Paving a Smooth Road Home

Check Presentation

FHCA’s 2014 CNA Essay Contest invited Certified Nursing Assistants from member nursing and assisted living facilities to write about their successful practices in delivering Activities of Daily Living (ADLs) using the theme, “Back to Basics, Paying Attention to Activities of Daily Living.” More than 50 essays were submitted, and Ms. Shae Brown, CNA at Haven of Our Lady of Peace in Pensacola, was the first-place winner. Here is her essay.

Paving a Smooth Road Home

Shae Brown, CNA
Haven of Our Lady of Peace in Pensacola

If you take a good look around your facility, you will see that residents come in many different ages, sizes, and shapes, with different physical abilities, different prior levels of function, and different home environments. Some residents come to live at the facility; others come to stay for a limited time before heading home with their family or a caregiver. When a resident leaves your facility to go home, it is important that you have educated their future caregiver (family or otherwise) on how to safely and consistently assist the resident with their ADLs. This presents some unique challenges that require the CNA to use his or her best creativity, diplomacy and skill.

The transition from a skilled nursing facility to home can be overwhelming for both the resident and the family alike. A once independent mother now relies on her son to help her dress and use the bathroom. The father of the family can no longer speak or move his right side; his children take turns caring for him. The list goes on and on. As CNAs, our handling of these delicate and emotional situations makes the difference between a smooth path to home or a bumpy road filled with potholes.
There is a huge difference in providing personal care for a child and for an adult. Most people outside the healthcare industry never have had to bathe, dress or feed another adult. The role reversal that occurs when a parent needs assistance from a child is hard for the parent as well as the child. A good CNA knows that fear of the unknown is a major factor here, and will talk with the resident and the family to identify concerns before they occur. Once everyone is on the same page as far as expectations, the true teaching can begin.

Whoever came up with the saying about us all putting our pants on one leg at a time clearly never worked in a nursing home! There is no one right way to dress a person. Consequently, when trying to teach another person how to do this, we have to ignore our own habits and encourage the other person to give up theirs, as well. We have to look closely at the resident’s preferences and abilities (or disabilities) and make the process work for them. It may be trial and error, and most people are afraid to “fail.” It is up to us as CNAs to keep the mood positive and light, to avoid embarrassing anyone, and to instill confidence in the learner that they will be successful.

Mothers and sons, along with fathers and daughters, often present a delicate situation. Modesty and family relationships can create angst for the resident and the child. If both parties agree that this is the caregiver situation that will exist at home, we need to present the care teaching in a professional, matter-of-fact way that imparts information while respecting dignity. It goes without saying that most men have never toileted their mother or fastened her bra. Societal norms suggest that most daughters have never seen their father’s “private parts.” Are you cringing as you read this? Then imagine how strange this may be for the family and resident. Again, using professional terminology and a calm, respectful demeanor will help take the focus off the emotional discomfort and place it on the task at hand.
It is very important that you give the caregiver the opportunity to perform the necessary tasks in the facility, so you can judge competence and reinforce confidence. Have the family member assist you before they try the task themselves. Obviously, this is not a one-time lesson, which is why discharge planning is so important. Encourage both the resident and the caregiver to ask questions, and make sure you know what obstacles they may face at home. When it comes to personal care, you are likely to be the best informed and have the most experience in caring for this particular resident. Share your secrets to success; you will be benefitting the resident and the family with your wisdom.
The time and effort you utilize to effectively train the caregiver of a discharging resident will manifest itself tenfold when the resident gets home. Be kind, be thorough, be honest, and be encouraging. Your residents and families will appreciate the smooth road ahead!