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Interview with Certified Nursing Assistant

"I wish that she could see that her body is not her. Her nails – her hair is not her. She is something deeper."

Photo of Alex Alea
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     I had the pleasure of sitting down with Lynette, age 45, who became a Certified Nursing Assistant (CNA) in 2010.  Since then, she has worked in nursing homes, assisted living homes, and now serves as an in-home caretaker for my great-grandmother, age 93.  We spoke about CNA training, her experiences in homes, assistive products, and how her faith has enabled her to become a more patient and compassionate caretaker.  Here are a few of her insights:

  • Much of the fall danger is due to sensory deterioration: visual impairment and loss of hearing and vestibular senses. Some medications can exasperate these problems and induce dizziness.
  • After a fall, even if they recover, the fear of falling again causes them to become less active, thus further aggravating the problems that caused the first fall.
    • Often times, her patient can only get up from a chair if her hands are there (not even doing any lifting)
  • Many falls (especially those with hip and head injuries) result in a trip to the hospital, then to likely permanent care in a nursing home.
  • Into the minds of the elderly:
    • Don’t think it will happen to them
    • Their bodies are tired
    • Calmed by routine
    • Fearful of falling again
    • Feel their decisions are being made for them
    • Controlled
    • Burdensome
    • “It’s pain – it’s pride.”
  • In her home country of Nicaragua, she cared for her grandmother till she passed. This was a common responsibility for children, often not even being considered a chore/burden.  In the U.S. she’s noticed there is more distance between families and generations; she often never meets her patients’ families even after years.
  • Into the minds of the CNA’s:
    • Homes are often understaffed
    • Nurses are often overworked and underpaid
    • Some “bring their problems to the job”
    • Training helps but you learn the majority of the skills from experience
  • Many of the current assistive products (canes, walkers) make her patients think “I’m done, I’m dying.”

     Throughout the interview, Lynette mentioned methods she uses to reduce fall risk for her patients, as well as suggested tactics other parties could adopt:

  • A physical therapist or medical provider could assess their fall risk BEFORE the first fall.
  • Arrange their environment in a safer way:
    • Install handles in bathrooms, seats in tubs, higher toilets, non-slip surfaces
    • Clear clutter
    • Keep things in consistent places, form routines
    • Add lighting marking safe paths
  • Physical therapies to increase balance and mobility
  • Keeping the mind sharp
  • Bring them to a nursing home just to see and maybe talk to patients about what can happen
  • A booklet sent to sons/daughters of elderly with information
  • CNA training should involve more classes in empathy and compassion:
    • Compassion, empathy were never a focus
    • The physical things (bathing, transport) are important, but really are just learned on the job
    • If you can become aware of it more (compassion, empathy), it will develop independently
    • Perhaps CNA’s could be sent on a spiritual retreat to learn these

     Lynette really emphasized the importance of preventing the first fall in order to prevent debilitating injury, hospitalization, and psychological damage.  Preventing the first fall will likely be an educational challenge; people transitioning into a vulnerable age need to be aware and accepting of the help that is available to them.  All too often it is a fall that brings this awareness, and care for the individual after the fall proves a substantially more difficult task; a proactive and preventative approach would serve better to assist the individual.

What is a provocation or insight that might inspire others during this challenge?

How can we effectively instill this knowledge in aging individuals in a respectful and uplifting way?

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Photo of Kate Rushton

Hi Alex!

Great post! It is good to see you in the challenge and I hope you will be around for the ideas phase. I wonder what the spiritual retreats and booklet would look like. What would an ideal pre-fall fall prevention assessment include?

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