How a CNA Influences the Hopes & Wishes of a Dying Patient

Perhaps one of the most difficult situations any CNA will be faced with is dealing with a dying patient. Whether you work in a nursing home facility or a general hospital, death is a part of the medical industry. Therefore, in order to be the best certified nursing assistant ( you can be, you must narrow your focus on how to handle the physical and emotional difficulties of this already difficult and challenging situation. While there are many ways to accomplish this goal, you must hold a full understanding of the most common hopes and wishes of a dying patient.

The Most Common Hopes and Wishes of a Dying Patient

The following is a list of the most common hopes and wishes of a dying person. Study this list and think of creative and effective ways to accomplish the goals listed within the words.

  • To remain clean and sanitary
  • To name a person who makes major decisions
  • To feel comfortable with their physicians, nurses and all other health care members
  • To have a calm and understanding ear to listen to their needs
  • To maintain the highest sense of dignity as possible
  • To maintain the highest level of trust among their caregivers
  • To be as pain-free as possible
  • To not experience shortness of breath
  • To eliminate anxiety
  • To discuss their fears with their physicians and nursing staff
  • To resolve an ever-growing list of unfinished business
  • To experience kind, human touch
  • To know their medical staff is comfortable with their own death
  • To share time with friends and loved ones
  • To feel prepared for death, in whatever fashion that may be
  • To have their family wish them, if possible
  • To have their life accomplishments recognized and appreciated
  • To receive regular care regardless of the terminal diagnosis

Of course, the aforementioned is only a small portion of the most common hopes and wishes of a dying patient. If you’re assigned to a dying patient, it’s important to understand these wishes and do your best to support them. Obviously, the most effective way to deal with a dying patient is to be calm, present and caring. For more tips on caring for dying people visit the National Institute on Aging.


CNA Tips for Alzheimer’s Disease – How to Handle Sundowning

According to data outlined by the Alzheimer’s Association, nearly 20 percent of Alzheimer’s patients experience a mystifying condition known as sundowning. Characterized as a shift in emotional and physical states as the sun begins to set, researchers and physicians do not know the true cause of this condition. If you chose to work in a nursing home or with elderly dementia patients, then you must learn how to effectively handle this rapid shift in moods, which include: delusions, hallucinations, insecurity, suspicion, disorientation, confusion and anxiety, just to name a few.

Effectively Dealing with Sundowning

As late afternoon approaches, you may notice your patient becoming more and more restless. This mild anxiety may swiftly switch into confusion, suspicion or disorientation. As the day progresses, a person with Alzheimer’s Disease may become tired or be less able to handle distractions, either real or imaginary. This inability to control themselves means they have a difficult time coping with natural processes around them. Instead of communicating this altering mental state, patients often exhibit strange and intense symptoms.

It’s important to realize that when an Alzheimer’s patient begins to showcase symptoms of Sundowning they may actually be behaving in such a way because they have a need they’re unable to express. A sudden outburst of anxiety or anger may be their way of letting you know they need to use the bathroom or they’re hungry. On the other hand, these outbursts may be an emotional need of needing a loved one who is no longer with them, such as a deceased spouse. Therefore, as a CNA you must actively work to determine what the Alzheimer’s patient truly needs.

Once you determine that the patient does not have a physical need, it’s time to delve deeper. Look for other clues that may reveal what her emotional need could be. Is the patient afraid of the dark? Are they worried about a situation that is not actually real, but to them, is quite real? Identifying the source of their aggravation or alteration is not easy; however, these patients behave like anyone else ñ they use nonverbal communication methods in an attempt to clarify their actual need; whether or not the need is based in reality.

Some of the most effective ways to handle a patient who is sundowning is to keep bedtime the same every evening. In many cases, developing a stable routine at the same time of day, or night, is an effective way to eliminate the severity of this mysterious condition. One of the most important things to remember is this patient is not behaving in such a way on purpose or to make your job difficult. Rather, the patient is trying to communicate a real need, desire or fear. By taking time to understand this and to learn your patient you can create effective remedies to reduce the severity and ensure the safety of your patient.

You should learn about this and other conditions related to Alzheimer’s in your CNA certification training. To find CNA training near you visit

How to Help Agitated and Confused Dementia Patients

Working with the elderly can be a rewarding experience for any certified nursing assistant. While dealing with these patients requires a unique training and skill-set, the benefits of assisting those who are in their later years of life provides thousands of CNAs with a sense of accomplishment that’s unlike any other profession. If you’re interested in working with elderly patients, then you must become well-versed in dealing with dementia patients and the symptoms of this degenerative disease. As the patient delves deeper into dementia it’s not uncommon for them to begin experiencing agitation and confusion. Throughout your training and work as a certified nursing assistant (CNACertificationScoop), it’s essential that you work on ways to help relieve this agitation and confusion while not sacrificing the quality of patient care.

The Most Effective Ways to Help Dementia Patients

The following tips are used by professional CNAs throughout the country and are recommended by health care organizations and websites like this one.

  • Environmental Focus – As a certified nursing assistant you must place your focus on creating a stress-free and restful environment for your patients. One of the most effective ways of creating such an environment is through good communication skills. Dementia patients who are unable to clearly use verbal communication methods will likely turn to nonverbal communication to explain their desires and dislikes. Therefore, you must become well-versed in communicating by reading the body language and behavior of patients.
  • Increase Kindness – Patients with severe dementia and other cognitive impairments have been shown to respond much better to those who treat them with a gentle, sensitive quality. As a certified nursing assistant, you can enhance the quality of your care by letting the patients know you actually care for them and are trying to understand them. Repeat this as many times to the patients as necessary so they understand you are a friend and not a foe.
  • Increase Quiet Time – Many times, those with dementia are sensitive to loud noises. When a bang or loud conversations are heard, these patients may become agitated and angry. To eliminate this agitation and confusion, it’s imperative that you eliminate as much excess noise as possible. When speaking to patients, do so in a quiet and soft voice. Play their favorite music on a low volume to help entertain them while drowning out other noises they may find frightful.
  • Increase Calmness – As we all can attest, when you have a calm disposition it’s difficult to become agitated or confused. However, most dementia patients have a difficult time maintaining this necessary mental state of calmness. Therefore, you must actively work to promote relaxation and calmness by encouraging patients to sit int their favorite chair, providing them something soft to hold or playing a favorite song. Sometimes, simply speaking to the patient in a calm and relaxing voice is enough to increase their level of calm, which may help avoid moments of agitation or confusion.