CHHA common mistakes
CHHA · Understand the traps and how to avoid them.
Answering personal-care questions by describing what the aide prefers or what is fastest (e.g., 'give the bath in the morning because it fits my schedule') instead of describing the client's stated preference and usual routine.
Candidates study routines as tasks to complete rather than as services built around the client, and under time pressure they default to the most efficient sequence they know.
What to do instead
Before answering any ADL item, ask yourself 'whose preference decides this?' Eliminate any option that centers the aide's convenience or an arbitrary schedule, and choose the option that preserves the client's usual routine, dignity, and stated choice.
In safety and emergency items, choosing to 'finish the task first' or 'call the supervisor before acting' when a client is choking, falling, bleeding, or has stopped breathing.
Candidates conflate the aide's reporting duty with a duty to get permission, and they have memorized 'report to supervisor' as a universally correct phrase.
What to do instead
Sort every emergency item into two buckets: immediate life-saving action (activate EMS, obstructed-airway maneuvers, stop the fall, do not move an injured client) versus notification (supervisor, family, agency) that always comes after the client is safe. Reporting never precedes rescue.
Skipping or shortening hand hygiene and glove changes in scenario questions, for example wearing the same gloves from perineal care to the client's face, or using hand sanitizer after contact with C. difficile diarrhea or visible soil.
Candidates memorize 'wear gloves' as the whole answer and do not track the sequence of contamination across a described task.
What to do instead
Practice tracing a scenario in order and name the hand-hygiene moment at each transition: before client contact, before a clean/aseptic task, after body-fluid exposure, after client contact. Remember soap and water is required for visibly soiled hands and for C. difficile or norovirus, and gloves never replace handwashing.
Recording subjective judgments and conclusions in the record ('client seems depressed,' 'client was difficult,' 'ate well') rather than objective, measurable observations ('ate 50% of lunch,' 'refused to speak during care, looked at floor').
Charting is taught as a summary of the visit, and candidates write the way they would talk to a coworker.
What to do instead
Before selecting a documentation answer, test each option: can another aide see, count, or measure this? Eliminate words that interpret mood, attitude, or effort. Report changes to the nurse, and never alter, erase, or back-date an entry - correct with a single line, initials, and date.
Using yes/no or closed questions with a client who is anxious, confused, or upset, or answering for the client, instead of using open-ended prompts and active listening.
Candidates focus on getting the task done and treating the exchange as information-gathering rather than relationship-building.
What to do instead
Choose responses that reflect back what the client said, sit at eye level, allow silence, and ask open questions ('tell me more about that'). Eliminate options that argue, correct, minimize ('don't worry'), or rush the client.
Serving a full tray or pushing fluids with a client who has dysphagia, is on thickened liquids, or must sit upright, and positioning the client lying back or rushed during the meal.
Candidates treat feeding as 'get calories in' and underestimate how positioning and texture are the actual choking-prevention measures.
What to do instead
For every nutrition item, first check the prescribed diet texture and liquid consistency and the required upright position (typically 90 degrees, and remain upright after the meal). Never add thickener, change texture, or substitute foods on your own; report poor intake or coughing/wet voice to the nurse.
Sharing client information in casual conversation - with a neighbor, in a hallway, on social media, or with a family member who is not authorized - or discussing a client by name in a public space.
Candidates think confidentiality only means 'don't open the chart' and do not recognize informal disclosure as a breach.
What to do instead
Use the rule: information about a client goes only to people who need it to provide care, through the proper channels. Identify the single option in each item that limits disclosure to the care team, and treat any answer involving social media, curiosity, or 'just family' as wrong.
Arguing with, correcting, or physically restraining a client with dementia who is repeating a question, refusing care, or insisting on a false belief; or trying to reorient the client to reality repeatedly.
Candidates apply logic and reality-testing to behavior that is driven by brain change, and they interpret refusal as a behavior problem rather than a communication.
What to do instead
Choose redirection, validation, and reassurance: acknowledge the feeling, offer a simple distraction or a different activity, and return to the task later. Never argue, quiz the client on facts, or use physical force; safety comes first, then attempt the task again.
Treating normal aging changes as disease, or disease symptoms as normal aging - for example dismissing new confusion, sudden incontinence, or a change in gait as 'just getting old.'
Candidates memorize lists of age-related changes but cannot apply the distinction in a scenario, and they assume decline is inevitable.
What to do instead
Anchor on sudden change: new or abrupt confusion, falls, incontinence, appetite loss, or behavior change is a reportable health change, not aging. Normal aging is gradual and does not include delirium, fever, or acute pain. When in doubt, choose report to the nurse.
Taking on tasks outside the aide's scope or role - adjusting a medication dose, changing a sterile dressing, giving a PRN med, or canceling a scheduled visit without notifying anyone - because 'the family asked' or 'no one else was available.'
Candidates want to be helpful and are flattered by being trusted, and they have not internalized that scope of practice is a legal boundary, not a personality trait.
What to do instead
Memorize the boundary set: aides perform personal care and delegated tasks, observe and report; they do not assess, teach, medicate, or change care plans. Practice the script 'I'm not able to do that, but I will call the nurse right now,' and choose that option even when it feels unhelpful.