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We start this Psychosocial care skills section by looking at patients and their needs, both emotionally and mentally. Check out our free CNA study guide module 2.

The emotional and mental health needs of patients

Emotional and mental health needs of patients is the first step in CNA Psychosocial care skills

When speaking of the above, we need to start with the order of a patient’s needs.

Maslow’s hierarchy of needs

This is portrayed as a pyramid with five horizontal layers.

Maslow believed that starting at the bottom, a person will look to fulfill specific needs, and once done, they will move up to the next level of his model.

Let’s look at how the five levels of the Maslow needs pyramid are split into:

  • Physiological: These are basic such as food, shelter, fluid, air, warmth, and sleep
  • Safety: This is not only a place where they can safely live but includes other aspects like having a job, feeling safe and secure, having insurance, saving for their future, and living in a law-abiding society
  • Social: This involves the sense of belonging and feeling loved. Other players in this level of the pyramid include family, significant others, friends, co-workers, the community a person lives in, and even religion
  • Esteem/self-respect: Knowing that they deserve respect, esteem, attention, and status as a successful person
  • Self-actualization: The final level sees the person reaching a point of acceptance. This includes accepting the situation when it comes to their life, the various situations they’ve been in, and the choices they’ve made as well as the acceptance of others. Other aspects here include the happiness felt from expressing themselves and a feeling of independence

Mechanisms of defense  

When dealing with patients, there are times when they will use defense mechanisms. 

There are several that are worth understanding which will help a nurse aide in their daily interactions with patients. 

These include:

  • Denial: An example of this is when a patient that’s terminally ill refuses to accept that they are. It could also extend to a patient who doesn’t carry out various activities that they should be able to. Denial is very normal and a patient showing signs of it isn’t an exception, but the norm. It can become a problem when a patient remains in this state for an extended period of time
  • Withdrawal: When patients withdraw, they lose interest in things, from activities they usually carried out to even the people around them. When a patient continues in this manner for an extended period of time, they might even slip into depression. Note, however, withdrawal can be used as a protective mechanism as well as a way for patients to refrain from confronting problems
  • Projection: A patient uses projection to help safeguard their own self-image. This manifests itself in numerous ways, for example, accusing others of mistakes they have experienced but consider unacceptable
  • Blaming: As a way to protect themselves, this sees a patient blame others for their negative behavior

New patient orientation

When orienting a patient to the medical facility, how long they are going to be there plays a big part in what they need to know.

For example, a patient who is staying the night after a small surgical procedure only needs to be orientated to their room usually. 

Patients that are staying in a facility for a longer period should be given a tour of the facility, especially those areas that they will frequent often.

They could even be introduced to other long-term patients. 

No matter how long they will stay in a facility, patients should always be told the rules that they will need to abide by as well as other important information, like visiting hours, for example. 

Supporting patients emotionally

There’s no doubt that patients need emotional support from the staff in a medical facility.

The easiest way a nurse aide can do this is to always listen attentively to patients and while doing so, observe them closely.

This is critical in noting when patients are becoming withdrawn, which may result in depression later on. 

When it comes to things they control, for example, food and clothing choices, nurse aides should encourage a patient to carry these out on a daily basis. 

Positive reinforcement is key too and should be provided whenever possible, while showing empathy towards a patient is another key area of supporting them emotionally.

A number of intervention strategies can be used to help those patients coping with loss or others that are adjusting to a nursing home placement, for example. 

These include:

  • Control: Giving the patient a chance to exercise control can be a powerful tool. Also, ask their opinions where the situation warrants it
  • Autonomy: In this context, the patient is allowed to act and make decisions on their own basis. Patients are allowed to make decisions about their care and should understand that
  • Privacy: All patients must be afforded utmost privacy at all times

Patients with neurological disorders

Let’s look at several neurological disorders that can affect patients.

Alzheimer’s disease

It is a brain degenerative disorder that usually causes dementia in those aged 65 or older.

To start, those suffering from Alzheimer’s will suffer from short-term memory loss but later, they will become confused and could even be aggressive.

Long-term memory loss will set in as well as deterioration in other cognitive abilities.

Alzheimer’s patients usually die because their bodily functions break down.   


This describes the effects of long-term illness (Alzheimer’s, depression, or a cerebral vascular accident) and the cognitive dysfunction that occurs as a result of it. 

Following a period of six months of this dysfunction, a patient is then considered to be demented which can affect problem-solving, language, and memory. 

In certain situations and depending on what causes it, dementia can be cured. 

Sundowner’s syndrome

This sees confusion in patients but only at certain periods of time, most notably, the end of the afternoon into the start of the evening. 

Usually, patients with this syndrome already have a history of either dementia or Alzheimer’s but that’s not always the case. 

Often patients with this syndrome can be confused, restless, or agitated. 

On rare occasions, patients with Sundowner’s syndrome may wander as well as hallucinate. 

Parkinson’s disease

Many people suffer from this disease which attacks the nervous system and causes it to degenerate. 

In turn, patients will see their speech deteriorate and motor skills steadily decline while in some cases, cognitive skills can also be affected.

Signs of Parkinson’s include trouble when turning, speaking, and swallowing, a shuffling walking style, tremulousness, and a face with a mask-like appearance. 

In advanced cases of the disease, patients can also experience dementia as well as suffer from memory loss. 

Cultural and spiritual needs

Cultural and spiritual needs is the second step in the Psychosocial care skills section of cna study.

There are a number of factors that can play a role in the outlook of a patient that is in long-term care.

First, culture

This is shaped by many aspects, including age, gender, and ethnicity. 

It can affect what a patient can eat, how they behave while they are ill as well as how they see death.

When planning for the care of a patient, their culture should always be taken into account.

If not, their stress levels can rise and retard the healing process.

Second, religion

This can affect how patients participate in their care as well as what treatment they will allow being carried out on them. 

When planning for the care of a patient, their culture should always be taken into account.

Your coursework will cover caring for various religious groups like Christians, Muslims, Hindu , and Jewish patients, amongst others, so it’s worthwhile looking at these specifically for the exam. 

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