2. Who are these People?
• Elderly
• Disabled
• Social Attitudes about the elderly
3. Myths About Aging
• Old Age starts at 65
• Most elderly live in adult care homes
• Older adults are isolated and alone
• Older adults are isolated and alone
• Older adults are useless segment of society
• All elderly have trouble remembering and
become confused
• The elderly are poor
• The elderly are miserable most of the time
11. Psychosocial Aspects
• Privacy
• Control over environment
• Responsibilities for home
maintenance
• Social contact outside the facility
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OBRA
• Sets minimum training and
competency evaluation requirements
of C.N.A.s
– Training program
– Competency evaluations
– Nursing Assistant Registries
13. Resident Rights
• OBRA is a federal law.
• Nursing centers must:
– Protect and promote
resident rights.
– Inform residents of their
rights orally and in writing.
• Information
• Refusing treatment
• Privacy and
confidentiality
14. Resident Rights
• Personal choice
• Disputes and grievances
• Work
• Participation in resident and
family groups
• Care and security of personal
possessions
• Freedom from abuse,
mistreatment, and neglect
• Freedom from restraint
• Quality of life
15. Ombudsman Program
• The Older Americans Act requires a
Long-Term Care Ombudsman
Program in every state.
• An ombudsman is someone who
supports or promotes the needs and
interests of another person.
18. 05/04/16 18
Neglect
• Failure to use the care that a
reasonable, prudent, and careful
person (CNA) would use in a similar
situation.
19. 05/04/16 19
Exploitation
• Resident’s physical or financial
resources taken by a caretaker (or
anyone else) by use of undue
influence, coercion, harassment,
duress, deception, false
representation or pretense.
20. 05/04/16 21
Reporting Abuse (Obj. 11)
• Abuse is mental or physical injury to
a resident
• Abuse is a crime
• Abuse must be reported
• Failure to report
• Method of reporting
• Ethical decisions
21. 05/04/16 22
Goals of LTC Obj. #1
• Provide an environment that is safe
environment
• Promote quality of life for each resident
• Provide services & activities to aid the
resident in attaining the highest practical
physical, mental, and psychosocial well-
being
• Provide quality care
• Provide an environment that is home-like
22. 05/04/16 23
Types of LTC facilities in Kansas
Obj. 2
• LTC units in hospitals
• Nursing Facilities
• Assisted Living Facilities
• Home Plus
• Adult day care
• Board and care
23. 05/04/16 24
Introduction to Healthcare
Agencies
Purposes:
Health Promotion
Disease Prevention
Detection and Treatment of disease
Rehabilitation and Restorative Care
25. 05/04/16 26
Goals
• Provide quality care
• Focus on the individual
• Team work
• Coordination of care
• Communication
• Cooperation
• Promote & maintain Health
• Provide a satisfying social environment
• Provide a safe environment
26. Kansas Long-term care
facilities
• Nursing Facility
• Assisted Living Facility
• Residential Health Care
• Home Plus
• Boarding Care Home
• Adult Day Care
27. 05/04/16 28
Types of Agencies
• Hospitals
• Rehabilitation & sub-acute
care
• Assisted Living
• Long Term Care Centers
28. 05/04/16 29
Types of Agencies
• Skilled Nursing Facilities
• Mental Health Centers
• Home Health Agencies
• Hospices
• Health Care Systems
• Adult day care
29. 05/04/16 30
Types of Agencies
• Skilled Nursing Facilities
• Mental Health Centers
• Home Health Agencies
• Hospices
• Health Care Systems
• Adult day care
Editor's Notes
Learning about the aging process and about social attitudes toward the elderly enables the aide to provide resident care with understanding and respect. By federal regulations instruction covering residents rights and promoting independence must be completed prior to direct care to those that live in adult care homes.
What comes to mind when someone asks you what is an elderly person?
What are stereotypes that people have when they think of the elderly?
When does old age start?
Where do most elderly live?
Are most elderly poor?
Are they miserable, just waiting to die?
What things do they like to do?
What is their quality of life?
Did your list include any of these?
Chronological age is not the basis for determining abilities. Individuals age at different rates. Organs and organ systems also decline at different rates. Normal aging includes the common group of diseases and impairments that characterize many of the elderly. Some get diseases and impairments while others do not. Not all persons living in long term care facilities are elderly. Younger persons may have debilitating illnesses and injuries and require assistance.
People of all ages have trouble remembering. There is some memory change with aging but MOST older adults will not face severe memory loss.
Creativity doesn’t stop. Hobbies can provide personal satisfaction for residents of LTC.
The financial status of the elderly can be very limited. Medications and care can be very expensive. The cost of staying in a LTC facility can be between $4,000-$10,000 per month. On the other hand, the Baby-Boomers are coming into the retirement age and this group of people can be some of the most wealthy.
Air/oxygen
When a resident has trouble breathing, elevate the head of the bed
Assist to assume a more upright position
Allow rest between activities of daily living (ADL)
Assist the resident to use supplemental oxygen when ordered/needed
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Food
Allow resident to eat more independently, set food up, cue to eat
When resident cannot eat without assistance, provide aid at meals and snacks as needed
Respect resident’s food choices and preferences
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Water
Provide water and other liquids within reach at mealtime, cue as needed to drink
Offer sips of water or other liquids before or after providing care
Keep resident’s water pitcher filled and accessible
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Assist resident to toilet or to use the bedpan or commode
Observe for nonverbal signs of need to urinate or to have a BM
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Activity, rest, and sleep
Assist resident with ambulation
Provide quiet environment for sleeping and during night hours
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Sexuality
Provide privacy and do not respond critically when residents masturbate
Protect resident rights when residents look for sexual satisfaction with on another
Recognize the maleness and femaleness of residents through clothing choices & grooming
Safety and Security Needs
Assist to feel safe from abuse, neglect, exploitation and retaliation
Handle gently during care
Respond to call signal and requests promptly
Help resident accept the facility as home
Demonstrate hospitality to family and friends
Promote trust by keeping your promises to the resident, but explaining what you are doing before doing it, bu working as a teach with other staff
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Belongingness and love needs
Show kindness and consideration to resident and to other members of staff
Involve resident in conversation while providing care
Demonstrate acceptance of family’s involvement
Assist to remain part of the community or church
Assist resident to find ways to feel that the facility is their home
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Self-esteem and respect needs
Show respect for age and sincere interest in resident’s contribution to society
Call resident by preferred name
Respect individuality and resident’s right to refuse
Respect privacy, including privacy of body during care
Accept resident’s request for personal care by member of same sex
Recognize resident’s ability to hear and comprehend conversations that take place between staff
====================================
Self Actualization (person growth and fulfillment) Needs
Talk about awards or other accomplishments displayed in the resident’s room
Encourage to verbalize about past, if resident desires
Allow resident to verbalize negative as well as positive feelings about the facility
Help the resident participate in meaningful activities
Support the resident’s interests
Identify daily pleasures
=========================================
Personal satisfaction from work and accomplishments
Sense of usefulness
Friendships and sense of belonging to a work group
Income
================
Death or impairment of a spouse or companion=loss of lover, friend, confidant, companion
Death of peers with whom one has shared life experiences
Isolation due to limitation of movility as well as other factors mentioned above
=================================
Financial health and safety needs may dictate life changes such as moving from home to a long-term care facility.
Diminishing senses of touch, smell, taste, vision, hearing
Change in physical appearance, body image
Physical ability, balance, mobility, speed of response time, energy
Memory changes such as slower thinking, requiring more memory cues for recall, decrease in ability to concentrate
Generalized decline due to cumulative effect of chronic illnesses
Psychosocial aspects of independent living at rish for loss when entering a long-term care facility include these things
So…what can CNAs do to help?
Privacy-pull privacy curtain, window curtain, and close door when providing personal care. Do not allow staff who are not involved in care to be present in room or interrupt care unless emergency.
Control over space, personal possessions-encourage resident choices. Request permission to handle resident’s personal items before touching or moving them.
If a resident would like to help with some areas of the facility, help them do things that make them feel useful.
Encourage social contact outside the facility-encourage to attend community activities as able. Allow privacy for making phone calls and visiting with friends/family.
Privacy, confidentiality of medical records, and the right to know what services are available and their cost.
Ethical people act ethically, doing what is right. This earns respect and honor.
Professional groups have codes of ethics. These codes of ethics coincide with the standard of good, honest, honorable actions.
This is simply taking advantage of another person.
Examples: Striking, slapping, hitting or kicking, yelling, calling degrading names, threatening physical abuse, sexual abuse. As CNAs and other healthcare workers, we are required to report all abuse, neglect, and exploitation. It is unlawful not to do so. The Kansas hotline is 1-800-842-0078.
Board of directors makes the policies. Administrator Manages the facility and is responsible for the overall operation of the adult care home. The Administrator is responsible to the governing board or owners. Directors or Managers oversee the operations within their departments. The director of nursing is responsible for the direction of the nursing staff and resident care staff. She/he is supervised by the Administrator.
The goals of the team are governed by the quality of care given to the residents/patients. It is important to acknowledge that each is a person who has needs, expectations, rights, and hopes for the future. Teamwork is a term used frequently which requires working together, communicating with other team members, and cooperation between departments.
