Care of the Elderly and Chronically Sick

Nursing Home Environment

Certified nurse’s assistants who work in nursing homes will often take care of elderly and chronically ill patients. Duties in the settings often differ from those working in hospitals and other healthcare environments. Nursing homes, otherwise known as convalescent homes are settings where residents may require constant care.

While some residents may be younger people with physical or mental disabilities, most of the residents are elderly adults. Patients who reside in nursing homes typically receive long-term care. For this reason, it is crucial that you develop an adequate relationship with the resident.

Recent research has revealed that the chief complaint by residents of nursing homes is loneliness. As a nurse’s aide, you can help to alleviate a resident’s feeling of displacement by simply spending time with them, and understanding their emotional concerns.

Nursing Home Duties

In general, many patients in nursing homes will require assistance from you. Patients will need to be bathed, may require help walking and often need help to the bathroom. In some cases, residents will require the use of diapers, which will need to be frequently changed.

Residents will need to be groomed by having their teeth and hair brushed. Be prepared to help some of the male residents shave or to help female residents paint their fingernails.

Just like in a hospital setting, you will also be responsible for completing your primary duties such as monitoring and recording vital signs and observing and reporting food and liquid intake.

On many occasions, the residents will be instructed to perform range of motion exercises. These exercises are frequently done in a patient’s bed or in another part of the facility if they are able to ambulate. If you observe a patient having difficulty during activity, properly document the event and inform the nursing staff.

Chronically Sick Patients

Taking care of patients who are chronically ill presents its own set of challenging circumstances. These patients will routinely encounter fear, frustration, fatigue and depression.

Examples of chronically ill patients include those who may have suffered from heart attacks, strokes and chronic conditions such as cancer, emphysema and advanced diabetes.

With the increasing aging population, there has been a dramatic rise in chronically sick patients. A 2004 study completed by the Psychiatric Times revealed that long-term facilities, such as nursing homes are routinely understaffed. This circumstance often makes it necessary for the nurse’s aide to be able to multitask during their care of the chronically ill.

In your role as a nurse’s assistant, it is critical that you do your best to be a member of the complete care team. If one of your nursing colleagues needs assistance during the day, take the time to help them. Teamwork is essential for success in the healthcare industry.


The bottom line for dealing with elderly and chronically ill patients is that while every patient may have their own unique set of circumstances, your care plan will encompass a multifaceted approach. You will provide for the patient’s physical needs as well as their emotional needs. They are both equally important parts of your duties as a nurse’s aid.

The foundation to your successful interaction with the elderly and chronically ill patient relies on your ability to effectively observe and respond to their emotional needs. Do your best to answer the patient’s needs, and if you need help don’t hesitate to ask assistance from the nursing staff. You will find as you mature in your nursing career that this effective use of communication will assist your patients while making your job easier at the same time.


Q.  What are some common feelings and emotions experienced by individuals who are chronically ill?

A.  Individuals who are chronically ill or who are in declining health as they age can experience a range of emotions.  They are often feeling a bit afraid especially if the future of their health is uncertain.  Patients become frustrated if they are ill often.  It is not uncommon for patients to have a sense of anger.  Some patients will even suffer from depression.

Explanation:  It is hard on an individual’s emotions if they are ill quite often or if they are affected by health problems that will never go away.  An individual can lose the ability to carry out task and activities that they are used to doing on their home.  This can result in the feelings above and a large assortment of other emotions and feelings.

Q.  Why is it important for a nursing plan (including aspects of the plan carried out by CNAs) to include plans to help care for a patient’s mental/emotional health?

A.  Caring for a patient’s mental health including elderly and chronically ill individuals is very important.  Many elderly individuals and some with long-term ailments will be in nursing care facilities for an extended period of time or for the very long-term.  As a result, individual can become lonely, angry, sad and upset.  You can help to reduce these feelings by providing for their emotional care.  If a patient has a better state of mental health, they are more likely to be able to see improved physical health.

Q.  What level of care is needed for elderly and chronically ill patients?

A.  The level of care needed will vary from one patient to another.  Some individuals need assistance with nearly all or most activities of daily living.  There are other individuals who require just minimal help.

Explanation:  Each patient has a unique set of care needs.  No two patients are alike when it comes to the care that they need on a day to day basis.   Some individuals need help walking, eating, bathing and with various other daily activities.  Other patients just need a little assistance with these tasks or with other tasks they find difficult as a result of health conditions.

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