Psychosocial Care: Behavior Is Communication
What this domain tests
Residents have emotional, social, cultural, and spiritual needs alongside physical ones. This domain covers dignity and choice, communication, grief and dying, confusion and dementia, behavior, and family relationships.
Core concepts
- Maslow's hierarchy. Physical needs (oxygen, food, safety) come first; belonging, esteem, and self-actualization follow. A hungry, frightened, or in-pain resident cannot engage in higher-level needs.
- Grief. Common stages include denial, anger, bargaining, depression, and acceptance. They are not a strict sequence, and not everyone passes through all of them.
- Dementia care. Keep routines consistent, give one instruction at a time, use short sentences, and redirect rather than argue. Do not correct a mistaken belief unless the resident is endangered.
- Behavior has a cause. Restlessness, calling out, or resistance may mean pain, a full bladder, hunger, noise, or fear. Look for the trigger first.
- Resident rights. Privacy, dignity, choice, confidentiality, freedom from abuse, and the right to refuse care.
- Culture and religion. Ask about preferences; never impose your own beliefs or practices.
- Hearing and vision loss. Face the resident, speak clearly without shouting, and use touch to get attention.
Traps
Exam questions punish arguing, correcting, or cheerleading ("Don't worry, you'll be fine"). Also avoid promising secrecy, discussing a resident with others, completing sentences for a resident who speaks slowly, and using restraints to manage behavior.
Worked example
A resident with dementia insists her deceased husband visited that morning. Do not say "He's dead." Instead acknowledge the feeling ("You miss him"), redirect to a safe activity, and report the change to the nurse.