Define the following terms:

1. Define the following terms: • Long-term care • care for persons who require 24-hour care and assistance. • Length of stay • the number of days a person stays in a healthcare facility. • Terminal illness • a disease or condition that will eventually cause death. • Chronic • refers to the fact that a disease or condition is long-term or long-lasting. • Diagnosis • physician’s determination of an illness.

2. Define the following terms: • Home health care • care provided in a person’s home. • Assisted living • facilities where residents live who need some assistance; they do not usually require skilled care. • Adult daycare • care given at a facility during daytime hours; generally for people who need some help but are not seriously ill or disabled. • Acute care • care performed in hospitals and ambulatory surgical centers. • Skilled care • medically necessary care given by a skilled nurse or therapist.

3. Define the following terms: • Subacute care • care performed in either a hospital or a traditional nursing home. • Outpatient care • care usually provided for less than 24 hours for persons who have had treatments or surgery requiring short-term skilled care. • Rehabilitation • managed by professionals to restore a person to the highest possible level of functioning after an illness or injury. • Hospice care • care for individuals who have six months or less to live; provides physical and emotional care and comfort.

4. 1. Compare long-term care to other healthcare settings • Discuss the different healthcare settings. Briefly emphasize aspects of long-term care, including: • Reasons why people live in LTC facilities • Common conditions in LTC • The fact that LTC facilities are residents’ homes

5. Define the following terms: • activities of daily living (ADLs) • personal dailycare tasks, such as bathing, dressing, caring for teeth and hair, toileting, eating and drinking,walking, and transferring. • culture change • a term given to the process of transforming services for elders so that they are based on the values and practices of the person receiving care; core values include choice, dignity, respect, self-determination, and purposeful living.

6. 2. Describe a typical long-term care facility • The following services are commonly provided at LTCFs: • Assistance with personal care • Physical, occupational, and speech therapy • Wound care • Care of different types of tubes and catheters (a thin tube inserted into the body that is used to drain fluids or inject fluids) • Nutrition therapy • Management of chronic diseases

7. 2. Describe a typical long-term care facility • REMEMBER: • There different models of LTC facilities. Some may include dementia or assisted living wings.

8. 2. Describe a typical long-term care facility • Think about this question: • Why do you think care might be changing to reflect the residents’ individual psychosocial needs?

9. Define the following terms: • Medicare • a federal health insurance program for people who are 65 or older, are disabled, or are ill and cannot work. • Medicaid • a medical assistance program for low-income people.

10. 3. Explain Medicare and Medicaid • Define Medicare and Medicaid.

11. Transparency 1-1: Facts About Medicare • For 65 or older or disabilities and illnesses • Part A pays hospitals, skilled nursing facilities, hospice care, and some home health care. • Part B pays doctors’ services and other medical services and equipment. • Part C allows private health insurance companies to provide Medicare benefits. • Part D helps pay for medications prescribed for treatment.

12. 3. Explain Medicare and Medicaid • Remember these facts about Medicaid: • Medicaid is funded by the federal government and each state • Eligibility for long-term care coverage under Medicaid is determined by income and special circumstances • People must qualify • Under Medicare and Medicaid • Long-term care facilities are paid a fixed amount for services • Services based on the resident’s needs upon admission

13. Define the following terms: • Charting • writing down important information and observations about residents.

14. 4. Describe the role of the nursing assistant • How can NAs provide services for residents? • Performing assigned nursing tasks • Providing personal care or assisting with self-care

15. 4. Describe the role of the nursing assistant • Think about these questions: • Which tasks do NAs typically perform? • Are there tasks NAs do not perform? What are they?

16. 4. Describe the role of the nursing assistant • What are some typical NA duties? • Feeding residents • Helping with toileting and elimination • Assisting with mobility • Keeping living areas neat and clean • Encouraging residents to eat and drink • Caring for supplies and equipment • Helping residents dress • Making beds • Giving back rubs • Helping with mouth care

17. 4. Describe the role of the nursing assistant • There are some tasks that NAs are generally not allowed to do: • Giving medications • Inserting or removing tubes • Changing sterile dressings • Giving tube feedings • REMEMBER: • NAs are the “eyes and ears” of the healthcare team.

18. Define the following terms: • Care plan • a plan developed for each resident to achieve certain goals; it outlines the steps and tasks that the care team must perform.

19. 5. Describe the care team and the chain of command • Think about these questions: • What is the purpose of the care plan? • How and why is each care plan different?

20. 5. Describe the care team and the chain of command • REMEMBER: • Activities not listed on the care plan must not be performed.

21. 5. Describe the care team and the chain of command • What are the roles of each of the following team members? • Nursing Assistant • Registered Nurse • Licensed Practical Nurse/Licensed Vocational Nurse • Physician or Doctor • Physical Therapist • Occupational Therapist • Speech Language Pathologist • Registered Dietitian • Medical Social Worker • Activities Director • Resident and Resident’s Family

22. Define the following terms: • Chain of command • the line of authority in a facility that helps make sure that residents get proper health care. • Liability • a legal term that means someone can be held responsible for harming someone else. • Scope of practice • defines the things that healthcare providers are legally allowed to do and how to do them correctly.

23. Transparency 1-2: Chain of Command

24. 5. Describe the care team and the chain of command • REMEMBER: • Some tasks are never performed by NAs. • NAs must never honor a request to do something outside their scope of practice; such requests must be reported to the nurse.

25. Define the following terms: • Policy • a course of action that should be taken every time a certain situation occurs. • Procedure • a method, or way, of doing something.

26. 6. Define policies, procedures, and professionalism • These are common policies and procedures in facilities: • All resident information is confidential. • Resident’s care plan must be followed. • NAs only perform tasks in job descriptions. • NAs report changes/observations to nurse. • Personal problems must not be discussed with residents or families. • Gifts and money cannot be accepted from residents or families. • NAs must be dependable.

27. 6. Define policies, procedures, and professionalism • REMEMBER: • Ask questions or review your facility’s procedure manual when you are unsure about care. • If you do not understand a policy at your facility, ask questions until you do understand.

28. 6. Define policies, procedures, and professionalism • NAs can maintain professional relationships with residents by • Being positive • Doing only assigned tasks • Keeping resident information confidential • Being polite and cheerful • Never discussing personal problems • Not using profanity • Listening • Calling resident by proper name • Explaining care • Following care practices

29. 6. Define policies, procedures, and professionalism • NAs can maintain professional relationships with employers by • Completing duties • Following policies/procedures • Documenting and reporting care • Communicating problems • Asking questions • Taking directions and criticism • Being clean and neatly dressed and groomed • Being on time • Notifying if absent • Following chain of command • Participating in education programs • Being a role model for the facility

30. Transparency 1-3: Qualities of Great Nursing Assistants Nursing assistants must be • Compassionate • Honest • Tactful • Conscientious • Dependable • Respectful • Unprejudiced • Tolerant

31. 6. Define policies, procedures, and professionalism • Think about this question: • Can you think of examples of how each quality of a great nursing assistant pertains to care of residents?

32. Define the following terms: • Ethics • the knowledge of right and wrong. • Laws • rules set by the government to help people live peacefully together and to ensure order and safety.

33. 7. List examples of legal and ethical behavior and explain Residents’ Rights • Remember these guidelines for legal and ethical behavior: • Be honest at all times. • Protect residents’ privacy. • Keep staff information confidential. • Report abuse or suspected abuse of residents, and assist residents in reporting abuse if they wish to do so. • Follow the care plan and your assignments.

34. 7. List examples of legal and ethical behavior and explain Residents’ Rights • Remember these guidelines for legal and ethical behavior (cont’d.): • Do not perform any task outside your scope of practice. • Report all resident observations and incidents to the nurse. • Document accurately and promptly. • Follow rules on safety and infection control (outlined in Chapter 2). • Do not accept gifts or tips. • Do not get personally or sexually involved with residents or their family members or friends.

35. 7. List examples of legal and ethical behavior and explain Residents’ Rights • Think about this question: • What each of these guidelines mean for your behavior on the job?

36. Define the following terms: • Omnibus Budget Reconciliation Act (OBRA) • law passed by the federal government that includes minimum standards for nursing assistant training, staffing requirements, resident assessment instructions, and information on rights for residents. • Cite • in a long-term care facility, to find a problem through a survey.

37. Define the following terms: • Residents’ Rights • numerous rights identified in OBRA that relate to how residents must be treated while living in a facility; they provide an ethical code of conduct for healthcare workers. • Informed consent • the process in which a person, with the help of his doctor, makes informed decisions about health care.

38. 7. List examples of legal and ethical behavior and explain Residents’ Rights • Remember these important points about OBRA: • Sets minimum standards for NA training • Requires regular in-services for NAs • Establishes state registry of NAs • Includes increased minimum staff requirements • Sets resident assessment requirements (MDS) • Includes changes in survey process • Establishes Residents’ Rights

39. Transparency 1-4: Residents’ Rights Residents have a right to • Quality of life • Services and activities to maintain a high level of wellness • Be fully informed regarding rights and services • Participate in their own care • Make independent choices • Privacy and confidentiality • Dignity, respect, and freedom • Security of possessions • Be informed of and consent to transfers and discharges • Voice complaints • Have visits

40. 7. List examples of legal and ethical behavior and explain Residents’ Rights • Think about this question: • Look at the bulleted list on page 11 of your textbook. Can you think of other ways NAs can protect residents’ rights?

41. Handout 1-1: Decision Quiz Choices I have made today include 1. 2. 3. 4. 5. 6.

42. 7. List examples of legal and ethical behavior and explain Residents’ Rights • REMEMBER: • Everyday decisions may not seem that important because you are able to make them.

43. 7. List examples of legal and ethical behavior and explain Residents’ Rights • Think about these questions: • What if you were not able to make all of your own choices? • Why do you want to make your own decisions?

44. 7. List examples of legal and ethical behavior and explain Residents’ Rights • REMEMBER: • Making decisions about our own lives is a very important part of being an adult. Residents’ Rights guarantee that residents can continue to make many decisions about their own lives.

45. Define the following terms: • Neglect • harming a person physically, mentally, or emotionally by failing to provide needed care. • Active neglect • purposely harming a person by failing to provide needed care. • Passive neglect • unintentionally harming a person physically, mentally, or emotionally by failing to provide needed care. • Negligence • actions, or the failure to act or provide the proper care, that result in unintended injury to a person.

46. Define the following terms: • Malpractice • injury to a person due to professional misconduct through negligence, carelessness, or lack of skill. • Abuse • purposely causing physical, mental, or emotional pain or injury to someone. • Physical abuse • any treatment, intentional or not, that causes harm to a person’s body; includes slapping, bruising, cutting, burning,physically restraining, pushing, shoving, or rough handling.

47. Define the following terms: • Psychological abuse • any behavior that causes a person to feel threatened, fearful, intimidated, or humiliated in any way. • Verbal abuse • the use of language—spoken or written—that threatens, embarrasses, or insults a person. • Assault • the act of threatening to touch a person without his or her permission. • Battery • touching a person without his or her permission.

48. Define the following terms: • Sexual abuse • forcing a person to perform or participate in sexual acts against his or her will; includes unwanted touching, exposing oneself, and sharing pornographic material. • Financial abuse • the act of stealing, taking advantage of, or improperly using the money, property, or other assets of another person. • Domestic violence • physical, sexual, or emotional abuse by spouses, intimate partners, or family members. • Workplace violence • verbal, physical, or sexual abuse of staff by residents or other staff members.

49. Define the following terms: • Involuntary seclusion • separating a person from others against the person’s will. • Sexual harrassment • any unwelcome sexual advance or behavior that creates an intimidating, hostile, or offensive working environment; includes requests for sexual favors, unwanted touching, and other acts of a sexual nature. • Substance abuse • the use of legal or illegal drugs, cigarettes, or alcohol in a way that is harmful to the abuser or to others.

50. Transparency 1-5: Suspicious Injuries