Certified Nurse Aides: FAQ's

Part 2 of our Frequently Asked Questions regarding CNA's in Kansas: 

Q.  What happens if I don’t pass this course?

If you do not pass the course successfully the instructor will submit a written notification to the state of your name and you will not be eligible to sit for the state test.  You would then have to retake the entire CNA course again.

Q.  What happens once I complete the course successfully?

Once you complete the course your instructor will send your name into the state.  Once the instructor receives the “Approval to Test Notice” your instructor will contact you and get you the Approval letter.  The “Approval to Test Notice” will assign the test date, location, and time.

Q.  What if I am unable to take the test on the date scheduled?

If you are unable to take the test on the date assigned you must contact Health Occupations Credentialing (HOC) at 785-296-1250 to request a rescheduling form to submit along with a $20 application fee.

Q.  Tell me more about the state test.

The state test is timed and contains 100 multiple-choice questions.   You are given 2 hours in which to complete the test.  The score of 75% or greater constitutes a passing score.    

Q.  What do I need to take to the state test?

You must provide the following at the test site when you go to test:

• Original photo ID
• Test fee
• Approval letter to test

You need to be extremely punctual for the state test.  This test is timed and there are other students testing as well.  The testing sites are very prompt on delivering the test.  The testing sites will not accept any students who walk in the door after the testing has begun.  I recommend you arrive at least 30 minutes ahead of schedule to get seated for your state test.

You WILL NOT be admitted if you are not listed as eligible on the site schedule, or are late, or do not provide required ID

Q.  What if I have a disability?

Any candidate who has a:

• Physical disability
• Learning disability
• Psychological disability

If you require a reasonable accommodation to take the state test you need to complete a request form.  As a student you must have performed in a satisfactory manner in both the classroom and lab/clinical settings of the course, and successfully completed the Skills Competency Checklist.

Q.  Is the state test given in more than one language?

The state test is read in only the English language.  If English is your second language may use a bilingual language dictionary during the state test.  Computer dictionaries and medical dictionaries are prohibited.

Q.  What happens when I pass the state test?

If you pass the state test, a certificate will be mailed to you at the address in which you provided. On average it takes 3-4 weeks from the time the state test has been taken until the department received and enters the test score.   You should allow 30 days to lapse from the date the test was taken before calling the department to check on the status of the certificate. 785-296-1250.

Q.  What happens if I fail the state test?

You will receive a letter that includes the score.  The information on your performance in the categories will help you prepare to retake the test.  A rescheduling form, if you are eligible, will be included.  You should complete this and send it to HOC with the non-refundable $20 application fee.

Q.  How long do I have to retake the test?

The state test must be passed within one year from the beginning date of the nurse aide training course.  You are eligible to retake the test a maximum of 3 times within that year.  If the test is not passed within one year from the starting date of the course, the entire course must be retaken to be eligible to take the test again.

Q.  What is KNAR?

KNAR is the Kansas Nurse Aide registry which is federally mandated program to track the employment and training for aides in Kansas.  A unique identification number is issued to you if you have successfully completed the state nurse aide course and passed the test.

What are record checks?

The KNAR will be checked for reports of abuse, neglect, or exploitation, prohibited offenses, or misappropriation of resident property.  Each adult care home must contact the registry prior to hiring you as a nurse aide.  A criminal record check will be requested by a facility to determine your eligibility to work.  A facility may NOT employ any person with any of this on record after April 1, 1992.  You can see prohibited offenses under the tab “Course Information”. 

Q.  KNAR should never be contacted to:

• Inquire about test results.  The results are mailed to you within 30 days from the test date.  The test results cannot be given over the phone. Call 785-296-1250.
• Inquire about test sites.  Instead call 785-296-1250
• Request replacement copies of certificates.  Instead call 785-296-1250
•  Report abuse complaint about a CNA or other personnel.  Instead call 800-842-0078
• Inquire about the CNA and competency evaluation Instead call 785-296-0058
• Inquire about employment verification procedures or issues.  Instead call 785-296-1250
• Locate course offerings.  Instead call 785-296-1250 or access website at www.kdheks.gov/hoc

Q.  Does my CNA certificate expire?

CNA certificates do not expire therefore you will not receive new certificates automatically.  As a CNA you will be eligible for employment for 24 months following the date the certificate is issued.  In order for you to extend the eligibility period, you as a CNA must be employed to perform nursing or nursing related tasks for at least 8 hours in the 24 month period. 

Q.  What if my employment was not received by KNAR?
If you worked 8hr in a 24 hr period and the information was not received and noted on the CNA”s KNAR record, the CNA should request the Employment Verification Form from HOC.

Q.  What happens if I have not been employed in a 24 month period for 8 hrs?

IF a CNA has not been employed to perform nursing or nursing related duties in the past 24 mo you can have a licensed, registered nurse may elect to administer the Kansas Nurse Aide Task Checklist-For Employment Verification.  The checklist may be done in an adult care home, hospital, or laboratory setting.   The checklist shall not be given to the aide.  Or the CNA may take a refresher course, if available, instead of having a nurse administer the task checklist.    Once completed and submitted to HOC, the eligibility period is extended by 24 months.  It is not necessary to work for “40 hrs” in order to complete the checklist for employment purposes.  The amount of time it takes to perform each task will vary. 

Q.  What if I have lost my CNA certificate?

If you have lost your CNA certificate, an application form is available and a new certificate will be sent upon receipt of the form and a fee.

Q.  What if there is a change in name, address, phone number as a NAT or CNA?

Whenever there is a change in your mailing address, telephone number, or name you need to contact HOC so the department can keep your information updated.  785-296-0060.

To take a We Care Online CNA Class - Click Here

Kansas Nursing Assistants: FAQ's

Thinking about taking a CNA course in Kansas?  I'm sure you have lots of questions about Kansas requirements and employment issues.  We've accumulated our most asked questions and will address them over our next few blogs.

Q.  Can an employer request that I work for them for a period of time if they pay for my CNA training?

The use of contracts relating to training for employment is prohibited under federal regulations.  An adult care home cannot require a Trainee II or a CNA to enter into either verbal or written contracts to work for a specified period of time at the facility or else reimburse the facility for the cost of the training.   

Schools however may require students to enter into verbal or written contracts stating terms of payment.  However, a contract must not state that the student will be denied access to the state test.

Q.  Can I work for an adult care home as a Nurse Aide Trainee I?

A Nurse Aide Trainee I (NAT1) may not be employed by a facility in DIRECT care duties.  Direct, individual care refers to nursing activities that are resident oriented.  It involves personal contact with the resident by the trainee, and provides assistance in grooming, feeding, toileting, or ambulating the resident.

Q.  What happens once I complete Part 1 of the CNA Course?

Once you have completed Part 1 of this nurse aide training course, your clinical instructor will evaluate you on your performance using the Task Checklist provided by the State of Kansas.  The Task Checklist is used to evaluate your initial competence in performing basic nursing tasks.  Your clinical instructor must observe completion of each task in a satisfactory manner.  When you have successfully demonstrated each task successfully to your clinical instructor, he/she will fill out the Task Checklist and the original is given to you.  Once you have completed this Task Checklist successfully, you are now classified as a Nurse Aide Trainee II (NATII)

Q.  Can I also become a Paid Nutrition Assistant with the CNA course?

Part 1 of your CNA training also include the instruction and competency evaluation required to for you to be an employee as a  Paid Nutrition Assistant (PNA). 

Also upon completion of Part I and the Task Checklist, We Care On-Line will award you a certificate of completion for PNA training.  Once you have successfully completed the Task Checklist for Part 1, the online CNA instructor will notify you and issue you a certificate by email.    This certificate is permanent evidence that you have completed the PNA training and you should keep this for your records.  Once you have successfully completed Part 1 and the Task Checklist you may seek employment as a PNA if you choose, whether or not you complete the rest of the course.  You are to provide a copy of the PNA certificate to the facility of employment.

Q.  What are my employment options once I am a NATII?

Once you are a NATII, you are eligible to provide direct, individual care to residents in an adult care home under the direction of a licensed nurse.  You may work as a paid nutrition assistance if you choose. 

As a NATII, you should not be expected to perform nursing tasks that have not yet been adequately covered during the classroom training hours and you should respectfully decline to provide the service that is asked of you.

Q.  How long am I considered a NATII?

You are considered a NATII for 4 months from the beginning date of the course.  If you are unable to fully meet the certification requirements within 4 months from the beginning date of the course, you are no longer eligible to provide direct resident care services.  A second 4 month trainee period is not allowed.

To be continued. . . .

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Physical Aspects of Aging -- Part 4 of 4

Teeth and Mouth

Older adults are more likely to lose teeth to gum disease than to problems with the teeth themselves. However, with proper personal care, regular checkups, and improved dentistry methods, older people are more able to retain their natural teeth throughout their lives. Older people who do lose their teeth may now expect and demand comfortable, well-fitting, and durable dentures.

Digestion

The digestive system is very sensitive to emotions. An older person may experience an upset stomach or lack of appetite when lonely, depressed, or worried. Regular contact with friends and relatives, through visits and telephone calls, can help prevent these problems.
It is fairly common for older people to have less frequent bowel movements and to suffer from constipation. This is due to changes in tissue and muscles and reduced thirst. Regular exercise, such as a daily walk, can prevent constipation. A well-balanced diet that includes adequate fiber and fluid intake also encourages normal bowel function and minimizes the need for laxatives. In contrast, self-prescribed laxatives are an expensive substitute for foods that naturally keep the gastrointestinal system running smoothly, such as bran cereals, fruits, and vegetables. Overuse of laxatives can interfere with the availability of nutrients for healthy body functioning.

Adequate fluid intake is essential for maintaining proper body temperature and functioning of the digestive system. However, some older people make the mistake of limiting their fluid intake in order to avoid frequent urination. Dehydration is a serious problem for the elderly. This is due to their decreased sense of thirst and reduced capacity to conserve water. In addition, laxative abuse, diuretic therapies, infections, immobility, or excessive use of alcohol or caffeine tend to promote dehydration.

Caregivers and older adults should follow the guidelines below to assure proper gastrointestinal functioning.

• Get some form of regular exercise that is appropriate to the level of physical ability.
• Maintain a well-balanced diet that includes natural sources of fiber such as whole grains, fruits, and vegetables.
• On a daily basis, drink eight cups of water and other fluids.
• Watch for signs of dehydration, such as mental confusion, decreased urine output, constipation, nausea, lack of appetite, dryness of lips, and elevated body temperature.
• Pay special attention to fluid intake during hot weather.
• Monitor the fluid balance in older people with special medical problems, such as congestive heart failure or kidney disease. Discuss the appropriate methods to monitor fluid intake and output with your doctor.

Circulation

The older heart slows down and is less able to pump blood through the body than the younger heart. This results in older people having less energy and stamina for physical work. Decreased circulation also contributes to cold sensitivity, particularly in the hands and feet. Because oxygen necessary for proper physical and cognitive functioning is carried through the blood, the elder with poor circulation may experience forgetfulness and other symptoms of poor cognition.

Blood vessels, which play an important role in the circulation of blood throughout the body, lose elasticity as we age. This causes blood to tend to "pool" in the feet and legs. This means that swelling (edema) may occur in the extremities. Consequently, the heart, which undergoes muscle changes as we age, must pump harder in order to carry the blood to all parts of the body.

Changes in circulation make the older person more susceptible to the development of "little strokes" (TIAs) than when younger. Symptoms of such episodes include headache, vision disturbances, loss of balance, confusion, and dizziness when standing quickly from a sitting or reclining position. Because "little strokes" can be harbingers of a larger stroke, consult with the older person's primary health care provider, should these occur.

Many older people are on medications that impact circulation. Be familiar with these medications, and their side effects. This may prevent complications, which may arise from their use.

Pressure ulcers, a skin problem found in people with limited mobility, are due to impaired circulation. When an older person is unable to move about, tissue may die due to lack of an adequate blood supply to the skin. Areas particularly susceptible to these ulcers are those over bony prominences such as hips, shoulders, elbows, knees, ankles, and the heels of the feet.

To facilitate proper circulation and its effects:

• Prop the feet on a footstool or other appropriate stable object when sitting.
• Change the person's position at least every two hours to prevent pressure ulcers of the skin.
• Develop an activity routine which conserves energy and yet includes opportunities for movement.
• When the elder is sitting, rotate her or his feet at the ankles frequently to promote circulation.
• When the elder is rising from a reclining position, help her or him sit on the edge of the bed for a few moments before standing.
• Be familiar with the older person's medications and their side effects to prevent falls and other complications.
• Be alert to sensitivity to cold in the older person. Make certain there are sweaters, blankets, and other warm materials available.

Learn more in our Restorative Aide course!  For more information click here!

Physical Aspects of Aging -- Part 3 of 4

Vision

Even though changes to the eye take place as a person ages, many older people have good-to-adequate vision. Nevertheless, beginning in the late 30s and early 40s, an individual may begin to notice some changes. She or he may have to hold the paper farther away to read it due to changes in the ability of the lens to change its shape to accommodate to distance.

With aging, peripheral vision is reduced. A person may need to turn her or his head to see to the sides. The flexibility of the eye decreases and it takes an older person more time to accommodate to changes in light. Adaptations in lifestyle and behaviors must be made to cope with this change. An individual might give up driving at night. Placing more lights evenly around the room so that the entire room is lit is also helpful.
Degeneration of eye muscles and clouding of the lens are associated with aging. Several changes in vision result from this. Older people tend to have trouble focusing on near objects, but eyeglasses may correct this problem. In addition, the ability to see colors changes with age as the lens yellows. Red, yellow, and orange are easier to see than blue and green. This is why fabrics in warmer shades may be more appealing to the older person.

Serious vision impairments such as cataracts, glaucoma, and blindness affect between 7% and 15% of older adults. If someone you know must learn to cope with blindness or near blindness, you can play a critical role in helping them maintain their independence.

To help a person with any visual impairment, or to make your own life brighter:

• Light the room brightly and use more than one non-glare light in a room.
• Use blinds or shades to reduce glare.
• Keep a night light on in the bedroom, hallway, and bathroom to maintain an equal level of light.
• Increase lighting on stairwells and steps.
• Use concentrated light for sewing and reading.
• Turn lighting away from the television to avoid glare.
• Provide printed materials with high contrast between the background and lettering.
• Use contrasting colors in the home, such as colors between the doors and walls, and between the dishes and table coverings.
• Mark the edge of steps with a brightly colored tape or different colored paint, and paint the handrails.
• Provide audiotaped books and music for the elder's cognitive stimulation, entertainment, and relaxation.
• Wear a hat with a wide brim and sunglasses while outside. This will protect the eyes against too much sunlight, which can lead to cataracts.
• Know the warning signals of possible vision problems, including pain in or around the eyes, excessive tearing or discharge, double vision, dimness or distortion of vision, flashes of light, halos or floating spots, swelling of the eyelids or a protruding eye, changes in eye color, and changes in vision or movement of one eye.
• Make sure the older person has regular eye exams, including a glaucoma screening, at least once every 1-2 years.

Unfortunately, people who experience vision problems may avoid activities that require good vision and become isolated. Work with a professional to explore ways to help the older person maintain a normal lifestyle. With today's technologies and medical care, individuals don't have to accept limitations from declining vision as an inevitable part of aging.

Taste and Smell

Some loss in taste sensitivity takes place with aging. However, the loss is minor and does not seem to occur in most people until well after 70. There is also a loss of smell, but this is not severe.

Nevertheless, older people often complain that their meals are tasteless or that they no longer like their favorite foods. Most experts feel that these complaints are caused by a sense of loneliness at meals, or an unwillingness or inability to cook. Also, older persons may not buy more enjoyable foods when they have difficulty chewing due to poor dentures or dental problems, or are stretching their food dollars due to a limited budget.

To help the older person enjoy mealtime:

• Offer familiar, well-liked foods.
• Invite or encourage the elder to share meals with friends and family, in his or her home or at congregate meal sites.
• Experiment with different seasonings and flavorings.
• Prepare a variety of foods each day.
• Make the table colorful and inviting with bright napkins, mats, and flowers.
• Encourage exercise, when possible, which stimulates the appetite. 

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Physical Aspects of Aging -- Part 2 of 4

Touch

The skin serves a protective function by buffering us from the environment. Skin changes leave the older person vulnerable to discomfort and harm. Due to reduced sensitivity, heat sources such as heating pads, hot water bottles, and pot handles can hurt the skin before the elder realizes that damage is occurring.

An older person may develop a greater sensitivity to cool temperatures and drafts. This is caused by a decline in sweat gland activity, a decrease in the ability to maintain a normal body temperature due to poorer circulation, and a thinning of the skin. Wrinkling, drying, and scaling also occur. The skin tears and breaks more easily, increasing the chance of injury and infection.

To cope with these changes, the older person should:

• Avoid extreme exposure to sun and wind, which speed up the aging of the skin.
• Avoid daily baths or showers, as these tend to dry out the skin.
• Moisturize the skin with body oil after a bath, gently patted on with a washcloth.
• After bathing, pat the skin dry.
• Drink one to two quarts of fluid daily to maintain normal body temperature and functioning.

The sensation of touch connects us with others no matter what our age. Thus, touch is important in maintaining the elder's emotional well-being. Use touch to communicate that you are there for support and that you care.

Changes in Bones and Muscles

Aging adults, especially the very old, are vulnerable to broken bones. In addition, joints stiffen and connecting ligaments between bones lose their elasticity. Hand and foot pain may result.
Although there is no known way to prevent sometimes painful changes in aging muscles, bones, and ligaments, regular exercise helps to assure continuing mobility in old age. Most physicians feel that walking, along with adequate rest and a nutritious diet, are tremendously valuable for maintaining mobility and fitness in the later years.
Health professionals advise middle-aged and older adults to:

• Eat a well-balanced diet with the proper amount of calcium and other essential nutrients.
• With a physician's guidance, start or continue a regular exercise program.

It is very important to prevent falls. Due to changes in bone mass and strength, falls often result in injury, hospitalization, and continued declines in health.

The suggestions covered under vision and hearing, as well as those listed below, will help the older person take the necessary precautions to prevent falls.

• A no-slip bath mat and grasp rails are installed in the shower or tub.
• A seat is placed in the shower if standing is difficult.
• If scatter rugs are used, they should have no-slip backing or mats underneath.
• Chairs are sturdy and do not wobble, break, or tip over.
• A safe, sturdy step stool is available to reach high places.
• The telephone is placed in a convenient location.
• Chairs and sofas are at a height that permits easy sitting.
• Floors and stairs have non-skid surfaces.
• Railings line all staircases.
• Staircases and walkways are uncluttered.
• Front and back steps, and inside flooring and carpeting are in good condition.
• Instructions for the proper use of medications are followed carefully, as improper types or dosages often cause falls.

You can find this and other great information in our Restorative Aide class!  Click here for more info

Physical Aspects of Aging -- Part 1 of 4

Physical Changes of Aging 

It is important to recognize that people age differently, so what is presented here may not be exactly what you or your loved one experience. Also, even though there are many challenges of aging, these can often be addressed through simple steps that improve communication and make the environment safer and easier for the older person to navigate. These steps may also help to make it easier for the older person to live independently for as long as possible.

Sensory Changes

Humans receive and process information from the environment through hearing, vision, taste, smell, and touch. With aging, these senses are often diminished and incoming information may be distorted or difficult to understand. As a result, the older person may give up some enjoyable activities or lose contact with friends and family who are important sources of support. These problems can be reduced or overcome by following the suggestions described in the sections below.

Hearing

About 30% of people over 60 have a hearing impairment, but about 33% of those 75 to 84, and about half of those over 85, have a hearing loss. Hearing loss affects the older person's ability to talk easily with others. For example, older people often have trouble hearing higher pitched tones. They also may not be able to make out sounds or words when there is background noise. Conversations may be difficult to hear, especially if the speaker has a high voice or there is background interference.

Older persons may be frustrated or embarrassed about not being able to understand what is being said. They may have to ask people to repeat themselves, or endure shouting when a speaker tries to be heard. Older persons may hold back from conversation out of a fear of making inappropriate comments. They may tire from concentrating and straining to hear. As a result, the older person may withdraw from friends and family and outside activities.

Hearing loss doesn't have to cause social isolation and emotional distress. Simple changes in behavior and the home environment can increase the elder's ability to carry on a normal conversation.

• Speak clearly and in a normal tone of voice. Don't speak too fast or too slow. Hold your head still. Do not shout.
• Get the older person's attention before speaking.
• Look directly at her or his face and at the same level.
• Stand or sit with the light above or toward you, not behind you. Keep your hands away from your mouth.
• Eliminate background noise from radio and television.
• Try using different phrases with the same meaning if you are not getting your point across.
• Build breaks into your conversation.
• Use facial expressions or gestures to give useful clues.
• Repeat yourself if necessary, using different words.
• Ask how you can help.
• Include the hearing-impaired person when talking, do not exclude them.

There are many different devices that can be used in the home to help a hearing-impaired person. Special phones work with hearing aids and ring louder than a standard phone. There are alarm clocks, smoke detectors, and doorbells that have flashing lights and vibrations to alert the hearing-impaired.
Older adults need routine hearing exams by qualified professionals. Have hearing checked by an audiologist to be sure that another problem is not causing the hearing loss. If a hearing aid is needed, work with the audiologist to find the right brand and fit. If you are a caregiver, provide plenty of support and encouragement to the person who is adjusting to the hearing aid.

Learn more in our Restorative Aide course!  Click here for more info