The ability to identify and document in the medical record the resident's usual and current cognitive patterns, mood and behavior, and whether these present a risk to the resident or others, identifying and documenting how the resident typically displays personal distress such as anxiety or fatigue, recognizing a change in the resident and the resident's functioning and the ability to describe and report such changes to the nurse such as negative verbalizations and vocalizations, facial expressions of grimacing, frowning, or fright, changes in gait, skin color, vital signs, behaviors such as resisting care, distressed pacing, irritability, depressed mood, and or decreased participation in usual physical and/or social activities, loss of function or inability to perform Activities of Daily Living, difficulty eating or loss of appetite and difficulty sleeping according to CMS RAI requirements. The ability to identifying and document how the resident communicates physical needs such as pain, discomfort, hunger or thirst, as well as emotional and psychological needs such as frustration or boredom; or a desire to do or express something that he/she cannot articulate; Answers call lights in a timely and appropriate manner ensuring that all of the residents needs to be provided by C.N.A.