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Healthcare Training Institute - Quality Education since 1979

Section 21
Unfinished Job

Table of Contents | NCCAP/NCTRC CE Booklet

a. "The Unfinished Job" Success Story
The following is a recap of a story presented on the DVD. Skim through it should you wish to refresh your memory regarding the details.  When I was an Activity Director Harold was a resident in the facility.  He was a former policeman. Harold was an ambulatory resident who had a heart condition.  Harold could see, hear, and speak.  Harold was definitely a CMS Interviewable resident.  Because he was "Interveiwable" Harold was a resident the surveyors would usually select to talk to during the Survey.  He had many capabilities.  Verbally Harold could give the surveyors “the inside scoop regarding what went on in the facility.”  However, he is also a resident that the facility would receive a deficiency for because he was becoming disoriented regarding the day of the week, next meal, etc. because he refused to be involved in any of the activity programs.  So Harold was definitely an unmotivated resident who presented a motivating challenge. 

Think about your resident… Develop a motivational plan in your mind for your Harold.  I had a sheet of discount coupons from the Wednesday newspaper.  One day I was doing Coupon Clipping in the activity room. 

Choose a receptive time… Harold would come in the activity room to smoke, because you could smoke in the activity room then.  He didn’t want to be out in the smoker’s lounge with all the other disoriented residents.  So Harold is sitting in the Activity Room smoking.  I set my motivational plan into action when I knew I would be called out of the activity room for a care plan conference.  The conference room was right down the hall from the Activity Room.  So a member of the team would say, “Cathy time for Care Plan Conference” as she walked past the open door.  I was clipping coupons while I was talking to Harold.  Now listen to how I motivated Harold to do the coupon clipping.  I had approached him with all kinds of other things, but he would not get involved.  I said, “Look, Harold, I have to go.  If you could just cut this one line for me that would really help me out.  I’ve got to go.  Bye.”  What did I ask Harold to do?  Cut what?  One line.  I didn’t say, “Cut out the rest of the page of coupons”. 

1.  Give the resident a job so simple he can not help but succeed
So key point number one is to give your Harold a task so simple, so easy, he or she cannot help but succeed.  I got a really good insight into the concept of making a task simple from a CNA who really "knew her stuff."  When she was dressing a resident, she didn’t say to the resident “Here, put on your blouse.”  No…  Instead, the CNA gets the sleeve cuffed up, so all the resident has to do is push her arm forward about two inches to get it through the sleeve. 

2.  Leave the room before the resident has a chance to give an excuse.
Now the immediately after I asked Harold to do this, what did I do?  I left.  Do not leave space in the interaction for the resident to fill in the space with… what?  It begins with the letter E.  Excuses!  You have it!  Harold has his whole list of excuses, just like all your residents have their excuses.  “The scissors will hurt my fingers; my eyesight isn’t good enough!” because the minute he says his arthritis is acting up, my hands can’t do it, he has committed himself to a course of inaction.  That’s how I got Harold involved in Coupon Clipping.

b. What You Do with the Coupons?
Activities takes the coupons and puts them in a box in the employee's lounge. The box is labeled, “Compliments of Activities” so that when CNA’s come into the employees’ lounge, taking the coupons is on a first come first serve basis.  Note that I left the resident with scissors.  I obviously evaluated that Harold was capable of using scissors.  In that particular facility it was the policy that if scissors were in the activity area that residents could be left with scissors.  He was not in his room.  This policy of course varies from corporation to corporation.

Now it’s your turn to think about your residents.  Do you have a resident like Harold that perhaps could be motivated by finishing a job you had started?  If so write his or her name below along with the activity and the part of the unfinished task he or she might complete.  To comply with Culture Change if the residents becomes independent with this activity think if it could be left in their room for a CNA to provide encouragement.

Residents to be motivated by Completing an "Unfinished Job"

Culture Change CNA Inservice:  Brainstorm about residents CNAs feel they could motivate by providing an “Unfinished Job.”