CNA Care of Cognitively Impaired Residents 1
A resident with Alzheimer’s disease tells the nurse aide that she smells smoke. The nurse aide should
Often the first symptom of Alzheimer's disease is a loss of short-term memory. The client can still recall events and information about the past until the disease progresses to complete loss of brain function. Depending on the stage of Alzheimer's, a client could certainly detect the smell of a fire.
The primary reason for combative behavior in a resident is
The most common cause for combative behavior in clients with dementia is confusion about their care. Because of memory loss, clients become confused when staff members try to help them. Clients may not recognize their caregivers, or may not want to do what the caregiver is telling them, such as getting up, eating, or taking a shower. The clients' automatic reaction will be to say "No" and push, hit, or kick. Always allow plenty of time when dealing with the clients. Speak softly and explain what is happening. Don't argue. Remain calm and be prepared to try again in a few minutes.
When getting dressed, a client always wants to wear her favorite outfit. What is a good solution?
Getting dressed can be a source of confusion for a client with dementia. Simplify the process by limiting choices of clothing. If the client has a favorite outfit, try to get several identical sets. Clothing should be comfortable and easy to get on or off. Help the client by placing clothes in the order they are put on.
All of the following are clues to aggressive behavior EXCEPT
Knowing the signs of aggressive behavior can help you prevent a situation from escalating. An aggressive episode can develop unexpectedly. If the client has a clenched jaw or fist, or suddenly begins to pace or rock, act quickly. Assess the situation to find a possible cause. Is the client in pain? Tired or hungry? Overstimulated? Confused? Use a calm manner to deal with the client. Eliminate distractions and try to focus on a new activity.
Reality orientation should include
Reality orientation involves repeating information to help clients understand their surrounding. To keep a client oriented, their name is used frequently. Information such as date and time are reinforced with calendars and clocks.
A way to make sure a resident with dementia gets adequate nutrition is to
Eating can become a challenge for a resident with dementia. Start by reducing distractions so that the resident can focus on the meal by making the dining area quiet and calm. Make it easy for the resident to eat by serving finger foods, using bowls instead of plates, and putting lids on cups. Small meals and snacks are appropriate for the limited attention span of these residents.
Communication with a resident who has late-stage dementia or Alzheimer's includes
Residents with late-stage dementia or Alzheimer's lose their ability to communicate with speech. They are still able to understand some verbal communication, so talking to them in simple sentences is useful. They can also express themselves with facial expressions, emotions, and body language.
A resident who has not been discharged insists she is going home. What should the nurse aide do?
It is beyond the scope of practice for a nurse aide to deal with some client situations, such as leaving against medical advice (AMA). Immediately inform the nurse or a supervisor. Stay with the client and reassure her that the nurse will help her. Try to redirect her focus or offer a new activity.
A resident has difficulty remembering what day it is and where they are. How can you best help the resident?
Memory prompts are ways to help clients stay oriented to place and time. A calendar and a clock in each client's room are useful. Bulletin boards and public areas can be decorated for seasons and holidays. Repeat information at regular intervals to reinforce where the client is and what is happening.