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CAREGIVER BLOG - (CNA, STNA, PCA, HHA)
Posted: 12/9/2019 6:10:04 PM
Ten Things an Alzheimer’s Patient Wants You to Know
Alzheimer’s disease is a type of dementia wherein a person loses their memories, ability to make sound judgments, and bodily functions. It is a disease that worsens over time and affects millions of Americans. Taking care of a patient with this type of dementia can be very challenging. To help them overcome, certified nursing assistants must learn how to put themselves in their patients' shoes.
Here are ten things every patient with Alzheimer's disease wants their CNAs and other care providers to know:
1. “As frustrating as it is for you to take care of me, it's even more frustrating for me when I cannot recall my memories."
Even at the early stages of forgetfulness, it can be very stressful for a patient to be unable to remember what has just happened. Occasionally forgetting where you last placed your car keys is already infuriating when you’re in a hurry, but experiencing recent memory loss more often can damage one’s confidence in many ways.
Patients with Alzheimer’s disease feel deeply that something has changed for the worse.
It’s not just about the missing car keys—it’s also being unable to remember what you had for breakfast, which friend just came by to visit, or what the coffeemaker is for. It’s the frustration of not knowing how to make your own budget, when it has been an ordinary task your whole adult life.
This forgetfulness is different. It strips the life out of the patient, one memory at a time.
2. “I deserve to be respected in spite of . . .”
People with Alzheimer’s disease are ill just like other patients, even though the signs and symptoms start with changes in memory and judgment. As patients, they deserve to be respected at all times.
If you are a CNA, accept patients as they are as well as the changes that result from their illness. Even if patients lose their ability to think and remember, or become totally dependent on others for care, they still deserve respect from every member of the healthcare team.
3. “It rips me apart to know that loved ones are already dead."
Because patients with Alzheimer’s lose their recent memories, they tend to remember things only from farther back in the past. For them, being told that their loved ones have already passed is like hearing it for the first time. The shock and the grief are real and the emotions are raw.
Remember to be empathic and considerate when the truth is necessary. Better yet, use distraction to avoid giving them the sad news and prevent them from being distressed unnecessarily.
4. “Please bear with me when I insist on going home. Home is my happy place and my comfort zone.”
An Alzheimer's patient may do everything they can to “go home,” even though they are already there. They may shout, lie, drive, or run away, just to “go home.”
At that moment, this is their reality and their present. They feel that they are in an unfamiliar place and only want to be home with their family, being a good parent to their children and a loving spouse to their husband or wife.
Offer a positive distraction and tell them they need to stay for just awhile, instead of insisting that they are already home.
5. “I sometimes wet my pants, and I don’t want it to happen again.”
Patients with Alzheimer's disease in the advanced stages start to lose bodily functions, including their ability to control their bladder and bowels. This change can feel devastating and humiliating at the same time.
Remember to be empathic and compassionate. CNAs must preserve their patient’s dignity at all times.
6. “Please be patient. More than you, I want to get things done quickly and efficiently, the way I used to!”
Patients with Alzheimer’s will have difficulty accomplishing even the most basic tasks, like buttoning shirts, holding a glass of water, or brushing their teeth. CNAs must be extra-patient when a task such as eating or drinking takes a long time.
7. “If I zone out, it might be because I am too absorbed in the memories I have left.”
Patients with dementia such as Alzheimer’s enjoy reminiscing, because they are holding onto their remaining memories. They like thinking about happy times from their younger years. For CNAs, this is a wakeup call to do more activities that help them remember such times.
8. “The world has become a lot scarier for me. Losing my memories is a frightening experience.”
For Alzheimer’s patients, these feeling of fear come to the surface every time they cannot remember who has visited them or who is posing in their photographs. It is also a terrifying and traumatic experience when they wander and get lost.
Confusion is very scary. Nursing assistants must always be ready to offer safety and comfort.
9. “Be understanding when I cannot do things on my own anymore. Losing my independence to disease kills my morale.”
Alzheimer’s disease can render a person unable to function, to the point that they completely become dependent on others, even for self-care. Depending on others for personal matters is very difficult to accept, so nursing assistants should express understanding if a patient throws a fit or spills something on the bed.
10. “Talk to me more. I am not a zombie, and you are not a robot.”
When an Alzheimer’s patient’s ability to speak is also lost, it does not mean that their comprehension and hearing are gone, too.
Healthcare staff should not talk about their patients as if they aren’t in the room. Instead, they should try to engage in conversation with them even if they do not readily get a response. Keeping communication alive between CNAs and patients preserves the human connection.
Posted: 12/2/2019 3:12:31 PM
Supporting a Coworker During a Personal Crisis
Workplaces are special places because, for most people, at least 40 hours of their life each week are spent at work, with others striving toward the same goal. For nursing assistants, these colleagues are the healthcare team and other staff. Many times over, they work on the same tasks as they go through the motions of everyday patient care, creating a bond among themselves.
Because of these shared experiences, we can sense when a coworker is having a rough time. Those who have become friends at work usually talk about the life crises they're currently experiencing. These conversations happen a lot, don't they?
So, as a CNA, how do you support a coworker who is going through a difficult time? Check out these simple do’s and don’ts:
1. Don’t pry too deep.
If a coworker confides in you that they just got divorced, for example, it might be tempting to ask about all the gory details of their relationship. While your intention might be to support them, asking too many questions is intrusive and overwhelming. Wait for them to open up to you when they’re ready.
Do convey your presence.
What you can do instead is sit with your colleague and sincerely be aware of what they are going through. At this point, you have gained their trust and they are likely to verbalize more.
If they cry, let them. If they are to resume patient care, help them compose themselves first before going back to work. If they do not seem well enough to perform their duties, encourage them to tell the nurse supervisor so that appropriate measures can be taken to help them, and ensure patient safety at the same time.
2. Don't insist on “helping.”
Even if they have become a close friend, a colleague in crisis will need some space to process the situation. Do not insist on staying the night, for example. Instead, tell them that you could stay with them if they want, which brings us to the next tip in discussion.
Do offer help.
Ask your colleague if they'd like to talk more about their situation after the shift ends. If they are up to it and you can give more of your time and support, invite them somewhere quiet to talk. Offer what you can, but respect their privacy.
3. Don't tell them to look at the bright side of life, or that problems have a purpose.
While it has become a habit for some people to tell a troubled friend to find the good in a thorny situation, or that life is trying to teach them a lesson in every problem, CNAs must know better.
Our training has taught us that this response is not therapeutic because it undermines the patient's feelings. Outside of patient care, this “rule of thumb” also applies to anyone who is in distress.
Do emphasize their strength.
In difficult times, a person's morale is usually torn to pieces. Recognizing one's own strength during a crisis can be hard. As a CNA, boost your coworker's spirit by reminding them of their positive qualities.
4. Don't give unsolicited advice.
Let's say your coworker has recently received the news that they have cancer. This is certainly devastating.
Your mom happened to be a cancer survivor, and so you start lecturing your colleague on how to battle the disease. However good your intention, it can be disrespectful and inconsiderate to give such unsolicited advice.
Do is ask them if they need any help and mention casually that someone you know is a survivor and you may have helpful information.
Your main goal should be to listen to your coworker if they need to talk and offer your support.
Posted: 11/18/2019 3:43:15 PM
Unlikely Places Germs Hide: Contamination in Hospitals and Nursing Homes
They are deadly, unrelenting, and become more difficult to kill by the day. We never see them with the naked eye, but we know they are there (and everywhere), because patients get new infections while receiving hospital treatment or being cared for in nursing homes.
Here’s the proof: According to the Centers for Disease Control and Prevention (CDC), about 648,000 patients every year acquire an infection during their hospital stay, and about 75,000 of these patients die. This fact only means that the bugs' existence in so-called unlikely places is real.
Nursing assistants play an important role in preventing the spread of microorganisms as they move between clean and dirty places in their day-to-day work. If you are a CNA, let the following be an eye-opener for you.
It is common knowledge that the ground and toilet are teeming with bad microorganisms. But in hospitals and nursing homes, nursing assistants should also be careful about other places germs hide:
Where there’s moisture, microorganisms tend to multiply.
There are bacteria called Legionella that causes Legionnaire’s disease, a pneumonia-like illness where patients experience cough, shortness of breath, high fever, muscle pains, and headaches. Legionellae tend to grow in warm water and are spread through inhaled mist or contaminated water that accidentally gets into the lungs.
According to an article from the CDC regarding Legionairre's disease, nursing assistants should think about these places where legionella bacteria are found:
- Shower rooms and sinks
- Cooling towers or structures that spray mist to cool the air
- Hot tubs that remain undrained after each use
- Indoor and outdoor fountains and other water features
- Hot water tanks and heaters
- Large plumbing systems
Fungi, such as those that cause fusariosis, an opportunistic mold infection, were also found in showerheads, sink drains, and sink faucet aerators.
Softened water that is used in hemodialysis, where a patient's blood is run through a machine to be filtered, also tend to harbor bacteria.
In some cases, ice and ice machines, flower vases, and even children's water gun toys have been found to be contaminated.
2. Touch surfaces
Healthcare workers such as nurses and CNAs often touch patients as a normal part of their daily routine, moving between places within the hospital or nursing homes. Patients and staff continually touch common surfaces. These surfaces become breeding grounds for microorganisms:
- Bedside table
- Call buttons
- Bed rails
- Door handles
- Hard charts
- Nurse station desktops
- Computer keyboards
3. Shared equipment
When instruments or pieces of equipment are taken from one patient to another, germs can transfer that way, too. As a CNA, you are using digital tympanic thermometers, adhesive tapes, tape measures, and other supplies that are carried around, which are not regularly decontaminated. They are also potential carriers of harmful germs.
Microorganisms easily spread in healthcare settings because patients come and go frequently, and their germs are passed on as healthcare workers take turns caring for them. Without practicing infection control, these bacteria, viruses, and fungi spread and multiply, causing infections in patients who have weak immune systems. CNAs must not be complacent in thinking that “looking clean” means germ-free. On the contrary, they should be aware of seemingly harmless ways infectious microorganisms can be acquired.
Posted: 11/11/2019 2:32:21 PM
Creating Your Own Holiday Magic at Work
Diseases and other health conditions do not take breaks during the holidays. That’s why healthcare workers often spend some of their special holidays at work, caring for their patients.
Whereas most people are rushing home to share personal time with their families and friends, those in healthcare such as CNAs are going to work, just to make sure that patients have the care and support they need. They think about their loved ones at home, the good food, and the great times that go hand-in-hand with the holidays, and their hearts sink. To some, missing out on the good stuff during such special celebrations can trigger depression and burnout.
CNAs have a lot of love and care to give. In this kind of work as a nursing assistant, without a big heart, it is almost impossible to appreciate one's career. Here are some tips to help you bring holiday magic to work.
1. Change your mindset.
“It’s all in the mind”—this is true. The holiday spirit should perk you up wherever you are, even when you are at work. If this is your mindset, then you will be able to go about your shift bringing holiday cheer to others. It might help to realize that patients may need more cheering up than you, and that in just a short time you’ll be on your way home. Feel blessed that you have an opportunity to be able to give back to others by offering your time and your service to those in need of care.
2. Plan ahead and suggest an open house.
If you can’t be home, let families come to an open house in your place of work and join those who work the holiday shift. Talk this option out with other colleagues and the department head, and stay positive that it will be approved. If you get a green light on this, then it is definitely an event to look forward to! So, start making your to-do list.
3. Play some holiday music.
In places where music is allowed, it may create happy memories to play some holiday music. Music can be a part of healing for patients, and a mood-setter for healthcare workers such as CNAs. If you can level it up and do some caroling within the set limits, then you and your patients are in for a good time!
4. Put up some decorations.
There is something mysteriously magical about lights and shimmering decorations during the holidays. Hang up some holiday decor where allowed, and take a second to appreciate the season.
5. Give back.
Because CNAs have big hearts, they are often willing to give more, too. During the holiday season, giving makes both the giver and the receiver happy. If you can manage small trinkets to give away and, in the process, make someone's day a bit happier, it might just be your ticket to a memorable shift.
6. Put aside issues with colleagues and have something to share with everyone.
The best way to survive holidays at work is to temporarily set your happy place to work, and then set aside the issues you may have with your coworkers. A simple potluck with lots of holiday cheer can perk up everyone's mood.
Holidays at work don’t need to be a drag if you put in a touch of creativity and stay in the spirit of the season. This time of year is indeed a special opportunity to give, not only care, but good cheer to those around you.
Posted: 11/4/2019 2:57:59 PM
The Many Faces of Hopelessness
Hopelessness is a very powerful emotion that can tear down a person’s will to care for and improve themselves. Hopelessness makes the future seem dark and takes away the passion and happiness in doing everyday activities. For people who have lost all hope, they feel that nothing good will come out of their circumstances, even with their best efforts. There is nothing to look forward to. Only suffering and pain are certain in their future.
Hopelessness can happen to anyone, but as a Certified Nursing Assistant, more often than not, you may encounter patients who have given up on their situation. People with depression, those with chronic conditions, those who have suddenly lost bodily functions, and hospice patients are prone to this negative feeling.
How can a CNA know if a vulnerable patient has lost all hope? Nursing assistants must be alert for verbal cues, such as patients asking, “What’s the use?” They might say, “This is just a waste of time.” Also, phrases like “I give up” or “No one can help me” indicate feelings of hopelessness. These are all signs that a patient has given up. When a vulnerable patient gives these cues, they are red flags that a CNA must watch out for.
Other than what the patient says, CNAs must know how hopelessness is disguised by many different emotions.
Here are some of the faces of hopelessness:
Loss of hope often goes hand-in-hand with depression. The patient may cry or have an emotional outburst. They may stay in bed all day crying, or the patient may express their feelings to others who are willing to listen.
A person experiencing hopelessness may also show that they don't care if anything good might be waiting for them in the future. These patients appear indifferent and may go about their daily activities without showing much emotion. Like robots, they seem to be unfazed and simply waiting for the bad that will inevitably happen.
3. THE SILENT ROCK
When patients feel hopeless, they may hold back and withdraw from all socialization, simply because they do not find any meaningful purpose in being with others. They keep to themselves and usually stay in bed, away from everything and everyone.
Hopelessness may push patients to think about harming themselves or ending their lives, just to stop the suffering. They feel an overwhelming need to stop the negative feelings about themselves and the world, and that the only solution left is to take their own lives. This is the most dangerous expression of hopelessness.
Nursing assistants are in the position to observe a loss of hope in patients because they spend the most time with them. This makes them effective providers of care. Should a CNA see that a patient has started feeling hopeless, they must be there for them and encourage them to talk more about their feelings. They may also provide comfort to dying patients and their families. CNAs can also act as an advocate. If they see that their patient is in pain, for example, they should report their observations immediately. They should also suggest the option of calling a religious leader who can meet their patient’s spiritual needs.
CNAs must have empathy and compassion toward these patients because these values make their caring both genuine and effective. Most importantly, CNAs must be strong in their own belief that there is always hope.
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