Avanza Education: C.N.A. Tips for Performing ADL's

Incontinence

If a resident becomes incontinent it may be a temporary situation. You need to check to see if the resident is on any new medication. Have a nurse check for a urinary tract infection. Take note of any mental confusion your resident may have.

If a resident is having incidents of incontinence a C.N.A. should:

1. Make sure resident is drinking enough fluids.
2. Follow fluid schedules.
3. Note when resident is incontinent. Check him or her every 30 minutes.
4. Take resident to bathroom before "bathroom time."
5. Take resident to bathroom before and after meals and before bed.
6. Make sure resident urinates before getting off toilet.
7. Mark restroom with sign or picture.
8. Be matter-of-fact when cleaning episodes of incontinence.
9. Observe toilet patterns for two to three nights if resident is incontinent during night.
10. Make sure there is enough light in the bathroom and on the way there.
11. Put lids on trash cans, waste baskets, or other containers if resident urinates in them.
12. Encourage fluids.

Bathing

Each resident will have a bath schedule in their chart or care plan. It is important for each C.N.A. to carefully review each resident's schedule and follow it as close as possible. For some residents a bath or shower can be an ordeal. C.N.A.'s must be sensitive to a residents feelings. Even though bathing is important to maintain proper hygiene a C.N.A. must never force a resident to bathe.

If a resident is resisting a bath or shower you should try to:

1. Schedule bathing when resident is least agitated.
2. Give a resident their supplies before bathing to serve as visual aid.
3. Take a walk with resident down the hall and stop at tub or shower room.
4. Be organized so bath can be quick.
5. Make sure bathroom is well-lit.
6. Keep temperature comfortable.
7. Give privacy.
8. Be calm and quiet.
9. Keep process simple.
10. Be sensitive when discussing bathing with resident.
11. Give resident washcloth to hold during bath.
12. Ensure safety by using nonslip mats, tub seats, and hand-holds.
13. Be flexible about when to bathe.
14. Be relaxed.
15. Be encouraging. Offer praise and support.
16. Let the resident do as much as possible for him- or herself.
17. Check the skin for signs of irritation.
18. Understand if resident does not want to bathe.

Dressing

Some residents may need help dressing. As a C.N.A. you will help the resident in whatever help they need. You should always let the resident do as much as they can for themselves. Maintaining their independence is also a part of your job. Determine how much help a resident needs and assist them in those areas.

When helping a resident to dress you should:

1. Show resident what he or she is going to wear.
2. Avoid delays or interruptions.
3. Give privacy.
4. Encourage resident to pick out clothes to wear. Lay out clothes in order to be put on.
5. Break task down into simple steps.
6. Use a friendly, calm voice when speaking.
7. Do not rush the resident.
8. Praise and encourage.

Eating

Helping your residents to eat a good meal is very important. Without proper nutrition a resident's health can become compromised. A C.N.A. needs to be patient and encourage their residents to eat.

There are many things to consider when helping a resident at mealtime such as:

1. Have meals at consistent times each day.
2. Food should look and smell good.
3. Make sure there is good lighting.
4. Keep noise and distractions low.
5. Remind the resident it is mealtime.
6. Keep the task of eating simple.
7. Finger foods are easier to eat.
8. Do not serve steaming or very hot foods or drinks.
9. Use dishes without a pattern. Use a simple place setting. Remove other items from the table.
10. Put only one item of food on plate at a time.
11. Help resident taste a sample of meal first.
12. Place a spoon to the lips.
13. Ask resident to open his or her mouth.
14. Guide resident through meal with simple instructions.
15. Offer regular drinks to avoid dehydration.
16. Use adaptive equipment.
17. Feed resident slowly, giving small pieces of food.
18. Make mealtimes simple and relaxed. Give resident time to swallow each bite.
19. Seat residents with others to encourage socializing.
20. Observe for eating and swallowing problems.
21. Give simple, clear instructions on how to eat or use utensils.
22. Observe and report changes or problems.

Additional tips

1. Help with grooming.
2. Prevent infections. Follow Standard Precautions.
3. Observe and report potential problems.
4. Maintain daily exercise routine.
5. Maintain self-esteem. Encourage independence.
6. Share in fun activities.
7. Reward positive and independent behavior with smiles, hugs, warm touches, and saying thank you.