Specialized Care and Psychosocial Needs
Dementia and confusion
Approach slowly from the front at eye level, use short sentences, and give one instruction at a time. Offer choices instead of quizzes: 'the blue shirt or the red one' rather than 'do you remember?' Do not argue with a delusion or hallucination - acknowledge the feeling and redirect to a safe activity. Wandering is managed with supervision, alarms, and safe walking space, not restraints. For sundowning, maximize daytime light and activity, reduce evening stimulation, and keep routines predictable.
Communication and mental health
With hearing loss, face the resident, speak clearly at normal volume, and do not shout or exaggerate mouth movements; write things down if needed. With aphasia, ask yes-or-no questions, allow time, and do not finish sentences. Depression can look like withdrawal, poor appetite, or sleep changes; report it rather than dismissing it. Any statement of hopelessness or self-harm is reported immediately.
Rehabilitation, dying, and culture
Restorative care means helping residents do what they can and using adaptive equipment as ordered, not doing everything for them. Hospice and palliative care focus on comfort: mouth care, repositioning, pain reports, and presence. During dying, Cheyne-Stokes breathing, mottling, and decreased intake are expected - comfort measures still apply. Provide postmortem care per policy, treating the body with dignity and respecting family and cultural rituals.
Traps and a rule of thumb
Traps: forcefully correcting a confused resident's reality, promising 'you will be fine,' or raising death with a dying resident who has not brought it up. Rule of thumb: go with the feeling, not the fact - acknowledge, then redirect.