I. Considerations Prior to Performing Care

Before starting our shift, 0700 - 1500, we will get together and review the care plan of Mr. Warden. We make a plan where we pay close attention to his mood and dietary preferences and restrictions due to his diabetic condition. We will ensure all the equipment will be ready, especially the Mechanical lift and wheelchair for safety. To respect his dignity, we always address him as Mr warden as he prefers. We always make small talk about his interests to assess his mood so that we can proceed accordingly. This kind of practice will support meaningful engagement.

II. Considerations During the Care

In between the care, we will try to encourage him to participate in his care and also give him choices by keeping in mind his physical limitations. We will pay extra attention to all the transfers from bed to wheelchair and then wheelchair to toilet. We will use a Mechanical lift and make sure two people will always be around him during the transfer to keep the transfer safe.During the bed bath, we will give him choices if he needs oral care first or after Breakfast or if he needs a full bath or a partial bed bath. We will also ask what he would like to wear to maintain his Dignity. We will communicate calmly and discuss his interests so that he feels good about his intellect. We will try not to make him aggressive as he has already been diagnosed with bipolar disorder.

III. Considerations After Care is Completed and Follow-Up

When we have done the complete care. We will make sure Mr. Waden is comfortable and the call bell is in his reach. We will do the documentation accurately and report any changes to the assigned nurse time to time. We will mention everything about how he feels during the day, is skin integrity and his aggressiveness and also mention the incidents in the Progressive notes. We will also fill out the flow sheet to record his ongoing consistency and quality of his person-directed care.

2: Activities of Daily Living Flow Sheet

MONTH: October | YEAR: 2025 | SHIFT: 0700-1500hr (Day 2)
Dentures Clean Self/Yes/Declined/Family/NR
Service Day 2 (Entry)
Wash face and hands Self/ Yes/Declined/ FamilySelf
Axilla/ Back/ Pericare Self/Yes/Declined/FamilyYes
Bath/Shower/Bed Bath Declined/NR/FamilyShower
Shave Self/Yes/Declined/ Family/NRYes
Finger Nail Care RN/LPN/Ext/NR Self/Yes/Declined/FamilyDeclined
Foot Nail Care RN/LPN/Ext/NR Self/Yes/Declined/FamilyDeclined
Oral Hygiene Self/Yes/Declined/FamilyYes
Hair Service Self/Yes/Declined/HairdresserYes
Bladder Self/Yes/NoYes
Bowels (No BM/ Type 1/2/3/4/5/6/7/Self)3
BM (Small/Medium/Large/XLarge)Large
Lifts and Transfer (Ind/Supervised/Asst X1/Asst X2/ Stand-Up Lift/Mech Lift/Declined)Mech Lift (Asst X2)
Mobility Devices (Cane/Walker/W/C/Gerichair/ Scooter/Declined/NR)W/C
Exercise Program as per service plan (Yes/No/NR)Yes
Callbell accessible & working (Yes/No/Pendant)Pendant
Observation Checks - as per service plan (Yes/No)Yes
Repositioning (Yes/No)Yes
Breakfast (Full/1/4/1/2/3/4/Declined/NA)Full
LunchDeclined (See Progress Note)
Morning Fluid Pass (Full/Partial/Declined/NA)Full
Afternoon Fluid Pass (Full/Partial/Declined/NA)Full
0700-1500 CCA InitialsCCA/M MacLean

3: Progress Note (Narrative Note Sheet) - Incident Deconstructed

DATE TIME ID CODE SUBJECT  
10/17/25
12:25
CCA Incident & Safety Served client corn chowder and a roll for lunch. Client became verbally aggressive, stating, "I’m not eating that bowl of crud, get me something worth eating or I will throw this chowder at you.” Due to risk of physical harm/spillage, CCA immediately removed client (and tray) from the dining area to a quiet space to allow time to reset.
10/17/25
12:35
CCA De-escalation & Choice After 10 minutes, client settled and apologized for his language. Client was able to engage in conversation. To promote independence and honour personal preference, client was offered an alternative meal (sandwich), which he accepted. This action supports the care plan goal of improving coping skills (apologizing).
10/17/25
12:45
CCA Meaningful Engagement Strategy For future, De-escalation dietary aggression, CCA will check in at 10:00 so Mr warden can see the menu and choose his meals for lunch ahead of time. This Strategy will give me sense of control for his food choices which respect his intelligence and choices.
10/17/25
13:00
CCA Outcome & Reporting After the new plan discussion, the client was calm and cooperative. All Daily tasks finished successfully. The area was left clean and safe, and the call bell was in reach. The new plan is incident reported to C. Duggan, LPN and the Dietitian RD.

Our Team

This Meaningful Engagement is the result of a collaborative team effort. Ajay Kumar, Yichun Zhang, Michelle MacLean, and Abhinav Rayat each contributed their expertise to create a comprehensive document of a Meaningful Engagement.

doctor

Ajay Kumar

CCA Student

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Yichun Zhang

CCA Student

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Michelle MacLean

CCA Student

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Abhinav Rayat

CCA Student