Providing Specialized Care for Residents with Changes in Health
Your most important skill: noticing change
Residents change quickly. Your job is to recognize, report to the licensed nurse, and document - not to diagnose. Report objectively: “Resident coughed with every sip of water at lunch,” not “Resident has pneumonia.”
Common conditions
Diabetes: report shakiness, sweating, confusion, or hunger (possible low blood sugar) and excessive thirst or urination. COPD and oxygen: watch for increased shortness of breath and never adjust the flow rate. Heart failure: report weight gain, swollen ankles, and shortness of breath when lying flat. Stroke: expect one-sided weakness, trouble swallowing, and speech problems; support the weak side and follow swallowing precautions. Dementia: use short sentences, one instruction at a time, redirection rather than argument, and a calm routine; wandering and sundowning need safety measures, not restraints.
Rehabilitation, hospice, and mental health
Rehabilitation aims to restore function; follow the therapy plan even when progress is slow. Hospice focuses on comfort: reduced eating and drinking near the end of life is expected, so offer but never force. Depression and anxiety may look like withdrawal or anger - report changes in mood and behavior.
Emergencies
For choking, follow your training and the care plan. For a seizure, protect the head, clear the area, do not restrain the resident or put anything in the mouth, and time the seizure. For unresponsiveness, call for help, start CPR per your training and facility policy, and get the AED.
Rule of thumb. See it, say it, write it: any change goes to the nurse right away.