CHPNA key terms

A trained nursing assistant who provides personal care and supportive services to hospice patients under the direction of a registered nurse, following the plan of care and reporting changes to the supervising nurse.

A group of professionals from different disciplines, such as nursing, medicine, social work, chaplaincy, and therapy, who collaborate to plan and deliver coordinated hospice care to the patient and family.

A written, individualized set of instructions describing the services and interventions a patient will receive, who provides them, and how often, based on the patient's assessed needs and goals.

The range of duties and tasks a nursing assistant is legally and professionally permitted to perform, defined by state law, employer policy, and training, and which must not be exceeded.

The assignment of a specific task to a nursing assistant by a licensed nurse who retains accountability for the patient's care and who must ensure the task is within the assistant's training and legal scope.

The formal line of authority and communication in a care setting that tells staff whom to notify and in what order when a problem, concern, or emergency arises.

An approach that treats the patient and family as partners in care, respects their values and preferences, and shapes services around their goals rather than around the convenience of the organization.

A planned discussion among the care team, the patient, and family members to share information, clarify goals of care, and make decisions together, often led by a nurse, physician, or social worker.

The outcomes a patient and family most want from treatment, such as comfort, time at home, or prolonging life, which guide decisions about interventions and priorities in hospice.

Fully focusing on a speaker, noticing both words and feelings, and reflecting back understanding without interrupting, judging, or rushing to give advice.

Purposeful conversation that supports a patient's emotional and physical well-being through empathy, respect, honesty, and clear language, while avoiding false reassurance or dismissive responses.

A question that invites a full, descriptive answer rather than a yes or no, such as asking a patient to describe how they are feeling today.

The ability to recognize and respect a patient's cultural values, beliefs, language, and practices and to adapt care so it fits those needs without imposing the caregiver's own customs.

Trained language assistance used when a patient or family has limited proficiency in the dominant language, ensuring accurate communication rather than relying on untrained family members or staff.

A person's ability to obtain and understand basic health information needed to make care decisions, which affects how instructions and education should be given and checked for understanding.

Routine self-care tasks such as bathing, dressing, grooming, eating, toileting, and transferring that a nursing assistant supports when a patient cannot fully perform them independently.

Hands-on assistance with hygiene and appearance, including bathing, oral care, hair care, nail care, and dressing, delivered in a way that preserves dignity, privacy, and the patient's preferences.

Cleaning of the genital and anal area, performed front to back with proper technique and gloves, to prevent skin irritation and infection, especially after toileting or incontinence.

The inhalation of food, liquid, saliva, or vomit into the airway, which can cause choking or pneumonia and is a risk for patients with swallowing difficulty or who are fed while lying flat.

Difficulty swallowing that can lead to coughing, choking, or aspiration, often requiring changes in food texture, liquid thickness, and positioning during meals.

Measures that reduce the risk of food or liquid entering the airway, such as sitting the patient upright, offering small bites, slowing the pace, and stopping if coughing or choking occurs.

Localized damage to skin and underlying tissue caused by prolonged pressure, friction, or shear, commonly over bony areas such as the sacrum, heels, and hips, and largely preventable with repositioning and skin care.

Regularly changing a patient's body position, often at least every two hours, to relieve pressure on vulnerable skin areas and maintain comfort and circulation.

Moving a joint through its normal available movement, either actively by the patient or passively by the caregiver, to maintain flexibility and reduce stiffness and contractures.

A permanent shortening and tightening of muscle or tendon that limits joint movement, often prevented by regular range-of-motion exercise and careful positioning.

A standardized tool that rates risk factors such as mobility, moisture, and nutrition to estimate a patient's likelihood of developing a pressure injury and guide prevention planning.

Systematically asking the patient about pain location, quality, intensity, timing, and what relieves it, using scales or simple questions and documenting the response to interventions.

The concept that suffering includes physical, emotional, social, and spiritual dimensions, so effective comfort care addresses all of these sources rather than only physical discomfort.

Comfort techniques that do not involve drugs, such as repositioning, gentle massage, warm or cool compresses, oral care, music, and quiet presence, used alongside medication as appropriate.

Suffering related to questions of meaning, purpose, faith, or connection, which may appear as fear, anger, or withdrawal and is addressed through presence, listening, and referral to a chaplain.

The sadness, worry, and mourning a patient or family experiences before an expected death, which is a normal response that can be eased by listening and honest communication.

The natural emotional, physical, and social response to loss that varies widely among people and may include sadness, anger, guilt, numbness, or relief, without a fixed timeline.

Ongoing services offered to family and loved ones after a death, such as follow-up calls, counseling, and support groups, to help them adjust to their loss.

Physical changes near the end of life such as decreased appetite, increased sleep, cool mottled skin, irregular breathing, and reduced urine output, which are expected and are explained to families as normal.

A breathing pattern of gradually deeper and faster breaths followed by shallow breaths or pauses, common near death and usually not distressing to the patient though often alarming to families.

Respectful care of the body after death, including positioning, washing as needed, closing the eyes, and preparing the person and room for family viewing according to policy and cultural wishes.

Infection control practices applied to every patient, including hand hygiene, gloves, gowns, and safe handling of body fluids, based on the assumption that any blood or fluid may be infectious.

Cleaning hands with soap and water or alcohol-based rub at key moments such as before and after patient contact, after body fluid exposure, and before and after glove use, to prevent infection spread.

Barrier items such as gloves, gowns, masks, and eye protection worn to protect the caregiver and patient from contact with infectious materials and body fluids.

The timely, factual, and objective written record of care provided, patient responses, and changes observed, which supports communication, continuity, and legal accountability.

Recording observable facts such as vital signs, intake and output, and direct quotes rather than opinions or judgments, so the record is accurate and useful to the care team.

A confidential internal record completed when an unexpected event such as a fall or injury occurs, used to improve safety and not placed in the patient's medical record.

A legal document in which a person states preferences for future medical care or names someone to decide if they cannot speak for themselves, guiding care near the end of life.

The legally protected entitlements of people receiving care, including privacy, dignity, choice, freedom from abuse and neglect, and access to information about their care and treatment.

The legal duty of care staff to report suspected abuse, neglect, or exploitation of a patient to the appropriate authority, following employer policy and state law.

Deliberate practices a caregiver uses to protect their own physical and emotional health, such as rest, boundaries, peer support, and debriefing, which help prevent burnout and protect patient care.

Emotional and physical exhaustion that develops from repeatedly caring for suffering people, showing as irritability, detachment, or reduced empathy, and eased by support and self-care.

A state of chronic work-related exhaustion, cynicism, and reduced sense of accomplishment that builds over time and can affect judgment and quality of care.