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The principal objective for any Certified Nursing Assistant (CNA) is to maintain the well being of the resident. A Long Term Care (LTC) facility is not only a medical facility, but also home for the residents. In a resident’s room, you may see an emesis basin next to a picture of family members, or an oxygen concentrator next to a quilting frame. The CNA in an LTC works in the resident’s home, attending to the needs of the resident. It’s a relationship that is ongoing and grows over time. CNA’s work together with other CNA’s and other staff, adding to the family atmosphere.
In an LTC, there are any number of residents, along with CNA’s, nurses, housekeeping, laundry, dietary, supplies, purchasing, and other areas, all working for the resident. No one area has more importance. The resident has the most contact with the CNA, but the CNA is dependent on the other areas of the facility to provide for the resident.
There isn’t a typical resident, but often they are elderly and in need of physical assistance. Many have had spouses pass away and children are grown. The resident has needs that make it hard or impossible for them to live on their own. This puts the CNA and resident in a relationship that is different than most. Like a family member, the CNA is with the resident a great deal. The resident may tell stories of days gone by; the CNA may read to the resident, activities that they share together.
CNA’s assist the resident in Activities of Daily Living (ADL’s). Every resident has different needs and requirements. The CNA must adjust to residents, assisting when needed, all the while encouraging the resident to do as much as they can on their own. This requires a delicate balance that changes from day to day, and resident to resident. Physical activity keeps the blood flowing and the muscles flexing, but too much can lead to problems. The ability to take care of oneself is also connected to mental and emotional states. It is empowering for the residents to tend to themselves, yet it can be aggravating and depressing to struggle.
The CNA will monitor physical, emotional, and mental levels of residents, and report their observations. After months or years of working together, even slight changes can become obvious. The CNA must pay close attention to the abilities of the resident. If a resident shows signs of change, for example, if a resident can usually do dental ADL’s without assistance, but are showing signs of difficulty, it could be a sign or symptom of something else going on with the resident and may need to be reported to the nurse. Being able to confer with other CNA’s what they have seen or their opinion on the resident’s condition, can add to the picture.
Communication between the resident and CNA can be a hurdle. The resident may have physical limitations, such as a stroke making the muscles of the tongue and mouth not responding as the resident intends, or the resident may be hard of hearing. The age difference between residents and CNA’s often span many generation gaps. There are various forms of communication other than speech; there are tools, such as hearing aides and communication boards. The age difference can be over come with time and trust.
Dementia and Alzheimer’s are also factors in LTC facilities. The CNA who deals daily with residents with mental confusion has an advantage working in an LTC, as there are other CNA’s to help. When a confused resident has difficulty, another CNA can re-approach and may find all goes well. Allowing some time to pass can also help. Frequently the residents stress will diminish with time.
Inevitably, the CNA will experience the death of a resident. In an LTC, the CNA has spent much time with the resident, which in turn intensifies the loss. With time, CNA’s come to terms with death and recognize it as a part of life.
