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Taking a trip to the moon: 5 questions with a CNA

Residents play shuffleboard on the patio.
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Charlie Robertson, a project manager at EUA, spent time during his architectural schooling as a certified nursing assistant working with - older adults. I sat down with Charlie to learn more about his experience – from unique bonds he developed with residents to lessons about the built environment. (Interview edited for brevity.)

Sodo: Can you tell me about your time as a CNA?

Robertson: I was a CNA for just over three years in college. Architectural firms weren’t hiring interns, and I was encouraged to become a CNA – it was a decent paying job to pay the bills. I worked primarily on dementia-specific units, which was intimidating. I was trained on the night shift, and my work consisted of everything a CNA normally does – checking in on residents, turning bedridden residents, getting them dressed and other typical care tasks.

Sodo: Were there any experiences that have really stuck with you? What did you take away from those experiences?

Robertson: Growing up, my mom was an activity director at a local nursing home, and she would sometimes pull me in to help with activities. I remember going along with it, but always begrudgingly. It was an institutional environment and not very comfortable. You would see people sitting sort of hunched over – as a child, it’s a frightening scene.

But as an adult, it was different. I was more mature, and I also saw the residents as human beings. As a CNA, the experience becomes personal. It changed everything. The buck stops with you – if they have an infection, need range of motion exercises or to ambulate with assistance, it all rests on your shoulders. The onus of keeping these people healthier and living better, happier lives rests with the CNAs, and I took that responsibility seriously.

As a caregiver for people with dementia, a buzzword in the industry at the time was validation, a therapy used to communicate and connect with residents – emphasizing emotion instead of facts to support and respect the person. There was one resident who would refuse to change his clothes and refuse assistance from the CNAs. Every night he would say “Tonight, I’m going to the moon! We have a moon base and I have to get there.” I’d respond, saying his name and suggesting, “Well, if you’re going tonight, we should probably get ready to go. It’s a really long trip, so let’s just get you some new clothes, new underwear and you’ll be set for your trip.” And he’d get dressed.

While we learned this method from our training, the family would hear us talk and at first, they didn’t know how to react. They wondered why we were going along with this fantasy – but in the end, you’re not going to change his mind … this is who he is. At the end of the day, with validation, he would have new, clean clothes and would go to bed because we told him that he needed a good night’s rest for the journey tomorrow.

Sodo: With these experiences, is there an aspect of senior living design that captures your attention when working on projects?

Robertson: I try to focus on ways to design for purposeful living – whether it’s creating something university based where residents have opportunities to audit classes, or designing cafés or stores for older adults to work in their community. It’s great for them to socialize with other people to have that sense of purpose. I really believe senior living communities aren’t just places to live out our last days; they’re places to go to live full, happy lives.

Sodo: What advice do you have for senior living designers to help us empathize with caregivers?

Robertson: Care should be easy. Care should be something that gives CNAs joy rather than a string of repetitive tasks to complete before they clock out. With the built environment, there’s ways to help with that – things like centralizing supply storage and providing comfortable areas for employees to be out and engaging with residents.

We should be providing good, thoughtful storage, especially in tighter spaces like resident bathrooms. We always show door swings on plans, but also we should show cabinet door swings and drawer pulls. We need to think through where people are standing in those tighter spaces, which can make a world of difference. Especially for residents who cannot ambulate, figuring out the space for a CNA and a lift is critical – both for storage and active use. And we need to accommodate space for all this while at the same time keeping the space intimate and reminiscent of home.

Sodo: What's one hope you have for the senior living industry in the next 10 years?

Robertson: Specifically in the Midwest, I hope for more designs that get people truly engaged with nature. I’m not talking about just putting plants inside and watering them – we need to create an immersive environment. Figuring out ways in cold climates to get multisensory natural experiences for older adults will be so important. There are older nursing homes that have little solariums, and it’s great to feel the sun on your face. But to be truly surrounded by green, growing plants, hearing birds chirping and seeing a lizard scamper off – that would be incredible.

Charles Robertson, RA, CDT
Project Manager

Charlie is a Project Manager in the Living Environments Studio and a great mentor at EUA. He brings a perspective and a well-informed knowledge of Senior Living Environments as he is a former Certified Nursing Assistant.

Colorado Real Estate Journal

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