Changes in condition — observe and report
Any new or unusual change — more confusion, not eating, new weakness, pain, swelling, falls, sleeping much more — should be reported to your supervisor or the client's nurse the same day. You observe and report; you don't diagnose.
- 1Compare to the client's normal: you know their baseline better than anyone on the care team.
- 2Changes to report the same day: new/worse confusion, appetite loss, refusing fluids, new pain, dizziness, swelling, skin changes, changes in urine/bowel habits, unusual drowsiness.
- 3Call 911 first for emergency signs: trouble breathing, chest pain, stroke signs, unresponsiveness, severe bleeding.
- 4Report facts, not conclusions: 'ate 2 bites of breakfast, asked the same question 5 times in an hour' — not 'I think she has a UTI'.
- 5Document what you observed, when, and who you told.
Sudden confusion in an older adult is often a sign of illness (infection, dehydration, medication issues) — it is always worth a call, even if it seems minor. Small changes caught early prevent hospitalizations.
State training guidance (DSHS)
☎️ When in doubt, call — your supervisor or the client's nurse would rather hear about a small change than miss a big one.