1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter accountable: answerable for one’s actions. activities of daily living (ADLs): personal daily care tasks, including bathing, dressing, mouth care, hair care, toileting, and eating and drinking. acute care: 24-hour skilled care for temporary illnesses or injuries; generally given in hospitals and ambulatory surgical centers. adaptive devices: special equipment that helps a person who is ill or disabled perform ADLs; also called assistive devices.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) adult daycare: care given to adults at a facility during daytime work hours. assistive devices: special equipment that helps a person who is ill or disabled perform ADLs; also called adaptive devices. assisted living: a setting for people who require some help with daily care, but who need less care than a long-term care facility offers. care team: the group of people with different kinds of education and experience who provide resident care.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) chain of command: the order of authority within a facility. charge nurse (nurse-in-charge): a nurse responsible for a team of healthcare workers. chronic: the term for an illness or condition that is long-term or long-lasting. cite: to find a problem through a survey.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) conscientious: guided by a sense of right and wrong; principled. continuity of care: coordination of care for a resident over time, during which the care team is always exchanging information about the resident and working toward shared goals. courteous: polite, kind, considerate. delegation: transferring authority to a person for a specific task.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) dementia: the loss of mental abilities, such as thinking, remembering, reasoning, and communicating. diagnosis: the identification of a disease by its signs and symptoms and from the results of different tests. empathetic: identifying with and understanding another’s feelings. first impression: a way of classifying or categorizing people at the first meeting.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) functional nursing: method of care assigning specific tasks to each team member. holistic: care that involves the whole person; this includes his or her physical, social, emotional, and spiritual needs. home health care: care that takes place in a person’s home. hospice care: care for people who have six months or less to live.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) inter-generational care: mixing children and the elderly in the same care setting. Joint Commission: a not-for-profit organization that evaluates and accredits different types of healthcare facilities. length of stay: the number of days a person stays in a healthcare facility. liability: a legal term that means a person can be held responsible for harming someone else.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) licensed practical nurse (LPN) or licensed vocational nurse (LVN): licensed nurse who has completed one to two years of education; LPN/LVN passes medications, gives treatments, and may supervise daily care of residents. long-term care: 24-hour care provided usually in nursing homes for people with ongoing conditions. nurse practitioner (CNP): a registered nurse with advanced education who is able to see patients and write prescriptions.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) nursing assistant: an important member of the care team who performs assigned nursing tasks and gives personal care. outpatient care: care usually given for less than 24 hours to people who have had treatments or surgery. pet therapy: the practice of bringing pets into a facility or home to provide stimulation and companionship. policy: a course of action to be followed.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) primary nursing: method of care in which the registered nurse gives much of the daily care to residents. procedure: a method, or way, of doing something. professionalism: the act of behaving properly for a certain job. registered nurse (RN): a licensed nurse who has completed two to four years of education; RNs assess residents, monitor progress, provide skilled nursing care, give treatments, and supervise the care given by nursing assistants and other members of the care team.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) rehabilitation: a program of care given by a specialist to restore or improve function after an illness or injury. resident: a person living in a long-term care facility. resident-focused care: method of care in which the resident is the primary focus; team members are cross-trained in skills, allowing residents to see many of the same people performing their care. sandwich generation: people responsible for the care of both their children and aging relatives.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) skilled care: medically necessary care given by a skilled nurse or therapist. subacute care: care given in a nursing home or a hospital; used for people who need a higher level of care and observation than some long-term care facilities can give. team leader: a nurse in charge of a group of residents for one shift of duty. team nursing: method of care in which a nurse acts as a leader of a group of people giving care.

1 The Nursing Assistant in Long-Term Care 1. Define important words in this chapter (con’t) trustworthy: deserving the trust of others.

1 The Nursing Assistant in Long-Term Care 2. Describe healthcare settings There are many job opportunities for those trained to perform the important work of nursing assistants. Description of long-term care: ●LTC facilities provide 24-hour skilled care. ●LTC assists people with ongoing, chronic medical conditions. ●Other terms for LTC facilities are nursing homes, nursing facilities, skilled nursing facilities, and extended care facilities. The long-term care (LTC) facility is the residents’ home.

1 The Nursing Assistant in Long-Term Care 3. Explain Medicare and Medicaid ●Medicare is a health insurance program for people who are 65 or older and people under 65 who are disabled and cannot work. ●Medicare will only pay for care that it deems medically necessary. ●Medicaid is a medical assistance program for low- income people. People qualify for Medicaid based on income and special circumstances.

1 The Nursing Assistant in Long-Term Care Transparency 1-1: Facts about Medicare and Medicaid ●For 65 or older or disabilities and illnesses ●Hospital Insurance (Part A): pays hospitals, skilled nursing facilities, hospice care, and some home health care ●Medical Insurance (Part B): pays physicians’ services and other medical services and equipment 1 The Nursing Assistant in Long-Term Care

1 The Nursing Assistant in Long-Term Care 4. Describe the Residents for Whom You Will Care It is more important to understand each individual in your care than to understand the entire population.

1 The Nursing Assistant in Long-Term Care Transparency 1-2: Residents in LTC facilities ●Almost 91% are over 65 ●Almost 72% are female ●More than 85% are Caucasian ●About 1/3 come from a private residence ●Over 50% come from a hospital

1 The Nursing Assistant in Long-Term Care 5. Describe the nursing assistant’s role ●Nursing assistants perform delegated nursing tasks to help care for residents. ●Many of these tasks will involve assisting residents with ADLs.

1 The Nursing Assistant in Long-Term Care 5. Describe the nursing assistant’s role Some common nursing assistant tasks are: ●Serving meal trays and feeding residents ●Helping residents dress and undress ●Bathing, shaving, and shampooing residents ●Bedmaking ●Tidying living areas ●Taking vital signs

1 The Nursing Assistant in Long-Term Care 5. Describe the nursing assistant’s role Some tasks that nursing assistants do not perform are: ●Giving medications ●Inserting or removing tubes ●Giving tube feedings ●Changing sterile dressings

1 The Nursing Assistant in Long-Term Care 6. Discuss professionalism and list examples of professional behavior Professionalism is the act of behaving properly for a certain job. Examples of professional behavior for nursing assistants are: ●Arriving at work on time ●Avoiding unnecessary absences ●Keeping a position attitude ●Being polite and respectful ●Following policies and procedures ●Documenting carefully

1 The Nursing Assistant in Long-Term Care 7. List qualities that nursing assistant’s must have The best nursing assistant’s have the following qualities: ●Patient and understanding ●Honest and trustworthy ●Conscientious ●Enthusiastic ●Courteous and respectful ●Empathetic ●Tolerant ●Lacking prejudice

1 The Nursing Assistant in Long-Term Care 8. Discuss proper grooming guidelines It is important to make a good first impression. Proper grooming guidelines include: ●Keeping your uniform neat ●Bathing and wearing deodorant each day ●Brushing your teeth twice each day ●Keeping hair neat and tied back ●Keeping beards trimmed and neat ●Keeping nails short, filed, and clean ●Keeping shoes and laces clean

1 The Nursing Assistant in Long-Term Care 8. Define the roles of each member of the care team The care team is made up of professionals, including: ●Registered Nurse (RN) ●Nurse Practitioner (CNP) ● Licensed Practical or Vocational Nurse (LPN, LVN) ● Physician or Doctor (MD or DO)

1 The Nursing Assistant in Long-Term Care 8. Define the roles of each member of the care team (cont.) The care team is made up of professionals, including: ●Social Worker (MSW) ●Physical Therapist (PT) ●Registered Dietitian (RDT) ●Nursing Assistant/Certified Nursing Assistant (NA/CNA) ●The resident is the most important member of the team

1 The Nursing Assistant in Long-Term Care 10. Discuss the facility chain of command It is important to follow the chain of command to lessen the risk of liability.

1 The Nursing Assistant in Long-Term Care 11. Explain “The Five Rights of Delegation” “The Five Rights of Delegation” are: ●Right Task ●Right Circumstance ●Right Person ●Right Direction/Communication ●Right Supervision/Evaluation Asking questions and asking for help when you need it will help you to provide better care.

1 The Nursing Assistant in Long-Term Care 12. Describe four methods of nursing care A policy is a course of action to be taken every time a certain situation occurs. A procedure is a specific method, or way, of doing something. Holistic care improves the residents’ quality of life because it considers the whole person. The four basic types of nursing care used at facilities are: Resident-focused Care Team Nursing Primary Nursing Functional Nursing

1 The Nursing Assistant in Long-Term Care 13. Explain policy and procedure manual You should always ask questions or consult the policy manual or procedure manual when you’re unsure of something.

1 The Nursing Assistant in Long-Term Care 14. Describe the long-term care survey process Important points to know about the survey process are: ●Inspections are done periodically. ●Surveyors observe and interview residents and staff to find out how well residents’ needs are being met. ●Nursing assistants should answer any questions asked by surveyors to the best of their ability. ●If a nursing assistant does not know the answer to a question, he should say so and then find out.