CNA 1: Module S

Psychological Effects of Aging

an exploration of feelings, emotional stress, physical, psychosocial, and psychological adjustments that are part of the aging process

State law requires facilities to be surveyed for compliance with the federal regulations (OBRA), when?

annually, and unannounced

Omnibus Budget Reconciliation Act (OBRA)

major legislation passed nationally to protect residents in nursing homes and assure they have quality of care and quality of life

When can conflict arise when dealing with schedules?

when personal routines collide with institutional routines

Defense Mechanisms

unconscious behaviors that residents (and all of the rest of us) may display when stressed

How can you establish familiar surrounding for residents?

-explain procedures -talk about their room -keep promises -provide safe environment -promote use of personal belongings

How can you assist in making sure a resident gets food?

-feed those who are unable to feed themselves -make sure dentures are in place -sever food at proper temperature, in a friendly manner, in a pleasant environment, in appropriate amounts

How can you assist a resident in getting enough water?

-have water within reach -period fresh water periodically throughout the day

What should a NA do when a resident is depressed?

-listen to feelings -encourage to reminisce -involve them in activities -encourage friends and family to visit -report changes to eating/sleep/elimination -avoid pitying them -help them focus on reality -monitor eating and drinking -promote self esteem -report observations to superior

What are some typical feelings a person might feel when suddenly admitted to a nursing home?

-loss -fear -isolation -confusions -loss of control

What is a NA's role with regards to sexuality?

-maintain sexual identity by dressing the resident in clothing appropriate for them -assist with hygiene -assist to prepare for special activities -help them develop a positive self image -show acceptance and understanding -never expose them -provide protection of non-consenting residents -be firm but gentle in your objection of residents sexual advances

How can you assist a resident in getting sleep?

-minimize noise and light during sleep hours -provide back rub to relax -report any complaints of pain -listen to concerns or worries -leave nigh-light on by request

What methods are used to survey the facility?

-observation of staff providing care -interviews of residents/family -evaluation of environment -record reviews

What are your physical needs for sustaining life?

-oxygen -food -water -shelter -sleep -elimination -activity

What are types of defense mechanisms?

-projection (blaming others) -rationalization (false reason for situation) -denial (pretending problem does not exist) -compensation (making up for situation in some other way) -repression (blocking painful events) -regression (going back to past behaviors)

How can you assist in providing shelter for a resident?

-provide warmth -dress them appropriately for temperature -be aware of any draft or drafty areas

How can you provide for a residents safety and security needs?

-provide warmth -establish a familiar surrounding -maintain order and follow routine -assist to reduce fear and anxiety -check on resident frequently -avoid rushing and assist resident in a gentle manner

How do you assist with a residents spiritual needs?

-respect beliefs and religious objects -inform resident of time and place of religious services -assist in attending religious services -provide privacy for visits by members of the clergy

How can you assist to assure residents get activity?

-ROM exercises as directed -turn and reposition them every 2 hours -assist with activity as directed -encourage movement and interesting recreational activities

What are late adulthood developmental tasks?

-adjustment to retirement -reduced income -death of friends -death of spouse -physical changes -loss of independence -creating new friendships -loss of vitality -integrating life experiences -preparation for death

What issues may arise when caring for an elder adult?

-amount of care needed -cost - nutritional needs -relationship with family/support system -medical care needs -may experience changes in lifestyle -decisions about long-term care may cause stress

How can you assist a resident with elimination?

-assist with toileting as needed -provide for privacy -change soiled linen immediately -follow routine for bowel and bladder training as required

What are the 3 common ways a cognitively intact person adapts to living in a nursing home?

-become depressed or may regress, withdraws from others, only show interest in events that affect own personal, physical, or self -become narrow-minded, uncooperative with staff, fight all attempts to be included -determined to make the best of the situations

How do you assist to build/keep a residents self-esteem?

-call resident by proper name -praise accomplishments -discuss current issues -requests residents opinions -show respect and approval -assist to dress and grooming -encourage independence and socialization -share goals

What are common signs and symptoms of depression?

-change in sleep patterns -loss of appetite and weight loss -crying -withdrawal from activities -appearing sad-

What is the NA's role in assisting the individual to adapting to life in the nursing home?

-decrease doubts a fears of unknown, give them orientation of facility -allow them to place their keep sakes where they feel fit and provide praise for personalizing their space -respect privacy -become familiar with them and the reasons for admission

What are some reason an older individual may have to relocate from their home?

-decrease in finances -decline in physical or mental state -lack of social support -increasingly unsafe neighborhood

What might and individuals reaction to relocation depend upon?

-degree of choice that they had -degree of preparation that they had -degree of sameness of new location to previous location - degree of predictability of new location -number of additional losses that may have occured

How can you assist a resident to have good oxygen intake?

-elevate the head of the bed -sit individual up in chair -assist with breathing exercises -report any cyanosis

About ______ of men and _____ of women who turn 65 are expected to live in a nursing home before they die.

1/3; 1/2

What percentage of residents living in a nursing home are female?

75%

Basic Human Needs

elements necessary for survival and physical and mental well-being

What does the survey review?

quality of: -medical, nursing, and rehabilitation care -dietary services -infection control -physical environment