How does a certified nursing assistant build trust with a patient? By knowing what to look for. By actively listening. And maybe by getting a little help from Frank Sinatra.
That’s how HopeHealth Hospice Aide Audrey Thomas, CNA, has earned high marks for her work delivering excellent hands-on care, comfort and stability to her hospice patients. To mark the start of National Nursing Assistants Week on June 17, Audrey shares her expertise and wisdom with HopeHealth brand journalist Janine Weisman.
HopeHealth: Interpersonal communication skills are so important in your work. What techniques do you use to build rapport with your patients?
I talk to my patients as much as I can. I find things we have in common and build on that. And with nonverbal patients, I communicate in other ways. I look them in the eyes. With a smile I say, “Hi, my name is Audrey. How are you doing today?” I may get a smile back. Then I explain what I’m going to do. I use body gestures, like showing the motion of brushing teeth so they know what we’re going to do. We do it together, hand over hand. It makes it all click for them.
What is your own philosophy for providing care for patients at end of life?
I assure them that I’ve been doing this so long I feel like I’m giving a hug instead of doing what I’m doing. People say, “Why do you want to do this type of care?” I say, “This is me showing how much I appreciate you for what you’ve been doing for other people for all these years and now that you can’t, I am getting that privilege to share my love with you.”
You’re going to make me cry.
It puts them in a different place. You work with them and while you’re talking, it breaks the ice. You keep them interacting with you and they participate in their care. It offers dignity.
How do you connect with a patient who has with dementia?
I had one patient who said, “I don’t know you. Why are you here?” My first two visits, I needed to establish a connection. I hummed and she hummed. I turned my head and she turned her head, I tapped my feet and she tapped her feet. She started mimicking what I was doing. Next day, I went back, stretched out my hand for a handshake and she volunteered her hand. I said, “Can we take a walk?” Then we gradually took it from there.
“Frank is very popular. Everybody knows Frank. Frank or Elvis Presley. Those are my guys.”
What else might you do to keep a patient engaged in their care?
I have a patient who loves Frank Sinatra. I walk in with my phone blazing Frank Sinatra. I take her hand and I dance my way right to the bathroom. And I do a silly motion to let them know what task we’re going to do together. That works.
What musical performers are the most popular?
Frank is very popular. Everybody knows Frank. Frank or Elvis Presley. Those are my guys.
Family members may feel overwhelmed when a loved one with dementia needs care. What advice do you share to support them and help them build confidence?
Dementia is not a rope that you tie from one end to another and it stays tied. Patients go in and out. You go days trying something and it might not click. You do something else and they suddenly it clicks. Today, they’ll figure what you’re talking about. Tomorrow they might not. You just roll with it.
Even a patient who cannot verbally tell you thanks or is not physically able to give you a hug to show their appreciation, you can look in their eyes and you’ll know you just did something right.
How do you roll with it? How do you keep yourself present for the patient?
I talk. I smile. I laugh. I’ll have a conversation with the family first to learn about the patient and their background. The family might tell me things like, “She doesn’t show much pain. She doesn’t show much emotion.” They tell me where she is from, if they’re used to behaviors that are orderly and structured. So if you do things in a pattern, with clear, orderly steps, then they’ll understand better. If you know the patient’s background and culture, you can do things in a way they’ll recognize. I find ways to honor who they are and the way they like things done.
Hospice work can be both emotionally rewarding and challenging. What brings you joy in your job?
It’s that bond that I’ve built with my patients. Even a patient who cannot verbally tell you thanks or is not physically able to give you a hug to show their appreciation, you can look in their eyes and you’ll know you just did something right.