9.3 Mental Health, Grief, and End-of-Life Care
Key Takeaways
- Mental health care includes listening, observing, supporting routine, and reporting changes.
- Depression is not a normal part of aging and should be reported.
- Statements about self-harm require immediate reporting.
- End-of-life care emphasizes comfort, dignity, mouth care, positioning, family support, and reporting symptoms.
- CNAs should respect cultural, spiritual, and personal differences around illness and death.
Mental Health Observation
CNAs often notice changes before anyone else. Report mood and behavior changes that affect safety, nutrition, sleep, hygiene, or participation.
Report:
- Withdrawal from usual activities.
- Crying or hopeless statements.
- Refusal to eat or drink.
- New agitation.
- Sleep changes.
- Statements about wanting to die.
- Hallucinations or paranoia.
- Sudden confusion.
Depression
Depression is not normal aging. A sad mood after loss may be grief, but persistent hopelessness, poor appetite, isolation, and loss of interest should be reported.
Do not tell a resident to "cheer up." Listen respectfully and report concerns.
Anxiety And Fear
An anxious resident may need reassurance, clear explanations, quiet environment, and predictable routine. If anxiety includes chest pain, shortness of breath, or severe distress, report immediately.
Grief
Residents may grieve death, loss of home, loss of independence, or illness. Let the resident talk. Do not minimize feelings.
End-of-Life Care
CNA care may include:
- Mouth care.
- Repositioning.
- Skin care.
- Keeping linens dry.
- Offering presence.
- Reporting pain, breathing changes, or agitation.
- Supporting privacy for family visits.
Exam Tip
The CNA does not diagnose mental illness or give counseling beyond role. The CNA listens, supports, observes, and reports.
A resident says, "I wish I would not wake up tomorrow." What should the CNA do?
Which action supports end-of-life comfort within CNA role?