Job aids

Psychosocial needs and cultural competency: the steps to remember

The short step lists from each lesson of Psychosocial needs, cultural competency and LGBT older adults, on one page. Print it for the station or the break room. Each list points back to its lesson, where the sources are linked.

Open the course Print a poster with a QR code

Decision guide

A resident's mood, identity or rights: what do I do?

Is anyone in danger right now, or has the resident talked about death or suicide?

Yes
Get help now. Call 911 if anyone is in danger, and tell your supervisor at once. The 988 Suicide & Crisis Lifeline answers 24 hours a day.
No
Has the resident's mood, interest, sleep, eating or time with others changed and stayed changed?
- Yes
  Write down what you see and hear, with dates, in plain words and with no diagnosis. Tell your supervisor, so the home can bring it to the physician and responsible person.
- No
  Is a resident being treated differently because of identity, faith, culture, sexual orientation or HIV status?
  - Yes
    Have you already told your supervisor or the administrator, and it is still going on?
    Yes
    Tell the administrator again, in writing, with dates. Tell the resident about the posted Ombudsman notice and the hotline, 1-800-231-4024, and help them call if they ask.
    No
    Write what you saw and heard, who was there and when. Tell your supervisor or the administrator. The resident may also complain, and no one may punish them for it.
  - No
    Does the resident want something different from the day's plan, such as another activity or free time?
    Yes
    Ask the resident what they would like, and tell your supervisor so the plan can change. Free time and daily choices belong to the resident.
    No
    Keep offering choices, use the name and pronouns the resident gives, and keep noticing. Report changes under your home's procedure.

This guide helps you choose your next step on shift. It does not diagnose anyone or decide whether a rule was broken: the physician, the home, Community Care Licensing and the Ombudsman each do their own part, and the resident chooses what to do.

Step through it one question at a time: alwbeta.com/training/courses/psychosocial-needs-cultural-competency#decision-guide

Lesson 1

Loneliness and depression: notice, describe, report

You see residents every day, so you are often the first to notice when someone pulls away or seems low. On shift you decide what to write down and who to tell. This lesson shows the signs to watch for, and how to report what you see without naming a diagnosis.

Lonely and isolated are different: ask, do not assume
Depression is not a normal part of aging
Watch for changes that last: mood, interest, sleep, eating, contact
Write what you see and hear, with dates; no diagnosis
Tell your supervisor; the home tells the physician and responsible person
Talk of suicide: get help now; 911 for danger; 988 Lifeline

Lesson: alwbeta.com/training/courses/psychosocial-needs-cultural-competency#lesson-psy-mood-changes

Lesson 2

Meaningful activity and choice

A good day in a care home is more than meals and medications. On shift you decide how to invite a resident into the day, and when to step back. This lesson covers the planned activities a home offers, why meaning matters, and the resident's right to choose.

Offer variety: social, physical, mental, cultural and religious, and free time
Ask the person what gives them purpose
Invite, then respect a no
Let residents help plan and run activities
Start small: one or two activities
A sudden stop in every activity is a change to report

Lesson: alwbeta.com/training/courses/psychosocial-needs-cultural-competency#lesson-psy-activity-choice

Lesson 3

Culture, language and faith in daily care

Every resident brings a life story: a culture, a language, perhaps a faith, and a sense of who they are. On shift you decide how to give care that fits this person. This lesson covers the rules that protect each resident, and how to ask instead of assume.

No discrimination: race, religion, national origin, sex, orientation, gender identity and more
Ask the person; do not assume from a group
Faith is a choice; services are voluntary
Find out how the person talks with others best
Traditions belong in the plan, chosen by the resident

Lesson: alwbeta.com/training/courses/psychosocial-needs-cultural-competency#lesson-psy-culture-faith

Lesson 4

The rights of LGBT residents

California has a law just for LGBT residents of long-term care homes, and the RCFE rules repeat it. LGBT means lesbian, gay, bisexual or transgender. On shift you make choices about rooms, restrooms, clothing, visitors and personal care. This lesson shows what the law protects.

The law covers RCFEs and every staff member, employed or contracted
Gender identity is what the resident says
Room and restroom match gender identity; no ID checks
Same clothes, accessories and makeup as any resident
Any limit on visitors or relationships applies equally to all
Care fits the body; privacy for every resident

Lesson: alwbeta.com/training/courses/psychosocial-needs-cultural-competency#lesson-psy-lgbt-rights

Lesson 5

Names, pronouns, privacy and raising a concern

A name is the first thing you say to a resident each day. On shift you decide which name and pronouns to use, what to keep private, and what to do when a coworker gets it wrong on purpose. This lesson shows the rules, and how to raise a concern.

Use the name and pronouns the resident gives
Chart wrong? Tell your supervisor so it is fixed
Orientation, transgender status, transition and HIV status stay private
Complaints are a right; no one may punish a resident for one
Write what you saw and heard, with times; tell your supervisor
Ombudsman hotline 1-800-231-4024, 24 hours

Lesson: alwbeta.com/training/courses/psychosocial-needs-cultural-competency#lesson-psy-names-concerns