June 10th-17th is National Nursing Assistants Week.  It is a time to recognize the hard work and personalized care that they provide. Certified Nursing Assistants (CNAs), like many health care professionals, manage a variety of roles and in a variety of settings. This could be in a hospital, a rehabilitation center or even someone's home. Due to the type of care they provide, CNAs are usually present in senior communities. The Pointe at Kilpatrick is a supportive living community and the  residents here are highly independent.  Unlike the daily care a CNA might provide in a nursing home, the role of the CNA at The Pointe is provide support for the residents so that they can remain independent.  They may remind residents to take medications, escort them to the dining room and if necessary, may even assist in showering at times.  Because the nature of care is so personal, relationships between CNAs and residents becomes personal.  This provides continuity of care and enables staff and residents to develop a personal rapport.

The administration would like to recognize all of their CNAs that provide loving care to the residents.  Throughtout the year, different CNAs will be highlighted with a brief history of their experiences. In honor of National Nursing Assistants Week, we will begin with three of our on-staff CNAs.

Sherry Brown joined The Pointe at Kilpatrick shortly after it opened it's doors, bringing with her over 15 years of experience.  She became a CNA while studying to be a nurse, but loved working with seniors so much, she decided to remain a CNA.  Sherry is a Team Leader and trains others to be CNAs. She is also the right hand to the Residents Service Director. When asked about being a CNA, Sherry said, "I love having direct interactions with the residents.  I have a good rapport with seniors and love talking to them".

Wanda Jones has been with The Pointe since she bacame a CNA in 2007.  Wanda plans on starting nursing school this fall and intends on working with seniors throughout her career. The residents commented that "Wanda is always happy and willing to help" to which she replied  "I love caring for them and interacting with them.  They make me happy".

Diane Rios has worked at The Pointe for 7 years.  She decided to become a CNA after caring for her mother.  She didnt like the way her mom was being treated by her home health care providers and decided that she wanted to make a diference to others by becoming a CNA.  She is also a Team Leader and described by residens and coworkers alike as "..very kind and very friendly".  "She always brightens our day"

One of the early symptoms of Alzheimer' Disease, is the deterioration of speech as well as trouble understanding others speak.  If you are caring for someone who has Alzheimer's Disease, then is it imperative that you find a way to communicate positively to the individual.  Being related to the person with AD can make this both easier and harder than for someone who isn't so emotionally connected.  Today, I want to highlight some basic tips on communicating with a person with AD.

As with all individuals with AD, a routine and personalized level of care has to be established.  I've mentioned before, that even the day to day functions of an individual may change significantly.  Being prepared to handle these changes will make it easier and less traumatic for both of you.  Finding your own way of communicating, that produces the best results, will greatly benefit you and the quality of life of a person with Alzheimer's. It is common for a person with AD to know what they want to say, but just can't find the word or phrase.  We all know how frustrating that can be for any of us. You are having a conversation and you have to stop to think of a specific word.  It becomes awkward as the conversation comes to a halt while we fumble around for that single word.  Now imagine, you having this trouble, several times a day.  Compound that feeling with not understanding what people are saying to you.  You may not recognize the words you are hearing, or know the word but forget the meaning.  It quickly becomes aggravating. A person with AD can become quite agitated during a simple conversation.

Here are some basic principles in establishing a positive and productive line of communication with the individual:

- Do not talk to the person as if they weren't there. They may not respond to you, but that doesn't mean they cant hear or understand you.

- Most importantly, DO NOT TALK TO THE PERSON AS IF THEY ARE AN INFANT! This can be degrading and frustrating to the patient.

 

Depending on their cognitive level, some people can remember being more productive and active.  Losing the ability to communicate is an immediate intrusion on their independence.  Speaking to the person in "baby talk" or otherwise known as  "elderspeak" is demeaning. Studies show that it actually creates a negative response in individuals who are treated like children. Their is a fine line between being intimate and pandering.  If you are a spouse you can, and should, talk to them as you always have, with a level of intimacy.  Using nicknames or holding hands can revive the memory and help give the patient a more secure feeling even though they may not understand what is going on exactly at that moment.  By easing the stress for them, you ultimately relieve the stress on yourself as a caregiver.  Even if you are not personally involved in the person's life and are a professional caregiver, simple, kind gestures are still important. A smile can convey a lot, even if the person can't understand what you are saying.

 

Once you have established a routine with your patient, you will recognize that there may be certain times of the day that they are able to make themselves understood as well as understanding you.  Plan accordingly. Trying to force and activity or function will only create stress and poor results.  If the person tends to be more alert and responsive in the early morning, schedule appointments or visits during that time. Keep in mind, that a person with Alzheimer's is going to have good days and bad days.  Being flexible is as important as having patience.

 

Assisted Living/Supportive Living/Nursing Home

Regardless of whether you are responsible for making the decisions on how to care for a parent/spouse or choosing your own health care future, having the right information is crucial to choosing the best path.  There are many options available and it is important to find one that fits the needs of the person or persons involved.  Unfortunately, life isn't always convenient, and these decisions may have to be made in a short period of time and under a great deal of stress.  Most people don't sit down and say "at age 70, I'm moving into a retirement community"  or  "When I become forgetful, I'm admitting myself to a nursing home".  There may be a general plan agreed on by family members, but as people get older, their needs change, thus their level of care changes. There are several options available for seniors requiring some form of care, beyond what is capable of spouses or children.  Knowing what community is right for you or your family member can be confusing. We'll concentrate on three similar options and their differences.

Assisted Living:  An assisted living community is for the senior who may only need help managing day to day activities. They have no need for constant medical care and, for the most part, are independent. Help in managing their medications, cooking meals, bathing and laundry are several of the most common needs met for a resident at an assisted living residence.  An emphasis is placed on giving the resident the independence he/she wants to live their lives according to their schedules and interests. Many consider assisted living facilities as a bridge between fully independent living (such as a retirement community) and a nursing home.  Personalized assistance is given to each resident, based on their level of need.  One might need medication management and help with bathing, while another resident may need help cooking meals and getting dressed.  Each persons needs are assessed and administered.  Residents at the beginning stages of Alzheimer's and other forms of dementia, are usually better suited for living in an assisted living community.  With some daily assistance and provided structure, they are more capable of living independently.

Supportive Living:  Most senior health care communities are guided by individual state criteria and are regulated by state laws and oversight committees.  Some states, including Illinois, have what is know as supportive living residences. These are communities that provide similar needs as an assisted living location would, but offer financial assistance through state aid to those with moderate income. Although one's assets and income determine the fees paid for medical and personal services, a person with a higher income may also live in this residence and not worry about relocating if their private funds should ever run out. This design was formed to reduce the need for those who are only in need of minimal assistance to have to go to a nursing home strictly due to financial limitations.

Nursing Homes:  By far, the most common and recognized form of senior health care is the nursing home. Before the development of assisted living residences in the 1990s, nursing homes were the "catch all" for seniors who needed any kind of care, whether they were becoming forgetful, had trouble walking or needed constant medical care, the nursing home was the most viable option.  With individual needs being met by the development of more specialized options, the nursing home is best suited for seniors who need 24 hour care.  On premise medical staff are able to provide the individual care a patient may need.  Many nursing homes are becoming specialized in the medical treatment they provide, such as advanced Alzheimer's, diabetes's, wound care and so on.

Having the facts and knowing what's best for the individual, will help anyone who has to make a decision for the health care of a senior family member or one's self.

Have any of you been confused by these differences or do you have additional questions or comments? We welcome your participation on this topic.