TRUE OR FALSE
1. Universal Precautions
When you are caring for the individual, you should always wear gloves when:
You touch urine or stool.
An individual is toileting.
It’s cold outside.
Taking out the garbage.
When should you wash your hands?
After changing the individual’s Depends.
After toileting the individual.
After using your cell phone.
Before handling food.
After cleaning and disinfecting surfaces.
To communicate well, it is important to:
Allow the individual to express what he/she needs or wants.
Tell the individual your life story and your problems.
Ask questions if you don’t understand.
Spend time on your cell phone.
With individuals with dementia or Alzheimer’s disease, don’t use too many words or long explanations because this may be confusing.
Some individuals may not be able to speak so you just smile and go about your business.
Contact your supervisor if you notice a difference in the individual’s ability to move, gestures, pained facial expressions.
Interrupt the individual if they are talking too long to tell you what they need and tell him/her to get to the point.
You should let the individual know how you feel about politics and religion.
Sometimes movements, gestures, facial expressions and shifts in the client’s body may tell you that something may be going on that they are not telling you.
3. Changes in Individual’s Condition
When there are changes in an individuals condition:
You should report changes in condition immediately to your supervisor. Do not leave a voice mail. Speak to a live individual.
If you see red spots on the individual’s skin, it is okay to wait to report it until it gets worse.
A sudden change of appetite should be reported immediately to your supervisor.
If the individual has difficulty urinating, constipation or frequent diarrhea, you can wait to see if it will get better.
If the individual begins to yell a lot, say mean things and is angry all the time, you should report this to your supervisor.
You notice that the individual is starting to sleep a lot more. You don’t need to report this to your supervisor. Since the individual is tired, you put the individual in bed for naps more often.
Individuals who cannot change position in bed or in a chair should be repositioned every two hours.
It is important for an individual to drink enough fluids to prevent dehydration unless there is a fluid restriction in the individual’s care plan.
Older people’s skin tears very easily and it is important to prevent bumps and scrapes.
Why is Proper Positioning Important?
To relieve the pressure on various body parts.
To help the individual see the television.
To help the individual be comfortable
To prevent health problems from being in bed a long time.
To prevent bed sores.
What are the Procedures for Proper Positioning?
Have all necessary assistive equipment ready.
Make sure the individual is safe and comfortable.
Stretch over the individual and use the client’s arm to pull the individual across the bed.
Reposition the individual every two hours.
Take note of redness or irritation on the skin so you can report it if it gets worse.
What are the Proper Procedures for Lifting?
Bend over, grab the individual under the arms and lift.
Stand close to the individual.
Squat and stand to lift a heavy individual.
Figure out on your own how to use a Hoyer lift to lift a heavy individual
Coordinate your movements with the individual’s movements.
To change the direction of the individual’s movement, twist your body, bend over and lower the individual.
Keep your back straight, knees and hips flexed, with weight distributed on both feet.
You should stoop and bend over to lift an individual from the toilet to a wheelchair.
It is okay to use a Hoyer lift without training.
How do you transfer an individual safely?
The individual should be wearing secure fitting shoes or slippers.
The position of the wheelchair is not important as long as the wheels are locked.
The individual’s commode should be next to the bed so the individual can be transferred easier.
When toileting the individual, you should assist the individual to a standing position, help the individual pull down her/his pants, and safely place the individual on the toilet.
If the individual has fallen a few times, you can allow the individual to transfer himself/herself.
7. Medication Policies
What are the proper procedures for helping an individual to take medication?
The PCA may administer medication directly to the individual.
A PCA never gives the individual injections.
The PCA may assist the individual with opening the pill bottle and remind the individual to take the medication as prescribed.
The PCA may take some of the individual’s pills.
The PCA may give the individual medications even though the pills have fallen on the floor.
If you drop the med box, do not give the individual the pills and contact your supervisor.
It is okay for the PCA to crush medicine and put it in applesauce or pudding if the individual doesn’t want to take their pills.
If the medications look different or messed up, you should notify your supervisor after you give the medication to the individual.
Do not give any pills or medicine, like cold medicine, you get from the store.
If the family tells you it’s okay to give the client insulin injections, you should do it.
8. Emergency Procedures
When there is an emergency you should:
Take the individual to the hospital in your own car.
Lift an individual up to a chair after a fall.
Immediately report the incident to your supervisor.
Look for all accessible exits in case there is a fire.
Wait in the emergency room with individuals who have dementia or Alzheimer’s disease until the individual is taken to a room. Clear this with your agency.
Encourage the individual to use his/her walker or cane to prevent falls.
Let the individual navigate around furniture and clutter to get to the bathroom.
Let the individual turn the lights off at night when she/he is walking to the bedroom to go to sleep.
Let the individual try to get up on her/his own after falling. You do not need to report falls when the individual seems to be okay.
9. Reporting Abuse, Neglect, Exploitation and Abandonment
For individuals who are aged 60 and older, you and your agency are legally required to report abuse, neglect, exploitation and abandonment to Protective Services for the Elderly.
You should contact your supervisor immediately if you see or suspect abuse.
You arrive for your shift in the morning and discover that no one has been with the individual since the day before. Since the individual is fine, there is no need to report this.
The individual tells you that his/her grandson has been taking money out of his/her bank account, using the EBT card to buy their own groceries and using the individual’s credit card to shop. Since the client can’t do his/her own banking and shopping, there is no need to report this.
When you arrive for your shift, you see the individual’s neighbor yelling, threatening to hit the individual and shove him/her. This is an example of abuse.
10. Caregiver Boundaries
Which of these are considered good boundaries?
You and the individual give each other gifts for holidays, birthdays and other occasions.
The individual needs some items at the store so you take the debit card to shop during the individual’s nap. You can also buy some items at the grocery store for yourself if the individual says it’s okay.
You should always get a receipt when using the individual’s money to buy things.
It’s okay for your friend to deliver food for you at the individual’s home.
You are an employee in the individual’s home.
If the individual goes to a nursing home, you should visit the individual while you are off duty.
If you can’t find a babysitter and there is no one to replace you, it is okay to bring your children to the individual’s home while you are working.
The individual may be able to help you and give you advice after you discuss your money problems, arguments with your partner or spouse, or your children’s troubling issues.
If you don’t have a car and don’t want to take the bus, you can have your boyfriend/girlfriend take you to work at the individual’s home.
You should never friend the individual on Facebook and never post anything about her/him like pictures or comments, good or bad.
11. Individuals with Acquired Brain Injury
An individual with an acquired brain injury might:
Might not understand what you say.
Remember everything he/she hears you and others say.
Not be able to say what they want to say.
Have mood swings, become anxious, depressed or irritable.
Individuals with acquired brain injury often have very good decision making and problem solving skills, very sound judgment and learning capabilities.
If an individual becomes angry, you should:
Tell the individual he/she needs to calm down and stop talking.
Turn the TV on really loud to distract the individual.
Remain calm and speak softly.
Threaten the individual with negative consequences if he/she doesn’t calm down.
Put the individual in a corner of the room and limit where he/she can move.
Causes of Agitation and Aggression in Individuals with Dementia or Alzheimer’s Disease
Individuals usually get angry for a reason so it is helpful if you can figure out the reason the individual is angry.
If the individual starts getting stressed and frustrated, try to help before the individual gets upset.
Individuals who need PCA services are usually lonely so you should encourage a lot of people to come over and have a lot of loud music in the home to cheer her/him up.
If you are a new PCA just meeting the individual for the first time and they get upset and say mean things to you, it’s just because the individual is unfriendly and grouchy.
The individual may not be able to tell you that he/she is sitting on a wet Depends®, has to go to the bathroom and start getting angry and upset.
Safety in the bathroom is very important.
It is okay to leave the individual alone in the bathtub or shower if you have to answer the phone.
Never have the individual step into the bathtub or shower until you check the water temperature.
You should wash the genital area from back to front.
Do not cut fingernails or toenails.
13. Bathing Individuals with Dementia, Alzheimer’s Disease or Cognitive Deficits
You should give the individual a bath or shower at a different time every day because they get bored with the same daily routine.
Many older Individuals don’t like bathing because they are afraid of being too hot. Make sure the room temperature is cool before you start.
You should report any redness or other skin changes to your supervisor.
If the individual does not want to bathe, talk about something the individual likes or something positive and rewarding and they may change their mind.
Tell the individual what you are doing to keep her/him calm.
14. How to Give a Bed Bath
You do not need to check water temperature since the water is in a basin and it will cool off.
Make sure the individual cannot fall out of bed.
Report any sores or redness to your supervisor.
You should wash the soap off of the individual.
Wash the genital area first.
15. Washing Hair
The individual can wash their own hair if they are able to do it.
If the individual doesn’t ever want their hair washed they don’t have to. This is easier than trying to convince the individual to wash their hair and stressing over it.
You should report any redness, a lot of dandruff or concerns over lice to your supervisor.
Many people don’t like water in their face so you should face the individual away from direct water to the face.
If the individual seems steady in the shower, it is okay to leave and put the dirty clothes in the laundry and fold the clothes from the dryer.
16. How to Wash Hair in Bed
Make sure you have all of the supplies you need before you get started.
You should start pouring water on the individual’s head. Don’t worry about the pillows getting wet.
Try to keep the floor dry by putting a bucket or large bowl on the floor and put a sheet or towel underneath.
If the individual has short hair, instead of pouring water to wet the hair; you can rub a wet washcloth over the hair.
Make sure the room temperature is warm and check the water temperature before starting.
17. Mouth Care
Good mouth care is important for an individual’s general health, to prevent gum disease, cavities, toothaches, pain and other health problems.
Wearing gloves isn’t necessary because you won’t be touching the individual’s mouth.
Brush the teeth really hard to make sure they get clean.
Start brushing at the top and move downward because it moves plaque away from the gums.
Report any redness, bleeding or sores to your supervisor.
18. Mouth Care for Individuals with Dementia, Alzheimer’s Disease or Cognitive Impairment
Smile and explain that you are going to brush their teeth if it’s ok with them.
Tell the individual their teeth are dirty so you have to brush their teeth.
If the individual gets upset, ask what is upsetting her/him about having his/her teeth brushed.
Tell your supervisor if you see redness, sores, bleeding or broken teeth.
If the individual refuses, tell her/him all of the good things about brushing their teeth. If this doesn’t work, try again at another time.
Wash your hands before you begin dressing the individual.
You should set out a lot of different clothes with a variety of shirts, pants, skirts, dresses, suits and ties.
If the clothes won’t come off, you can push and pull them off.
Make sure the individual does not get too tired or dizzy. Help her/him to sit down if they need to.
It is easiest to use simple elastic clothing or clothes with Velcro fasteners.