Psychosocial Care Skills
Core concepts
Psychosocial questions test whether you treat the resident as a person with a history, preferences, and rights. Use person-first language, knock, introduce yourself, and speak to the resident rather than about them to family members. With hearing loss, face the resident, get their attention, and lower your voice pitch; shouting distorts sound. With aphasia, ask yes-or-no questions, allow silence, and never finish their sentences.
Dementia care rewards redirection over correction. Do not argue about facts; validate the feeling, then redirect to a safe activity. Look for sundowning and for unmet needs - pain, toileting, hunger, noise, fear - behind agitation.
Know resident rights: privacy, dignity, choice, refusal, confidentiality, visitors, personal possessions, freedom from abuse and restraints, and access to the ombudsman. Restraints require a physician's order, must be the least restrictive option, and require regular release, repositioning, and circulation checks per facility policy.
When a resident refuses care, respect the refusal, document it, report it, and try again later. Never force care.
Grief is not linear; the stages - denial, anger, bargaining, depression, acceptance - may repeat or be skipped. For a dying resident, provide mouth care and repositioning, do not force food or fluids, and keep talking normally, since hearing is thought to persist.
Trap: questions about an angry or crying resident want empathy, safety, and reporting - not a lecture or a threat. Never discuss a resident in hallways, elevators, or on social media.
Rule of thumb: behavior is communication - find the unmet need before responding to the behavior.