Mental HealthQuestion 139 of 200

A 78-year-old resident has begun drinking large amounts of mouthwash. Empty bottles are found in his bedside drawer. The CNA should:

a.Report to the charge nurse immediately, document the observation, and ensure mouthwash with alcohol is removed and replaced with an alcohol-free product as ordered
b.Confront the resident about the empty bottles, demand that he stop drinking them, and remove the rest of the mouthwash from his drawer without charting the observation
c.Ignore the behavior, since what a resident chooses to drink is his own right
d.Remove the mouthwash from the drawer quietly without telling anyone on the team

Explanation

Substance use disorder in older adults is under-recognized and dangerous (falls, GI bleed, drug interactions). Ingesting alcohol-containing mouthwash is a red flag. The CNA must report observations to the nurse so the physician can assess and the IDT can revise the plan (alcohol-free mouthwash, screening, possibly addiction medicine consult). Ignoring (c) abandons clinical duty. Confronting (b) is shaming and outside CNA scope. Hiding without reporting (d) defeats care planning and may itself be a form of self-neglect facilitation. Under W&I §15610.07 self-neglect is a form of reportable elder abuse.

Law Reference: 42 CFR §483.40; W&I §15610.07

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