests that are being carried out. They might also want to know what their healthcare will look like in the future. This is a good time to introduce them to annual visits. Women, for example, will need to begin seeing a care provider annually for reproductive health examinations. Men will start similar annual visits at this age.
Keep adolescents involved in health matters, explain things clearly, and treat them with respect. Balance the need for privacy that adolescents exhibit with the necessity of honest communication in healthcare, and try to impress upon patients that they don’t need to be embarrassed with their care providers. As an FNP, you must be ready to handle even unusual concerns without showing surprise or judgment. Don’t order adolescents around either, as this will likely result in rebellion on a few different levels.
Young adults (21 to 39 years)
Young adults have reached sexual and physical maturity, and their nutritional needs are now to maintain good health rather than to support continuous growth. This age range is typically incredibly busy for young adults. From dating to settling down and starting families, if desired, or establishing their careers, these patients are in the thick of life at this point. This can be an especially stressful age for patients at both ends of the spectrum. Patients aged 21 or just a bit older will likely be dating, perhaps receiving higher education, or beginning their first full-time jobs. Patients closer to 39 are often getting married, raising their own children, and building their professional identity.
Communicating with young adults is typically easier than it is with younger patients. They understand the need for honesty and mutual respect between care provider and patient, though further reinforcement of this fact is always a good idea. As an FNP, you must be ready to treat patients with respect and let them make their own decisions, even if you don’t agree with them. While you can always give your own opinion and try to steer patients toward healthy choices, young adults have the ultimate say.
Be ready to encourage healthy lifestyle choices, including updated diet and exercise recommendations; educate patients about common health risks such as heart disease, cancer or diabetes; and monitor things such as blood pressure and indications of issues such as thyroid disease and excessive stress. Overall, FNPs must be ready to support young adults as they make healthcare choices and build boundaries.
Middle adults (40 to 64 years)
Middle adults begin to age noticeably, especially as they move toward the latter end of the life stage. This means that health issues not previously present might start to manifest, including chronic health problems such as heart disease or lung disease. Women will go through hormonal changes, including menopause. FNPs should be aware that this stage is not always an easy one for patients. On the contrary, accepting that they are aging and must pay more attention to their health is often a difficult adjustment.
FNPs working with middle adults should approach treatment in a few different ways. First, remain hopeful! The last thing that your patient needs is to hear all about how the aging process will slow them down or limit their lifestyle. While some change is inevitable, focus instead on their strengths and the ways that they can continue to enjoy life in the manner to which they have become accustomed. Educate them about maintaining mobility and making smart health choices that will support their lifestyle as they age.
Middle adults need regular healthcare with a positive tone. Support them as they move through the aging process and help them find the health solutions they need to maintain their physical and mental wellness as much as possible.
Older adults (65 to 79 years)
Older adults have many of the same concerns that middle adults do, but they are more pronounced. They will continue to age, for example, and the slowdown will be more apparent in this age range. Some patients, but not all, will experience a marked decline in their mental and physical abilities. This includes compromised memory function and, sometimes, a reduction in general cognitive function. Older adults also begin to transition into new social roles. Some volunteer to stay busy, while others balance their need for independence with their need for effective care.
FNPs must be considerate of the difficulties that patients in this age range are facing. Friends and family members will begin to pass in this stage, and sometimes patients lose their spouses. This is a period of constant change and, for some, growth as they build new relationships and mourn lost loved ones. Make sure to remain supportive of your patients and encourage them to come in for more frequent check-ups to monitor for any developing issues such as cancer or heart disease. FNPs should be especially aware of signs of depression and apathy.
As you work with patients in this age range, pay attention to their mood, life changes, and the fears and hopes they have for the future. You must also be ready to educate them about physical safety precautions they can take, such as ramps and bathtub grips, as well as medication safety. Promote self-care as much as is appropriate and safe, but don’t make patients feel bad for needing help to function in some areas of their lives.
Elderly (80 years and older)
Elderly patients need quite a bit of care. As they continue to move through the aging process, their risk of chronic illness increases, and their skin and bones become more frail. Make sure to touch them using your palms rather than your fingertips if appropriate and possible. Mental abilities continue to decline in tandem with physical abilities, and it is imperative to screen these patients regularly for new health concerns, including mental confusion and loss of mobility.
FNPs should be ready to support patients as they move toward the end of their lives and seek to maximize independence as much as possible. Note that mental confusion is not always a sign of permanent cognitive ability loss, but can sometimes be either a consequence of medication or a condition that needs medication to overcome. You should always seek to improve the lives of your elderly patients rather than simply writing off issues because of age alone.
Are you ready to begin your journey to FNP certification? Keep the information above in mind as you refine your skills, and you’ll be providing your patients with the best care possible in no time!