Investigating Communication Between Certified Nursing Assistants and Senior Residents In Assisted Living Facilities

While Certified Nursing Assistants (CNAs) provide the vast majority of care in long-term care settings, their communication adequacy remains under-researched. This mixed-methods study quantified the perceptual communication gap between CNAs and senior residents across 12 Assisted Living Facilities (ALFs) in Boca Raton, Florida. Quantitative t-tests revealed statistically significant discrepancies (p < 0.0001) across seven evaluated aspects of the CNA-resident relationship, with the most notable effect sizes being on the teach-back method (d = 1.73) and resident involvement (d = 1.48). Further qualitative coding identified 'Repetition without Adaptation' and 'Efficiency over Empathy’ as the primary barriers to this disconnect. Although the baseline communication gap did not produce a statistically significant correlation with lower medication adherence scores (rs = -0.133), the data expose a trust-understanding gap where residents trust their caregivers but remain mentally isolated from their treatment plans, emphasizing the need for personalized communication strategies in CNA training.