(5) FTCC CNA 1 Modules S-W

Basic Human Needs

Elements necessary for survival and physical and mental well-being

Defense mechanisms

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

Omnibus Budget Reconcilliation Act (OBRA)

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

Psychological effects of aging

An expoloration of feelings, emotional stress, physical, psychosocial and physiological adjustments that are part of the aging process

Physical needs required to sustain life

Oxygen, food, water, shelter, sleep, elimination, activity

Examples of safety and security needs

warmth, explain procedures, keep promises, provide safe environment, follow routines, maintain order, avoid rushing, and check on resident frequently

Examples of love and affection needs

Friendship, social acceptance, closeness, love, and belonging

Activity-based care

Care focused on assisting resident to find meaning in his/her day, rather than doing activities just to keep the person busy

Alzheimer's Disease

A progressive disease characterized by a gradual decline in memory, thinking and physical ability, over several years

Behavior

How a person acts

Catastrophic Reactions

Out-of-proportion, extreme responses to activites or situations

Cognition

Ability to think quickly and logically

Confusion

Inability to think clearly, causing disorientation and trouble focusing

Delusion

A fixed, false conviction in something not real or shared by other people

Dementia

Usually progressive condition marked by development of multiple cognitive deficits, such as memory impairment, aphasia, and inablility to plan and initiate complex behavior

Depression

A loss of interest in usual activities (Signs include change in sleep pattern, loss of appetite, crying, withdrawal from activities, appearing sad)

Dignity

Respect and honor

Doing activities

Activities that keep the person busy

Independence

Ability to make decisions that are consistent, reasonable and organized; having the ability to perform ADL's without assistance

Irreversible

Disease or condition that cannot be cured

Meaningful Activities

Have value to the resident with dementia

Onset

The time when signs and symptoms of a disease begins

Paranoia

An extreme or unusaul fear

Progressive

The way a disease advances

Quality of life

Overall enjoyment of life

Respect

Treated with honor, show of appreciation and consideration

Sundowning

Increased agitation, confusion and hyperactivity that begins in the late afternoon and builds throughout the evening

Trigger

An event that causes other events

Wandering

Moving about the facility with no purpose and is usually unaware of safety

Alzheimer's Disease progresses into how many stages?

3 Stages

(Mild) Early-Stage Alzheimer's Disease

Difficulty with remembering names and using words. Having difficulty performing tasks at home or work. Not recalling read material. Losing or misplacing items. Difficulty with organizing or planning

(Moderate) Middle-Stage Alzheimer's Disease

Forgetting current or past events. Displaying behaviors or withdrawal and changes in mood. Unable to recall address or telephone number. Not oriented to person, place, or time. Requires assistance with choosing appropriate clothing for the occasion or weather. Occasional incontinence. Sleep pattern disturbances. Wandering. Changes in behavior and personality.

(Severe) Late-stage Alzheimer's Disease

24-hr. Care is required for personal needs. Difficulty with sitting, walking, and swallowing. Communication challenges. At risk for infections, especially pneumonia

Postmortem Care

Care of the body after death

Wandering

Moves about the facility with no purpose and is usually unaware of safety

DNR

Do Not Resuscitate: An order written by a doctor at the request of a resident which tells the health care team that the resident does not wish any extraordinary measures to be used when the resident suffers cardiac or respiratory arrest.

Apnea

Respirations stops

Obsessive-Compulsive Disorder

A long-lasting disorder in which a person experiences uncontrollable and recurring (obsession), engages in repetitive behaviors (compulsions), or both

What is Delirium? Dementia is both_______ and _______.

reversible, progressive/irreversible

De-escalate

To (cause to) become less dangerous or difficult

Mental Health

A resident's ability to cope with and adjust to everyday stresses in ways that society accepts

Mental Illness

A disturbance in the ability to cope or adjust to stress; behavior and function are impaired; mental disorder, emotional illness, psychiatric disorder

Considerations of de-escalation

Behavior, posture, position self for safety, body movement and language, facial expression, eye contact, attitude, tone, responses, and reasoning

Pain

anything the patient says it is, occurring whenever the patient says it does

Pain descriptions

sore, stiff, aching, squeezing, throbbing, stabbing, gnawing, sharp, dull, tender, burning, numb, radiating

Acute pain

temporary, lasts for a few hours, or, at most, up to six months; sudden onset as a result of disease, inflammation, or injury; goes away when the healing process is complete

Chronic pain

Long term, lasting for 6 months or longer; often comes on gradually; serves no purpose since it continues after the healing process is complete; diagnosis of cause can be difficult

Effects of pain

Giving up hope, depression, anxiety, withdrawal, decrease in or loss of appetite, decrease in activities, inability to sleep, restlessness or agitation, thoughts of suicide, negative effect on immune system

Hospice Care

Health care agency or program for people who are dying (usually less than 6 months to live) that provides comfort measures and pain management, preserves dignity, respect, and choice, and offers empathy and support for the resident and the family

What is the nurse aide helping to prevent when providing physical resident care during the dying process?

Pressure Injuries (Ulcers)

Pain is a normal process with aging

FALSE

What is the purpose of activities for dementia/Alzheimer's residents?

strengthen their current level of functioning

Advanced Directives

A living will written while resident is mentally competent or by resident's legal representative which outlines choices about withdrawing or withholding life-sustaining procedures, if terminally ill

Examples of self-esteem needs

Calling resident by proper name, praise accomplishments, request resident's opinion, show respect and approval, assist to dress and aid with grooming, encourage independence

Stages of grief

Six Stages: Denial, anger, bargaining, depression, acceptance, and the most recent addition, meaning

The Nurse Aide is tired of the same routine with the Dementia and Alzheimer residents. The Nurse Aide decided to move the morning activities to the afternoon. This is the right action taken by the Nurse Aide. True or False?

False. The staff should not vary the resident's routine unless there is an order to do so. Dementia and Alzheimer residents require a regular routine.

If a Dementia or Alzheimer's resident has difficulty with being heard, what is another means of communication that maybe interpreted?

Nonverbal communication. This type of communication is very important to the Dementia and Alzheimer's residents.

As a Nurse Aide, you should always offer several choices in clothing to a resident with Dementia or Alzheimer's Disease. True or False?

False. Keep choices to a minimum in order to reduce the resident's frustration and confusion.

Pain is never associated with behavior issues. True or False?

False. Pain can be a trigger for behavioral issues.

While giving postmortem care to a resident, the Nurse Aide may remove all tubing and other devices from the body. True or False?

False. The Nurse Aide does not remove tubing or other devices from the body.

Nurse Aides will always know how to deal with their emotional feelings with the impending death of a resident. True or False?

False. Nurse Aides may feel differently each time a resident dies.

It is always a smooth transition for a resident to move into a Nursing home environment. True or False?

False. Older adults face numerous emotional challenges with a change in where they live.