Dementia and functional abilities can be improved. They may

Dementia is
caused by pathological changes of brain cells. It is a degenerative brain
syndrome which affects one’s memory, comprehension, language, learning, calculation
and judgment. Suitable activities for patients/residents with dementia not only
help to delay their physical and cognitive decline, and enhance quality of
life, but may also improve their relationships with caregivers and relieve
caring stress. Activities are common treatment modalities for patients/residents
with dementia. They can be in the form of individual, small group and large
group. Any group formed with two or more persons having the same treatment goal
which may bring out group dynamics, is considered a therapeutic activity group.
Through careful planning of meaningful and purposeful activities for patients/residents
with dementia, their physical, cognitive, social and functional abilities can
be improved. They may also gain a sense of satisfaction and abundance.

Orientation is a method of reducing confusion, disorientation, memory loss and behavioral
problem by giving the patients/residents different environmental cues so that
they can master the important information such as time, person and place. When patients/residents are confused,
getting them back on track as much as possible is a major part of their care.
Reality Orientation is a technique based on the useful tool of repetition.
Sometimes elderly people tend to withdraw from conversations as communication
becomes more difficult. Try to draw them into conversation, using questions,
pictures, or whatever may spark their interest. Ask only one simple question at
a time, and allow time for response. First, get the patient/resident attention.
Always be patient, calm and kind. Speak slowly and clearly, using simple words
and brief sentences. Allow time for processing information and response. Ask
questions that can be answered with one word or gesture. Repeat and rephrase as
often as necessary. Repeat the person’s name often, and introduce yourself each
new contact with the person. Repeat the day, date, and time often. Put
calendars and clocks where the person can easily see them. Discuss familiar
people, places, and events. Open the drapes during the day, and close them at night.
Encourage the patient/resident to watch TV or listen to the radio. Maintain a
predictable routine and be consistent. Avoid changes don’t move the person’s
belongings or furniture. Encourage the person to enter social activity and do
not permit them to isolate. Music can also be a very useful form of therapy, as
it communicates with people on a non-verbal level. Music may stimulate memories
of people, events, places and feelings.

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Observe and report resident’s level
of orientation

of the time, nursing assistant spend their entire working time giving the care
to the patients/residents. By doing that they observe the patients/resident and
can determine problems that needs to be solved as early as possible. Some of
these problems need to be found out as early as possible to save the
patient’s/resident’s life. It is necessary for nursing assistant to have the
ability to assess and observe changes in resident’s physical, emotional, mental
and social conditions. A patient/resident who might not be socializing well
with others may have emotional problems or even deep depression thus noticing
reporting it to the nurse can make a big difference in the resident’s outlook
in life and well-being.

Even if such changes maybe small, it
is important to solve them early before they worsen and complicate the
condition of the patient/resident. Vital signs are equally important and should
be monitored vigilantly because a dramatic change might be a warning sign that
an infection, illness or depression is developing. Assessing
the patient/resident through his or her verbal statements without seeing a
physical sign is known as subjective assessment (SA). SA confirms that there is
something wrong with the client due to its verbal signals, which can portray
pain and emotional distress.
You should keep in mind not to underestimate even the faintest signs of change
because this can lead to devastating results in the residents’ health
conditions. Whenever in doubt follow your gut and intuitions based on the
previous encounters or experiences and perform a suitable course of action. When
collecting important information regarding the status of resident’s health,
keep in mind to immediately report a change in the resident’s present condition
to RN or supervisor. If unsure what the exact signs are, ask the patient to
repeat himself/herself (subjective assessment) or measure/review the signs
again (objective assessment).

Physical changes can be usually seen
in the skin in the form of lesions, bruises, rashes, swelling and others. Other
objective signs that can be visually observed are body weakness, coughing,
vomiting, mood changes. Documenting changes in patient’s/resident’s health is
an important daily task and it requires skill, especially if the facility uses
computers and other devices in recording. The use of abbreviations should also
be in accordance to the facility’s guidelines in using medical terms and abbreviations.
If the facility requires observations to be written, use only blue or black ink
in writing and print it in a way that they are clear, precise and complete. All
entries should be signed by the person documenting it and if corrections are
made then do it according to the guidelines of the facility. A resident’s/patient’s chart is a legal
record, which has their medical information and condition, therefore do not
erase or use an eraser in correcting them. To avoid such mistakes, you
can use first a scratch paper to serve as a draft. To make sure that what you
chart is correct and concise, you can get help from supervisors or nurses.

Direct resident to recreational activities

a patient/resident who rarely sees family members and friends, and who has no
relationships with other patients/residents in the facility. With whom can the patient/resident
share his/her feelings, stories and personal experiences? It is important that
each patient/resident has people to care about and people who care about
him/her. Nursing assistance need to be aware of the importance of social
contact in the lives of patients/residents. Whenever possible, interaction with
other patients/ residents and with family members and friends should be
encouraged. Such interaction can contribute to physical as well as mental
health. a nursing assistant should encourage
socialization among residents. For some residents, adjusting to life in
a personal care home can be very difficult, particularly when having limited
contact with family members and friends. It is not always easy to make new
friends and adjust to new people, new stores, new food, new activities and a
new routine. Some things a nursing assistant can do to encourage patients/residents
to socialize with one another: Introduce a new patient/resident to other
residents. Introduce residents with shared interests. Promote activities in the
personal care home. Constantly encourage and remind the patient/resident to
participate in activities. Find and provide activities that the /resident
enjoys. Talk with the patient’s/resident’s family and friends to find out more
about his/her interests and hobbies. Check the resident’s support plan for
special interests. Encourage the patient/ resident to join interest groups,
activity groups or social committees. Honor the patient’s resident’s rights to
choose activities.

            A nursing assistant should pay
attention to the patient’s/resident’s abilities and interests. The more you get
to know the patient/resident, the better you will be in recommending that
he/she participate in activities that match his/her interests. Find ways to
support the patient’s/resident’s interests in various activities. Some staff
persons believe that their jobs are easier when patient’s/ residents are less
active and not involved in activities. However, over the long run, the opposite
is the case. An inactive, socially isolated patient/resident is more likely to
be dependent on staff attention and will miss out on the physical and mental
health benefits associated with being active with others. Nursing assistant
have an important role to play in terms of letting /patient/residents know
about various activity options and in encouraging them to participate. Enlist
the support of the patients/ residents, other direct care staff persons, family
members and community members in helping the resident to learn about and be
able to participate in activities in the facility and in the community. Ensure
that the patient’s/ resident’s health and safety needs are met. A patient/resident
may be fearful of getting involved in a community activity due to concerns
about being able to get around, being able to take a rest when necessary and
being safe. Ensuring that the patient/resident will be safe and comfortable in
the activity is likely to increase his/her motivation to participate. The
activities in which a patient/resident participates should be consistent with
his/her support plans.

resident and family to facility and room

the resident is admitted to a facility everything is new and unfamiliar. This
new environment is strange and frightening. In coming to the facility, the
patient/resident had to leave a home and a familiar environment. Also, the
resident may have left the love and support of friends, a loving and faithful
pet, and pleasurable activities, such as gardening. The decision to come to a long-term
care facility is a difficulty one It is not made easily. At the facility, there
is less freedom to come and go. Less responsibility for making simple decisions
such as when to eat or what to eat. Less time alone, privacy, and fewer social
contacts. The new patient/resident entering the facility may be sad and
fearful. The nursing assistant may ne the first person the patient/resident
meets. Nursing assistants can make the patient’s/resident’s first impressions
of the facility more positive. A friendly considerate, and caring attitude can
help calm the patient’s/resident’s fears. An attitude of respect helps the new
patient/resident maintain self-esteem at a difficult time. the nursing assistant
attitude can help make the patient’s/resident’s adjustment to his/her new
surroundings easier.

you meet the resident, introduce yourself immediately. Be cheerful, patient and
supportive. Understand that the resident needs time to adjust to his/her new
home. Let the patient/resident know you are there for them to help make
adjustment. Introduce the ne patient/resident to the roommate, if he/she has
one, explain the equipment in the room. Show he/she which items are theirs.
Show he/she how to operate each piece of equipment. Be patient. The
patient/resident may be upset and not able to concentrate on what you are
saying. Always repeat information calmly. Give the patient/resident time too
adjust to their new surroundings. Always keep in mind that the patient/resident
is in and unfamiliar place and may need encouragement. Change is always

admitting a patient/resident was hands. Get everything you will need such as
bedpan, urinal, emesis basin, and wash basin etc. Fan-folded bed covers to the
foot of the bed if the new patient/resident is to be in bed. Leave the bed
closed if the resident will be up. Put the resident equipment away. Put gown or
pajamas on the foot of the bed (it appropriate). Make sure room is meat. Greet resident
and introduce yourself to patient/resident and family members. Be certain you
have the right patient/resident. Check identification band. Ask resident how he
wants to be addressed. Introduces resident to roommates. Ask
patient’s/resident’s family to leave room. Show them where they can wait. Tell
them when they can return. Tell them you will come to get them. Provide
privacy. Explain how call signals work and bed controls. Explain facility policies,
such as visiting hours and mealtimes. Tell them about facility services available,
such as activities, religious services, newspapers, library. Explain how to use
the telephone, location of the bathroom and what you are doing to admit them.
Ask patient/resident if there are any questions.

patient /resident to put on gown of pajamas if appropriate. Patient /resident
may want to keep their clothes on if permitted. Put all clothing in closet and
personal items in bedside stand. Be sure that all personal items and clothing
are identified and marked with the resident name. Check weight and height. Help
to bed if ordered put bed rails up. If the patient/resident had valuables, make
a list of jewelry, money and wallet. Have resident/relative sign the list.  Take and record vital signs. Obtain a urine
specimen if required. Complete admission checklist. Allergies, medication being
taken, and food preferences and dislikes etc. Sign admission checklist. Prepare
to leave the patient/resident and make sure the water pitcher is filled with
water. Bed should be at the lowest level. Make sure bell is within reach. Make
sure patient/resident knows how to use it. open privacy curtain. Tell the
patient/ resident after family leaves to answer any questions. Tell family they
may return to patient/resident room. Record information according to your
facility’s policy. Wash hands. (Shirley
A Badasch., Doreen S. Chesebro) Essentials for the Nursing Assistant in Long-term

Duty F-Providing
Resident’s Right

Assist resident in
personal communications

is verbal and non-verbal. Verbal communications are written and spoken
language. Non-verbal communications are body language, gestures, tone of voice,
and facial expressions. Verbal communication can be hard for patients/residents
and the nursing assistant should be aware and alert for non-verbal
communication to address the requests of each patient/resident.
Patients/residents who speak a different language should be assisted with the
required needs.  Appropriate means could
be a communication board or translator.

will sometimes need help with personal communication tasks. A patient/resident
may ask a nursing assistant to open or read mail.  A patient /resident may ask you to write a
letter of card due to a physical impairment. The nursing assistant must write
word for word what the patient/resident wishes and don’t edit or paraphrase
without the patient/resident permission. A patient/resident may ask a nursing
assistant to make a call for them. If asked, allow the patient/resident to
manipulate the phone as much as possible. A nursing assistant should assist
only when needed. Before a nursing assistant assist with personal
communication, make sure the tasks approved by the family and in the care plan.

professional ethics

of ethics is a set of guidelines, rules and standards for the proper care of
the patients. These standards are prescribed by the nursing authority, and
these rules and regulations are obligatory to follow by all the nursing
assistant while serving the patients/resident. The importance of the code of ethics helps restore health of the
patients/resident. Eases sufferings of the patients/resident. Aids in
preserving life of the patient/resident. Assists in maintaining and
establishing professionalism and high standards.

the duty of a nursing assistant to serve all the patients/residents equally and
provide equal care. A nursing assistant should work towards improving the
patient health. They should not treat the patient/resident according to their
race, age, religion, gender, medical condition. The nursing assistant is also
responsible for addressing the physical, emotional, spiritual and social
necessities of the patients/residents. Personal appearance of
the nursing assistant is observed by the patient/resident each day. Your
hygiene and grooming should be at high level. Wear clean clothes and maintain a
neat and clean environment. Your facial gestures and conduct also helps in
early recovery of the patients/resident. So, always have a smile on your face
and calmness in your behavior. A nursing assistant should be
technically prepared and must be attentive towards learning during in-service
program to enhance and improve his/her technical skills.

nursing assistant should recognize his/her duties and responsibilities for all
the actions and activities. They should not work under the effect of alcohol
and drugs. Your personal accountability includes: Show promptness and arrive on time.
Demonstrate honesty and display reliability. Work with a team, respect the
colleagues and maintain patient’s/resident’s confidentiality. Follow the
work-related guidelines and exhibit professional behavior.

should follow the HIPPA (Health Insurance Portability and Accountability Act).
The healthcare or nursing care professionals are not allowed to reveal the
healthcare information of the patient/resident to anyone. They can discuss the
personal information only with the supervisors and caregivers, engaged in the
care of the patient/resident. All the information should be kept secured if the
patient’s/resident’s data or healthcare information is maintained on the
computer. All the data including access codes, passwords and user names should
be protected according to HIPPA.  You are required to inform the
supervisor in case of breach of security.  A nursing assistant must not be
involved in altering the patient’s/resident’s record or falsifying it. A
nursing assistant must provide the services to the patients/resident to the
best of his/her ability. A healthcare professional must pay attention towards
the safety and welfare of the patients/resident. You are required to inform
your supervisor in case the patient/resident care doesn’t meet the desired
excellence standards.