Respect each person's culture in daily care and use the six principles of trauma-informed care to lower triggers and build trust.
ForNursing home, Home health, Hospice staff
TimeAbout 73–81 minutes
Lessons10, each with a quick check
FinishA quiz (80% to pass) and a printable certificate of completion
What you will learn
Explain what culture is.
Know that federal rules require care that fits each person's culture.
Check meals against diet and faith needs before serving.
Protect modesty during personal care.
Know that every person has the right to equal, respectful care.
Name people who may be trauma survivors.
Name the six guiding principles of a trauma-informed approach.
Explain what a trigger is.
Know that culture and faith shape end-of-life wishes.
Respect the patient's home, belongings and customs.
Written by Pact Compliance from federal rules and CDC, CMS, OSHA and NIH guidance (sources under each lesson), checked October 2026. Where your facility's policy is different, follow your facility's policy.
Lesson 1: What Culture Means in Care
In this lesson you will:
Explain what culture is.
Name parts of culture that shape care.
Learn a person's culture by asking, not assuming.
Culture
A way of seeing
CMS defines culture as the way people see the world. It is the set of beliefs, norms, and values that shape how people live. It shapes how they relate to others and how they order their lives. Everyone has a culture. You do. Each person you care for does too. And culture is not only about where someone was born.
Many parts
Faith, family, language
Culture has many parts. CMS lists language, customs, beliefs, values, and ways of talking and acting. These come from racial, ethnic, religious, or social groups. CMS also counts religious preference, sexual orientation, and gender identity as part of culture. NIA adds family traditions, age, schooling, and abilities. NIA notes that some differences are easy to see. Others are not.
Shapes health
Shapes choices
Culture shapes health. CMS says it affects what people believe about health, healing, and how care should be given. NIA says a person's culture affects whether they seek care, how they understand health information, and how they make choices. In daily care, it can shape what a person eats, how they pray, and who they want involved in their care.
Show the answer
Ask him, and tell your nurse what he says. NIA says find out each person's own values and preferences instead of assuming.
Family roles
Ask the person
Families play different roles. NIA says some people want family involved in their health care choices. Others want to decide alone. NIA advises finding out how the person sees the role of family, and what they want shared. You can ask, 'Who would you like with you when we talk about your care?' Then tell your nurse what they said.
No stereotypes
Each person differs
A stereotype is a fixed idea about a whole group. CMS says cultural competence means valuing differences and avoiding stereotypes. NIA says do not make assumptions about a person's beliefs based on their culture or background. Instead, find out what this person values. Someone from a culture you know may not follow its customs. Someone you think has no faith may pray every night.
Why it matters
Better care
NIA says respecting differences can lead to safer care, more open talk, and better health. When you respect a person's values, they are more likely to work with you as a partner. CMS warns that when people can't make their needs known because of language, they may become isolated and depressed, and their needs may go unmet.
On your shift
Learn one thing
On your next shift, learn one new thing about a person you care for. Start with their name. NIA says to ask what name and terms a person prefers, and to use them every time. Then ask what matters most to them in their day. Tell your nurse what you learn, so it can go into the care plan.
Quick review
Ask, don't assume
Let's review. Culture is the beliefs, norms, and values that shape how a person lives. It includes language, faith, family traditions, sexual orientation, and gender identity. It shapes health choices and daily care. Avoid stereotypes. Ask each person what they want. And share what you learn with your nurse.
Your facility's policy (ask your supervisor):
Where staff record and find each person's cultural preferences (care plan, profile sheet, or kardex)
Know that federal rules require care that fits each person's culture.
Know that aides help build and follow the care plan.
Report preferences so every shift can follow them.
The rule
Culturally competent
In nursing homes, a federal rule says the services in each care plan must be culturally competent and trauma-informed. Another rule says care planning must include the resident's personal and cultural preferences when goals are set. So culture is not an extra. It is part of the plan.
Home health
Hospice
Home health and hospice have their own rules. In home health, each patient gets a written plan of care made just for them. It includes the patient's mental and social needs. Patients have the right to take part in planning their care. In hospice, the patient has the right to help develop the plan of care. The hospice must assess physical, emotional, social, and spiritual needs.
You're on the team
Your input counts
In a nursing home, the team that writes the care plan must include a nurse aide who cares for the resident. In home health, aides are members of the team and must report changes to the nurse or therapist. Hospice aides must report changes in a patient's needs to a registered nurse. You often see and hear things that others miss.
Show the answer
A nurse aide who cares for the resident. The rule lists a nurse aide with responsibility for the resident.
Fits who they are
Their identity
CMS says the steps in a care plan must match the resident's needs and wishes, and fit their cultural identity. Cultural competence means being respectful and responsive to a person's health beliefs, practices, and language needs. CMS also checks whether direct care staff know the care plan steps, and whether the steps are followed on all shifts.
How it's learned
Ask and listen
CMS says facilities should use more than one way to learn about a person's culture and history. That includes asking the person, admission forms, assessments, and the social history. Assessments note a person's preferred language and whether they want an interpreter. You add to this every day by listening. When you hear something new, share it with your nurse.
Daily tasks
Choices show up
Culture shows up in every task. How a person wears their hair. What clothes they put on. When they bathe, wake, and sleep. Nursing home residents have the right to choose their schedules, including when they sleep and wake. They also have the right to keep and use their own clothes and things, as space allows.
On your shift
Report what you learn
Say Mrs. Haddad tells you she prays five times a day and wants to wash her hands, face, and feet first. Help her if you can, then tell your nurse what she said and what she needs. Do not change the care plan yourself. The nurse can add it to the plan, so every shift helps her the same way.
Quick review
Plan, follow, report
Let's review. Federal rules require care that fits each person's culture. In nursing homes, care plans must be culturally competent and trauma-informed. Home health and hospice patients help plan their own care. You are part of the team. Follow the care plan on every shift. And report what you learn, so the plan stays right.
Your facility's policy (ask your supervisor):
How aides add input to the care plan (huddle, report sheet, or care conference)
Where aides find the current care plan or written aide instructions
Check meals against diet and faith needs before serving.
Support faith practices and handle sacred items with care.
Know that holidays can bring comfort or stress.
Food matters
Culture and faith
Food is more than nutrition. NIA notes that healthy diets differ among cultural traditions. People have a hard time following food advice that ignores what they like to eat. In nursing homes, the rule says meals must be planned with residents' needs and preferences in mind. Meals must also take into account the cultural and religious make-up of the residents.
Real harm
A CMS example
CMS gives an example of serious harm. A nursing home did not identify that a resident's Islamic faith forbids pork. She ate a dinner with pork in it. When she found out, she cried and screamed. She stayed upset for days. She would not eat the food, and she lost weight. CMS lists this as an example of the most serious level of harm.
Check every tray
Before you serve
So check before you serve. Look at the tray card or meal ticket. Make sure it matches the person and their diet. If something looks wrong, don't serve it. Ask your nurse or the kitchen. If you don't know what is in a dish, don't guess. Check the diet before you offer a snack or a treat, too.
Show the answer
Don't serve it. Get her a correct meal and tell your nurse. CMS describes serious harm when a religious food rule was missed.
Faith practices
Support them
Faith can be a big part of a person's life. Nursing home residents have the right to take part in religious activities, as long as they don't get in the way of other residents' rights. CMS also lists keeping residents in touch with their cultural heritage and religious practices as part of good mental health care. Help people get to services. Keep prayer items close. Give quiet time when asked.
Sacred items
Handle with care
Many people keep sacred items close. A rosary, a prayer book, a head covering, a cross, or a small statue. Residents have the right to keep and use their own things. Ask before you touch or move these items. If you must remove one for care, ask first. Then put it back where the person wants it.
Fasting
Tell your nurse
Some faiths have fast days or seasons. A person may want to skip meals, or eat only at certain times. If someone tells you this, don't argue and don't ignore it. Tell your nurse right away. The nurse and the team can plan care that respects the fast and keeps the person safe.
Holidays
Joy or stress
Holidays can bring comfort. They can also be hard. Ask which holidays a person celebrates and how. CMS notes that loud noise at holiday events, like fireworks on the Fourth of July or New Year's Eve, can be a trigger for trauma survivors. Residents have the right to choose their activities. Ask before you bring someone to a party, and respect a no.
Quick review
Check, ask, respect
Let's review. Meals must fit each person's needs, culture, and faith. Check every tray and snack against the diet before you serve it. A food mistake can cause serious harm. Support faith practices, and ask before you touch sacred items. Tell your nurse about fasting. And ask before you include someone in a holiday event.
Your facility's policy (ask your supervisor):
How to check a tray card or diet list, and who to call in the kitchen
Respond calmly to a request for a caregiver of the same gender.
Use the name and terms a person prefers.
Modesty
Deeply personal
Modesty is about how much of your body you are comfortable showing, and to whom. Culture, faith, age, and life history all shape it. For many people, being undressed by someone else is one of the hardest parts of care. CMS lists removal of clothing as a possible trigger for trauma survivors.
Privacy
In every setting
Nursing home residents have the right to privacy in their personal care. Home health and hospice patients have the right to have their person treated with respect. So knock and wait before you enter. Close doors and curtains. Keep the person covered. Uncover only the part of the body you are washing, then cover it again.
Show the answer
Remove clothing slowly and explain what is happening. CMS lists removing clothing slowly and explaining what is happening.
Go slowly
Explain each step
CMS gives ways to help a trauma survivor with undressing. Remove clothing slowly. Explain what is happening. Use the same caregivers when possible. These steps help everyone, not just trauma survivors. Say what you will do before you do it: 'I'm going to wash your back now. Is that OK?'
Who gives care
A fair request
Some people ask for a caregiver of the same gender. The reason may be faith, culture, modesty, or past trauma. CMS lists a same-sex caregiver as one way to help trauma survivors with undressing. Nursing home residents also have the right to be told in advance about their care and the type of caregiver who will give it.
Stay calm
Get your nurse
If someone asks for a different caregiver, don't argue. Don't take it personally. Stay calm and polite. Tell your nurse or supervisor right away, so they can try to meet the request under your policy. If the request is in the care plan, follow it every time. CMS checks that care plan steps are followed on all shifts. If you can't follow it on a shift, ask for help before you start care, not after.
Gender identity
Use their words
CMS counts gender identity and sexual orientation as part of culture. NIA advises asking what name and terms a person prefers, and using them every time. NIA says this small step helps people feel welcome, safe, and accepted. A person's body may not look the way you expect. Stay calm and kind, and keep what you see private.
On your shift
Plan before you start
Say you are a female aide on a home visit. The care plan says Mr. Hassan wants male caregivers for bathing. Don't just go ahead. Call your nurse before you start. Ask Mr. Hassan what he is comfortable with today. He may want help only with his hair and back, and do the rest himself. Respect his answer, and write down what care you gave.
Quick review
Cover, explain, respect
Let's review. Modesty is personal and shaped by culture and faith. Protect privacy. Keep people covered. Go slowly and explain each step. A request for a same-gender caregiver is reasonable. Stay calm and tell your nurse. Follow the care plan every time. And use the name and terms each person prefers.
Your facility's policy (ask your supervisor):
Your policy on same-gender caregiver requests and who arranges them
Lesson 5: Respect for Everyone: Bias and Fair Treatment
In this lesson you will:
Know that every person has the right to equal, respectful care.
Notice your own biases, including ageism.
Speak up and report unfair treatment.
Equal care
For everyone
Nursing homes must treat each resident with respect and dignity, and honor each person as an individual. They must give equal access to quality care no matter what the person's diagnosis is, how sick they are, or how they pay. Every person gets the same quality of care from you.
No discrimination
Every setting
Home health patients have the right to be free from discrimination or punishment for using their rights or making a complaint. Hospice patients have the right not to face discrimination or punishment for using their rights. Nursing home residents have the same protection. This is true for every person you care for.
Look inward
Know your bias
Bias means judging a person based on a group they belong to. It can happen without you knowing it. CMS says cultural competence includes looking at yourself and avoiding stereotypes. NIA suggests thinking about your own background, beliefs, and values, and how they shape the way you give care.
Show the answer
A treatable problem may be brushed off as aging. Tell the nurse. NIA warns that ageism can lead to missing treatable problems.
Ageism
A common bias
Ageism is judging people because of their age. NIA calls it a common, often missed form of bias. NIA says ageism is linked to poorer physical and mental health, lower quality of life, and even earlier death. One harm is when treatable problems are brushed off as 'just old age.' So report every change you notice. Don't explain it away.
Bias harms health
Real effects
NIA lists racism, sexism, and other kinds of discrimination as causes of unequal health. NIA also says bias and prejudice can be a big source of stress for lesbian, gay, bisexual, and transgender older adults. In one NIA-funded study, these older adults got more checkups and preventive care when their provider was accepting and affirming.
Fair in small things
Same respect
Fair care shows up in small things. Answer call lights by need, not by who you like. Use the same warm tone with everyone. Give the same careful care to a person who complains, has an accent, or has a different faith. Don't joke about anyone's accent, faith, body, or who they love.
Speak up
Report it
If a coworker treats someone worse because of who they are, speak up if you feel safe, and tell your supervisor. People have the right to complain without discrimination or punishment. If the treatment is abuse, like insults, threats, or neglect, follow your abuse reporting steps right away.
On your shift
Check yourself
On your next shift, notice how you talk to each person. Do you use the same warm tone with everyone? Do you rush some people more than others? Do you call some people by name, and others 'sweetie'? NIA says to use the name each person prefers. Small changes like these make your care fair.
Quick review
Same care for all
Let's review. Every person has the right to respectful, equal care. Discrimination is not allowed in any setting. Everyone can have bias. Look at your own. Watch for ageism, and never brush off changes as old age. Be fair in small things. And speak up and report unfair treatment.
Your facility's policy (ask your supervisor):
Who staff tell about unfair or disrespectful treatment
Lesson 6: Trauma: Who Carries It and How It Shows Up
In this lesson you will:
Name people who may be trauma survivors.
Recognize signs that trauma may be affecting someone.
Report what you see, and report harm that is happening now.
Old wounds
Still felt today
Trauma can come from one event or many. Its effects can last for years. CDC says hard events in childhood, like violence, abuse, or neglect, can be traumatic. CDC links them to long-term health problems in adults. So trauma from long ago can still affect a person today.
Who may carry it
Not just veterans
CMS says people often think only veterans have PTSD. That is not true. People who were attacked or abused, or lived through a disaster, may also have it. Some older adults lived through genocide, such as the Holocaust. NIMH says anyone can develop PTSD, at any age. Even learning that a loved one was hurt can cause it.
Show the answer
Be gentle. Let her choose what to share, and tell your nurse. CMS says numbered tattoos may mean a Holocaust survivor. Let her choose what to share.
Clues
Not proof
CMS says there may be clues to a trauma history. Scars. A row of numbers tattooed on the arm, which may mean a person survived the Holocaust. Anxiety, depression, or alcohol or drug problems. Clues are not proof. Don't question people about their past. If someone shares, listen calmly and tell your nurse.
Reliving
Avoiding
NIMH describes signs of PTSD. A person may relive the event in flashbacks or bad dreams. Their heart may race, or they may sweat. Words, objects, or situations that remind them of the event can set this off. They may also avoid places, things, or people that remind them, and change their routine to stay away.
On edge
Mood changes
NIMH says a person may startle easily, feel tense or on edge, and have trouble sleeping. They may be grouchy or have angry outbursts. They may feel fear, guilt, or shame, and pull away from others. CMS adds that trauma can show up as aggression, depression, anxiety, eating problems, or substance use.
New place
Old memories
CMS says moving into a nursing home can be very hard for a person with past trauma. It can make symptoms worse or bring them back. The set routines of a facility can bring back memories. CMS also notes that losing independence can stir up old trauma. Needing help with personal care, in any setting, means giving up some control.
Harm now
Report it
NIMH notes that some people are still living through trauma, such as abuse at home. If you think someone is being hurt now, that is not old trauma. It may be abuse. Report it right away, using your abuse reporting steps. Don't wait, and don't try to look into it yourself.
On your shift
Notice, don't label
Say Mr. Gold, a new resident, won't go into the dining room. He sits with his back to the wall and startles at every sound. Don't call him difficult. Notice what seems to upset him and what calms him. Then tell your nurse what you saw. Your report helps the team plan care that feels safe to him.
Quick review
Notice and report
Let's review. Many people carry trauma, not just veterans. Signs include flashbacks, bad dreams, startling easily, avoiding things, anger, and pulling away. A new setting or a loss of control can bring symptoms back. You don't diagnose. A mental health professional does that. Tell your nurse what you saw and heard. And report harm that is happening now, right away.
Your facility's policy (ask your supervisor):
Your abuse reporting steps and contact (see the abuse course)
Who to tell when a resident or patient shares a trauma history
Name the six guiding principles of a trauma-informed approach.
Use each principle in daily care.
Know that trauma-informed care is a way of working, not a checklist.
Six principles
A way of working
CDC lists six principles that guide a trauma-informed approach. Safety. Trustworthiness and transparency. Peer support. Collaboration. Empowerment, voice, and choice. And cultural, historical, and gender issues. CDC says this is not a checklist. It takes steady attention, caring awareness, and sensitivity.
Safety
Body and feelings
CMS says the goal is a place that feels welcoming and safe, in body and in feelings. CMS notes that trauma survivors may have lost the ability to trust caregivers and feel safe. Small things help. Say your name. Knock and wait. Speak in a steady voice. Explain what you will do before you do it. Keep the call light in reach.
Show the answer
Trust. Trust is built by keeping your word. If you're delayed, send word.
Trust
Keep your word
Trust is built in small promises. CMS says to build and keep trust among staff, residents, and families. If you say you'll be back in ten minutes, come back. If you can't, send word. CMS lists seeing the same caregivers as a way to help. A familiar face can calm a person who has been hurt.
Peer support
Not alone
Peer support means people who have been through similar things help each other. CMS says staff may help residents find and go to support groups run by trained professionals. Some groups may meet in the facility. If someone asks about a group, tell your nurse or social worker. Help them get there.
Collaboration
Healing together
Collaboration means working together. CMS says healing happens in relationships, and in sharing power and decisions. CMS encourages talking about care with residents and asking them to say what support they need. Try asking, 'How can I make this easier for you?' Then listen, and use what they tell you.
Voice and choice
Build on strengths
CMS says to honor choices and help people take an active part in their care. Build on what they can do. Let them wash their own face if they can. Offer a choice of order. Agree on a way for them to say 'stop,' and stop when they say it.
Culture, history, gender
Look deeper
The sixth principle is about culture, history, and gender. CMS says to value cultural and gender differences, and to recognize and address historical trauma. Some people belong to groups that were harmed as a whole, such as through genocide like the Holocaust. That history can shape how safe they feel with staff and rules.
On your shift
Practice one
Pick one principle to practice on your next shift. Maybe trust: keep every promise, even small ones. Maybe choice: offer one real choice in every task. At the end of the shift, think about how people responded. Share what worked with your nurse and your team, so it can help on every shift.
Quick review
Six ways to help
Let's review the six principles. Safety: help people feel safe in body and feelings. Trust: keep your word. Peer support: help people connect with groups. Collaboration: work together. Voice and choice: honor choices and build on strengths. Culture, history, and gender: respect differences and past harm. Use them every day, with everyone.
Your facility's policy (ask your supervisor):
Support groups your facility or agency can refer to
CMS defines a trigger as something that brings back the memory of a past trauma. It can do this even when the trigger itself is not scary. Most triggers are very personal. CMS says facilities must still try to find a person's triggers, even when the person won't share their history.
Common triggers
CMS list
CMS lists some common triggers. A lack of privacy. Being in a crowded or small space. Loud noises. Bright or flashing lights. Objects that remind a person of someone who hurt them. And certain sounds, smells, and even touch.
Showers
Other options
Showers and shower fixtures can be triggers. CMS gives an example: offer other ways to bathe, such as a tub bath or a sponge bath. Only the nurse and the care plan change how a person bathes. If showers upset someone, tell your nurse. Describe what happened, so the team can plan.
Show the answer
Another way to bathe, such as a tub or sponge bath, through the care plan. CMS lists other bathing methods as a trigger-specific step.
Noise and space
Turn it down
For loud noise, CMS suggests lowering it during holidays and lowering or stopping overhead paging. For crowded spaces, CMS suggests one-on-one or small group activities. For someone upset by smoke or fire, keep them away from smoking areas and cookouts, and offer meals inside. Lower the TV. Close drawers and doors gently.
Night checks
Gentle and low
Night can be hard. Bright or flashing lights can be triggers. When you check on someone at night, knock softly and say your name. Use a low light. Don't shine a flashlight in their face. Move slowly, and speak quietly before you touch them.
Touch
Tell first
Touch can be a trigger. NIA notes that people differ in how much touch and personal space feel OK. Tell the person before you touch them, and where. Keep the path to the door clear, and don't stand over them. If they tense up or pull away, pause and ask what would help.
Track and report
Help the plan
NIMH says words, objects, or situations that remind a person of a trauma can set off symptoms. So when someone becomes upset, notice what happened just before. What were you doing? What did they see, hear, or smell? What helped? Tell your nurse. CMS says care plans should name ways to lower a person's exposure to triggers and lessen their effect.
On your shift
One good clue
Say Mrs. Fox gets upset every evening at about the same time. You notice it happens when the floor polisher runs in the hall. That is a useful clue. Tell your nurse what you saw and when. The team may change the cleaning time or offer her a quiet place. One good observation can change a care plan.
Quick review
Notice, lower, report
Let's review. A trigger brings back a past trauma. Triggers are very personal. Common ones include crowding, loud noise, bright light, showers, smells, and touch. Lower noise and light. Offer space. Tell before you touch. Notice what happened before someone got upset. Tell your nurse, so the care plan can help on every shift.
Your facility's policy (ask your supervisor):
Where known triggers and calming steps are listed for each person
Know that culture and faith shape end-of-life wishes.
Support spiritual needs and family traditions.
Respect that people grieve in different ways.
End of life
Four kinds of needs
NIA says people who are dying need care in four areas. Physical comfort. Mental and emotional needs. Spiritual needs. And practical tasks. Their families need support too. NIA says the end of life looks different for each person, based on their wishes, needs, and choices.
Culture shapes
Choices differ
NIA says culture and faith can shape end-of-life choices. That includes advance directives, feeding tubes, and other care to prolong life. It also includes whether the sick person or the family should be told the person is dying. If a person or family asks you about these things, don't answer for the team. Get your nurse.
Hospice rules
Spirit and grief
Hospice rules require an assessment of physical, emotional, social, and spiritual needs, to promote comfort and dignity in dying. Hospice must also look at the social, spiritual, and cultural factors that affect how the family will cope. Spiritual counseling must fit the patient's and family's beliefs. Hospice must try to help local clergy visit.
Show the answer
Tell your nurse, so the hospice can help arrange the visit. Hospice must try to help clergy visit and meet spiritual needs.
Faith comfort
Help them connect
NIA says spiritual needs may matter as much as physical ones near the end of life. Many people find comfort in their faith. Others struggle with it. Prayer, holy books, or religious music may help. A person may want to talk with a minister, priest, rabbi, or imam. If they ask, tell your nurse right away.
Being present
Talk to them
NIA says your presence can be a great gift. Sit with the person. Talk or read to them. When you come in, say who you are. Talk to the person, not about them. A dying person may seem to see or talk to someone who isn't there. NIA says don't correct them. Give them space.
Vigils
Family traditions
Some families keep a vigil, staying with the person all the time. NIA notes that some cultural or religious traditions call for this. Families may pray, sing, or bring sacred items. Make room for them. In a shared room, tell your nurse, so the roommate's needs are met too.
After death
Ask first
Families may have customs for the time right after a death. These may cover prayers, who may touch the body, washing the body, and timing. Hospice must consider cultural factors in grief. Before you do any after-death care, ask your nurse what the family wants, and follow your policy.
Grief
No one right way
NIA says there is no right or wrong way to mourn. Feeling numb, guilty, or angry is normal. One family member may cry loudly. Another may be quiet. Both are grieving. Hospice offers grief support to families for up to a year after a death. If a family member seems to be struggling, tell your nurse.
Quick review
Ask, support, respect
Let's review. Dying people have physical, emotional, spiritual, and practical needs. Culture and faith shape end-of-life choices and customs. Bring questions about those choices to your nurse. Help people connect with their faith and their clergy. Be present, and don't correct what a dying person sees. Ask before after-death care. And remember, there is no right or wrong way to grieve.
Your facility's policy (ask your supervisor):
Chaplain, spiritual counselor, or clergy contacts
Your after-death care policy and how to learn family customs
Lesson 10: You Are a Guest: Culture and Trauma in the Home
For: Home health, Hospice
In this lesson you will:
Respect the patient's home, belongings and customs.
Follow the written care instructions and report changes.
Use trauma-informed habits and free language help in the home.
Their home
You're a guest
In home health and hospice, you work in the patient's home. You are a guest. Home health and hospice patients have the right to have their property and their person treated with respect. Aide training must cover ways to work with the people the agency serves, with respect for their privacy and property.
House customs
Ask first
Every home has its own customs. Some families take off shoes at the door. Some have rooms that are private or set aside for prayer. NIA says don't assume. Ask. On your first visit, ask, 'Is there anything I should know about your home?' Then follow your agency's policy for things like shoe covers.
Their things
Ask before moving
Don't move furniture, photos, or sacred items without asking. If something is a safety risk, like a rug or a candle near oxygen, explain your worry. Then tell your nurse. Don't throw anything away, even if it looks like trash.
Show the answer
Ask if they'd like you to remove your shoes, and follow your agency's policy. Ask instead of assuming, and follow policy.
Family roles
Who decides
NIA says some people want family involved in their health care choices. Ask the patient how they want their family involved. Home health patients have the right to take part in and agree to their care. If the family's wishes and the patient's wishes don't match, tell your nurse.
Follow the plan
Written instructions
A registered nurse or therapist gives you written care instructions for each patient. You give the care in the plan. If a patient asks for care in a different way for cultural or faith reasons, call your nurse. Home health and hospice aides must report changes in the patient's needs to the nurse.
Safe at home
Same principles
The six principles work at home too. Call ahead if you'll be late. Come on the same days. Knock and say who you are before you walk in. Don't block the door. And remember, some people are still living through harm at home. If you see signs of abuse, report it right away.
Language help
Free services
Home health agencies must offer free language help, including interpreters and written translations. Hospices must tell patients their rights in a language they understand. NIA says experts discourage using family members as interpreters. They may miss medical words or hold back hard news, and it can affect privacy. Use your agency's service.
On your shift
Start well
Before your next home visit, read the written care instructions. Look for notes about culture, faith, or trauma. When you arrive, knock, say your name, and greet the patient first. Ask if anything has changed since your last visit. Then call your nurse about anything new. A good start helps the whole visit go well.
Quick review
Guest, ask, report
Let's review. In the home, you are a guest. Treat the person and their things with respect. Ask about house customs. Don't move things without asking. Follow the written care instructions, and call your nurse about changes. Use the six principles at home. Use your agency's language service. And report signs of abuse right away.
Your facility's policy (ask your supervisor):
Agency language service number and how to use it in the home
Policy on shoe covers and on moving patient belongings for safety
Who to call when a patient asks for care to be done differently
Answer every question. You need 80% to pass. You can try again as many times as you like.
Your quiz covers the lessons for: Nursing home ( questions). Change your setting
Please read
This free course gives you a certificate of completion from Pact Compliance. It is not continuing education (CE) credit and is not approved by any state.
Your employer decides whether it counts toward required in-service hours. Home health and hospice aide training must be given or supervised by the agency's registered nurse.
California: it does not count toward CNA or HHA renewal hours.
Your name and quiz answers stay in your browser and are never sent to Pact.
Pact Compliance LLC, Cordova, TN
Certificate of Completion
This certifies that
completed the online in-service course
Cultural Competency and Trauma-Informed Care
Setting
Completed
Seat time
Quiz score
Certificate ID
This free course gives you a certificate of completion from Pact Compliance. It is not continuing education (CE) credit and is not approved by any state. Your employer decides whether it counts toward required in-service hours. Home health and hospice aide training must be given or supervised by the agency's registered nurse. California: it does not count toward CNA or HHA renewal hours.
Part of this topic needs a hands-on check with your supervisor; this online course does not cover that part.
Pact does not keep a record of this certificate. Print it or save it as a PDF and give a copy to your supervisor. pactcompliance.com/free-training/cultural-competency-trauma-informed-care/
For owners, administrators and staff development coordinators
Track every staff member's training and licenses in one place. Try the 30-day demo.