In Missouri, most of the "training" of Nurses Aides is done "on the job" with some classroom required but more "in the field" at the Long Term Care Facility and under the supervision of the facility.
Aides are the "backbone" of Skilled Nursing Facilities/Nursing Homes. They're responsible for the majority of the extensive physical workload of patient care.
Their jobs are physically, mentally and emotionally challenging and yet they're usually the lowest compensated level of care giving.
Who would want this job? Everyday they face the challenges of answering to everyone and being sent to do jobs no one else wants to do.
Aides operate the Hoyer Lift, they are assigned to feed residents, they clear the rooms of food trays, take residents to the bathroom and wipe them if necessary, clean them up when they have an accident (food or other), give showers/bathe, make beds/change bedding, assist residents from wheelchairs into chairs/beds, wake up and assist residents in getting up in the morning, move wheelchair patients who cannot move themselves to on floor dining and more.
Their training is primarily "in house" with some classroom instruction. They go to facilities that have "partnered" with specific training facilities for Certified Aides. From these ranks facilities often add to their staff. Yet many are not paid for this training or minimally paid while still paying for the "privilege" of learning this "trade".
Who trains these Aides? The Nurse on duty? Another Nurse's Aide? One who received their "certification"?
As with any other training, the level of ability depends on the accuracy of the training and the ability of the instructor. And, it depends on the ability of the individual.
Mom had some great CNA's and she had some very poor CNA's.
The challenge as I saw it was the training for use of medical equipment like the HOYER lifts was minimal. There were two kinds, for one the individual had to be capable of standing and of holding on while the unit raised their body from a sitting to a standing position or vice versa.
With Dementia, individuals often "forget" they need to hold on or fear falling and let go.
With Dementia, the introduction of this "new" equipment for which the individual has no previous experience is as frightening as introducing a swing or bicycle to a young child for the first time. Some form of cooperation from the individual is needed to ensure the person doesn't fall -- balance, upper body and or lower body strength.
Usually one person is sent to "move" the resident as the facility believes it's a simple task.
That's not always the case, especially with someone who has varying abilities due to Dementia or even to the use of medications which can affect balance and/or perception.
We took a picture of Mom having a Hoyer lift used and almost falling by slipping down because she could not hold on sufficiently. The CNA tried to use a Gait Belt to control this and that meant Mom was even more "pulled apart" and in more than one direction causing her to have even more challenges.
Facilities should be required to have two person assists with each use of the HOYER equipment whether it's the one where the resident stands or sits.
Looking back and watching today, we still see safety issues in LTC's and believe the causes for falls is more than a resident's inabilities -- it's due to the lack of adequate caregiving.
Mom lived with us through many medical challenges including operations and a hip "nailing" and an escar on her foot the wound specialist was convinced would mean she'd lose her leg at least to the knee.
Didn't happen.
Took a great deal of patience and endurance on our part; a working together to ensure Dr's orders were followed even when Mom complained and initially rejected procedures but Mom came through these situations without the myriad of falls, injuries and infections.
Why? We believe it was because we provided a high level of caregiving.
People were amazed at Mom's advanced age when she passed and while she lived. Yes, it was genetic, a good quality of life in her later years but it was also because there was a direct involvement and interest in her as an individual and ensuring a high quality of life.
At the level of residential care Mom had to go to, this just wasn't offered. Mom did receive excellent care from a few, but not for long and not when they weren't there. There are many more like my Mom; placed in facilities where standards are low, turnover is high and outside resourcing of services provides many who simply don't care because tomorrow or in a few days, they'll be somewhere else and it's "just a job".
To those who do care, we applaud you. Your job is difficult, often unrewarding for the most part and unrewarding.
Thank you to those who are CNA's making a positive difference and truly caring about our Seniors.
Who trains these Aides? The Nurse on duty? Another Nurse's Aide? One who received their "certification"?
As with any other training, the level of ability depends on the accuracy of the training and the ability of the instructor. And, it depends on the ability of the individual.
Mom had some great CNA's and she had some very poor CNA's.
The challenge as I saw it was the training for use of medical equipment like the HOYER lifts was minimal. There were two kinds, for one the individual had to be capable of standing and of holding on while the unit raised their body from a sitting to a standing position or vice versa.
With Dementia, individuals often "forget" they need to hold on or fear falling and let go.
With Dementia, the introduction of this "new" equipment for which the individual has no previous experience is as frightening as introducing a swing or bicycle to a young child for the first time. Some form of cooperation from the individual is needed to ensure the person doesn't fall -- balance, upper body and or lower body strength.
Usually one person is sent to "move" the resident as the facility believes it's a simple task.
That's not always the case, especially with someone who has varying abilities due to Dementia or even to the use of medications which can affect balance and/or perception.
We took a picture of Mom having a Hoyer lift used and almost falling by slipping down because she could not hold on sufficiently. The CNA tried to use a Gait Belt to control this and that meant Mom was even more "pulled apart" and in more than one direction causing her to have even more challenges.
Facilities should be required to have two person assists with each use of the HOYER equipment whether it's the one where the resident stands or sits.
Looking back and watching today, we still see safety issues in LTC's and believe the causes for falls is more than a resident's inabilities -- it's due to the lack of adequate caregiving.
Mom lived with us through many medical challenges including operations and a hip "nailing" and an escar on her foot the wound specialist was convinced would mean she'd lose her leg at least to the knee.
Didn't happen.
Took a great deal of patience and endurance on our part; a working together to ensure Dr's orders were followed even when Mom complained and initially rejected procedures but Mom came through these situations without the myriad of falls, injuries and infections.
Why? We believe it was because we provided a high level of caregiving.
People were amazed at Mom's advanced age when she passed and while she lived. Yes, it was genetic, a good quality of life in her later years but it was also because there was a direct involvement and interest in her as an individual and ensuring a high quality of life.
At the level of residential care Mom had to go to, this just wasn't offered. Mom did receive excellent care from a few, but not for long and not when they weren't there. There are many more like my Mom; placed in facilities where standards are low, turnover is high and outside resourcing of services provides many who simply don't care because tomorrow or in a few days, they'll be somewhere else and it's "just a job".
To those who do care, we applaud you. Your job is difficult, often unrewarding for the most part and unrewarding.
Thank you to those who are CNA's making a positive difference and truly caring about our Seniors.
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