Patient Care Fundamentals - Nursing Assistant in Long-Term Care

Patient Care Fundamentals - The Nursing Assistant in Long-Term Care

Introduction to Long-Term Care (LTC)

  • Definition of Long-Term Care (LTC): LTC refers to a range of services that help meet the health or personal care needs of individuals with chronic illnesses or disabilities who cannot care for themselves for long periods.

  • Comparison to Other Healthcare Settings:

    • LTC facilities serve as homes for residents while providing medical and personal care.

    • Different from acute care (short-term treatment) and subacute care (more intensive care post-acute).

Key Terminology

  • Skilled Care: A type of medical care that requires professional skill, such as nursing care.

  • Length of Stay: The duration a person resides in a long-term care facility, which can vary widely.

  • Terminal Illness: A disease that cannot be cured and will lead to death.

  • Chronic Conditions: Long-lasting conditions that can be controlled but not cured.

  • Home Health Care: Medical services provided in a patient's home.

  • Assisted Living: A type of housing for seniors that provides various services to help with daily activities.

  • Adult Day Services: Programs for adults who need assistance or supervision during the day.

  • Acute Care: Immediate and often short-term treatment for severe injuries or illnesses.

  • Subacute Care: Care for patients that require more intensive therapy than what is available in traditional nursing care.

  • Outpatient Care: Care provided to patients who do not require overnight stays.

  • Rehabilitation: Services that help individuals recover skills lost due to illness or injury.

  • Hospice Care: Support for people in the last phases of a terminal illness.

Residents in Long-Term Care Facilities

  • Types of Residents:

    • Elderly individuals,

    • Persons with disabilities,

    • Individuals recovering from serious illness or surgery.

  • Core Values of Culture Change:

    • Empowerment of residents,

    • Person-centered care promoting dignity and independence.

The Role of Nursing Assistants (NAs)

  • Tasks Performed by NAs:

    • Assistance with activities of daily living (ADLs).

    • Monitoring vital signs and reporting any changes.

    • Providing personal hygiene and grooming assistance.

  • Personal Care Provided:

    • Help with bathing, dressing, eating, and toileting.

  • Other NA Duties:

    • Light housekeeping and meal preparation.

    • Companionship and emotional support for residents.

Professionalism and Ethics in Care

  • Professional Relationships: Maintaining boundaries with residents; demonstrating compassion and empathy.

  • Legal and Ethical Behavior:

    • Actions must comply with legal standards; ethical responsibilities to protect resident dignity and rights.

    • Know your rights and responsibilities under the Omnibus Budget Reconciliation Act (OBRA) and what constitutes Residents' Rights.

  • What is OBRA?: Legislation that sets standards for nursing facility care, focusing on residents' rights and quality of care.

Documentation and Reporting

  • Importance of Documentation: Legal requirement; if it is not documented, it is assumed the care was not provided.

  • Guidelines for Documentation:

    • Detailed and accurate recording of care provided,

    • Use of military time for accuracy.

  • Minimum Data Set (MDS): A comprehensive assessment tool for nursing home residents that helps to assess their needs and develop care plans.

Abuse and Neglect Awareness

  • Signs of Abuse:

    • Unexplained injuries,

    • Changes in behavior,

    • Withdrawal or fear of certain caregivers.

  • Types of Abuse:

    • Physical Abuse,

    • Psychological Abuse,

    • Verbal Abuse,

    • Sexual Abuse,

    • Financial Abuse.

  • What to Report: Suspicious injuries or changes in a resident’s condition must be reported using the proper channels.

Ombudsman and Residents' Councils

  • Role of Ombudsman: Advocates for residents' rights, investigating complaints and promoting quality care.

  • Purpose of Residents' Councils: Provide a forum for residents to voice concerns and share experiences, enhancing community within the facility.