Recently I substituted for a teacher of a Certified Nursing Assistant class. Being a twenty year veteran nurse in a long-term care facility, I feel I bring a different perspective to these youth in this important career choice. Possibly even more important than my perspective as a nurse, is my perspective as a daughter. My mom, a victim of Alzheimer’s, was a resident of the nursing facility where I worked until she died at age 89.
The training that young men and women, who are aspiring to serve the elderly of our world, include many aspects of care giving. Much of what they learn involves skills such as taking blood pressures, temperatures, giving baths and measuring heights and weights. They are concerned, as they should be, about getting these procedures done in an accurate and timely manner. Test scores are of utmost importance and require measurable outcomes and answers that must be correct. Grades must be up to a certain level to move toward that all important goal of graduation.
Even more important in the relationship between caregiver and patient, is learning how the elderly think and respond to their environment. The mannequins that the students encounter in a classroom setting while practicing skills are not, in reality, very representative of human beings, and surely not elderly patients. My focus in my opening introduction to the students includes introducing them to what elders, living in a nursing home setting, are usually like. Unlike the statue-like appearance of the mannequins or the compliance of a fellow student, pretending to be a patient, most elderly people are somewhat contracted from years of disuse of their arms and legs.
They usually do not lie perfectly still and extend their arms in compliance for blood pressures or open their mouths voluntarily to have temperatures taken. Giving them a bath, even just a bed bath, can be a real challenge. They are often cold and do not want to be undressed, much less have water applied to their skin. They are often in pain and are not ready to be moved around, although this is necessary for good hygiene and to promote blood flow, as well as discourage many illnesses. For the most part, their skin is fragile and lying in bed, especially in the same position, can quickly lead to skin breakdown, infection and even death.
The resistance of care by the elderly can be perceived by the inexperienced caregiver as meanness or disrespect. However, the elderly are often afraid of a caregiver that is different from someone they have been used to and this may result in refusal care. Their perception is that a stranger has entered their “house” uninvited. Not being in control of their situation and the tremendous loss of privacy and personal space can be devastating for them. Loss of hearing and sight can limit a patient’s understanding of the care you are about to give. Remembering that these folks are people, with feelings and emotions, is a vital part of the success of relating to them and rendering them the best care possible.
Respect, given in very large doses for these valuable members of our society, can make a world of difference in how they respond to a caregiver. Youth need to know the limitless value of getting on the patient’s eye level, introducing themselves to the patient, smiling and using an appropriate tone of voice. Words should be plainly spoken and distinct but not shouting. A detailed explanation should be given of the type of care you are about to give. However, do space the information out in several simple sentences…”Mrs. Smith, I would like to brush your hair now. Next I will remove your glasses.
I will use a wet warm washcloth to clean your face.” A kind touch or gentle pat of the hand speaks volumes to one who is lonely, confused and unhappy. The Golden Rule can be appropriately applied. Always treat the elderly the way you would want to be treated if you were in their place. If we live long enough we will be. Each of them is someone’s mother, father, sister, brother, wife or husband. They had a productive life in their past. Most probably raised a family, were business men or women or served in the military. They were loved by someone and each is infinitely precious to our Creator.