Week 7: Counselling skills across the lifecycle

Question 1

What are the 4 main ‘age groups’ outside of adulthood?

Answer 1

Pre-school (Ages 2-5yrs)
Middle Childhood (Ages 6-11yrs)
Adolescence (Ages 12-19yrs)
Older Adults (from age 65yrs)

Question 2

How would you communicate to a pre-school patient (2-5yrs?

Answer 2

3 main influences:

Family:
really understand the family situation of the child

Cultural:
ethnicity (may influence food choice), mealtime structure.

Media: Will prefer discretionary foods because of advising targeted at them.

They learn through exploration and the education is mainly aimed at caregivers. Iron, zinc and calcium are the main target nutrients for growth. Intervention should involve the whole family. Really look at action-orientated interventions. AGHE for children is a great resource.

The whole experience should be fun, remember the fantasy mode of thinking.

Question 3

How would you communicate to a middle-school patient (6-11yrs)?

Answer 3

This group has family still has family as a major determinate, however now school is another major determinate so lunchbox focused.

They are more influenced by screen media now as well. Causal thinking ( can understand the link between nutrition content and how it affects our body).

We can start to explain that more to the children themselves than before. They start should with autonomy and self-regulation, the intention therefore could possibly be goal setting and motivation interviewing.

We want to be mindful that the nutrition risk is really around overweight and obesity.

Intervention: motivation interviewing and goal setting. Still include the whole family for support. Activity that is fun and engaging like food dairy, tick chart, playing games (about healthy choice eating-food balance game)

Screentime: Because of the influence and research, it shows that it is important to ask how much screen time per day and set goals to reduce the screen time. 2 hours or less per day.

Question 4

How would you communicate to Adolescence (Ages 12-19yrs)

Answer 4

Three stages of influence:

Key Determinates: school, purchased food options (pocket money), perception of time-poor

Development stages:

Early adolescents mean we still see respective for authority (very black and white)- we don’t want to be vague, direct is better.

Interventions: Family involvement, want to be really clear with messages, very direct.

Middle adolescents: start to challenge adults, relies more on peers and need high level of motivational interviewing and education.

Interventions: We want to really start to think about roleplay- what if discussions to get the child to do the thinking. Intervention may need to be very centred around the children wants.

Later adolescence: Pre-adult a lot more individual, have the ability to complex problem solve therefore treat them as a young adult. Chronic health disease is the main factor to think about in this age group. Decreased level of physical activity. The guideline is 60 minutes of vigorous exercise per day.

Interventions: Really really with pre-adults, speak to them as if they were grown adults, but need to manage the dynamic by balancing the adequate information for both the patient and family and managing different beliefs between the two. Motivation interviewing.

Question 5

How would you communicate to Older Adults (from age 65yrs)

Answer 5

Determinate Factors:
Living in isolation, poverty. 
If they are living in aged care
Reduction in taste acuity and smell.
Denture issues
Disabilities or decreased morbidities.

Development factors:
Chronic health issues
sarcopenic and cachexia
changes to metabolism
Changes to gastrointestinal function

All these factors affect overall nutrition intake.

Patients usually have been inbalance in core food groups. whole grains and a variety of vegetable teams to suffer. Zinc iron and folate take a hit are very crucial for good health. Antioxidants for organ health also are low.

Intervention stratergies:
Do these people have family or friends that can assist with food?

Social intervention: We really wanna consider the time when they are eating with others because it can influence increased appetite.

If we are going to use visual resources we must make sure to make the materials really easy to read.