CHCAC317A Support Older People To Maintain Their Independence

CHCAC317A Support older people to maintain their independence
CHCAC317A. Support older people to maintain their independence

Author: John Bailey Copyright Text copyright 2008 by John N Bailey. Illustration, layout and design copyright 2008 by John N Bailey. Under Australias Copyright Act 1968 (the Act), except for any fair dealing for the purposes of study, research, criticism or review, no part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without prior written permission from John N Bailey. All inquiries should be directed in the first instance to the publisher at the address below. Copying for Education Purposes The Act allows a maximum of one chapter or 10% of this book, whichever is the greater, to be copied by an education institution for its educational purposes provided that that educational institution (or the body that administers it) has given a remuneration notice to JNB Publications. Disclaimer All reasonable efforts have been made to ensure the quality and accuracy of this publication. JNB Publications assumes no responsibility for any errors or omissions and no warranties are made with regard to this publication. Neither JNB Publications nor any authorized distributors shall be held responsible for any direct, incidental or consequential damages resulting from the use of this publication.
Published in Australia by: JNB Publications PO Box, 268, Macarthur Square NSW 2560 Australia.
Document Name: Document No: John Bailey 2009
CHCAC317A Support older people to maintain their independence Version No: V1
Created Date: Last Modified Date: Page Sequence:
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CHCAC317A. Support older people to maintain their independence Contents

CHCAC317A. SUPPORT OLDER PEOPLE TO MAINTAIN THEIR INDEPENDENCE........................................... 2 Author: John Bailey .................................................................................................................................. 2 Copying for Education Purposes ............................................................................................................... 2 Disclaimer ................................................................................................................................................. 2 Description: ............................................................................................................................................... 7 Employability Skills: .................................................................................................................................. 7 Application: ............................................................................................................................................... 7 Introduction .............................................................................................................................................. 7 Learning Program ..................................................................................................................................... 8 Additional Learning Support ..................................................................................................................... 8 Facilitation ................................................................................................................................................ 8 Flexible Learning ....................................................................................................................................... 9 Space......................................................................................................................................................... 9 Study Resources ........................................................................................................................................ 9 Time ........................................................................................................................................................ 10 Study Strategies ...................................................................................................................................... 10 Using this learning guide: ....................................................................................................................... 10 THE ICON KEY............................................................................................................................................ 11 THE SUPPLEMENTARY ICONS .................................................................................................................... 12 How to get the Most out of your learning guide .................................................................................... 13 Additional research, reading and note taking. ....................................................................................... 13 EMPLOYABILITY SKILLS ........................................................................................................................... 14 CERTIFICATE III IN AGED CARE .................................................................................................................. 14 PERFORMANCE CRITERIA .......................................................................................................................... 18 SKILLS AND KNOWLEDGE .......................................................................................................................... 20 Required Skills ......................................................................................................................................... 20 Required Knowledge ............................................................................................................................... 21 RANGE STATEMENT .................................................................................................................................. 22 EVIDENCE GUIDE ....................................................................................................................................... 23 1. SUPPORT THE OLDER PERSON WITH THEIR ACTIVITIES OF LIVING. ................................................... 24 1.1 ENCOURAGE OLDER PEOPLE TO UTILISE SUPPORT SERVICES WHERE APPROPRIATE. ............................................ 24 Social Justice ........................................................................................................................................... 26 Aged Care Standards .............................................................................................................................. 27 Aged Care Assessment Teams ................................................................................................................ 28 Home & Community Care Program (HACC) ............................................................................................ 29 Community Aged Care Packages (CACP) ................................................................................................ 31 Extended Aged Care at Home (EACH) .................................................................................................. 31 Extended Aged Care at Home Dementia (EACH D) ................................................................................. 32 National Respite for Carers Program (NRCP) .......................................................................................... 33 Centrelink Assistance .............................................................................................................................. 34
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Commonwealth Respite and Carelink Program ....................................................................................... 35 Transition Care Program ......................................................................................................................... 35 Community nursing and Health Centres .................................................................................................. 37 Types of Care and Services ...................................................................................................................... 38 Hostel/accommodation services ............................................................................................................. 39 Low level Care .......................................................................................................................................... 40 Ageing in Place ........................................................................................................................................ 41 Extra Services........................................................................................................................................... 41 End-of-life Care/Palliative Care ............................................................................................................... 42 How palliative care is managed in aged care homes? ............................................................................ 42 Short-term Care ....................................................................................................................................... 42 How does your client access respite care? .............................................................................................. 43 How much respite care can a client have? .............................................................................................. 43 What fees do they have to pay? .............................................................................................................. 43 Transition Care ........................................................................................................................................ 43 Cultural and Identified Needs .................................................................................................................. 44 Aboriginal and Torres Strait Islander people ........................................................................................... 44 Aged care homes for culturally and linguistically diverse people ............................................................ 45 Particular health conditions .................................................................................................................... 45 Independent Living Units ......................................................................................................................... 46 Home nursing .......................................................................................................................................... 47 What if your client is not happy with their care? .................................................................................... 47 Where else can they get help? ................................................................................................................ 47 Activity 1 .................................................................................................................................................. 48 1.2 CLEARLY EXPLAIN THE SCOPE OF THE SERVICE TO BE PROVIDED TO THE OLDER PERSON AND/OR THEIR ADVOCATE. ... 49 Informal Care ........................................................................................................................................... 50 Personal Cost of Caring ........................................................................................................................... 51 Carer Support .......................................................................................................................................... 52 Respite ..................................................................................................................................................... 52 Carer Resource Centres ........................................................................................................................... 52 Formal Care ............................................................................................................................................. 53 High level care ......................................................................................................................................... 54 Ageing in Place ........................................................................................................................................ 56 Activity 2: Case Study .............................................................................................................................. 57 1.3 IDENTIFY THE NEEDS OF THE OLDER PERSON FROM THE SERVICE DELIVERY PLAN AND FROM CONSULTATION WITH A SUPERVISOR. .................................................................................................................................................... 58 Stages of Care Planning ........................................................................................................................... 60 Supervision .............................................................................................................................................. 61 Activity 3 .................................................................................................................................................. 65 Activity 4 .................................................................................................................................................. 65 Ensure visits and service delivery accommodate the older persons established routines and customs where possible. .......................................................................................................................... 66 Routine in an Aged Care Facility .............................................................................................................. 67 Activity 5: Case Study .............................................................................................................................. 67 Customs/Cultural needs .......................................................................................................................... 68 The Iceberg Model ................................................................................................................................... 69 Cultural communication .......................................................................................................................... 70 Co-workers............................................................................................................................................... 73 Activity 6 .................................................................................................................................................. 73 1.5 PERFORM WORK IN A MANNER THAT ACKNOWLEDGES THAT THE SERVICES ARE BEING PROVIDED IN THE CLIENTS OWN HOME. .................................................................................................................................................... 74 Carer attributes ....................................................................................................................................... 75 Working with Carers ................................................................................................................................ 75 Roles and Responsibilities ........................................................................................................................ 76 Limited Supervision.................................................................................................................................. 76 Documentation ........................................................................................................................................ 77 Activity 7 .................................................................................................................................................. 78
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1.6 PROVIDE SERVICES IN A MANNER THAT ENABLES THE OLDER PERSON TO DIRECT THE PROCESSES WHERE APPROPRIATE. ... 80 Meeting Care Needs ............................................................................................................................... 81 Home and Community Care (HACC) Services .......................................................................................... 81 Activity 8 ................................................................................................................................................. 84 Activity 9: Case Study .............................................................................................................................. 85 1.7 PROVIDE SUPPORT/ASSISTANCE IN ACCORDANCE WITH ORGANISATION POLICY, PROTOCOLS AND PROCEDURES. ..... 87 Activity 10 ............................................................................................................................................... 88 1.8 DEMONSTRATE APPROPRIATE USE OF EQUIPMENT TO SUPPORT/ASSIST THE OLDER PERSON WITH ACTIVITIES OF LIVING WITHIN WORK ROLE AND RESPONSIBILITY..................................................................................................... 89 Activity 11 ............................................................................................................................................... 93 Activity 12 ............................................................................................................................................... 94 2. RECOGNISE AND REPORT CHANGES IN AN OLDER PERSONS ABILITY TO UNDERTAKE ACTIVITIES OF LIVING. ................................................................................................................................................ 97 2.1 MONITOR THE OLDER PERSONS ACTIVITIES AND ENVIRONMENT TO IDENTIFY INCREASED NEED FOR
SUPPORT/ASSISTANCE WITH ACTIVITIES OF LIVING. .................................................................................................. 97
Activity 13 ............................................................................................................................................... 99 Activity 14 ............................................................................................................................................. 102 2.2 REPORT TO A SUPERVISOR THE OLDER PERSONS INABILITY TO UNDERTAKE ACTIVITIES OF LIVING INDEPENDENTLY. 103 Telephone ............................................................................................................................................. 103 Face to face/Verbally ............................................................................................................................ 104 Clinical notes/Progress notes/Care Plan ............................................................................................... 104 Activity 15 ............................................................................................................................................. 105 2.3 SUPPORT/ASSIST THE OLDER PERSON TO MODIFY OR ADAPT THE ENVIRONMENT OR ACTIVITY TO FACILITATE INDEPENDENCE. ............................................................................................................................................. 107 Activity 16 ............................................................................................................................................. 109 Activity 17 ............................................................................................................................................. 110 2.4 SEEK AIDS AND/OR EQUIPMENT TO SUPPORT/ASSIST THE OLDER PERSON UNDERTAKE ACTIVITIES OF LIVING INDEPENDENTLY. ............................................................................................................................................ 111 Figure 1: Safety ..................................................................................................................................... 111 Activity 18 ............................................................................................................................................. 115 Activity 19: Research ............................................................................................................................. 115 Activity 20 ............................................................................................................................................. 116 3. SUPPORT THE OLDER PERSON TO MAINTAIN AN ENVIRONMENT THAT MAXIMISES INDEPENDENCE, SAFETY AND SECURITY. ................................................................................................ 118 3.1 ENCOURAGE AND SUPPORT/ASSIST THE OLDER PERSON TO MAINTAIN THEIR ENVIRONMENT. ............................ 118 Activity 21: Case Study .......................................................................................................................... 121 Activity 22 ............................................................................................................................................. 122 3.2 PROVIDE SUPPORT TO PROMOTE SECURITY OF THE OLDER PERSONS ENVIRONMENT. ...................................... 123 Activity 23 ............................................................................................................................................. 127 3.3 ADAPT OR MODIFY THE ENVIRONMENT, IN CONSULTATION WITH THE OLDER PERSON, TO MAXIMISE SAFETY AND COMFORT. .................................................................................................................................................... 129 Activity 24 ............................................................................................................................................. 132 3.4 RECOGNISE HAZARDS AND ADDRESS IN ACCORDANCE WITH ORGANISATION POLICY AND PROTOCOLS.................. 134 Table 2: Hazards in the Environment .................................................................................................... 135 Activity 25 ............................................................................................................................................. 136 Activity 26 ............................................................................................................................................. 137 4. SUPPORT THE OLDER PERSON WHO IS EXPERIENCING LOSS AND GRIEF. ....................................... 139 4.1 RECOGNIZE SIGNS THAT OLDER PERSON IS EXPERIENCING GRIEF AND REPORT TO APPROPRIATE PERSON. ............. 139 Reporting Grief ..................................................................................................................................... 142 Activity 27 ............................................................................................................................................. 143 4.2 USE APPROPRIATE COMMUNICATION STRATEGIES WHEN OLDER PERSON IS EXPRESSING THEIR FEARS AND OTHER EMOTIONS ASSOCIATED WITH LOSS AND GRIEF. .................................................................................................... 145 Listen with Compassion ........................................................................................................................ 146 Concentrate your efforts on listening carefully and with compassion. ................................................. 147
Comments to avoid when comforting the bereaved ............................................................................. 147 Offer practical assistance ...................................................................................................................... 148 Provide ongoing support ....................................................................................................................... 148 Watch for warning signs ....................................................................................................................... 149 Activity 28: Case Study .......................................................................................................................... 150 4.3 PROVIDE OLDER PERSON AND/OR THEIR SUPPORT NETWORK WITH INFORMATION REGARDING RELEVANT SUPPORT SERVICES AS REQUIRED. .................................................................................................................................... 152 Support from family and friends is important ....................................................................................... 152 Bereavement counselling ...................................................................................................................... 152 Where to get help .................................................................................................................................. 153 Things to remember .............................................................................................................................. 153 Moving on with life ................................................................................................................................ 154 Activity 29 .............................................................................................................................................. 155 Activity 30 .............................................................................................................................................. 156
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CHCAC317A. Support older people to maintain their independence

Description: This unit describes the knowledge and skills required by the worker to support the older person to maintain their independence with activities of living. Employability Skills: This unit contains Employability Skills. Application: This unit applies to workers in the aged care sector, or those working with older people. Introduction As a worker, a trainee or a future worker you want to enjoy your work and become known as a valuable team member. This unit of competency will help you acquire the knowledge and skills to work effectively as an individual and in groups. It will give you the basis to contribute to the goals of the organization which employs you. It is essential that you begin your training by becoming familiar with the industry standards to which organizations must conform. This unit of competency introduces you to some of the key issues and responsibilities or workers and organizations in this area. The unit also provides you with opportunities to develop the competencies necessary for employees to operate as team members. This Learning Guide covers: Support the older person with their activities of living. Recognise and report changes in an older persons ability to undertake activities of living. Support the older person to maintain an environment that maximises independence, safety and security. Support the older person who is experiencing loss and grief.
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Learning Program As you progress through this unit you will develop skills in locating and understanding an organizations policies and procedures. You will build up a sound knowledge of the industry standards within which organizations must operate. You should also become more aware of the effect that your own skills in dealing with people has on your success, or otherwise, in the workplace. Knowledge of your skills and capabilities will help you make informed choices about your further study and career options. Additional Learning Support To obtain additional support you may: Search for other resources in the Learning Resource Centres of your learning institution. You may find books, journals, videos and other materials which provide extra information for topics in this unit. Search in your local library. Most libraries keep information about government departments and other organizations, services and programs. Contact information services such as Infolink, Equal Opportunity Commission, Commissioner of Workplace Agreements. Union organizations, and public relations and information services provided by various government departments. Many of these services are listed in the telephone directory. Contact your local shire or council office. Many councils have a community development or welfare officer as well as an information and referral service. Contact the relevant facilitator by telephone, mail or facsimile. Facilitation Your training organization will provide you with a flexible learning facilitator. Your facilitator will play an active role in supporting your learning, will make regular contact with you and if you have face to face access, should arrange to see you at least once. After you have enrolled your facilitator will contact you be telephone or letter as soon as possible to let you know: How and when to make contact What you need to do to complete this unit of study What support will be provided. Here are some of the things your facilitator can do to make your study easier. Give you a clear visual timetable of events for the semester or term in which you are enrolled, including any deadlines for assessments. Check that you know how to access library facilities and services.
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Conduct small interest groups for some of the topics. Use action sheets and website updates to remind you about tasks you need to complete. Set up a chat line. If you have access to telephone conferencing or video conferencing, your facilitator can use these for specific topics or discussion sessions. Circulate a newsletter to keep you informed of events, topics and resources of interest to you. Keep in touch with you by telephone or email during your studies.
Flexible Learning Studying to become a competent worker and learning about currents issues in this area, is an interesting and exciting thing to do. You will establish relationships with other candidates, fellow workers and clients. You will also learn about your own ideas, attitudes and values. You will also have fun most of the time. At other times, study can seem overwhelming and impossibly demanding, particularly when you have an assignment to do and you arent sure how to tackle it..and your family and friends want you to spend time with themand a movie you want to watch is on television.and. Sometimes being a candidate can be hard. Here are some ideas to help you through the hard times. To study effectively, you need space, resources and time. Space Try to set up a place at home or at work where: You can keep your study materials You can be reasonably quiet and free from interruptions, and You can be reasonably comfortable, with good lighting, seating and a flat surface for writing. If it is impossible for you to set up a study space, perhaps you could use your local library. You will not be able to store your study materials there, but you will have quiet, a desk and chair, and easy access to the other facilities.
Study Resources The most basic resources you will need are: a chair a desk or table a reading lamp or good light a folder or file to keep your notes and study materials together materials to record information (pen and paper or notebooks, or a computer and printer) reference materials, including a dictionary
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Do not forget that other people can be valuable study resources. Your fellow workers, work supervisor, other candidates, your flexible learning facilitator, your local librarian, and workers in this area can also help you. Time It is important to plan your study time. Work out a time that suits you and plan around it. Most people find that studying in short, concentrated blocks of time (an hour or two) at regular intervals (daily, every second day, once a week) is more effective than trying to cram a lot of learning into a whole day. You need time to digest the information in one section before you move on to the next, and everyone needs regular breaks from study to avoid overload. Be realistic in allocating time for study. Look at what is required for the unit and look at your other commitments. Make up a study timetable and stick to it. Build in deadlines and set yourself goals for completing study tasks. Allow time for reading and completing activities. Remember that it is the quality of the time you spend studying rather than the quantity that is important. Study Strategies Different people have different learning styles. Some people learn best by listening or repeating things out loud. Some learn best by doing, some by reading and making notes. Assess your own learning style, and try to identify any barriers to learning which might affect you. Are you easily distracted? Are you afraid you will fail? Are you taking study too seriously? Not seriously enough? Do you have supportive friends and family? Here are some ideas for effective study strategies. Make notes. This often helps you to remember new or unfamiliar information. Do not worry about spelling or neatness, as long as you can read your own notes. Keep your notes with the rest of your study materials and add to them as you go. Use pictures and diagrams if this helps. Underline key words when you are reading the materials in this learning guide. (Do not underline things in other peoples books). This also helps you to remember important points. Talk to other people (fellow workers, fellow candidates, friends, family, your facilitator) about what you are learning. As well as helping you to clarify and understand new ideas, talking also gives you a chance to find out extra information and to get fresh ideas and different points of view. Using this learning guide: A learning guide is just that, a guide to help you learn. A learning guide is not a text book. Your learning guide will describe the skills you need to demonstrate to achieve competency for this unit, provide information and knowledge to help you develop your skills provide you with structured learning activities to help you absorb the knowledge and information and practice your skills direct you to other sources of additional knowledge and information about topics for this unit.
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The Icon Key

Key Points
Explains the actions taken by a competent person.
Example
Illustrates the concept or competency by providing examples.
Activity
Provides activities to reinforce understanding of the action.
Chart
Provides images that represent data symbolically. They are used to present complex information and numerical data in a simple, compact format.
Intended Outcomes or Objectives

Statements of intended outcomes or objectives are descriptions of the work that will be done.
Assessment
Strategies with which information will be collected in order to validate EACH intended outcome or objective.
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The Supplementary Icons

PowerPoint
Any PowerPoint associated with a unit will have this icon next to them
Forms and Care Plans

If there is a form or care plan associated with a unit there will be an icon like this with the relevant number of the form or care plan in the format FFACF-015
Employability Skills
Where the employability skills are shown to be embedded in the unit and relates to the table in the front of each unit eg: T1, S1, E1.
Readings
Provides backup and reasoning to the underpinning knowledge and skills
Primary Skills Assessments

Where the Primary Skills Assessments are applicable there will be an icon in the format PSA - XX
World Wide Web

Where the world wide web is used for an activity in the unit you will find this icon.
Resource Document
Where the Resource documents are applicable there will be an icon in the format RDN - XX
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How to get the Most out of your learning guide 1. Read through the information in the learning guide carefully. Make sure you understand the material. Some sections are quite long and cover complex ideas and information. If you come across anything you do not understand: talk to your facilitator research the area using the books and materials listed under Resources discuss the issue with other people (your workplace supervisor, fellow workers, fellow candidates) try to relate the information presented in this learning guide to your own experience and to what you already know. Ask yourself questions as you go: For example Have I seen this happening anywhere? Could this apply to me? What if.? This will help you to make sense of new material, and to build on your existing knowledge. 2. 3. 4. Talk to people about your study. Talking is a great way to reinforce what you are learning. Make notes. Work through the activities.
Even if you are tempted to skip some activities, do them anyway. They are there for a reason, and even if you already have the knowledge or skills relating to a particular activity, doing them will help to reinforce what you already know. If you do not understand an activity, think carefully about the way the questions or instructions are phrased. Read the section again to see if you can make sense of it. If you are still confused, contact your facilitator or discuss the activity with other candidates, fellow workers or with your workplace supervisor. Additional research, reading and note taking. If you are using the additional references and resources suggested in the learning guide to take your knowledge a step further, there are a few simple things to keep in mind to make this kind of research easier. Always make a note of the authors name, the title of the book or article, the edition, when it was published, where it was published, and the name of the publisher. If you are taking notes about specific ideas or information, you will need to put the page number as well. This is called the reference information. You will need this for some assessment tasks, and it will help you to find the book again if you need to. Keep your notes short and to the point. Relate your notes to the material in your learning guide. Put things into your own words. This will give you a better understanding of the material. Start off with a question you want answered when you are exploring additional resource materials. This will structure your reading and save you time.
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Employability Skills Certificate III in Aged Care

EMPLOYABILITY SKILLS FACETS ADDRESSED: Industry/enterprise requirements for this qualification include the following facets: 1. Listening to and understanding work instructions, directions and feedback 2. Speaking clearly/directly to relay information 3. Reading and interpreting workplace related documentation, such as prescribed programs 4. Writing to address audience needs, such as forms, case notes and reports 5. Interpreting the needs of internal/ external clients from clear information and feedback Communication 6. Applying basic numeracy skills to workplace requirements involving measuring and counting 8. Sharing information (eg. with other staff, working as part of an allied health team) 9. Negotiating responsively (eg. re own work role and/or conditions, possibly with clients) 11. Being appropriately assertive (eg. in relation to safe or ethical work practices and own work role) 12. Empathising (eg. in relation to others) 1. Working as an individual and a team member 2. Working with diverse individuals and groups 3. Applying knowledge of own role as part of a team Teamwork 4. Applying teamwork skills to a limited range of situations 5. Identifying and utilising the strengths of other team members 6. Giving feedback C6 C8 C9 C11 C12 T1 T2 T3 T4 T5 T6 Code
C1 C2 C3 C4 C5
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EMPLOYABILITY SKILLS
FACETS ADDRESSED: Industry/enterprise requirements for this qualification include the following facets: 1. Developing practical solutions to workplace problems (i.e. within scope of own role) 2. Showing independence and initiative in identifying problems (i.e. within scope of own role) 3. Solving problems individually or in teams (i.e. within scope of own role)
Code
P1 P2
P3 P5
Problem solving
5. Using numeracy skills to solve problems (eg. time management, simple calculations, shift handover) 6. Testing assumptions and taking context into account (i.e. with an awareness of assumptions made and work context) 7. Listening to and resolving concerns in relation to workplace issues 8. Resolving client concerns relative to workplace responsibilities (i.e. if role has direct client contact)
P6
P7
P8
Initiative and enterprise
1. Adapting to new situations (i.e. within scope of own role) 2. Being creative in response to workplace challenges (i.e. within relevant guidelines and protocols) 3. Identifying opportunities that might not be obvious to others (i.e. within a team or supervised work context) 5. Translating ideas into action (i.e. within own work role) 6. Developing innovative solutions (i.e. within a team or supervised work context and within established guidelines)
I1 I2
I3
I5
I6
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EMPLOYABILITY SKILLS Planning and organising
FACETS ADDRESSED: Industry/enterprise requirements for this qualification include the following facets: 1. Collecting, analysing and organising information (i.e. within scope of own role) 2. Using basic systems for planning and organising (i.e. if applicable to own role) 3. Being appropriately resourceful 4. Taking limited initiative and making decisions within workplace role (i.e. within authorised limits) 5. Participating in continuous improvement and planning processes (i.e. within scope of own role) 6. Working within clear work goals and deliverables 7. Determining or applying required resources (i.e. within scope of own role) 8. Allocating people and other resources to tasks and workplace requirements (only for team leader or leading hand roles) 9. Managing time and priorities (i.e. in relation to tasks required for own role) 10. Adapting resource allocations to cope with contingencies (i.e. if relevant to own role)
Code
O1 O2 O3 O4 O5 O6 O7 O8
O9 O10 S1 S2
Self management
1. Being self-motivated (i.e. in relation to requirements of own work role) 2. Articulating own ideas (i.e. within a team or supervised work context) 3. Balancing own ideas and values with workplace values and requirements 4. Monitoring and evaluating own performance (i.e. within a team or supervised work context) 5. Taking responsibility at the appropriate level
S3 S4 S5
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EMPLOYABILITY SKILLS Learning
FACETS ADDRESSED: Industry/enterprise requirements for this qualification include the following facets: 1. Being open to learning new ideas and techniques) 2. Learning in a range of settings including informal learning 3. Participating in ongoing learning 4. Learning in order to accommodate change 5. Learning new skills and techniques 6. Taking responsibility for own learning (i.e. within scope of own work role) 7. Contributing to the learning of others (eg. by sharing information) 8. Applying a range of learning approaches (i.e. as provided) 10. Participating in developing own learning plans (eg. as part of performance management)
Code
L1 L2 L3 L4 L5 L6 L7 L8
L10 E1 E2 E3 E4
Technology
1. Using technology and related workplace equipment (i.e. if within scope of own role) 2. Using basic technology skills to organise data 3. Adapting to new technology skill requirements (i.e. within scope of own role) 4. Applying OHS knowledge when using technology
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CHCAC317A.Support Older People To Maintain Their Independence Element
Performance Criteria
Support the older person with their activities of living.
1.
1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 2.
Encourage older people to utilise support services where appropriate. Clearly explain the scope of the service to be provided to the older person and/or their advocate. Identify the needs of the older person from the service delivery plan and from consultation with a supervisor. Ensure visits and service delivery accommodates the older persons established routines and customs where possible. Perform work in a manner that acknowledges that the services are being provided in the clients own home. Provide services in a manner that enables the older person to direct the processes where appropriate. Provide support/assistance in accordance with organisation policy, protocols and procedures. Demonstrate appropriate use of equipment to support/assist the older person with activities of living within work role and responsibility.
Recognise and report changes in an older persons ability to undertake activities of living.
2.1 2.2 2.3 2.4
Monitor the older persons activities and environment to identify increased need for support/assistance with activities of living. Report to a supervisor the older persons inability to undertake activities of living independently. Support/assist the older person to modify or adapt the environment or activity to facilitate independence. Seek aids and/or equipment to support/assist the older person undertake activities of living independently.
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3.
Support the older person to maintain an environment that maximises independence, safety and security.
3.1 3.2 3.3 3.4 4.
Encourage and support/assist the older person to maintain their environment. Provide support to promote security of the older persons environment. Adapt or modify the environment, in consultation with the older person, to maximise safety and comfort. Recognise hazards and address in accordance with organisation policy and protocols.
Support the older person who is experiencing loss and grief.
4.1 4.2 4.3
Recognise signs that older person is experiencing grief and report to appropriate person. Use appropriate communication strategies when older person is expressing their fears and other emotions associated with loss and grief. Provide older person and/or their support network with information regarding relevant support services as required.
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Skills and Knowledge

Required Skills It is critical that the candidate demonstrate the ability to:

Apply demonstrated understanding of own work role and responsibilities Follow organisation policies and protocols Liaise and report appropriately to supervisor Adhere to own work role and responsibilities Monitor older peoples ability to undertake instrumental activities of living and providing support/assistance in accordance with service delivery plans
In addition, the candidate must be able to demonstrate relevant task skills; task management skills; contingency management skills and job/role environment skills These include the ability to:

Accommodate older peoples established routines and customs and right to direct service delivery processes Apply reading and writing skills required to fulfil work role in a safe manner and as specified by the organisation/service: this requires a level of skill that enables the worker to follow work-related instructions and directions and the ability to seek clarification and comments from supervisors, clients and colleagues industry work roles will require workers to possess a literacy level that will enable them to interpret international safety signs, read clients service delivery plans, make notations in clients records and complete workplace forms and records Apply oral communication skills required to fulfil work role in a safe manner and as specified by the organisation: this requires a level of skill that enables the worker to follow work-related instructions and directions and the ability to seek clarification and comments from supervisors, clients and colleagues industry work roles will require workers to possess oral communication skills that will enable them to ask questions, clarify understanding, recognise and interpret non-verbal cues, provide information and express encouragement Apply numeracy skills required to fulfil work role in a safe manner and as specified by the organisation:
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industry work roles will require workers to be able to perform basic mathematical functions, such as addition and subtraction up to three digit numbers and multiplication and division of single and double digit numbers Apply basic problem solving skills to resolve problems of limited difficulty within organisation protocols Work effectively with clients, social networks, colleagues and supervisors
Required Knowledge The candidate must be able to demonstrate essential knowledge required to effectively perform task skills; task management skills; contingency management skills and job/role environment skills as outlined in elements and performance criteria of this unit These include knowledge of:

Relevant policies, protocols and practices of the organisation in relation to Unit Descriptor and work role The importance of community engagement and the ability to undertake instrumental activities of living for older people Principles and practices of confidentiality and privacy Principles and practices associated with providing services in a clients own living environment Strategies for supporting/assisting an older person to undertake instrumental activities of living independently Services and aids available to support independence with instrumental activities of living Referral mechanisms Safety and security risks associated with ageing Hazards in an older persons environment Strategies for minimising hazards in older persons environments Stages of loss and grief and impact of ageing on persons experiences of loss and grief
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Range Statement
The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.
Older people may include: Contexts may include:
Individuals living in residential aged care environments Individuals living in the community The older persons own dwelling Independent living accommodation Residential aged care facilities Home maintenance Garden maintenance Transport and attendance at appointments and social and recreational activities Domestic cleaning Domestic laundry Meal preparation Shopping Attendance to financial matters and personal correspondence Pet care Verbal: - telephone - face-to-face Non-verbal (written): - progress reports - case notes - incident reports Domestic appliances utilised for cleaning, laundering and meal preparation Gardening equipment Personal and security alarms Mobility devices Poor or inappropriate lighting Slippery or uneven floor surfaces Physical obstructions (e.g. furniture and equipment) Poor home and domestic appliance maintenance Inadequate heating and cooling devices Inappropriate footwear and clothing
Activities include:
of
living
may
Report include:
may
be
and
Aids and/or may include:
equipment
Hazards may include:
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Evidence Guide
The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package. Critical aspects for assessment and evidence required to demonstrate this unit of competency:

Access and considerations:
equity
Context of and specific resources for assessment:
Method of may include:
assessment
The individual being assessed must provide evidence of specified essential knowledge as well as skills This unit will be most appropriately assessed in the workplace or in a simulated workplace and under the normal range of workplace conditions It is recommended that assessment or information for assessment will be conducted or gathered over a period of time and cover the normal range of workplace situations and settings Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible All workers in community services should be aware of access, equity and human rights issues in relation to their own area of work All workers should develop their ability to work in a culturally diverse environment In recognition of particular issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on Aboriginal and Torres Strait Islander people Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on Aboriginal and/or Torres Strait Islander clients and communities This unit can be assessed independently, however holistic assessment practice with other community services units of competency is encouraged Resources required for assessment include access to: - appropriate workplace where assessment can take place - relevant organisation policy, protocols and procedures - equipment and resources normally used in the workplace Observation in the workplace Written assignments/projects Case study and scenario analysis Questioning Role play simulation
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1.
Support the older person with their activities of living.

1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8
Encourage older people to utilise support services where appropriate. Clearly explain the scope of the service to be provided to the older person and/or their advocate. Identify the needs of the older person from the service delivery plan and from consultation with a supervisor. Ensure visits and service delivery accommodates the older persons established routines and customs where possible. Perform work in a manner that acknowledges that the services are being provided in the clients own home. Provide services in a manner that enables the older person to direct the processes where appropriate. Provide support/assistance in accordance with organisation policy, protocols and procedures. Demonstrate appropriate use of equipment to support/assist the older person with activities of living within work role and responsibility.
1.1
Encourage older appropriate.
people
to
utilise
support
services
where
Being aware of ageism (the process of systematic stereotyping and discrimination against older people simply because they are old), stereotyping and the impact of attitudes on how services are delivered will help aged care workers and carers to focus on their clients. Remember that the client not the worker or anyone else should be at the centre of the service. Services must always focus on the individual client and their needs, preferences and perspectives. To promote a clientcentred or person-centred approach and minimise ageism and discrimination: assume that everyone is different check to see whether you use collective or childish names for older clients, such as'duckie', 'sweetie' or 'old codger' if you do, you may think you are being very caring but you are also being ageist always use the person's preferred name, as this is an excellent start to providing an individualised, non-stereotypical service
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always ask the person what they need and how they would like things done use good listening and communication skills to clarify information and develop a working environment that is mutually respectful learn about and uphold client rights, and tell clients what their rights are if the client is from a culturally and linguistically diverse (CALD) community, use a trained interpreter do not use a member of the family, and do not try to guess what the person is saying let the older person be the judge of what is in their best interests.
The elderly have certain absolute rights that should be built into all services that are provided. These rights include respect for their dignity, the ability to make informed choices either directly or through a guardian, and respect for their right to confidentiality and privacy and these are found in state and federal legislation and acts such as the Privacy Act and the Confidentiality Act. Healthy ageing requires providing support to older people before they experience physical or mental health crisis. The availability of accessible transport and leisure and recreation programs is vital to realise the expectation of a healthy and enjoyable old age, as is access to information services such as computer and electronic media to assist in maintaining social networks. Home support services such as home help, personal care, home modification and home maintenance are important in supporting older people to remain independent at home. Health Ageing approaches: research to identify causes of disease and the best way to deal with them health promotion recognition of individualised needs, including cultural preferences, beliefs and values physical activity to maintain fitness mental activity, including learning, recreation and social activity good nutrition regular health checks for the early identification of diseases immunisation programs revising lifestyle choices such as diet, exercise, drug and alcohol use, smoking careful medication management
Quality Care Services for Older People affordable, services accessible, appropriate, efficient and high-quality
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planned, integrated, innovative, flexible and coordinated services a range of private and publicly funded services a trained workforce providing information to clients so that they can make informed choices supporting the needs of carers (Andrews 2001)
In 2001, the Australian government established the Commonwealth Carelink Centre to help people locate the right services. Carelink Centres provide information about community services, aged care homes and other support services via a freecall number. These centres have been successful in helping consumers understand how to use the system and in referring them to relevant services in their area. The expectations we have on services are: Are reliable, dependable and on-going Meet the required government standards set by federal and state legislation Empower older people to participate in the delivery of their care Are affordable and accessible Have a fair society in which, everyone is of equal worth and everyone has an equal opportunity to succeed (social justice). Are holistic and individualized to promote a person-centred approach.
Social Justice Social justice is where everyone is of equal worth and everyone has an equal opportunity to succeed. There are four key areas to consider:1. Fairness in the distribution of resources-services, housing, wealth 2. Peoples rights are promoted 3. People have fair access to resources and services to meet their basic needs and to improve their quality of life 4. People have better opportunities to participate and be consulted about decisions that affect their lives. As part of social justice comes access and equity is a commitment on behalf of your client and their personal carers. This is demonstrated by the work an aged care worker performs and aims to: develop a client-centred culture based on responding to their expressed needs and wants provide services that take a non-discriminatory approach to all people using the service including clients, family and friends, coworkers and the general public
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undertake work that caters for individual differences including cultural, physical, religious, economic, social, developmental, behavioural, emotional and intellectual protect the rights of clients. These rights include rights to: privacy and confidentiality being treated with dignity and respect being safe and comfortable in the environment being able to express their feelings and concerns freedom of association and forming friendships choosing to participate having access to complaint mechanisms.
These rights should be referred to in all relevant documentation including the clients' charter of rights and the Aged Care Act 1997 that includes a quality system of accreditation as it relates to the Aged Care Standards. Aged Care Standards There are four standards and up to 44 expected outcomes to continue to receive funding from the government. Standard 1: Management systems, staffing and organizational development. Among other things this standard ensures: homes have management and information systems that are responsive to the needs of clients, representatives, staff and stakeholders and the changing environment that the home operates within continuous improvement that you have access to a complaints system that the staff who care for you are skilled, and that the home has the appropriate goods and equipment.
Standard 2: Health and personal care, and requires that: medication is managed safely and correctly clinical care meets your needs continence is managed effectively pain management continence management you are offered a varied, healthy and well-balanced diet oral and dental health is maintained, and your best level of mobility is achieved.
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Standard 3 is about lifestyle, and: maintaining your independence respecting your privacy, dignity and confidentiality encouraging your participation in decisions about services the home provides fostering your cultural and spiritual life, and ensuring clients understand their rights and responsibilities.
Standard 4 requires a safe and comfortable environment that ensures quality of life, your welfare and that of your visitors and the homes staff by: minimising fire, security and emergency risks Occupational Health and Safety having an effective infection control program, and providing catering, cleaning and laundry services to enhance your clients quality of life.
This part helps your client, you as the carer, your clients family and friends understand the various types of home help available why your client might want or need them, and how they can be arranged for your client. Home help is often described as 'community care'. Aged Care Assessment Teams To work out if you're eligible for certain subsidised aged care services you'll need to contact your clients local Aged Care Assessment Team (ACAT or ACAS in Victoria). These are teams of health professionals who help decide on the types of care that will best meet your clients needs, such as home help or the support provided by an aged care home. Referrals to an ACAT can be made by anyone you as a carer, your client or a health professional such as your clients doctor. Once your client or their representative has made an appointment, a member of your clients local ACAT will visit them in their home, hospital or elsewhere, ask your client a series of questions and discuss the assessment with your client. You as carer are able to be involved in this discussion. The ACAT member visiting your client may be a doctor, nurse, social worker, physiotherapist, occupational therapist, psychologist or other appropriate health care professional. Their job is to discuss your clients situation, give your client all the information your client requires, and help your client make the best choices based on their individual needs and the services available. There are no fees charged for this assessment. The ACAT is made up of health care professionals who have experience with the system and can help you in many ways:
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with decisions about whether your client can continue living at home with home help or if your client should consider moving into an aged care home by providing information about aged care homes and home care services in your clients area by assessing your clients eligibility to receive aged care services by organising and approving care and support services by referring you to other services that may assist you, and by arranging short-term care, such as respite care, so you as their carer or your clients can take a break.
Home & Community Care Program (HACC) If your client requires some basic help with everyday tasks, the Home and Community Care (HACC) program can assist by supporting your clients independence at home and in the community. This is an ideal solution if long-term care in an aged care home is inappropriate and your client only needs low-level care. An assessment by an ACAT is not necessary to access these services. The primary aim of all home and community care is to maintain or enhance the personal independence and quality of life of frail older people, people with disabilities and their carers. Home and community care services enable people to remain living at home rather than using hospitals, residential or institutional-based care. Without access to home and community care services many frail older people and people disabilities would require placement in a residential facility much sooner. The Home and Community Care (HACC) program aims to provide your client with a basic range of maintenance and support services to help your client stay at home. The services are provided by the community, privately, and by church or charitable organisations throughout Australia. The HACC Program can help your client with services such as:
nursing care, including home nursing, assistance with continence management, all in your clients own home home help, such as housework, washing and shopping home maintenance and modification personal care, such as help with bathing, dressing and eating meals on wheels and day centre-based meals ancillary health services like podiatry and speech therapy community-based respite care (day care) transport assessment and/or referral services counselling, information and advocacy services social support (including neighbour aid), and carer support
To access HACC your client can contact your local HACC provider directly, such as Meals on Wheels service, to discuss your clients needs and adjust them as your clients requirements change. And remember, should your client develop more complex care needs your client should enquire about other community services, such as Community Aged Care Packages, Extended Aged Care at Home (EACH) and EACH Dementia. EACH HACC service provider will assess your client to determine the appropriate level of service for your client. To contact your clients nearest HACC services, use the Talk to someone about this box in the right hand corner of this page, or call the Commonwealth Respite and Carelink Centre on 1800 052 222 during business hours or, for emergency respite support outside standard business hours, call 1800 059 059. HACC services are designed for people who need support to continue living in the community and who are older and frail or who have a disability. So if your client has difficulties with everyday tasks, such as getting dressed or showering, this could well be the extra support your client needs. HACC services are designed to reach people with the greatest level of need, as decided by HACC service providers. To be eligible for the HACC Program your client must: be living at home, be an older and frail person, or a person with a disability and have difficulty doing everyday tasks such as dressing or preparing meals, be a carer of a frail older person or person with a disability, or be likely to need to go into an aged care home or a hospital for care if your client were not being provided with support from HACC.
Some services charge a small fee that varies between states and territories check with your clients local HACC service about the costs of the particular services your client needs. These vary according to your clients income and the number of services your client uses. Special arrangements may be made if your client cannot afford to pay. Community care service providers are expected to comply with obligations under laws such as the Aged Care Act 1997. Under these laws your client has the right to be treated respectfully and be informed and consulted about their care. The HACC Program operates under a comprehensive quality framework to ensure that acceptable standards of service provision and program administration are maintained. The National Guidelines for HACC Service Standards provide agencies with a nationally consistent approach to the quality and delivery of all HACC funded services. Agencies funded through the HACC Program are required to report on aspects of quality, including standards. The Standards Instrument was developed to provide a consistent method for evaluating and monitoring the quality of service provision, as well as assist in the planning aspects of the service delivery system on a regional, state, territory and national level.
Community Aged Care Packages (CACP) This program provides a planned and managed package of community care for your client if your client has complex low-level care needs but can still live in their own home. To be eligible to receive a package, your client must be assessed by an Aged Care Assessment Team (ACAT). Your clients CACP care managers role is to plan and manage your clients care package, tailoring it to your clients individual needs. For example, a package may give your client help with personal care such as bathing and dressing, domestic assistance such as housework and shopping, or possibly help participating in social activities Other types of services that may be provided include: meal preparation laundry assistance with continence management transport personal care social support home help gardening, and temporary in-home respite care
To be eligible to receive a care package, your client must be assessed by an Aged Care Assessment Team (ACAT or ACAS in Victoria) as requiring the level of assistance this package delivers. Extended Aged Care at Home (EACH) Extended Aged Care at Home (EACH) is a program that provides your client with high-level care at home if your client needs more assistance than a Community Aged Care Package can provide. EACH is also an individually planned package and is coordinated for your client. An EACH package is highly flexible and includes qualified nursing input. The services that may be provided as part of an EACH package include: care by an allied health professional such as a physiotherapist or podiatrist personal care domestic assistance in-home respite transport social support home help, and assistance with continence management
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To receive an EACH package an Aged Care Assessment Team (ACAT or ACAS in Victoria) must assess your client as needing high-level care at home. Information on ACATS is available from Doctors, Hospitals and Community Centres, or the Aged Care Information line on 1800 500 853 (free call), or Commonwealth Respite and Carelink Centres on 1800 052 222 (free call) during business hours or, for emergency respite support outside standard business hours, call 1800 059 059 (free call). Community care service providers are expected to comply with obligations under laws such as the Aged Care Act 1997. Under these laws your client has the right to be treated respectfully and be informed and consulted about their care. The Australian Government sets standards to ensure your client receive quality care. For example, community care standards make sure that your client receives a service that meets their individual needs and that they have access to complaints procedures if they need them. Services that provide EACH packages are required to take part in Quality Reporting. It checks that services have systems and processes in place to meet the care standards that are put in place by government legislation. Extended Aged Care at Home Dementia (EACH D) If your client or someone your client cares for needs assistance because of behavioural problems associated with dementia, including periods of changes in behaviour, the Extended Aged Care at Home Dementia (EACH D) program can provide high-level care through an individually tailored package An EACH D package is highly flexible and includes qualified nursing input. The services that may be provided as part of an EACH D package include: linkages to government funded Dementia Behaviour Management Centres care by an allied health professional such as a physiotherapist or podiatrist personal care home help, and assistance with continence management
To receive an EACH D package, your client must first be assessed and approved by an Aged Care Assessment Team (ACAT or ACAS in Victoria) as a person who: is experiencing behaviours of concern and psychological symptoms associated with dementia that significantly impact upon your clients ability to live independently in the community, and may impact on functional capacity needs high level care in an aged care home prefers to receive EACH D, and is able to live at home with the support of an EACH D package.
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Community care service providers are expected to comply with obligations under laws such as the Aged Care Act 1997. Under these laws your client has the right to be treated respectfully and be informed and consulted about their care. The Australian Government sets standards to ensure your client receives quality care. Recipients of an EACH D package of care (or their representatives) are entitled to: quality services that meet their required needs where possible, their preferred level of social independence access information about the care options available and the facts they may need to make informed choices access to details of the care being provided take part in developing a package of care that best meets their needs.
National Respite for Carers Program (NRCP) Caring for a frail or older person can be physically and emotionally demanding. To make sure you as a carer get a break, the National Respite for Carers Program (NRCP) provides day care centres, in-home and activity respite programs. Your client does not need an ACAT assessment for community based respite services only if your client is receiving respite in an aged care home. There is a lot of assistance available for carers today, including timely, quality information, carer education and support thats both culturally and linguistically sensitive. If your client cares for a family member or friend to help them to continue living at home, your client may also be interested in respite care opportunities, which give your client and the person they're caring for the chance to take a short break. The National Respite for Carers Program (NRCP) allows carers of older people, people needing palliative care and people with disabilities to have a break to look after their own health and well-being, with the comfort of knowing that their clients dependants are well looked after. A range of community-based and residential respite is available and includes: day care centres that provide respite for a half day or full day in-home respite services, including overnight, home care and personal care services providing respite and support activity programs a break away from home, perhaps with a support worker respite for carers of people with dementia and challenging behaviours respite in a residential aged care home or overnight respite in a community setting, and respite for employed carers and for carers seeking to return to work.
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The NRCP can provide you as carer with specialised professional counselling. These services are operated through Carers Australia and The Network of Carer Associations, located throughout Australia. You can call them on 1800 242 636. Access to respite care is based on priority and need. For respite care in your clients home or in a day care centre, the respite service provider, or the Commonwealth Respite and Carelink Centre will assess whether you and your carer are eligible. The amount of care you receive will depend on your needs, your eligibility, and the availability of respite care services. You can contact the Commonwealth Respite and Carelink Centres on 1800 052 222 during business hours or, for emergency respite support outside standard business hours, call 1800 059 059. To receive respite care in an aged care home, you will have to be assessed by an Aged Care Assessment Team (ACAT or ACAS in Victoria), except in emergency situations. Usually, you can have up to 63 days of government-funded respite care in any financial year, and it may be possible to extend the care period by up to 21 days at a time, if your ACAT considers this necessary. Commonwealth Respite and Carelink Centres can help you with locating and booking a respite bed.
Centrelink Assistance Financial assistance is available in many forms to help your client and/or you including: the Disability Support Pension, available for people who are unable to work for a prolonged period of time because of a disability the Mobility Allowance, paid to eligible disabled workers to meet the extra cost of travel the Carer Payment, which provides an income support payment (similar to a pension) for people whose caring responsibilities prevent them from significantly participating in the workforce, and the Carer Allowance, which provides an income supplement for people who provide daily care and attention at home for an adult or child with a disability or severe medical condition.
Centrelink can also help with information about Rent Assistance, the Age Pension and concession cards. It also provides the Financial Information Service, a free and independent financial planning service available whether or not your client is receiving a pension or benefit. Community care service providers are expected to comply with obligations under their funding agreements and to deliver quality services that must meet national standards. Your client has the right to be treated respectfully, be informed and consulted about their care, and the right to make a complaint. In turn, your client has a responsibility to treat their service provider with respect. The Australian Government sets standards to ensure your client receives quality care. For example, community care standards ensure that your client receives a service that meets your clients individual needs. Your client has access to complaints procedures should they require them.
Commonwealth Respite and Carelink Program The Commonwealth Respite and Carelink Program is a national network of centres that provide up-to-date information on local community, aged care and disability services in your clients area that will help them continue living at home. The Commonwealth Respite and Carelink Program is a national network of centres that maintains an extensive database. These centres can provide your client with free and confidential information on: household help personal care home nursing meal services home modifications carer support short-term care day care centres day therapy centres special services for people with dementia services for people with incontinence and a range of allied health services.
There are 65 walk-in shopfronts throughout Australia, ensuring that the Commonwealth Respite and Carelink Centre closest to your client will know about the services in your clients particular location. You or your client can call Commonwealth Respite and Carelink Centres on 1800 052 222 (free call) or visit the Commonwealth Respite and Carelink website. Transition Care Program The Transition Care Program is aimed at helping your client improve their independence and confidence after a hospital stay, giving your client and their family more time to determine whether they can return home with additional support from community care services, or need to consider the level of care provided by an aged care home. An ACAT assessment and approval is required to access this service. The Transition Care Program aims to help your client improve your independence and confidence after a hospital stay. It provides a package of services including low intensity therapy and personal and/or nursing care as part of an ongoing but slower recovery process. This means that your client and their family or carer has time to consider their long-term care arrangements, which may include returning home with community support or accessing the level of care provided by an aged care home.
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Transition care is provided in their own home or in a live-in setting. Transition care can be provided for a period of up to 12 weeks, with a possibility to extend to 18 weeks if your client is assessed as needing an extra period of therapeutic care. The average period of care is expected to be about seven weeks. To be eligible for transition care, your client must be an older person and an in-patient of a hospital. Your client must have completed their acute and any necessary sub-acute care (eg rehabilitation). While your client is still in hospital, they must be assessed by an Aged Care Assessment Team (ACAT, or ACAS in Victoria) as someone who would be suitable for transition care. This includes consideration of their ability to benefit from the services transition care offers (eg low intensity therapy such as physiotherapy and occupational therapy) within the allowable time limits (a maximum of 12 weeks, with a possibility to extend to 18 weeks if they are assessed as needing an extra period of therapeutic care). Transition care provides a package of services tailored to their needs. This may include a range of low intensity therapy services and nursing support and/or personal care services. Examples of low intensity therapy services may include: physiotherapy occupational therapy dietetics podiatry speech therapy counselling, and social work.
Example of personal care services may include assistance with: showering, dressing eating and eating aids managing incontinence transport to appointments moving, walking, and communication.
Transition care can take place either at home or in a live-in setting. When its offered in a live-in setting, it must be provided in a more homelike, non-hospital environment that has space available for therapy. Access to transition care is decided on a needs basis, not on your clients ability to pay fees. In determining their ability to pay fees, your clients transition care provider takes into account their other
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unavoidable expenses such as high pharmaceutical bills or fees that your client still needs to pay to your aged care home. While youre in transition care you have rights, including the right to have a Transition Care Recipient Agreement with the service provider. You also have the right to: full and effective use of your clients personal, civil, legal and consumer rights be in a safe, secure and homelike environment be given enough information to make an informed choice about their care have written information about their rights, care, accommodation and any other information that relates to your client personally be involved in deciding on and choosing the care most appropriate to your clients needs receive care that takes account of their lifestyle, cultural, linguistic and religious preferences be given a written plan of the services they will receive take part in social activities and community life as far as possible have their dignity and privacy respected complain about the care theyre receiving, including the manner in which its being provided, without fear of losing the care or being disadvantaged in any other way, and choose a person to speak on their behalf for any purpose.
Its also good to know that the government has a quality framework in place to monitor: the quality of transition care your client receives the qualifications of staff the building where transition care takes place the complaints procedure, and your clients rights.
Community nursing and Health Centres Community health centres aim to improve your clients health and wellbeing by: encouraging them to actively participate in their own health care working on their needs with other primary health care providers offering facilities for their local community groups encouraging active participation in the centre's activities, including involvement in management, fundraising and volunteer work promoting prevention of lifestyle-related diseases and conditions, and
developing health care programs and activities to improve social and physical environments in the community.
Community health centres offer a range of services that can help your client remain at home by supporting them and you as their carer. The types of services that may be available at the local health centre include: medical services physiotherapy to help maintain their flexibility, strength and movement podiatry for foot and lower limb problems nursing, including health advice, education, counselling and monitoring speech pathology to help them communicate more effectively should they have a speech disorder social workers to help them or you as their carer with problems related to finances, accommodation or socialisation, and tailored programs for their specific dietary needs.
Types of Care and Services High level care High-level care is for people who need 24-hour nursing care. This may be because they are physically unable to move around and care for themselves, or because they have a severe dementia-type illness or other behavioural problems. Clients in high care must receive additional care and services at no additional cost. All aged care homes must provide a specified range of care and services at no additional cost to clients. These requirements vary according to whether the client has low-care or high-care needs. There are some specified care and services that all clients receive and additional ones that are provided for high-level care clients. If your client is unsure of whether they are receiving high-level care or low-level care, you as advocate could assist in getting that information by perhaps asking the manager of the aged care home. The specified care and services that must be provided by the aged care home at no additional cost are listed below. If a home provides the required range of specified care and services but the client would like certain other brands, or has individual specific needs, then the home does not have to cover the cost of those products.
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Hostel/accommodation services All clients receive specified care and services relating to: maintenance of buildings and grounds accommodation furnishings bedding cleaning services general laundry toiletries - bath towels, face washers, soap and toilet paper meals and refreshments social activities provision of staff on call to provide emergency help.
Additional requirements for high-level care High care clients must be provided with additional items, care and services such as: goods to help them move themselves e.g. crutches, walkers goods to assist with toilet and incontinence management more basic toiletries such as tissues, toothpaste, denture cleaning preparations, shampoo, conditioner and talcum powder.
Personal care and services All clients receive specified care and services including: assistance with the activities of daily living, such as: bathing and grooming using the toilet eating dressing mobility
maintaining continence or managing incontinence communicating with other people emotional support treatments and procedures (such as assistance with taking medication) recreational activities rehabilitation support
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assistance in obtaining health practitioner services and access to specific therapy services, and support for people with memory loss or confusion.
Additional requirements for high-level care High care clients must be provided with additional items, care and services such as: Nursing services and equipment, such as equipment to assist with: mobility, continence aids, basic medical and pharmaceutical supplies and equipment, helping with medications, provision of therapy services and short term oxygen.
Homes must also meet the requirements under the Accreditation Standards for Residential Aged Care. Low level Care Low-level care places are for people who need some help. Mostly, people in low-level care can walk or move about on their own. Low-level care focuses on personal care services (help with dressing, eating, bathing etc.), accommodation, support services (cleaning, laundry and meals) and some allied health services such as physiotherapy. Nursing care can be given when required. Most low-level aged care homes have nurses on staff, or at least have easy access to them. Low-level care is for people who need some help, but do not have very complex ongoing care needs. Low care includes: accommodation-related services furnishings, bedding, general laundry, some toiletries, cleaning services, all meals, maintenance of buildings and grounds, and the provision of staff on call to provide emergency assistance, and personal care services assistance with the activities of daily living, such as bathing, going to the toilet, eating, dressing, moving around, maintaining continence or managing incontinence, rehabilitation support, and assistance in obtaining health and therapy services.
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Ageing in Place Ageing in place refers to aged care homes that offer both high- and lowlevel care, and to situations where it is possible to stay in the same home if your care needs increase. It is possible in some aged care homes for you to receive care at lowlevel or high-level in the same place of residence. This means you dont need to move as a result of changing care needs. It is called ageing in place. An ageing in place policy is particularly beneficial for couples planning for a move from the family home as it may enable them to remain together even if their care needs significantly change over time. It also means people can maintain the relationships they have developed with staff and clients. The staff will be qualified and trained to support older people needing varying styles of care, including nursing, if needed. The ageing in place homes are designed to cater for people with a variety of care needs. Not all aged care homes offer ageing in place, with some providing for either low-level or high-level care needs, but not both. Also, a home may not be able to appropriately care for you in certain circumstances such as when behaviours of concern associated with dementia develop, that cannot be managed, or if you need acute care and need to go to hospital. Extra Services Some aged care homes may offer a higher standard of accommodation, food and services for an additional daily fee. They may also charge an accommodation bond for both low and high-level care when receiving extra services. Extra-service homes offer clients a higher standard of accommodation, services and food (sometimes referred to as 'hotel' services) at a higher fee. As this amount varies from home to home, its best to check costs directly with the aged care home. However, extra service does not mean that clients will be provided with a higher level of care (such as nursing), because all homes have to provide the same level of care to their clients. If paying for extra service, a client may receive, for instance, a bigger room, a wider choice of meals, or wine with meals. If your client chooses to enter an extra-service aged care home, an extra-service agreement must be made between the aged care provider and the client, in addition to the normal client agreement. It should specify what the home will provide at a higher standard, how much those aspects will cost, how often the extra service fees can be increased and by how much.
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End-of-life Care/Palliative Care End-of-life care or palliative care is care provided for people who have a life threatening illness, with little or no prospect of a cure, and for whom the primary treatment goal is quality of life. Palliative care in aged care homes aims to give the client the best possible quality of life, reducing the need to move clients to another location such as a hospital or hospice. End-of-life care, or palliative care, is care provided for people who have a life-limiting illness, with little or no prospect of a cure, and for whom the primary treatment goal is quality of life. Palliative care uses a holistic approach managing pain and other symptoms, whilst also addressing the physical, emotional, cultural, social and spiritual needs of the person, their family and their carers. It focuses on living well until death. How palliative care is managed in aged care homes? Palliative care in aged care homes aims to give the client the best possible quality of life. In fact, the approach of some aged care homes reduces the need to move clients to another location such as a hospital or hospice. This allows the client receiving care and their family to stay in their familiar environment and to feel supported, safe and comfortable. Also, accreditation standards of aged care homes make them responsible for ensuring that symptoms such as pain are managed, and that the comfort and dignity of the client is maintained at all times. In some cases, where clients have complex symptoms and the aged care team within the home needs more specialist palliative support, external palliative care services may be consulted. The Guidelines for a Palliative Approach in Residential Aged Care Facilities have been developed to provide support and guidance for the delivery of a palliative approach in residential aged care homes across Australia. All residential aged care homes in Australia have received a copy of the guidelines and national workshops have been held across Australia to raise the awareness of these guidelines and the benefits of using a palliative approach to care. Short-term Care Respite care in an aged care home is short-term care on a planned or emergency basis, where the person will ultimately return home. Respite care in an aged care home is short-term care on a planned or emergency basis, where the person will ultimately return home.
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How does your client access respite care? Respite care can be provided at a low-level care or high-level care in an aged care home once an Aged Care Assessment Team (ACAT or ACAS in Victoria) has assessed you as needing one of these levels of care. There are exceptions for emergency situations. Your regional Commonwealth Respite and Carelink Centre help your client find respite vacancies in an aged care home. How much respite care can a client have? Your client may have 63 days of respite care in a financial year, with the possibility of extensions of 21 days at a time if an ACAT considers this necessary. Respite care in aged care homes assists frail older people who are living at home and gives carers a break from their usual care arrangements. Carers can use respite to help with stress, in the event of illness, for holidays or the inability to provide care for other reasons. People who live alone may also stay in an aged care home for a short break. The availability of services may vary from region to region. What fees do they have to pay? If a person receives government-subsidised respite care in an aged care home, they will be asked to pay a basic daily flat fee. A booking fee may also be payable to assist in organising care. The booking fee is a prepayment of respite care fees and not an extra payment. Respite clients do not pay an accommodation charge or accommodation bond. And they dont have to pay any additional income-tested charges. Transition Care The Transition Care Program is aimed at helping your client improve their independence and confidence after a hospital stay. It works by providing low-intensity therapy and support as part of an ongoing but slower recovery process, giving your client and their family more time to determine whether they can return home with additional support from community care services, or need to consider the level of care provided by an aged care home. The Transition Care Program aims to help you improve your independence and confidence after a hospital stay. It provides a package of services including low intensity therapy and personal and/or nursing care as part of an ongoing but slower recovery process. This means that your client and their family or carer have time to consider their long-term care arrangements, which may include returning home with community support or accessing the level of care provided by an aged care home. Transition care is provided in their own home or in a live-in setting. Transition care can be provided for a period of up to 12 weeks, with a possibility to extend to 18 weeks if they are assessed as needing an
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extra period of therapeutic care. The average period of care is expected to be about seven weeks. Cultural and Identified Needs Some aged care homes offer specialised services for particular groups such as veterans, people who live in rural and regional areas, people with a disability, people who are culturally and linguistically diverse, Aboriginal and Torres Strait Islander people, and people who are socially or financially disadvantaged. Quality aged care is a basic right for all older Australians, whatever their background, no matter where they live. There are many care and support services that are designed to meet the needs of older Australians. But some groups of people need additional services. Veterans, Aboriginal and Torres Strait Islander people, those from culturally and linguistically diverse backgrounds and people in rural and remote areas all have particular needs that must be provided for to preserve and enhance their quality of life. No matter what your gender, ethnicity, culture, language, economic circumstance or geographic location, the Aged Care Act 1997 facilitates their access to aged care. People from different cultural, language or religious backgrounds are able to access all aged care homes and the homes must acknowledge and respect their cultural identity. But some homes provide additional services that are specific to their individual needs as well. Aged care homes will encourage and help clients to maintain existing links with cultural, national or social communities, and to take part in the social life of those communities. Aged care homes may arrange for a translator, if your client needs one, to help explain their needs and preferences. People living in aged care homes have the right to practice their own religion; some homes have their own chapel or quiet room. Some homes have regular visits from clergy or can arrange transport to places of worship. Aboriginal and Torres Strait Islander people Conditions associated with ageing generally affect Aboriginal and Torres Strait Islander people earlier than other Australians. Planning for aged care services is based on the Aboriginal and Torres Strait Islander population aged 50 years or older, compared with 70 years or older for other Australians. Flexible models of care are provided under the National Aboriginal and Torres Strait Islander Aged Care Strategy, often in remote areas where no aged care services are otherwise available.
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Aged care homes for culturally and linguistically diverse people People from different cultural, language or religious backgrounds are able to access aged care homes. However, some homes provide specific services to meet particular needs. A number of aged care homes run by ethnic community organisations receive public funding to improve the quality of life and care for older people from diverse cultural and linguistic backgrounds. Clustering brings together people who share similar cultural, language or religious backgrounds within one aged care home. Other options include multicultural services and services that are specific to a particular nationality or language group. The Partners in Culturally Appropriate Care (PICAC) program supports aged care homes to provide culturally appropriate care. The Community Partners Program (CPP) allows aged care homes and culturally and linguistically diverse communities to work together to establish and maintain links between people living in aged care homes and their social, cultural and language networks. Particular health conditions Some aged care homes offer specialised facilities for particular conditions, such as dementia, mental health, falls, and continence management. If your client requires these services, they will need to discuss them with the managers of homes they are considering. Once an aged care home accepts your client, it must cater for their particular health needs. These might include any one from a range of conditions such as dementia, incontinence, and chronic, terminal or mental illness. Some homes cater specifically for these particular needs.
Dementia While all homes cater for clients with dementia, some provide more targeted dementia services. These homes generally have staff who are specially trained, and areas that have been specifically designed for people with dementia. Not all people with dementia require a specific dementia unit in an aged care home. However, people with special care needs, such as those who may not be safely accommodated in general residential facilities, are best suited for these homes. Alzheimers Australia produces a checklist that may help.
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Multipurpose services (MPS) Multi-Purpose Services (MPS) are designed specifically for rural and regional areas, and bring together a range of health and aged care services under one management structure. The Multi-Purpose Services Program is a joint Australian and state/territory government initiative specifically designed for rural and regional areas. The aim of the Program is to provide a coordinated and cost-effective delivery of health services where separate health and aged care services may not be viable. Australian Government funding for flexible aged care is combined with State Government health services funding. The multi-purpose service applies this combined funding flexibly across health and aged care services to offer more service choices specific to the needs of the local community and to be innovative in service delivery. Services provided could include: aged care, both residential and home care, Home and Community Care (HACC) services including community nursing, domestic assistance and meals on wheels, respite care, acute care, emergency services, mental health services, and a range of allied health services including physiotherapy and podiatry
The National Aboriginal and Torres Strait Islander Aged Care Strategy provides a culturally appropriate and flexible approach to the delivery of aged care services for Indigenous Australians, mainly in rural and remote areas. Independent Living Units Independent Living Units are residential communities that offer a range of services for independent older people, and are regulated by state and territory governments. People who need less care than that offered by aged care homes may wish to consider independent living units, or retirement villages. These residential communities offer a range of services for independent older people, and are regulated by state and territory governments.
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Home nursing A nurse may also visit to help: restore health after an illness, and allow you to maintain the best level of independence.
They may also provide assistance with: personal hygiene medication injections, or changing dressings.
Care may be provided regularly or occasionally when your client needs it. What if your client is not happy with their care? If your client feels that the facility is not responsive to their needs or that theyre not getting the level of care they expect then they can get more support by contacting: The Aged Care Information Line on 1800 500 853 who will tell them about advocacy services in their state or territory, or The National Dementia Helpline on 1800 100 500.
Where else can they get help? doctor local community health service local council Carers Australia, phone 1800 242 636 Dementia Helpline, phone 1800 100 500 Carer Respite Centre, phone 1800 059 059 Carers Resource Centres, phone 1800 242 636 Aged Care Assessment Teams, or Aged Care Information Line, phone 1800 500 853.
Maintaining independence and feeling a sense of control is important for all people but especially to the older person. This could be as simple as maintaining the routine, desire to choose who to spend time with, the types of clothing to wear, when and where they need privacy, the choice of activity the person wants to participate in, ability to control their immediate environment such as listening to music, opening a window, or turning a fan or heater on/off. Remember, the older person is still a person regardless of their ability to communicate, frailty and cognitive ability. It is still important to offer choices whether it be simple or complex, be treated with respect, dignity and courtesy, explain what you
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are doing and to help as much as possible with their activities of daily living (ADLs). Activities of daily living (ADLs) are similar shared needs that everyone has such as, sleeping, eating, showering, dressing, grooming and elimination (urinary & bowel). Activity 1 What is Carelink? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Does an older person deserve the same rights as everyone else? Why/why not? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ What are the Aged Care Standards? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ What does ACAT stand for? _________________________________________________________ _________________________________________________________ In your own words, what does the Home and Community Care (HACC)Program, provide to older people? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ List other services, programs or packages that older people can utilise? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
_________________________________________________________ _________________________________________________________ Name and summarise the types of care and services available _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ What does ADLs stand for? _________________________________________________________
1.2 Clearly explain the scope of the service to be provided to the older person and/or their advocate.
Independence is central to a well-developed sense of self. The ability to live your life the way you want and to pursue your wishes, hopes and desires, is the basis of a happy and fulfilling life. As a person gets older, the ability and importance of controlling your own life should remain unchanged. One of the key characteristics of an effective aged care worker is the ability to think of ways in which we can support people to do as much for themselves as possible. And where extra support is required this needs to be provided in a manner that allows people to maintain their dignity. An advocate is a person who can provide support to the older person in deciding and discussing what they want or how they will live. The advocate may attend discussions about the older persons support and care. To make sure that the older person is able to say what they want and receive the service they need. Peoples rights are important, and sometimes older people may need support from the advocate to exercise their rights. Empowerment is the process of supporting people to assert their own rights, this is the fundamental key of advocacy. Many of the issues facing older people in our society are the very issues facing the majority of the population. These include: coming to terms with the ageing process access to family, friends and community cultural isolation changing needs for physical comfort, sleep and rest general feelings of isolation and loneliness real or anticipated loss of privacy
loss of home and loss of independence death, grieving and loss changes that ageing may bring to physical processes, memory, intellectual function, personality and social interaction ageism fear of change itself
Informal Care Informal care is the care provided by family and friends (often referred to as carers) and it is by far the most common type of home care received. Carers may be parents, partners, children, relatives or friends who provide support to frail older people and people with a disability. Often there is at least one carer who assumes responsibility for most of the care provided; this person is referred to as the primary carer. Being a primary carer can be as demanding as a full time job; however many carers juggle their caring role with paid employment and/or the responsibilities of caring for their children and grandchildren. The difference between formal care and informal care is that carers work in an unpaid capacity and the work they do is not regulated by government bodies. Informal care is not considered to be volunteering, as carers are generally not able to negotiate the terms of their commitment. They often sacrifice a great deal of their time and quality of life to care for someone else. Many people who provide care do not identify them-selves as carers because they take on their caring role as part of their family responsibilities. Facts about carers (Australian Bureau of Statistics 2003) In 2003, there were 2.6 million carers who provided some assistance to those who needed help because of disability or age. About one in five carers are primary carers. Most primary carers (78%) cared for a person living in the same household. Just over half (54%) of all carers were women. Twenty-four per cent of primary carers were aged 65 years and over, compared to 13% of the total population 37% of primary carers spent on average 40 hours or more per week providing care and 18% spent 20 to 39 hours per week.
The current system of providing support to people who need care in their home relies heavily on the role of carers. Carers in fact, deliver more than 70% of all care to family members and friends needing care and support. In many cases, the role of carers is paramount to the success of the individual's ability to remain living at home.
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As Australia's population ages, the supply of carers cannot keep pace with the increasing need for care. Without carers, many older people and people with a disability may require institutionalised and long-term residential care at great cost to society. The amount and type of care provided by family and friends is diverse and each care situation is different. The level of responsibility that carers assume depends on the physical and psycho-social needs of the person requiring care and the dynamics of the relationship between the carer and the care recipient. The level of support that carers offer may include some or all of the following: personal care (bathing, dressing, toileting) domestic care (cleaning, meal preparation) auxiliary care (shopping, transportation, managing finances) social care (emotional support, informal counselling, social activities) complex and technical care (managing medications, catheters and colostomies) specialised care (managing challenging behaviour and monitoring mental health status).
Carers also provide an enormous amount of social and emotional support, often on a daily basis, for some of the most vulnerable members of our community. Please remember that a lot of carers are not recognised as carers and will take care of a loved one regardless of the slight remuneration they may get from the government. Personal Cost of Caring Caring for a person at home can affect family and friends in a number of ways. This includes finances, time constraints, household layout and most of all quality of life and lifestyle choices. Becoming a carer may limit a person's ability to work or socialise outside the home, or even perform routine tasks such as going shopping or taking a walk. Providing care frequently has a negative impact on the carer's quality of life with many carers reporting anxiety, depression, ill health, physical exhaustion, emotional exhaustion, fatigue, insomnia, weight loss and burnout. Some carers experience a loss of privacy, loss of sleep, psychological and emotional strain, physical tiredness and even injury when their caring duties require them to lift or move the other person. Carers themselves may need help and support from formal home and community care services in addition to the services provided to the person for whom they are caring. All services aim to support carers in their caring role and many formal services offer carer respite.
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Carer Support Carers play such a critical role in enabling frail older people and people with a disability to remain living at home, it is just as important that attention is given to the needs of the carer. While formal carer support may come in the form of financial assistance, access to information and respite services, services also need to be ever mindful of meeting the needs of carers and working in partnership with them. The Australian Government provides financial support to carers through the Carer Allowance or Carer Payment. Carer Allowance is a fortnightly supplementary payment for people who care for an adult with a disability or a severe medical condition or someone who is frail, aged and living at home. It is not income tested. Carer Payment provides income support (similar to a pension) to carers who, because of their extensive caring role, are unable to support themselves through participation in the workforce. Unlike the Carer Allowance, the Carer Payment is income tested. Respite The National Respite for Carers Program (NRCP) is one of several Australian Government initiatives designed to support and assist carers through the provision of information and support for carers and respite services. The National Respite for Carers Program funds: respite services Commonwealth Carer Respite Centres Commonwealth Carer Resource Centres the National Carer Counselling Program Respite care is provided by community care services, such as those provided by the Home and Community Care Program (HACC) and by residential care facilities.
Carer Resource Centres Each State and territory has a Commonwealth Carer Resource Centre, This includes information on:
services in the local area financial entitlements support services respite options advice on legal issues carer support groups and networks home help.
The National Carer Counselling Program (NCCP) provides short term counselling through professionally qualified counsellors and is delivered through the Commonwealth Carer Resources Centre. The focus on issues such as: stress management coping skills grief and loss issues practical problem solving techniques emotional support health and wellbeing.
Formal Care Formal care is the term used to describe any home and community care services provided by organisations or paid individuals. Formal home and community care services may be provided by a range of local, state or territory government bodies, community providers, charitable organisations and private service providers, or a combination of all of these providers. Recently, services to assist older people to remain in their home for as long as possible to include: Community care services including Home and Community Care (HACC), Community Aged Care Packages (CACP), Therapy Centres and Carers programs to assist an older person to stay independent and living at home and to maintain a life with dignity in the community; and Residential Aged Care (RAC), particularly when they develop chronic problems that prevent them from functioning at normal capacity or independently in the community. The primary aim of all home and community care is to maintain or enhance the personal independence and quality of life of frail older people, people with disabilities and their carers. Home and community care services enable people to remain living at home rather than using hospitals, residential or institutional-based care. Without access to home and community care services many frail older people and people disabilities would require placement in a residential facility much sooner. Home and Community Care (HACC) funds community agencies to provide services to help older people with: Provide a comprehensive, coordinated and integrated range of basic maintenance and support services for frail older people, people with a disability and their carers; Support people to be more dependent at home hence, enhancing their quality of life; Provide flexible, timely service to respond to the needs of the older person; Work around the home such as cleaning, cooking, washing, ironing and home maintenance;
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Personal care such as bathing and dressing, and social support such as banking and transport; Food services such as home nursing, podiatry and physiotherapy.
The range of assistance provided will vary depending on the needs of the client. Some clients need assistance with tasks such as household cleaning and transport. Other people have more complex and personal care needs such as assistance with mobilising, showering or bathing, continence management, technical nursing care, specialist mental health care and allied health or palliative care services. Although the specific services provided will differ from client to client, the most commonly used services include: assessment, case planning and review domestic assistance home nursing and personal care transport services home maintenance and modification meal services allied health care social support centre-based day care.
Some clients receive only a single service, but many frail older people and people with complex care needs access multiple services which are often provided by a number of different agencies. Residential Aged Care (RAC):- offer two options for frail older people who cannot live at home and who have been assessed as needing such care. These are: Hostels - Hostels generally provide accommodation and personal care, such as help with dressing and showering, together with occasional nursing care. Nursing homes - Nursing homes tend to care for people with a greater degree of frailty, often in need of continuous nursing care. This can be low and high nursing care.
High level care High-level care is for people who need 24-hour nursing care. This may be because they are physically unable to move around and care for themselves, or because they have a severe dementia-type illness or other behavioural problems. Clients in high care must receive additional care and services at no additional cost. All aged care homes must provide a specified range of care and services at no additional cost to clients. These requirements vary according to whether the client has low-care or high-care needs. There is some specified care and services that all clients receive and additional ones that are provided for high-level care clients.
If you are unsure of whether you are receiving high-level care or lowlevel care, ask the manager of the aged care home. The specified care and services that must be provided by the aged care home at no additional cost are listed below. If a home provides the required range of specified care and services but the client would like certain other brands, or has individual specific needs, then the home does not have to cover the cost of those products. Hostel/accommodation services All clients receive specified care and services relating to: maintenance of buildings and grounds accommodation furnishings bedding cleaning services general laundry toiletries - bath towels, face washers, soap and toilet paper meals and refreshments social activities provision of staff on call to provide emergency help.
Additional requirements for high-level care High care clients must be provided with additional items, care and services such as: goods to help them move themselves e.g. crutches, walkers goods to assist with toilet and incontinence management more basic toiletries such as tissues, toothpaste, denture cleaning preparations, shampoo, conditioner and talcum powder.
Personal care and services All clients receive specified care and services including: assistance with the activities of daily living, such as: bathing and grooming using the toilet eating dressing mobility maintaining continence or managing incontinence communicating with other people emotional support
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treatments and procedures (such as assistance with taking medication) recreational activities rehabilitation support assistance in obtaining health practitioner services and access to specific therapy services, and support for people with memory loss or confusion.
Additional requirements for high-level care High care clients must be provided with additional items, care and services such as: Nursing services and equipment, such as equipment to assist with:mobility, continence aids, basic medical and pharmaceutical supplies and equipment, helping with medications, provision of therapy services and short term oxygen.
Low level Care Low-level care places are for people who need some help. Mostly, people in low-level care can walk or move about on their own. Low-level care focuses on personal care services (help with dressing, eating, bathing etc.), accommodation, support services (cleaning, laundry and meals) and some allied health services such as physiotherapy. Nursing care can be given when required. Most low-level aged care homes have nurses on staff, or at least have easy access to them. Low-level care is for people who need some help, but do not have very complex ongoing care needs. Low care includes: accommodation-related services furnishings, bedding, general laundry, some toiletries, cleaning services, all meals, maintenance of buildings and grounds, and the provision of staff on call to provide emergency assistance, and personal care services assistance with the activities of daily living, such as bathing, going to the toilet, eating, dressing, moving around, maintaining continence or managing incontinence, rehabilitation support, and assistance in obtaining health and therapy services. Ageing in Place As stated before Ageing in place refers to aged care homes that offer both high- and low-level care, and to situations where it is possible to stay in the same home if your care needs increase.
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There are also short-term care options called respite care which can include: Care in a day centre Support in a persons own home for a number of hours a week A short stay in a residential care facility.
Activity 2: Case Study Paul is a 68-year-old man who had a stroke 10 years ago. The stroke left him unable to move his right arm. His right leg is weak. He has some memory loss. Paul lives in a small unit on his own. There is no garden. These are the things Paul does: Paul gets onto the community bus each week to go to the local shopping centre. He has a friend that goes with him to the shops, as Paul sometimes forgets the way back to the entrance and where to catch the bus home. Paul reads all his mail and sorts out the bills. To remind himself to pay the bills, he writes the dates they are due on the calendar. However, Paul doesn't remember to check the calendar regularly to read his notes. Paul uses a walking frame with wheels to get around, as the stroke has left him very weak on one side. Paul cannot take a shower or get dressed without help, and he needs to sit down to do these things and can only use one hand properly. Paul can no longer cook meals but he can make a sandwich. Paul cannot do his laundry or hang it out and he is unable to look after the building maintenance. His unit is cleaned for him twice a week. Paul has two cats that are very independent. Paul is able to feed the cats if the cans of cat food have been opened.
What help with the ADLs would Paul need to maintain his independence? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ What services are available to Paul to help him stay at home? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
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How does Paul get access to the help he needs? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Should Paul be put into an aged care facility? Why/why not? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
1.3 Identify the needs of the older person from the service delivery plan and from consultation with a supervisor.
Every client or client in your care will have a number of documents and records about their care requirements. The most important document you will work with is the care plan or service delivery plan. A care plan gives all staff, including yourself, detailed information about the person in your care and their specific care needs. This ensures everybody works together in a consistent way, to provide the best quality care. When assessing an older persons needs, a care plan or a service delivery plan is developed. The purpose of the care plan is to establish goals with the person/client and to determine ways of delivering services that suit their individual needs and preferences. The care plan is reevaluated regularly to check that all care is implemented and to reassess the needs of the client. For instance, if the older person has a fall and fractures a leg and usually the person only needs a walking stick to mobilise and now requires a wheelchair as cannot manage crutches then the care plan would be changed immediately to meet the new needs of the person and when the leg is healed then the care plan may need to be modified again. It is a crucial document for ensuring delivered care is responsive to the needs of the client. Care plans are legal documents. You must consult the care plan before completing any task with a client. This ensures the client or your team members and you remain safe. The role of the aged care worker in documenting what they do throughout the care planning process is very important. The care plan is an essential tool for providing evidence that the facility is meeting its contractual obligations to the government via the accreditation process, as well as ensuring appropriate care for clients. The care planning process is designed to ensure that the care provided meets the identified needs of the older person in the most effective way. There are many names given to this process, including continuous
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improvement, risk management, case management and individual service plans. The care planning process involves four steps:1. Assessment identifying the problems through comprehensive assessment. (Collect information) 2. Planning planning actions/strategies/solutions and identifying goals to be achieved. (Care plan developed by the team and the client) 3. Implementation putting the practice.(Carry out the plan of care) action/strategy/solution into
4. Evaluation reflecting/evaluating on how effectively the goals were achieved, and revising the plan in line with any revised care needs(Review the plan and revise as necessary) If you work in aged care, you will be involved in the care planning process, and your level of involvement will depend on your role in the team. You may be collecting information for the assessment phase, or suggesting actions/strategies/solutions to support your client. You may be involved in documentation of the plan, or reporting or recording details of care you provided and the older person's responses to that care. The care planning process is an example of a continuous improvement process care is evaluated on an ongoing basis, and the care plan is updated in response to this evaluation to ensure the most appropriate care is always provided. A care plan is a 'dynamic' document. This means it is reviewed and updated regularly, to meet changing needs. All staff, including yourself, will be responsible for maintaining the care plans for people in your care. Therefore, it is part of your role to report changes to your supervisor and seek guidance on how to update the care plans in your workplace. Different workplaces will have different ways of presenting information in a care plan. You need to know how to access and read the care plans in your workplace. They will help you plan your daily work with each client or client.
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Summary of Care Planning Process:1. Assessment
2. Planning
3. Implementation
4. Evaluation
Stages of Care Planning The care planning process directs client care, provides a framework for teamwork and ensures adequate documentation. In residential care, this process is closely linked to the funding mechanisms. By following this process, all staff will know exactly what care is required for each client/client and what issues exist for each client/client. 1. Assessment
Assessment is the process of gathering information to identify care needs. Assessment of older people tends to focus on function and include assessment through observation physical, cognitive/mental, social and emotional aspects of their life. Information can be collected by talking to or interviewing the client, their family or friends, past carers or health workers. Each new client will be interviewed, and comprehensive assessments are carried out to ensure that their abilities and care needs are identified. A range of forms and tools are used for assessment, and each health professional will undertake an assessment according to their area of professional expertise. As an aged care worker, your role in assessment will include documenting the client's abilities for example communication, mobility, eating and drinking, personal hygiene, toileting, social and emotional needs. You will need to observe your client, assess their level of independence or ability, and then document your observations. This contributes to a comprehensive assessment of their personal care needs. Assessment provides the opportunity to report and record your observations. 2. Planning
During the planning stage, the information collected during the assessment stage is reviewed, and a plan of care is developed to meet the needs of the older person. Aged care workers will be involved in case conference discussions and client interviews, which contribute to
the development of the care plan. The care plan should reflect the client's goals and the type of care and support they require. It will be documented in a way that provides clear directions on how to care for the older person, and assists the team to regularly review the plan to assess whether those needs/goals are being met. 3. Implementation
This is the action stage. Once the care plan has been agreed upon and documented, the interdisciplinary team will implement the strategies (also called actions or interventions/solutions) outlined in the care plan to ensure the older person's needs are met. You will follow this plan of care and document what you did for the client and how they responded. 4. Evaluation
Evaluation involves reflecting on the process and reviewing the care plan. Aged care workers look at how the older person has responded to the care given and make changes to the care plan as required. Evaluation asks the question 'is the plan achieving the needs/goals that were identified?' For example, if the care plan identifies that assistance with toileting is required, evaluation would include reviewing whether the older person has received assistance as required, do they still need the level of assistance provided, are they comfortable and dry at all times and if not, why the plan did not work and what should be done to achieve the desired outcome. The care planning process involves assessment, planning, interventions or actions, and evaluation of these actions. It allows workers to communicate effectively, leads to coordinated and client-focused care, and provides ongoing documentation to ensure care is consistent and holistic. When care plans are written, they should encompass all of the factors contributing to holistic care, empowerment to the older person, meet individual needs and in turn, inform future decisions about care delivery. Supervision Remember, your supervisor is there to help you provide the best possible support to older people. Always discuss any questions, queries or concerns with your supervisor prior to the event if possible rather than, doing something wrong because you are unsure of what to do then making mistakes and then having to either fix them or someone else fixes them. The person who has to fix the mistakes will be agitated or angry for fixing something up that shouldnt have to be done in the first place as it takes away time for their duties that need to be carried out. It may also highlight to your supervisor that the care plan or service delivery plan needs more details written on it so it is very clear about what needs to be done to meet this particular clients needs.
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Respite/Summary Resident Care Plan
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Another example of Resident Care Plan: (Front of Sheet)
FITZROY FALLS AGED CARE FACILITY RESIDENT CARE PLAN
Resident Name:____________________________________________ Care Need Relating To:_____________________________________ Date What is the Problems/Diagnosis? Signature
Date
What Goal/s do we want to Achieve?
Signature
Date
Which Interventions will achieve these Goals
Signature
RECORD EVALUATIONS OF INTERVENTIONS & GOALS ACHIEVED ON ATTACHED EVALUATION SHEET. Resident Care Plan: (Back of Sheet)
It is important to watch older people as you visit them EACH time to CARE PLAN EVALUATION FORM ascertain if their needs have changed or if they require extra help. Resident Name:____________________________________________ Care Need Relating To:_____________________________________
FITZROY FALLS AGED CARE FACILITY
Date
Evaluation
Signature
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Activity 3 Use the Respite/Summary Resident Care Plan form to fill out the following scenario. Bill Perkins is 90 years old. He lives in a nursing home in the dementia unit. He has high support needs. He speaks, but is often hard to understand. Bill has a hearing aid but doesnt wear it as he thinks he can hear okay. Bill fought in World War II. He likes to be up early, enjoys a daily morning shower, shave and dentures cleaned twice a day. He enjoys participating in ANZAC festivities. Bill enjoys the radio and television put on very loud. At times Bill is incontinent of urine and faeces if not taken to the toilet as per routine. He needs help to stand and transfer into a chair. He uses a wheelchair to move from one place to another. His wheelchair is old and one foot plate is broken. He uses a shower chair and needs someone to wash, dry and change him. He cannot stand without support. He has problems with migraine headaches. He also gets pain from an old ankle injury. At times, when Bill has migraines or pain in the ankle he can be verbally and physically aggressive if pain not subsided quickly. It has been six months since his family has visited him. On the last visit, he became angry. He told his daughter not to visit again. Next week is Bill's 91st birthday. Activity 4 What are the four stages of care planning process? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ In your own words, summarise the four stages of the care planning process. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Why does the care plan need to be up-to-date? _________________________________________________________ _________________________________________________________ _________________________________________________________
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What happens if you do not comply with or follow care plans of individual clients? _________________________________________________________ _________________________________________________________ _________________________________________________________ If you have a client that has a hearing impairment, what would or could you do to assist in the communication process? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
Ensure visits and service delivery accommodate the older persons established routines and customs where possible. Most people have a daily routine. Routine is the usual way a person arranges tasks and activities. It may involve a certain time, place and method used to complete EACH task. They might get up at a certain time in the morning. They may have the same food for breakfast every day. They might meet a friend for coffee on a certain day of the week. They might observe a religious custom at a certain time of the day, week or year. Generally, when a person gets older they like to keep to the routines they have always followed. Some older people feel very strongly about sticking to them. They might get upset if a routine is changed. It is important that services that support older people fit in around the older person's routine where possible. Aged care workers should be aware of the routines of older people who they work with so that they can work in a way that meets their needs. It is important that services are flexible so they can be changed to fit around the person's routine when necessary. We all feel more independent and in control of our own lives when we are able to decide what we want to do and how we want to do it. Our routines are important to us because they give us a sense of control over our lives. We know what is happening next, what to expect. An older person's sense of control over their lives lessens when they require more support to do their day-to-day activities. Our regular social appointments are important to keep us connected to our friends and family. Our customs are important as they help us to maintain our connection with religion or culture. As an aged care worker, it is your responsibility to help older people maintain their independence as much as possible. It could be a simple as allowing the person to wash their own face to holding the water nozzle in the shower right through to just washing their backs and toes
in the shower, this is the be assessed individually simply, by ask the person what they can door what they need help with. This ensures the person feels in control of their ADLs and a sense of empowerment with what you are offering to them. It is important to make sure the older person is as independent as possible for their situation/condition. This is because if you, the aged care worker, just do all the older persons ADLs (everything) for them they could lose the level of independence they have regardless if the amount of independence the older person has is a little or a lot. Routine in an Aged Care Facility Aged care facilities plan their daily routines around staffing and making sure that there is time for staff to meet the needs of all of those living in the facility. The routine for each shift are also put into the policies and procedures of the organisation so that, if new staff or casuals are on they can more effectively utilise their time and the clients/clients maintain the routines they are used to. Remembering, that the routine is also used in conjunction with the individual care plans, as it has what ADLs need to be met based on the older persons needs and preferences. The daily routine in an aged care facility is planned to meet the individual needs of the older people living there as much as possible. Sometimes it is not possible for the older person to maintain the routine they may have had in their own home when they move into an aged care facility. Older people in aged care facilities must sometimes follow the routines set by the facility for meals, personal care and some social and recreational activities. Aged care facilities make sure that older people maintain control over their lives through individualised care planning. When an older person first moves into the aged care facility, the staff find out what their routine was like at home. They ask about their customs. The staff at the facility will then try to match the daily routine at the facility as closely as possible to the older persons routine followed at their home. For example, if an older person always has a glass of sherry at night before their dinner, the staff may try to make sure that this still happens. If the older person goes out to lunch with relatives and friends once a fortnight, the staff will try to ensure that the older person is still able to do this. If the older person enjoys having a shower before they go to bed rather than in the morning this will be adhered to. Activity 5: Case Study Melinda is an aged care worker in an aged care facility. She goes to Mr Smyth's room to help him get dressed and ready for the day. Mr Smyths care plan says that he likes to get up at 0800hrs. It says he likes a cup of tea in bed before he gets up. It says that he is able to dress himself. He needs help only with doing buttons up and putting his socks on. Melinda arrives at Mr Smyth's room at 0730hrs. She wakes him and helps him out of bed. She puts his trousers over his feet for him, and pulls them up when he stands up. She helps him to put his arms in his shirt before doing up the buttons, then Melinda pulls his jumper over his head. She asks him to put his shoes and socks on while she tidies up
the bed, and then ties his shoelaces for him. Once he is dressed, Melinda makes sure he is comfortable in his armchair and serves him a cup of tea. 1. What tasks did Melinda do that were not part of Mr Smyths care plan/routine? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ 2. As a aged care worker, how do you think this may have made Mr Smyth feel? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ 3. What would you have done at 0730hrs? What would you have done to maintain Mr Smyths routine? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Customs/Cultural needs Aged care services in Australia are provided in a diverse multi-cultural setting. On any given work day, you may be working with clients who do not share the same cultural background or speak the same language. Working holistically in this context requires awareness of cultural differences and an understanding of your own attitudes towards cultural differences. Culture may be thought of as a collection of behaviours and beliefs that distinguishes one group of people from another. Culture is developed and passed on to others through formal and informal stories (fairytales, folk stories, poetry, literature, movies), education, family life, religion, government, media, social activity, work and law. Culture touches every area of a person's life. We usually identify that a person is from a different culture by their obvious behavioural differences, but we are less aware of the underlying cultural differences around belief systems.
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The Iceberg Model
The portion of an iceberg which is visible above water is only a small piece of a much larger whole. Similarly, people often think of culture as the observable characteristics of a group, be it their food, dances, music, arts, or even greeting rituals. The reality is that these are broad components of culture -- the complex ideas and deeply-held preferences known as attitudes and values. Deep below the "water line" are a culture's core values. These are primarily learned ideas of what is good, right, desirable, and acceptable, as well as what is bad, wrong, undesirable, and unacceptable. In many cases, different cultural groups share the similar core values (such as "honesty", or "respect", or "family"), but these are often interpreted differently in different situations and incorporated in unique ways into specific attitudes we apply in daily situations. Ultimately, these internal
forces become visible to the casual observer in the form of observable behaviours, such as the words we use, the way we act, the laws we enact, and the ways we communicate with each other. It is also important to note that the core values of a culture do not change quickly or easily. They are passed on from generation to generation by numerous institutions which surround us. These institutions of influence are powerful forces which guide us and teach us. So, like an iceberg, there are things that we can see and describe easily, but there are also many deeply rooted ideas that can only be understood by analysing values, studying institutions, and in many cases, reflecting on our own core values. Be aware that the Australian governments and territories have also passed laws to protect against discrimination, including discrimination based on cultural background. it is extremely important to keep in mind that all cultures share a common humanity. Human beings share many basic needs regardless of cultural differences, but we also seek out a cultural identity with specific groups and develop personalised ways of 'belonging' in the world. It is common to belong to many different cultural groups groups based on race, nationality, gender, religion, age and interests. Multiple combinations are possible for example, Australian Lebanese Christian, or Australian-born Chinese. Cultural competence means being able to interact effectively in many different cultural situations, where you enable the other person to feel respected and confident to express their cultural needs. Cultural competence recognises and accepts differences between people, and acknowledges that there is a shared humanity between all cultural groups. Workers demonstrate cultural competence when they provide services to meet the unique needs of each person, and when they are able to identify and reflect on their own attitudes about cultural differences. Cultural communication Many people are born and live in a variety of countries during the course of their life. To give the best care possible we need to gather detailed information about our client or client. We need to know about their language skills and their culture. One word written on a document, such as Vietnamese, does not give very true and accurate information about how that person lives, speaks, thinks and what they believe. The following may give you some ideas on things we need to know about our client or client: Family may be extremely important. It may be a specific requirement that family are involved with all decisions about treatment and care. The structure of the family may be very different from what you are familiar with.
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The care recipient may suffer extra stresses related to a change in their role and financial dependency because of their cultural beliefs. Different cultures have different values. Some client/clients may be proud. Independence and self-control are important to them. Another culture may value co-operation. Yet another may be brave. We need to be careful not to be judgemental about a client/client's outward personality. It takes a lifetime to get to truly know a person. The care recipient may use other types of healing. They may use folk medicine methods with or without Western treatments. Other cultures may look more at the whole person for healing. Their thoughts, feelings, spirituality, family, environment, diet and physical self are a key to their health. There may be issues related to the client or client being male or female. Some cultures have rules about what gender may treat and care for them. The care recipient may have lived through incredible suffering for example if they have been a refugee or prisoner of war. Some cultures feel shame to express their feelings about a trauma or loss. Some cultures use terms like "hot", "cold", "wind", "nerves" to describe symptoms.
A discussion with your client/client can find out a lot of information that will be useful for all care workers and most of all for benefit of that person. Another group of people we need to consider in our workplace are our working partners and colleagues. Many of our co-workers also have a diverse cultural background. To promote a better workplace, take time to find out about your co-workers without being too nosy! The more we know about people the easier it is to understand them and work with them. As many of our care recipients are born in another country or speak more than one language, we need to know information about them to ensure their care needs are met. As people age, it is common for language use to go back to their first learnt language. It is very important that we recognise this is happening and follow clear steps to support the person. The following are some tips to help you communicate effectively across cultures; 1. Speak slowly and clearly The care recipient or client needs time to understand your words. Pronounce your words clearly not loudly. We all have an accent check to see if your client or client understands yours. Take care not to talk down to the person. Clarify by writing down words. Don't use slang words or jargon (like medical terms and initials).
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2. Explain your role to the care recipient It is important to explain your role in words that is understood by your client or client. 3. Listen and observe Words are only one part of communication. The majority of our communication involves many other cues. The way someone is dressed, their stance, the tone of voice, the pitch, body gestures, the use of silence. Be aware of your body language and learn about the body language of your care recipient's culture. In some cultures it is respectful to maintain eye contact yet in another it is respectful NOT to have eye contact. Lack of understanding and awareness can lead to misinterpretation and lack of respect.
4. Take time to listen Extra time taken to listen can enable you to clarify what is needed. This will save a lot of time for all staff later and prevent the care recipient becoming frustrated or withdrawn. Take care not to approach the client or client when you know you really haven't got the time to talk it through thoroughly. Rather, make sure you have the time to discuss any issue with patience and respect. 5. People express feelings in many different ways Emotions and feelings are open to a lot of misunderstanding when translating from one language to another. Remain respectful of people's different ways. One person may cry and sob to express their grief and another may not show any signs of emotion at all. Care workers need to remain non-judgemental. Everyone has their right to express their feelings their own way. What may be proper behaviour for one group of people may be disrespectful for another. 6. Rules of communication All cultures have unspoken rules of communication. These rules include things like - what is the right thing to talk about and in what setting. What tone of voice we use, the speed we speak and the emphasis we place on words, are all factors to be considered when we speak with people of another culture.
7. Differences in word meanings Some words have different meanings in different cultures. "Yes" does not always mean the person understands, it may be their custom to say "yes" to be polite. It is better to have the person let you know that they "understand" what you have said rather than accept a simple "yes" for an answer.
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8. Beliefs and attitudes must be respected Care recipients have developed certain beliefs about illness and ageing over their lifetime. We need to ask for more information about what they believe rather than discount them. It is more respectful to ask them to tell you more about what they believe and how they would be cared for in their former country. Let the client or client know you are interested to know more about them.
9. Do not assume that a care recipient's level of English will always be correct As a care recipient translates from one language to another, the structure of their sentences can become confused. This can occur if a person is distressed or excited. Co-workers Another group of people we need to consider in our workplace are our working partners and colleagues. Many of our co-workers also have a diverse cultural background. To promote a better workplace, take time to find out about your co-workers without being too nosy! The more we know about people the easier it is to understand them and work with them. If the aged care worker is still having difficulties with the older person culture and the workers own beliefs and attitudes you may need to speak to the supervisor or manager to get guidance and possibly need further training in this area. Activity 6 Write down five things that are part of your routine. This could be every day or week. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Why are routines important to the older person and the aged care workers? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Why is the cultural and religious background of an older person important to meeting their needs? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
How do aged care workers communicate with an older person that has reverted back to their primary language which is not english? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
1.5 Perform work in a manner that acknowledges that the services are being provided in the clients own home.
Home care workers provide an important service in assisting people with a disability and frail older people, to maintain their independence in their home. Home care workers also provide significant support for, and work in partnership with carers. Home care workers may perform a large range of tasks which can include, but is not limited to: domestic duties such as vacuuming, cleaning, washing, cooking and shopping assisting with arranging social activities and accompanying people on community outings providing companionship, friendship and emotional support basic personal care such as assisting the person to bathe, dress, shave and perform other personal hygiene tasks providing assistance with meals monitoring health issues such as taking blood pressure readings and performing blood glucose level testing assisting with medications basic wound care implementing appropriate strategies for managing complex problems related to dementia, continence, pain management and challenging behaviours providing respite care services palliative care services
Home care workers may be employed to visit and work within both private homes and/or community establishments (such as group homes for
people with a disability) or day centres. They may be required to work evenings, weekends and public holidays and in rare circumstances they may be required to sleep-over in the person's residence or to live-in on a permanent basis. Working in people's homes and in the community setting requires a slightly different skill set than when working in residential aged care. In the community the worker must have effective time management skills and be able to prioritise their work EACH day. It is also important to be able to work closely with family members and carers as well as liaise with staff from other agencies. Home care workers can also exercise more control of their work routine and work flexible hours that may better suit their needs and the needs of the older person. Carer attributes In addition to particular skills that are important when working in home and community care there are also desirable personal attributes important for the home care worker. These include: excellent verbal and written communication skills the ability to communicate effectively with frail older people, people with a disability, carers and families the ability to provide professional and non-judgemental assistance to clients from diverse backgrounds the ability to work as part of a team, but also be able to work independently and without direct supervision the ability to maintain confidentiality and privacy the ability to be flexible and respond to the changing needs of the client ability to provide safe, competent and ethical care a commitment to best practice and continuous improvement principles
Working with Carers The needs of carers are as important as the needs of the client. Working in partnership with carers and providing appropriate support, information and respite for carers is central to providing quality home and community care services. Carers play such a critical role in enabling frail older people and people with a disability to remain living at home. Home care workers need to be mindful of meeting the needs of carers. Working in partnership with the carer may include: building a relationship of trust with the carer based on mutual respect and consideration identifying the carer's preferred way of doing things and working within these standards wherever possible consulting the carer and client before making any changes in their environment or usual care routine.
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Home and community care agencies go to great lengths to ensure that workers and clients are appropriately matched. Assigning an appropriate and suitable home care worker to the client is a critical aspect of the care planning process. When selecting the most suitable home care worker for the client, the agency will need to take into account the nature of the work, personal attributes of the worker, client needs and preferences, knowledge and skills required to perform the job, staff training and qualifications of the worker. Assigning the most appropriate worker is an important part of creating a positive and therapeutic relationship between the client, carer and the home care worker. Roles and Responsibilities Every employer will have a state of roles and responsibilities to guide their employees and are found in the policies and procedures of the organisations. While many personal care activities are provided by home care workers, some clients with personal care needs may require the services of a registered or enrolled nurse or an allied health professional. For example, complex wound care is to be performed by the district or community nurse. The appropriate person to provide such a service must be decided on an individual basis. During the assessment of the client, the client's characteristics, level of ability, complexity or technical skill of the service and the activity to be performed must be considered. Some agencies will also provide a list of duties that cannot be performed by the home care worker. For example, the home care worker must not give insulin injections or undertake any tasks related to the care and maintenance of renal dialysis equipment. It is essential that all home care workers have a clear understanding of their role and role boundaries and do not engage in duties or tasks that exceed their role and/or their training and qualifications allow. Most home and community care agencies will provide workers with a clear list of tasks or service descriptors. These may come in many forms, such as a service record, service sheet or task sheet and the individualised care plans. Limited Supervision Home care workers usually work alone in the client's home, unless two workers are required for specific duties. Make sure you get consent to enter the persons home and to do the tasks that are req uired. Even though the older person understands that you are from an organisation to do you job, you may be new and as yet have not build a positive, trusting relationship with that client. Support is available from a supervisor who is on call to assist home care workers if necessary, working in the client's home means that it is not always possible to provide home care workers with direct supervision. The home care worker must be able to work independently. This may involve making decisions about the order in which they complete their
scheduled work to best meet the needs of the client. It may also involve being able to respond to an unexpected event or emergency situation. Reporting to your supervisor Workers may be required to use their judgement about what to report to their supervisor and when to report it. It is critical that the home care worker uses whatever communication means are most appropriate to receive direction from others and to report events such as: absences from work or changes to routines any observed changes in a client's emotional and/or physical health all situations of risk to the worker, client and others all situations of abuse or possible abuse, both elder abuse and child abuse any difficulties or conflicts related to providing the client with services instances where services have been refused or where they no longer meet the needs of the client all instances of threatening, aggressive or violent behaviour from the client, their family or others incidents and deaths immediately according to the policies of the organisation.
It is also essential to report any instances where the client's or worker's rights and responsibilities have been ignored or are not being upheld. Documentation Documentation strategies used in the community must therefore ensure effective transfer of information between workers. EACH client will have a care record; however, many community organisations also use a diary, daybook or communication book to record information such as significant incidents, special instructions, or information about future activities/client appointments. As with all forms of documentation, you must record the date, time of entry, your signature and designation. Include relevant information only, maintain confidentiality and ensure the communication book is stored in a safe and secure place. Your employer will have guidelines, policies and procedures for the use of communication diaries and the type of information that is recorded in them. Health team members rely on documentation to provide individualised care which is responsive to the needs of the older person. Continuity of care depends on effective communication and accurate recording of care needs, the support that is provided, and the older person's response to interventions.
Progress notes for a client or client are the most appropriate place to note that the plan of care has been evaluated. The progress notes provide evidence that regular evaluation is taking place. Progress notes help in maintaining a record of the continuity of care and quality of care to the standards that are required by the organisation and by legislation. They reflect client/client care in a legal document which can be used to protect the organisation if there is a claim made against them by the client or their family. When writing in documentation such as progress notes, you will need to ensure that they are of the highest quality to meet legal and organisational standards. It is important to keep the following points in mind: Always use black ink. These documents are permanent records and may be required for legal purposes Avoid 'white out'. Draw a line through an error, date and sign Your writing should be neat, clear and legible Only use abbreviations approved by your organisation Use correct spelling, punctuation and grammar Don't leave spaces between entries Be objective, accurate, concise and factual and present the information in a logical order Use quotation marks when recording a resident's statement Consider who is going to read the document, why it is being written and what effect it is intended to have Write events in the order that they happened and as soon as practical after they happened Be certain the resident's/client's name is written on EACH page of your notes Sign your name then print name and status (i.e. Care Worker) on any written information No entry concerning a resident's care or treatment given should be made on behalf of another care worker
Activity 7 Mrs Stallone's care plan states that the community care worker should help her with all or part of the following tasks:
Preparing lunch Opening and reading mail Folding clean laundry Getting out of bed in the morning (Mrs Stallone likes to get up at 0730hrs) Preparing breakfast
Cleaning teeth Getting dressed Walking the dog
How would prioritise the tasks that need to be completed for Mrs Stallone? _________________________________________________________ List the tasks in order of priority for Mrs Stallone _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Is there any flexiblitiy between the older persons care plan and the community workers tasks that need to be completed? How? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ List the important points to remember when documenting in any clients progress/clinical notes. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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1.6 Provide services in a manner that enables the older person to direct the processes where appropriate.
The aged care worker needs to look at an older person as a whole, a holistic approach, this entails looking at the person in a physical, mental/emotional, social and cultural approach, and not as a specific illness or disease. This is so that positive contributions for health outcomes can be met for EACH older person. Remember, the key areas that underpin quality care services and promote successful ageing outcomes: an understanding of the key issues affecting older people social justice approaches culturally inclusive approaches positive ageing client-centredness or person-centred approach to individualised care
The client/person-centred approach to care encourages and values older people to maintain their independence and control over important and routine aspects of their daily lives. For instance, choosing the clothes they wear; when the person wants a shower, have lunch, or when they want to go to sleep; which sock goes on which foot first; what activities the person wants to do; and the list keeps going on and on. It is normal for most older people to fear losing a sense of control and selfworth especially if they do not have any choices or do not participate in meeting their own needs. It is vital that the older person retains and continues to practise skills required for daily living. As the saying goes, if you don't use it, you lose it. In some care situations it may appear to be more practical and usually quicker to take over doing something for the person, rather than encouraging and supporting their efforts, but it is critical that all care is tailored to maximise the abilities of the older person and to help them to regain or retain their optimal level of independence. How do you know what services are appropriate to the older person? Firstly, assessment is the process of gathering information to identify care needs. Assessment of the older person tends to focus on function and include assessment of the physical, cognitive/mental, social and emotional aspects of their life. The assessment will include an evaluation of risk factors for instance, whether the older person is at risk of falling, and this will also consider the needs of carers if appropriate. Assessment of the older person's needs should begin with their perspective of their needs, their abilities, concerns, views, fears and what support they feel they need to maximise their independence. Encourage the older person to ask questions and take an active part in the assessment. Assessments may be undertaken to gather comprehensive information about the older person's health condition, abilities and social
situation, or they may be targeted to collect specific information, for example to monitor their blood pressure. It is important for the aged care worker to approach the assessment with sensitivity. You need to inform the older person what issues will be covered and what information you are seeking. Remember that some of the questions you may need to ask during the assessment could cause embarrassment. The person has a right to privacy and should be able to share information about their problems, needs and circumstances without others being able to hear. Meeting Care Needs When the assessment of the older person is complete and necessary information has been collected, a care plan can be developed. Again, the older person should be actively involved in the development of the care plan and help to make decisions about the care they need. Family members, carers and those close to the older person should also have the opportunity to be part of making decisions about how best to meet the needs of the older person. The aim of any intervention will be to maximise the independence, abilities and quality of life of the older person, while considering resources available and the needs of carers. The care plan identifies appropriate support services, as well as adaptations or assistive devices that would help the older person to regain their independence and maximise their abilities. This may not be sufficient as the older person may require the assistance of another person to manage their ADLs, in particular to meet their personal care needs. People who require assistance with personal care have many differing personal characteristics, abilities and needs. Therefore, it is essential that all assistance with personal care reflects the highly specific needs and preferences of the individual, and that care services are provided in a manner that is free from discrimination, stereotyping and judgement. Home and Community Care (HACC) Services As a service provider working in a HACC program it is imperative that you understand the aims of the HACC program. The aims of the HACC program: To provide a comprehensive and integrated range of basic support services for frail, aged and other people with a disability, and their carers. To help these people be more independent at home and in the community, thereby preventing their inappropriate admission to long term residential care and enhancing their quality of life. To provide a greater range of services and more flexible service provision to ensure that services respond to the needs of users (Health& community services Victoria: aims of the HACC program)
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Social support This program is aimed at re-establishing people's community links. Because of illness or disability, the HACC consumer may experience loneliness, isolation and loss of social interaction. The social support program includes friendly visits, transport, telelinks, telephonemonitoring and participation in senior citizens' clubs/groups where appropriate/ Home help/Home care This program assists individuals and families with everyday and personal tasks. These include:- cleaning; laundering, cooking, shopping and helping people get appointments. Home care services also provide assistance in personal tasks such as dressing and showering, bill-paying and other appropriate services. Food services There is a variety of ways that this service can be delivered. EACH locality has adapted this service to suit local needs. The supply of meals into the home for the consumer is one important support to enable them to continue to reside in their own home Meals can be provided so the consumer can reheat them at a time appropriate for them, or they can be delivered hot as 'meals on wheels'. Some meals can also be arranged at senior citizen centres and community centres. Also a range of flexible options can be explored such as excursions or vouchers in restaurants and hotels. In many areas this service delivery is being tendered out to private industry. Consideration in the provision of food services must be given to food preferences, special dietary needs and to religious and cultural factors. Specific home help This service helps families who are caring for HACC consumer and who meet the criteria for specific home help. This service helps the usual care to take a break. Specific home help can also assist with everyday household task and can be available at night and weekends. Home maintenance This service provides essential repairs and maintenance tasks to the person's home. It can include cleaning spouts, repairing broken windows and occasional garden maintenance. Minor modifications to a home can also be carried for at-risk' situations. Community nursing This program provides nursing to improve and maintain the consumers health and well-being. Nurses visit consumer's home on a regular or onoff basis. The program also coordinates care with other areas of the home care organisations such as doctors, hospitals and other agencies. There are some localities where home care is being integrated to assist this service.
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Senior citizens centres There are centre that provide a regular meeting-place for senior citizens and provide opportunities for older people to meet socially. Adult Day Activity Support Services (ADASS) Planned activity groups are designed to provide out-of-home group activities that will enhance their physical, intellectual, psychological and social well-being for older people, people with disabilities and their carers. Various localities organise these programs to suit local needs. For most consumers, transport and meals are provided. Allied health This program assists the consumers to maintain independence, mobility and the ability to lead as normal a life as possible. The services include physiotherapy, podiatry, speech therapy and dietary advice. These services are provided either at home, or at community centres such as Adult Day Centres, Community Health Centres or Senior Citizen Centres. Interchange This program provides respite care for carers through the short term placement of children with disabilities (zero to eighteen years old) with host carers. Linkages, Co- Care, Community Care Options These programs aim to improve service delivery in the HACC system and be responsible for : the coordination of services the case management of consumers promoting service flexibility providing effective care offering consumers greater choice of services purchase or brokerage of services to meet special needs.
There are several different funding sources for the care services and this affects the manner of the service delivery. Co-care, for instance, uses case management and assesses consumers for 'on-going complex care needs.' Some services are subsidised and some are not. Money to deliver these services can come from Federal funds directly, or Via State administration or state funds directly. Personal care Personal care is the service provided by a HACC worker to assist the consumer in tasks or personal care. For example: assistance with dressing assistance with bathing
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assistance with personal hygiene( e.g. cleaning teeth, washing hair) assistance with access to transport (e.g. transfer to/from wheelchairs).
EACH program has a common objective, which is to provide services to the HACC target group. Once it is decided by the older person, carer, family and health professional about the persons needs, the services needed then an individualised care plan devised with the older person being to put some input into it. The care planning process entails:-
1. ASSESSMENT
Collect Information
2. PLANNING
Care plan developed by the team & the client
3. IMPLEMENTATION
Carry out the plan of care to meet the needs of the older person
4. EVALUATION
Review the plan & revise as needed or 6 monthly
Activity 8 For EACH step of the care planning process, in your own words describe in more detail what happens in EACH step _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
Activity 9: Case Study Norma is a widow and lives alone in her own home. She has two sons: Kane, who lives overseas with his wife, and Daniel, who is a courier. Daniel does not see a lot of his mother, calling in occasionally when his work takes him into that area or when he needs money from his mother to help cover the costs of running his truck. Over the last year, Norma has become quite confused. She often forgets appointments, does not go out much and has stopped catching up with friends. Her doctor contacted Daniel, who agreed to visit more regularly and help out with shopping and managing things in the house. Kane recently came from overseas to stay with his mother for a week. Kane was concerned not only about his mother's health, but also about her financial situation. Many bills had not been paid and all the money in her bank account had been gradually withdrawn over the previous six months. Norma now has no savings and it has become apparent to Kane that Daniel has been taking financial advantage of his mother without her knowledge. You have been assigned Normas case, what steps and/or actions would you follow and complete so that you can put an individualised care plan together for Norma and what services are available for Norma so she can stay at home. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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_________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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1.7 Provide support/assistance in accordance with organisation policy, protocols and procedures.
Policies and procedures manuals exist within organisations to ensure there is consistency in the delivery of care. This is an important document because it tells you what should be implemented in a particular situation and how it should be carried out. The policy and procedures manual will reflect all the relevant legislation, common law responsibilities and standards of care that you must follow. These manuals include a contents page to help you find information quickly. Usually the information will be organised under general section headings, with further information under sub-section headings. Before you start looking for information, think about where it might be in which general section, and in which sub-section. Policies are formal statements that guide the decisions of staff. They combine the values of the organisation within the broader professional and legislative framework to which the organisation belongs. Policies reflect the individual organisation's values and should be consistent with relevant Australian and state legislations, for example the Occupational Health and Safety Act, the Aged Care Act 1997 and the Aged Care Standards and Principles. Remember, policies have been written to make your job easier. They guide you in how to do your work and help you make decisions about the right thing to do. They are there to give you protection in difficult situations. They mean you do not have to guess about what is expected. There are policies for every aspect of workplace activities, for example working safely, lifting and handling heavy items, providing transport and handling money. An example of a policy is a rule that no aged care worker is to lift heavy items until they have successfully completed a manual handling certificate. An organisation's occupational health and safety policy specifies the course of action to be followed in relation to workplace health and safety issues. The policy will ensure that the organisation is complying with the occupational health and safety legislation and regulations of that state or territory. Procedures reflect the policies of the organisation. Procedures are stepby-step instructions on how to perform certain tasks, and they provide clear direction for all workers. This may be simple lists of instructions that are used every day. They may tell you how to act in a situation. Having procedures in place ensures that everyone knows exactly what to do and how to do it. For example, an organisation's Procedure for Handwashing or Disposal of Sharps or ways to support older people to complete their daily living activities, explains in detail how to carry out these procedures. You should familiarise yourself with your organisation's policies and procedures, as a reference book to consult when you are unfamiliar with a particular procedure or the accepted practice within your organisation.
Also you should know where and how to access the policy and procedures manual at your workplace. Ask your supervisor to explain any terms you do not understand, or to clarify any procedures that seem unclear. This is due to policy and procedures manuals sometimes use very complex language because they relate to legal frameworks. If you find yourself faced with a situation that does not seem to be covered by any particular policy, check with your supervisor. As a worker please be aware that policies and procedures are regularly being reviewed and updated so, you need to be updated with theses in the way of memos on staff notice boards or signing new policies that you have read or they may be on the computer in the organisations intranet of policies and procedures. The most important thing to remember about policies and procedures is that if you work within these guidelines you are protecting yourself as policies and procedures come from legislation which is law. As soon as a worker deviates from these policies and procedures you may be in trouble with the organisation and law enforcers. Activity 10 If an older person asks you, an aged care worker, to buy cannabis, roll it into a joint and then light it for them would you do it? Why/why not? _________________________________________________________ _________________________________________________________ _________________________________________________________ Why do organisations have a no lift policy? _________________________________________________________ _________________________________________________________ Where in the policies and procedure manual would I find the handwashing procedures? Why is it in this part of the manual? _________________________________________________________ _________________________________________________________ _________________________________________________________ You are a new employee in the organisation, during staff induction you need to locate where all the policy and procedures manuals are kept. Where are policy and procedure manuals located? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Give 5 examples of policy and procedure documents an organisation would have in their manual. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
1.8 Demonstrate appropriate use of equipment to support/assist the older person with activities of living within work role and responsibility.
An aged care worker may heed to use different types of equipment to help older people do their daily living activities. Mostly this equipment will be the same as what you use every day at home to do your own tasks. Sometimes the equipment may be different. It may be a special type of equipment that is used only by workers helping older people, or only by older people who can no longer use the normal household equipment for a common task. If you don't know what the piece of equipment is, or how to use it, make sure you tell your supervisor. Someone who knows how to use it will be able to show you how. You may need to be trained to use it by the manufacturer or a qualified per son. There may be a procedure to read about the equipment. There may be policies about how and when the equipment is to be used, and how to use it safely. Make sure you read these. Make sure you are confident in the safe use of equipment before you use it to help an older person. Where possible it is appropriate to have training in the use of all items or equipment which you may be using during the care of your client. For example, when using hoists/lifters; new shower bed; use of wheelchairs and so on.
Manual Wheelchair
Electric Wheelchair
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Lifter/Hoist 1
Lifter/Hoist 2
Stand Up Lifter 1
Stand Up Lifter 2
Shower Trolley
Walking Aids 1
Walking Aids 2
Walking Aids 3
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If there is a particular item of equipment which you are not familiar with, ensure that you ask your supervisor for instruction and training of it. It might also be possible to obtain the original training manual. If the instruction manual is no longer available access the Internet and obtain operating instructions for the equipment. Under no circumstances should you be using equipment for which you have no knowledge or training in the use of same. When utilising any equipment ensure that you follow organisational policy and protocol, and if the equipment requires the assistance of 2 persons to operate it, ensure that you bring this to the attention of your supervisor so as to ensure that there are appropriate and sufficient staff available to assist you in providing the care. There are many aids available to assist older people meet their needs. It is important that staff know and understand how to use aids safely. This is also important as you may need to train or educate the older person how to use the aid/equipment so that they do not get an injury. Remember, when using any aid/equipment never put yourself or colleagues and the client at risk of injury. Other aids available include:-
Shower Chair 1
Shower Chair 2
Shower Chair 3
Adjustable Toilet Chair
Modified Utensils 1
Modified Utensils 2
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Commode Chair 1
Continence Pads 1
Continence Pads 2
Continence Pads 3
Button Hook Aid 1
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Activity 11 You are an aged care worker, Mrs Jackson is your client and has had her mobility status revised as now needs 2 staff to help her as she has needs to use a hoist/lifter to transfer her at all times. If neither staff have used a hoist/lifter before, what do they need to do to be able to use the lifter? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
Should the staff use Mrs Jackson to practice on? Why/Why not? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ If both staff know how to use the lifter/hoist safely, what instructions/ explanations do you give Mrs Jackson as she is anxious and it is her first time using the equipment? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Activity 12 How would you as a carer encourage older people to utilise support services where appropriate? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ In what way as a carer can you clearly explain the scope of the service to be provided to the older person and/or their advocate? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ As a carer how do you identify the needs of the older person from the service delivery plan and from consultation with a supervisor? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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In what ways as a carer do you need to ensure visits and service delivery accommodates the older persons established routines and customs where possible? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ How, as a carer would you perform work in a manner that acknowledges that the services are being provided in the clients own home? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ How, as a carer could you assist in providing services in a manner that enables the older person to direct the processes where appropriate? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
As a carer you need to provide support/assistance in accordance with organisation policy, protocols and procedures. How would you go about doing this? Give examples. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ How is your role carer involved in Demonstrating the appropriate use of equipment to support/assist the older person with activities of living within work role and responsibility? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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2. Recognise and report changes in an older persons ability to undertake activities of living.
2.1
Monitor the older persons activities and environment to identify increased need for support/assistance with activities of living. Report to a supervisor the older persons inability to undertake activities of living independently. Support/assist the older person to modify or adapt the environment or activity to facilitate independence. Seek aids and/or equipment to support/assist the older person undertake activities of living independently.
2.2 2.3 2.4
2.1 Monitor the older persons activities and environment to identify increased need for support/assistance with activities of living.
Information is gathered through the initial assessment process, this information is then used to develop the client/client care and service needs. Care and service needs are recorded on relevant documents including care and service plans. Care needs are reviewed on a regular basis through the process of regular care plan evaluations and through case conference between the care provider and client/client/representative. Resident/client care and service needs can be subject to change. The changes are most commonly monitored through a regular process of evaluation of care and service plans. Changes in care and service needs can occur at any time though for many varied reasons. It is important as a care worker to report these changes either in written or verbal form to assist in the process of providing accurate care and service to client/client's. Clients/client's may request a change in their care and service delivery themselves or alternatively you may identify that a change is required through your own observation. As a care worker it is important to remember that client/client's are able to make individual choices and their choices must be respected. These choices may impact on a change to their care or service need. It is a requirement to provide information to your supervisor regarding changes to your client/client as this information may impact on a change to their care plan or service and impact on their overall wellbeing. An aged care worker who provides support with an older person's ADLs may be in regular contact with them. They may visit the older person every day or every week in their home, or several times EACH day in their room in an aged care facility.
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As someone who is regularly assisting an older person with their ADLs, it is important to notice changes in the older person's condition this is achieved through observation (watching, listening), asking questions and listening to clients and family or significant others. It is important to know when the older person may need more help with their ADLs. Example Warren is a community aged care worker. He visits Mr Rolland twice a week to help him with his shopping and laundry. Warren knows that this is the only regular help that Mr Rolland receives and that he has always seemed very capable of keeping his house and garden tidy and clean, doing his cooking and caring for his little dog, Fido. Over the past few weeks, Warren notices that the same dirty dishes are in the sink two visits in a row. He sees that some of the meat Mr Rollands buys on their shopping trips hasn't been cooked. He notices that Fido hasn't been washed or brushed for a while. Who and where would Warren report his observations to? _________________________________________________________ _________________________________________________________ _________________________________________________________ It is important to notice these changes in an older person's environment. Changes such as those in Mr Rolland's home may show that his condition has worsened and he is less able to do all his ADLs. Possible changes in condition of the client that must be immediately reported to a supervisor or health professional may include, but are not limited to: Changes to airway (eg choking), breathing (including slowed, fast or absent bathing, colour changes) or circulation (including unexpected drowsiness, colour change and absence of pulse) Rash Inflammation, redness or swelling Headache Skin tone Feelings of dizziness Slurring of speech Nausea and vomiting Blurred vision Confusion Changes in behaviour Anything that appears abnormal about the client/client
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Watch for signs of physical or memory impairment that strongly inhibit or prevent one from performing tasks of daily living without assistance. Basic Activities of Daily Living (ADLs) are the self-care tasks of bathing, dressing and undressing, eating, transferring from bed to chair and back, maintaining bladder and bowel control, being able to use the toilet, and walking (not bedridden). Listen to family members who may be in regular contact with their family member. They may be aware that your client has experienced difficulty with bathing and dressing or needing to be reminded to bathe, inability to prepare nutritious meals and taking medications incorrectly. Should you notice a change in your clients abilities to attend to the activities of daily living regardless of how subtle or small it may be, then it is important that aged care workers document these changes in the clients clinical/progress notes and verbally report the changes to your supervisor. Activity 13 The following is a case study and a sample of the daily progress notes. Belinda, an community care worker, has supported and attended to Mrs. Hughes for the past eight months. She writes daily notes in Mrs. Hughes communication / progress notes book. The first note was written three months ago and the next one was written after her latest visit. Case notes / progress Date and time 14/1/08 1100hrs Name .. Mrs. Hughes D.O.B 31/08/1929
Attended to Mrs. Hughes today for three hours activity including shopping. Assisted her in carrying in the shopping bags from the car. Mrs. Hughes put groceries away. Vacuumed and dusted living room and dining room, attended to make bed but it had already been done. Mrs. Hughes attended to some gardening whilst I did living room. Had afternoon tea with Mrs. Hughes when jobs finished. Mrs. Hughes had baked some homemade biscuits for us to have.
1200hrs
Belinda Smith ACW Belinda Smith ACW
1400hrs
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Care Notes / Progress Date and time Name. Mrs. Hughes Attended to Mrs. Hughes today for three hours. Carried delivered shopping to kitchen and put heavy items away such as the canned goods and cleaning products. Picked up newspapers and items from the floors prior to vacuuming the house. Cleaned bathroom and kitchen. Made bed. Vacuuming taking longer to do because carpet is becoming frayed. Mrs. Hughes stayed dozing in lounge recliner whilst I worked. Prepared lunch, for Mrs. Hughes but minimal amount eaten. She said she wasnt hungry. She says her knees and hands are very sore these days. Put Mrs. Hughes to bed before leaving. Belinda Smith ACW D.O.B 31/08/1929
21/4/08 1100hrs 1130hrs 1200hrs 1330hrs
1430hrs
1. Make a list of the changes which are in Mrs. Hughes care between the two sets of progress notes. ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________
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2. What changes might help and improve the care which you provide to Mrs. Hughes.? ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ 3. Give reasons for the changes in Mrs. Hughes ability to perform everyday tasks. ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ 4. Who would Belinda report these changes to? ______________________________________________________ ______________________________________________________ ______________________________________________________ 5. Look at the progress notes entries. As Belindas supervisor, what suggestions do you offer to improve the way the documentation is completed. ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________
Activity 14 List other changes, such as physical, emotional, social and cultural changes that may occur to an older person ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________
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2.2 Report to a supervisor the older persons inability to undertake activities of living independently.
Any change which you notice in your clients ability to undertake activities of independent daily living need to be reported to your supervisor as a matter of priority. This constitutes a risk assessment profile and will lead to a change in the care plan for your client. It might also necessitate an increase in care hours or increase in items or instruments necessary for your client to maintain living independently. It will also show a paper trail and provide appropriately and timely admission to a residential complex when the independent living situation deteriorates beyond suitability. When aged care workers identify changes in an older person's ability to do their ADLs, it is important that this is reported to a supervisor. Sometimes, aged care workers change the support they provide to the older person without telling anyone that the older person needs extra help. They start to do a little more to help the person. Doing this means that they are the only ones who know that the older person's condition is getting worse. This means: they are the only person who knows what support the older person is getting other aged care workers who support the older person may not be aware of their additional needs the care plan is not up to date the older person may not be getting extra services that they may be eligible for.
It is important that you follow the procedures for reporting that are set by your workplace. These procedures are there to make sure that there is clear and accurate information about the support needs of older people. They make sure that this information is communicated in a way that gives all workers supporting the older person access to current information about their support needs. When everyone has access to current information, older people can be reassessed as soon as their support needs change, so that they can get the support they need. This helps older people maintain their independence. How you report the change depends on the situation and the procedures for your workplace. You must make sure you know how your workplace expects you to report changes to an older person's abilities and their support needs. Ask your supervisor for help on reporting if you need to. Changes to the older person's ability to complete their ADLs are usually reported in the following ways. Telephone Generally you should call your supervisor if the change is sudden or puts the older person or others around them in danger. You might also phone your supervisor if you think they are not likely to read your written notes in a reasonable time.
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Face to face/Verbally If an urgent response is needed, you should contact your supervisor immediately to explain the changes, what you (aged care worker) have done and arrange to see them as soon as possible. If the change to the person's support needs does not require an urgent response, you might wait until you see your supervisor to report the change to them. Do not forget to hand over the changes to the supervisor but also to your colleagues in the next shift. Clinical notes/Progress notes/Care Plan You should write information about changes to the older person's support needs into the clinical notes or communication book for the older person. This makes sure that all the workers providing support to the older person have access to this information. Also the supervisor can change the care plan so that it reflects the new needs of the client, as necessary. Remember, if there are no changes reported or documented then your duty of care is not upheld. The consequences could be injury or harm to the client, yourself and other colleagues. Which may have been prevented if the aged care worker had reported any changes in an older persons needs, condition and level of independence.
For example In the example about Mrs Zimmerman, the aged care worker wrote about the extra help that they now had to give. However, they only described the tasks that they did for her. They did not mention that they had to do extra tasks because Mrs Zimmerman's condition was worsening. The following example shows how the notes can be written so they help everyone who looks after Mrs Zimmerman.
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Care Notes Date/Time NAME: Mrs Zimmerman Attended Mrs Zimmerman today for two hours. Carried shopping delivery to kitchen and put away the heavy items such as juice, cans and cleaning products. Picked up newspapers in lounge room and dirty clothes in bedroom before vacuuming. Dusted surfaces. Mopped bathroom and kitchen and wiped down surfaces. Mrs Z stayed in the lounge reading a magazine while I worked . I made us a cup of tea when jobs were finished and took it to Mrs Z. Note: Mrs Zimmerman says her hands and legs are very sore these days. She now needs assistance with her shopping bags and putting heavy items away. She doesn't pick up things from the floor. She finds it more difficult to clean. I also noticed that she does not go outdoors to work in the garden or do any baking herself. Safety note: The joins in the carpet in the lounge room have started to come apart. They are a tripping hazard. DOB: 25/7/31
3/12/07 1530hrs
Bella Jacob (AIN)
Activity 15 In your own words, rewrite the content so that it shows Mrs Zimmermans condition is getting worse. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
How would you tell your supervisor that Mrs Zimmermans condition is worsening? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ How would you report the following in an older persons condition or abilities? (in any setting) Put a tick in the box that describes the option you would choose. You can put a tick in more than one box.
Change in Older Person

Unable to work out how to put a shirt on Forgetting if the person has had lunch Placing electric kettle on a stove Person has become incontinent of urine Person has gone for a walk and cannot find their way back home Person is having trouble weight bearing with their walking frame
Phone
Face to face
Care Notes
Care Plan
Any change which you notice in your clients ability to undertake activities of independent daily living need to be reported to your supervisor as a matter of priority. This constitutes a risk assessment profile and will lead to a change in the care plan for your client. It might also necessitate an increase in care hours or increase in items or instruments necessary for your client to maintain living independently. It will also show a paper trail and provide appropriately and timely admission to a residential complex when the independent living situation deteriorates beyond suitability
2.3 Support/assist the older person to modify or adapt the environment or activity to facilitate independence.
Your assistance in identifying and overcoming difficulties may often be necessary to maintain an older persons independence and confidence. However, you may need to be creative in you approach. Offer assistance where you feel it may be necessary, but remember you will need to treat you client with respect. This includes being aware of their rights an adult to refuse assistance or choose not to continue with activity. The right to participate in situations that may involve some personal risk must also be respected. Some of the factors you will need to consider when planning assistance are: Decline in skills and abilities does not always happen with old age. Training or practice will make a big difference to a older persons ability to complete tasks independently. Assistance should be kept to a minimum. The older person also wants the opportunity to set goals and be successful. Problem solving skills and ability to stay with task until completed often parts of a persons personality. You may not be able to change that attitude. Computer driven technology and electronic aids may be available. These will give the older person a new skill and help them overcome environmental or physical problems.
Break activities down into small steps or tasks. Look at problems that might arise. Equipment and aids that may assist include: Wheelchairs and other transport devices Mobility aids Lifting and transferring equipment Beds Continence aids Toileting aids Personal audio-visual aids
You will need to consider the risk and rewards involved in completing tasks successfully. Talk to your supervisor as other family members or medical personnel may also need to be consulted if the difficulties are caused by age-related illness. Older people do not change a great deal in their ideas, like and dislikes. The ageing process, however, can limit opportunities through age related illness. This may affect a persons ability to complete tasks. You will need to think of the steps involve in the activity that may require assistance without removing the sense of enjoyment and participation.
This can sometimes be difficult. For example, Mrs Fong has enjoyed china painting for many years. But now the arthritis in her fingers makes this activity painful and frustrating. You will need to have a good understanding of older persons likes and dislikes. Knowledge of the persons character and personality will also give you clues about their ability and desire to complete tasks. Involvement in as many normal activities as possible allows an older person to exercise control over their lives. The activities should involve a number of the senses: sight, hearing, touch, smell and taste. Difficulties in one area can be compensated for by ability in another. For example, a keen gardener may not be able to bend or lift as they have in the past. You may consider overcoming some of their difficulties by asking if they are interested in Raised garden beds so they do not have to bend Indoor pots or flower arranging Gardening programs on radio and television Gardening books and magazines
Unresolved feelings or situations from stressful past events in an older persons life can give them a feeling of helplessness or reduced motivation to participate. Activities may need to be adjusted to allow for success in stages. Often, anticipating the difficulties an older person may face will help you in planning when and where you could assist. Sometimes, it is necessary to adapt the way in which the person performs the ADL, to help to maintain their independence. In the following example, you will see how Mr Rogers is given assistance to maintain personal independence. Mr Rogers is becoming increasingly confused. The carers in the residential care facility have noticed he often forgets item of clothing or dresses inappropriately. The Care Plan is altered and the night staff now hang out clothing for the next day on the wardrobe door. Mr Rogers continues to dress himself at his own pace in the morning without assistance, in the privacy of his own room. Other examples include: If your client has trouble bending down to pick up things from the floor then you could recommend they invest in a pick-up-device which can be purchased from a number of places including hardware stores and independent living specialists stores. If the older person likes to play bingo but the numbers are too small. This could be modified by having larger print, bigger numbers or even have a volunteer to help if there are other problems so the person can still participate in an activity they enjoy. If playing indoor carpet bowls and they cannot bend down then instead of standing up they could sit down and still play.
If an older person cannot read novels possibly get bigger font books, use magnifying glass, get books that have CDs so that it is read to them. When eating meals using plate guards so the food doesnt fall off the plate and appropriate utensils especially if fingers and hands have changed anatomically. If you client really likes to continue to attend to the local RSL to play lawn bowls but can no longer drive their own car and it is too far to walk or too difficult for them to take public transport, then you could make arrangements with the club for their courtesy bus to collect them and return them at the conclusion of the activity. If they love to do the weekly shopping but can no longer manage to bring all the bags home, then home delivery service would be the way to go, and possibly community transport bus or even applying for subsidised taxi vouchers for your clients use.
Activity 16 Gladys enjoys participating in the morning exercise in her aged care facility. This morning she is complaining of not being to stand for long periods. How could you modify this activity for Gladys so that she can still participate and not feel worthless? _________________________________________________________ _________________________________________________________ _________________________________________________________ Mrs Tran is a new resident in the aged care facility. You have noticed that she does not participate in any activities. In her care plan you notice she enjoys bingo, knitting and socialising in general. How can you encourage Mrs Tran to participate in the activities she enjoys? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ It is well known that nearly/if not all situations within the environment and / or activities can benefit from some form of modification, and your clients environment is not an exception to this rule. Sometimes it is more a matter of common sense which can make observation of the change or modification which is needed, rather than a professional university degree education. If your client has trouble bending down to pick up things from the floor then you could recommend they invest in a pick-up-devise which can be purchased from a number of places including hardware stores and independent living specialists stores.
If you client really likes to continue to attend to the local RSL to play lawn bowls but can no longer drive their own car and it is too far to walk or too difficult for them to take public transport, then you could make arrangements with the club for their courtesy bus to collect them and return them at the conclusion of the activity. If they love to do the weekly shopping but can no longer manage to bring all the bags home, then home delivery service would be the way to go, and possibly community transport bus or even applying for subsidised taxi vouchers for your clients use. Home handyman repairs and gardening could be attended to by firms such as Hire-A-Hubby, or VIP lawn mowing services. Activity 17 Research your local papers and/or the internet and make a list of at least 10 local organisations which you could refer your client over to for assisted services.
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2.4 Seek aids and/or equipment to support/assist the older person undertake activities of living independently.
The following figure lists some major areas to consider when planning assistance for older person. Aged care workers are often called upon to play an important part in helping and older person overcome difficulties with activities of daily living. Maintaining independence and pride in accomplishments must be balanced with safety and other factors, see below: Figure 1: Safety
Recognise the continual need for people of all ages to take risks & learn
Self-care, where possible, encourages physical & emotional health
Environmental designs may need improvement
Safety in daily routines is always a major concern
Maintaining ADLs provides valuable exercise
As an aged care worker, you will need to consider the risk and rewards involved in completing tasks successfully. Talk to your supervisor, other family members or medical personnel may also need to be consulted if the difficulties are caused by age-related illness. Older people do not change a great deal in their ideas, like and dislikes. The ageing process, however, can limit opportunities through age related illness. This may affect a persons ability to complete tasks. There are many many aids and pieces of equipment to support an older persons ADLs regardless if they live in their own home or in a aged
care facility. Remember that training is important for the colder person and their support so that aids and equipment are used safely and correctly to reduce the risk of injuries and harm. There are many different types of equipment that have been designed to assist older people and people with disabilities to perform everyday tasks that would otherwise be difficult or impossible for them. The type of equipment they need depends on what tasks they are having difficulty with, and why. Here are some examples of aids that are available: Tap turner long-handled dustpan and broom non-slip bench mats for mixing bowls jar grips to help open jars foam handle covers for knives, scissors and other utensils to assist with gripping large-print measuring jugs, labels for washing machine and oven knobs wash basket trolley to take washing to the line and prevent the need to bend call bells personal alarms mobility equipment-walking motorized scooter stick, walking frame, wheelchair,
Braille Printer for Visually Impaired
Works with aid of a microphone and a voice recognition recorder on one end and a printer on the other that puts out 25mm x 50mm labels that can be stuck on any item.
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Big Button Phone
Talking Microwave
Glasses
Button Hook
Pick Up Reacher
Sock & Stocking Aid
Toe Washer
Long Handle Comb
Long Handled Brush
Hearing Aid
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Inner Ear Hearing Aid
Stocking Aid
Long Handled Shoehorn
Any of the pieces of equipment described above may assist an older person to continue to do a daily living task independently. Without the equipment, the person may not be able to continue to live in their own home, or may need another person to do the task for them. Equipment can be a great solution in helping an older person to maintain their independence.
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Activity 18 An older person you work with can no longer bend down to pick things off the floor. What piece of equipment could be used for this? _________________________________________________________ _________________________________________________________ Mrs Samuels has difficulty using normal eating utensils because of her arthritic fingers, what suggestions could you offer her , to maintain independence? _________________________________________________________ _________________________________________________________ Mr Blake lives at home by himself in a two-storey house and is finding it more and more difficult to climb the stairs. What suggestions could you offer so Mr Blake can stay at home? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Activity 19: Research From the following website Independent Living Centre on www.ilcaustralia.org.au list 5 other products that can be used by older people to maintain their independence. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Activity 20 How as a carer would you monitor the older persons activities and environment to identify increased need for support/assistance with activities of living? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ In what way as carer is it your responsibility to report to a supervisor the older persons inability to undertake activities of living independently? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ As a carer you need to support/assist the older person to modify or adapt the environment or activity to facilitate independence. Give examples and reasons for this ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
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In what way as a carer are you able to assist in seeking aids and/or equipment to support/assist the older person undertaking activities of living independently? Give examples. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
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3. Support the older person to maintain an environment that maximises independence, safety and security.
3.1 3.2 3.3 3.4
Encourage and support/assist the older person to maintain their environment. Provide support to promote security of the older persons environment. Adapt or modify the environment, in consultation with the older person, to maximise safety and comfort. Recognise hazards and address in accordance with organisation policy and protocols.
3.1 Encourage and support/assist the older person to maintain their environment.
Health assessment data allow health care providers to implement primary and where needed secondary and tertiary regimens. Primary care addresses disease prevention and health promotion and maintenance. The individual can usually receive the care at home. Appropriate care requires professionals with specialized knowledge and skill to assist the client in remaining in their home. Aged persons often do not seek assistance from care organisations, and often the first approach to an organisation is made from a family member or friend or following hospitalization due to physical or emotional difficulties. The elderly are often reluctant to seek help due to previous adverse experiences with the health system or because they put their problems down to being just age related and dont realise that assistance is available. The initial interview with your client requires a skill in establishing your clients trust and confidence and in avoiding offending your client or their family. You may need to spend a considerable amount of time in completing a health assessment of your aged client. This is often due to a number of reasons, not the least being because of a lack of schooling of your client; English is a second language, impaired communication skills as a result of a previous illness dysphasic. Sometimes the initial health assessment can be completed by the client before a visit, if they have vision and intellectual ability.
Upon doing a house visit, you are able to assess the home environment and become aware of any modifications or improvements which might assist your client in being able to remain in their home and stay in their environment. With a home assessment you may be able to assist your client in maintaining their home environment. With your assessment, you would have a check list which could first be filled in by your client in relation to their home environment and then by yourself or your organisation. A key part of helping older people maintain their independence is to help them keep their environment safe, secure and comfortable. They will be able to go about their daily living tasks independently and happily if they feel confident that their environment is free from anything that could cause them to have an accident or put them in danger. It is important that older people are encouraged to make sure that their environment is kept in a way that makes their lives as easy as possible. All those responsible for supporting older people should make sure that their home (in the community or aged care facility), room, garden and other areas they use are safe, secure and comfortable. This helps the older person maintain their independence for as long as possible. It is important that aged care workers encourage older people to be aware of their environment so they can see the things that are making some tasks difficult for them. Encourage older people to think through the tasks that they do. Help them to plan how they can manage their home, room, equipment and other features of their environment so that tasks can be done safely and with as little effort as possible. This will help the older person maintain their independence. Older people must have the best possible space, tools and support in place to do the tasks they need to do to maintain their independence. It is more helpful to encourage the older person to look around their environment and spot things they can do to improve it, rather than tell the person the things they should do. This will help them think about the daily tasks they do. This helps the older person identify strategies for making sure that their environment is maintained in such a way that tasks are made as easy as possible. As an aged care worker, you may also need to refer to the individualised care plan to see the persons likes and dislikes, preferences and aids that they utilize. For example, you could say, It is important that you make sure that there is nothing for you to trip over. Look around to see if there is anything on the floor. This is better than saying, 'There are electrical cords here that you could trip on. You should move them.' It is also important that you get permission off the older person to move things. For instance, you work in community care and decide when visiting a client who is visually impaired that you move all their furniture because you dont like the way it is arranged without permission. The older person is likely to be injured because of this.
Also encourage the older person to put rubbish in bins rather than throwing it on the floor. If the bin is far away from the person then place a plastic bag or bin closer to them so the rubbish is there rather than in the floor which is a hazard itself. As a worker if you are supporting or assisting them in their environment ask the person questions to see if anything can be done to reduce risks and hazards. For example, Horace a client who lives in his home, slipped in the bathroom after going to the toilet because he didnt want to turn the light on to save money at money. When Horace, was telling the community worker the worker suggested to get a night light for the bathroom so the light is always on or to get a urinal or commode put beside the bed at night so Horace doesnt have to go the bathroom. Before recommending any adaptation, modification or assistive device, an assessment of the older person will be undertaken to ensure that the most appropriate intervention is recommended. The assessment will look at the older person's: ability to perform ADLs and lADLs vision and hearing transportation recreation home and work environment current equipment use.
Often, adaptations to their home environment will make it possible for the older person to regain their independence for example, a simple modification to make the environment safer and allow the person to mobilise more easily may be sufficient. The type of modification necessary will depend on the needs of the individual and the part of the home that is being modified. Modifications can include ramps, grab rails, wider doorways, hand-held showers, better lighting and lowered bench tops. Assistive devices include any aids that help older people to perform ADLs more independently and more easily. There are many assistive devices available that can increase the older person's independence in all ADLs for example, aids that enhance safety with walking (such as a walking frame), plate guards and cup holders that make eating and drinking easier, and commodes that can increase an individual's independence in toileting. Any modification, adaptation or aid that is recommended and utilised should increase the older persons sense of security, safety and independence.
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Activity 21: Case Study Geraldine has had arthritis in her hands for 15 years. Her husband died eight years ago and since then, Geraldine has lived alone. She is determined to remain independent, and to stay in her own home for as long as possible. Over the years she has developed innovative ways of doing things and with support, manages to live a full and independent life. Geraldine enjoys and can still do the gardening, reading, cooking and swimming. The activities Geraldine has difficulty with, but still manages to do, are dressing and grooming, simple household chores and hanging and removing washing from a clothes line. What aids/equipment independence? could Geraldine use to maintain her
_________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ How would you make sure Geraldine understands and knows how to use the aids in a safe manner? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Why is it important to maintain Geraldines independence in her home? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Activity 22 An aged care worker notices the following things when they visit Mrs Lyon's home: The brick path to the washing line has a couple of bricks sticking up. A jar grip has fallen into the laundry basket. The telephone ring is very quiet.
Write down some things you could say to Mrs Lyon that would help her look after her environment so that tasks are as easy as possible to reduce the risk of injury. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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3.2 Provide support to promote security of the older persons environment.

The older individuals in our society will share the same sentiment, the same fears about violence and crime as is held by the rest of the population, but there fears may-well be intensified as they feel more vulnerable due to their frailness or disability. Everyone needs to feel secure in their own homes and in their daily lives. Feeling secure means being free from anxiety and worry. It means feeling that you are protected from harm. Feeling secure is very important for older people, especially if the person is living alone. An older person may feel less independent if they don't feel secure. They may feel that they cannot or do not want to do things for themselves in case they get hurt or something else bad happens. Part of the role of an aged care worker is to help older people feel secure in their own environment. Whether you work in the community, in older people's homes or in aged care facilities it is important to help older people feel secure. A significant contribution and aspect to the fear of crime amongst the elderly is the socioeconomic deterioration of the neighbourhood and the loss of true neighbours. It would be pertinent as part of your assessment of your clients condition to do an assessment of their environmental surrounding. For most people, feeling and being secure in their own home can mean feeling safe from intruders, fire and other serious events that would cause them harm or distress. For an older person it may also mean more than this. It may mean: being sure that floors, steps and pathways are clear and even so they don't feel that they may accidentally trip and fall not being abused, harassed, pushed or bullied from anyone having windows and doors locked making sure that they are able to shop, clean, wash, care for pets, visit friends and pay bills so that they remain in control of their own lives knowing that the older person can get help at anytime especially if in a facility knowing that someone is coming to visit at a particular time and will know if the older person is unwell, hurt or in danger.
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For example Julia is the aged care worker who visits Sheila in her home. She does not visit at a regular time, but only as requested by her employer, when Sheila needs support. When Julia is leaving, Sheila always asks her when she will see her next. Julia says she doesn't know which day, but she is sure it will be soon. Sheila always seems upset when she leaves. Julia talks to her supervisor about this. Her supervisor suggests she talk to Sheila about the things Sheila does during the week and who else she sees. The next time Julia visits Sheila, she talks to her and discovers that she is the only person who visits Sheila at home on a regular basis. She discovers that Sheila is very worried that if she is sick or has a fall in her house, it could be days before someone finds her. Julia talks to her supervisor again, and they arrange for Julia to visit Sheila at a set time and day to provide support. They also arrange for Sheila to get a personal alarm, so she can get help quickly if she needs it. The next time Julia visits Sheila she seems much calmer and says she feels very safe with her personal alarm around her neck all the time. When Julia is leaving, Sheila doesn't ask when she will be back, but says, 'See you next Thursday.' Sheila feels more secure due to her personal alarm and that someone will come if she presses it. Also that Julia will be checking on her on a particular day.
Make a list of the external environment of the home, is there Adequate tamper proof external lighting, possibly on a motion sensor switch? Does the house have lockable screen doors in good excellent condition? Do the windows have key locks installed? Is there an alarm system installed? Does the client have an independent personal alarm? Are there instruments or items outside the home which could possibly be used as a weapon in the event of a break and enter?
You may also: Take time out to talk to the neighbours, and maybe exchange phone numbers with the neighbour in case of emergency situations. If your client gets on well with a close neighbour it might be beneficial and cost effective to install between them a cordless doorbell alarm system, purchased cheaply from most hardware shops. Your client
holds the buzzer portion, and the neighbor houses the ring component. (Average cost is ($10-45). A cost effective alternative to a duress alarm which can cost upwards of $300 - $400 a year to maintain. Introduce them to communitycentered neighbourhood crime prevention networks, public education. Suggest they carry only a small amount of money and personal items in a wallet or purse. Encourage your client to keep house keys and larger amounts of money and credit cards in an inside clothing pocket or in a body band. People who snatch purses and wallets are usually not interested in injuring anyone, so it is best to hand over their bag or wallet when being accosted. If there are no keys or identification in the bag then the risk of having their house invaded is almost nil. Encourage your client to believe in safety in numbers. If going for a walk always try to walk with a friend or neighbour. Encourage the wearing of a small sports whistle. Suggest when the client is going for a walk carry a cane or umbrella as it can act as a deceptive weapon of defense. Encourage your client to be alert to stories and news items of fraud, and bogus schemes. Encourage your client not to be overly trusting and not to let anyone that they do not know into their home uninvited. If someone attends and wants to gain entrance by showing identification, encourage them to always phone the agency involved before allowing the person to enter, to verify the authenticity of the identification. Encourage your client to engage in a self-defense course. Encourage an increase in police surveillance of the area or areas that you or your client attends. If you notice that your client is purchasing a lot of unnecessary items over the internet or from phone or door to door salesman, advise them thats its inappropriate. A lot of unscrupulous sales people will try and sell anything to the elderly as they are a very vulnerable part of our society and often the elderly dont know how to say NO. Contact the companies concerned and return the items for a full refund.
For an older person living in an aged care facility, feeling secure may also mean feeling that they have their own private space, maintaining dignity and have privacy. Most areas, such as lounge rooms, dining rooms and sometimes bathrooms and toilets, are shared with other people. Often the only space the older person has that is their own is their bedroom. It is important that the older person can feel secure when they are in their own space, knowing that their belongings are safe, knowing they have aged care workers to call upon and that no one will go into their room without permission.
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For example Timothy lives in an aged care facility. He has his own bedroom but shares a bathroom with Basil in the next room. Basil has dementia and spends most of the day and part of the night walking up and down the hallways. He often comes into Timothy's room. Timothy locks the door when he is in the bathroom. This puts an 'engaged' sign up outside the door. However, Basil will often still rattle the door handle or call out through the door, 'Anyone there?' Timothy likes to spend the afternoon sitting in a chair in his room, reading the paper and writing letters. The cleaner comes a couple of days a week to mop the floor and empty the bin. She doesn't knock on the door, or ask if it is OK to come in. The young man who brings the afternoon tea also just walks in and puts the afternoon tea on his tray. Even though Timothy lives in an aged care facility, his home, what should staff be doing for Timothy? _________________________________________________________ _________________________________________________________ _________________________________________________________ How would you feel if you were Timothy and this is happening to you? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
For example Elaine is a resident in an aged care facility, when particular aged care workers are looking after her at night, she feels safer as the workers always check the windows are locked and that her bed rails are up. Other workers put her bed rails up but Elaine does not see the workers look at the windows to see if they are locked so she doesnt feel as safe. For example, leaving a small night light on at night may make older people feel more safe and secure than if there is no light on. Sometimes feeling secure may depend on the older person's condition. An older person who has a physical condition, such as arthritis or a weak hip, wants to know that they can get around safely and get the support they need to do physical tasks such as cleaning, laundry, gardening and cooking. An older person with a condition that affects them mentally, such as dementia, wants to know where they are, when
their appointments are, and what to expect will happen next. It can be very difficult to provide appropriate support for this. For people with memory problems, security can also mean making sure that they do not go out on their own. People with memory problems can get lost if they go out on their own. They can forget to cross roads safely. They may wander into bushland. Security of these people can mean providing areas in aged care homes where they are able to walk around and go out to a garden that is locked to make sure they cannot leave the facility without someone knowing. It is important that security measures in these facilities are followed so that these people are safe. Sometimes the older person may not be aware that the security measures are making them safer. Other times they may not feel secure. The older person might be worried that they could go for a walk and get lost. At these times the aged care worker can explain the security measures to them so they will know that they are safe. Activity 23 What could be done by the aged care worker or community care worker in the following situations to assist the older person to feel and be more secure? Mr Parker has Parkinsons disease. He enjoys coffee but has stopped having it as his hands shake, he is also worried he will burn himself. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Carol has dementia and has lived in the same house for 30 years. Carol enjoys going for a walk but lately has forgotten how to come home and the police have brought her home. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Ken lives by himself in the same family home he was born in. Ken has mild dementia but tries to remain independent. Ken took the care for a drive, parked the car, locked it and went for a walk. Ken was found wandering the streets and taken back home. His family was notified and it took 3 weeks to locate the car. ___________________________________________________________
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___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Dorothy lives in an aged care facility, she has dementia and when her family comes to visit which is quiet regularly, Dorothy cannot recognise who they are. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
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3.3 Adapt or modify the environment, in consultation with the older person, to maximise safety and comfort.
It is impossible to completely separate the environment from the person observing it. (Bowers 1973) Individuals by their overt behaviour create, select and maintain environments with properties congenial to their own cognitive, motivational and behavioural states. (Altman 1975) The individuals environment will be installed with qualities that are consistent in some respects to the individuals purpose and intention. By their residential behaviours, individuals select, modify or maintain their everyday environment by moving into and out of a place and by remaining in a place for shorter or longer periods. By their activity behaviours, individuals select, modify, or maintain their everyday environment by the extent to which they differently occupy (temporarily) and utilise its varied contents. In other words, people are reluctant or are complacent to change their environment or to repair it even though they realize it is in disrepair. Your client may well stay in only 2 or 3 rooms of their house, due to the balance of the house being too cold, and they are unable to or have no idea on how to heat it. They may have an increasing difficulty in managing to walk up and down stairs, and as such they no longer access the back yard and sunshine because it is too difficult and painful to walk up and down the 2-3 steps. There are ways and means of assisting your client to make modifications along a simplistic scale without rebuilding the whole environment. Before recommending any adaptation, modification or assistive device, an assessment of the older person will be undertaken to ensure that the most appropriate intervention is recommended. The assessment will look at the older person's: ability to perform ADLs vision and hearing transportation recreation home and work environment current equipment use.
Assessment of the older person's needs should begin with their perspective of their needs, their abilities, concerns, views, fears and what support they feel they need to maximise their independence. Encourage the older person to ask questions and take an active part in the assessment. An assessment will be carried out on initial contact with the older person, and then regularly to monitor their wellbeing and to detect any changes. In residential aged care facilities, an admission assessment will be conducted when the person moves into the facility. In home care,
physical assessment may not be the primary focus, as the assessment may be directed towards the type of support offered by that service and the assistance that the older person needs. For example, assessment of an older person attending a day care centre may focus more on their social, emotional, behavioural and leisure needs. Often, adaptations to their home environment will make it possible for the older person to regain their independence for example, a simple modification to make the environment safer and allow the person to mobilise more easily may be sufficient. The type of modification necessary will depend on the needs of the individual and the part of the home that is being modified. Modifications can include ramps, grab rails, wider doorways, hand-held showers, better lighting and lowered bench tops.
Ramp to a house
Wheelchair Elevator
Assistive devices include any aids that help older people to perform ADLs more independently and more easily. There are many assistive devices available that can increase the older person's independence in all ADLs for example, aids that enhance safety with walking (such as a walking frame), ramps (to make wheelchairs or walking frames easier access than steps), plate guards and cup holders that make eating and drinking easier, and commodes that can increase an individual's independence in toileting. Any modification, adaptation or aid that is recommended should increase the older person's sense of security, safety and independence. Being safe means being free from harm, injury, danger or risk. It is similar to feeling secure. Being comfortable means being free from pain and anxiety and feeling that all our needs are satisfied. It is still important that the older person is aware of their environment and how to keep it safe and well arranged. This helps them to be independent and in control. For example, an older person may be encouraged to think about where they keep things in their room, so that the things they use frequently are easily accessible, and that walkways are clear.
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Making the environment safe and comfortable There are many ways that an older person's environment can be adapted to make sure that it is safe and comfortable for the that person. Some examples might be: Make sure that the older person has locks on doors and windows, which the older person can operate Make sure there are no tripping hazards around their home such as uneven footpaths, rugs, frayed carpet Check electrical appliances and cords for faults or breaks Make sure that the older person can pay their bills, so that they always have electricity, gas, telephone etc. Provide support for the older person to visit doctors and other appointments when necessary. Make sure furniture is comfortable and that the older person can get in and out of it independently. Make sure the temperature is at a comfortable level not too hot or cold. Support an older person to shop regularly so they always have fresh, healthy food and drink available.
Environments that are outside the older person's home, such as footpaths and shops, are not controllable by the older person. The older person should be encouraged to maintain an awareness of any dangers in these places, for example uneven patches on footpaths. The older person can then plan to avoid or manage these things. The older person should also be encouraged to carefully plan how they will do the tasks that involve the environment they cannot control. What are 5 activities that we do everyday that we cannot control? (For instance, uneven footpaths, drivers, etc) __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ Helping older people to have a safe and comfortable environment can be different depending on where the older person lives. As an aged care or a community worker, you may find that it is difficult to adapt the environment in the person's own home. The home belongs to the older person and they may not want, or they may not be able to afford, to have big changes made to make their environment safe and comfortable.
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For instance, if an older person is having difficulty getting in and out of a lounge chair, the best solution would be to buy a new electric chair that gets the person to a standing position, however this is costly to the older person. The older person may not want to do this. They may like their armchair. It may suit their house. The older person may not be able to afford to buy an expensive new chair. The aged care worker can help the older person to think of another way to adapt the environment. An occupational therapist can help with this too. A suggestion may be to have cushions on the chair to make the seat higher, or to attach blocks to the legs to make the chair taller, or teach the older person to get out of the chair by wriggling closer to the front edge then pushing up to stand up. In an aged care facility, the organisation running the facility has control over the environment and how it can be adapted to make older people safer or more comfortable. Discussing with an older person about safety It is very important to discuss with the older person about the ways in which their environment could be adapted to make it safer and more comfortable. You should never change something in the person's home or room without first talking to them about it, making sure that they understand why it needs to be modified or changed, and getting their consent to do it. It may be difficult to talk to an older person about making changes in their environment as they don't like change. It may make them feel disempowered over their own home and/or their life. It may make them feel that they are becoming less independent and therefore have less motivation, less self worth and confidence. It is important to approach the older person with respect, courtesy, sensitivity to their needs in the way you speak to an older person. Make sure that they understand that they have choices and with the choices there may be consequences that need to be considered. Allow the older person time to make decisions as if they feel rushed or overwhelmed they lose that sense of control. Emphasise that by making changes in the older persons environment will help them to maintain or increase their independence and control, as long as the older person has made the decision themselves and not the worker coercing them into a decision. Activity 24 Winifred lived at home and enjoys having a bath 2-3 times a week. Last time she was in the bath she found it difficult to get out of the bath. What can be done so Winifred can continue to have bathes? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Max lives in an aged care facility. He has very limited movement to the left side of his body. Today, instead of having a bath he wants a shower. He needs to 2 aged care workers do to his ADLs. Do you accommodate Maxs wishes? W hy/Why not? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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3.4 Recognise hazards and address in accordance with organisation policy and protocols.
Having a good understanding of your organisations policy and procedures and protocols, will be instrumental in addressing the issue with regards to recognizing the hazards of your clients residence. In recognizing the hazards it is important to document them in line with your organisations policy. Hazards can be in any form, they can include those in-house and external. In-house hazards could be: clients failing eye sight and unable to see whether the gas stove is lit or not old carpet which is fraying at the seams
One of the most important parts of helping older people have a safe, secure and comfortable environment is to recognise things that are likely to be dangerous or cause injury or harm. These things are called hazards. Hazards in an older person's environment means anything that might cause harm or injury and affect the older person's independence. For instance, an older person has magazines and newspapers piled up in the hallway this is a hazard in the home. As an aged care worker or community worker it is your responsibility to recognise hazards, remove the hazards, report them verbally to the supervisor and written by completing the paperwork as per the organisations policies and procedures. The purpose of following the policies and procedures of the organisation means that you, as a worker, are complying with the appropriate federal and state legislation such as Occupational Health and Safety Act, Confidentiality Act and Privacy act to name a few. Remembering that legislation is law so when organisations are writing policies and procedures they comply with the law and so will you when you follow them. For instance, if an older person in a facility smokes inside and you as a worker do nothing to stop him, as the facility has a no smoking policy on-site. Could you as a worker be in trouble? What happens if the cigarette starts a fire? Below are some examples of different hazards in the environment.
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Table 2: Hazards in the Environment
HAZARD
WHAT HAZARD
WHAT DANGER
CONTROL MEASURES Mop floor Install light Hide, tape cord
Environmental Lighting Electrical
Wet floor No light on stairs Cords across the floor Faulty machine
Slipping Fall up or down Tripping
Equipment
Back injury, electrocution Back Shoulder
Out of order
Storage
Heavy boxes high
Store at low and central height Clear way
Entry/exit
Blocking exits
No exit in emergency Exhaustion
Human
Lack of sleep
Adequate sleep/rest
Basically, risk management is the overall process of identifying hazards, assessing the risk of those hazards, eliminating or controlling those hazards and monitoring and reviewing risk assessments and control measures. The steps of risk management is Step 1-Identify hazards (find a problem) Step 2-Assess risk (check it out) Step 3-Eliminate or control risks (fix it) Step 4-Monitor and review
When identifying risks from as simple as boxes obstructing the fire exit to equipment not working properly and water on the floor there is a policy and procedure in place to do with occupational health and safety. The reason for this is that there is an Occupational health and Safety Act at a federal and at a state level. This legislation is past through parliament and therefore are law. As these are legal documents that outline the requirements for that particular legislation and is law that is, why they form the basis for all organizational policies and procedures.
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Hence, the risk management process is essential to have steps in place for all workers to follow as it will provide a safe working environment. The process to do this will vary from organisation to organisation but generally it involves reporting to your supervisor, complete a hazard report form, complete maintenance forms, if it entails equipment put out of service tags and remove equipment and handover verbally to colleagues and/or put in communication book what has been done. By complying with the policies and procedures in place you have also complied with your duty of care responsibilities. Activity 25 Where would you locate the policy and procedures manuals in any organisation? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ As an aged care worker, if you do not understand the policy and procedures who do ask for help? _________________________________________________________ _________________________________________________________ List 5 possible hazards in your home _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Pick one hazard in your home from the list above, and do the risk management steps. (Identify hazards, Identify hazards, eliminate or control risks and monitor and review). _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Activity 26 How as a carer would you encourage and support/assist the older person to maintain their environment? Give Examples ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ How would you as a carer provide support to promote security of the older persons environment? Give examples ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
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If an environment needs to be adapted or modified how would you as a carer, in consultation with the older person, go about maximising safety and comfort? Give examples ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ As a carer there are many hazards in your day to day activities. How do you recognise hazards and address in accordance with organisation policy and protocols? Give examples and how to go about rectifying them. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
4. Support the older person who is experiencing loss and grief.

4.1
Recognise signs that older person is experiencing grief and report to appropriate person. Use appropriate communication strategies when older person is expressing their fears and other emotions associated with loss and grief. Provide older person and/or their support network with information regarding relevant support services as required.
4.2 4.3
4.1 Recognize signs that older person is experiencing grief and report to appropriate person.
Change is a natural part of life and a significant part of the experience of ageing. The changes that come with ageing are often associated with loss, and this loss can be physical, emotional, psychological and social. Grief is a natural response to loss and is experienced in many different ways. There is no right or wrong way to grieve; it is the central part of the healing and recovery process after a loss. Reactions to loss and grief are very individual, and each of us will experience unique responses to change, loss and grief. The process of grief can be experienced emotionally, physically, psychologically and behaviourally. Not everyone will experience loss and grief the same way, some common feelings of grief include:
assumption of the lost loved one's mannerisms or speech patterns denial or disbelief that the loss occurred feeling of emptiness in the stomach or abdomen feelings of restlessness heaviness in the chest inability to complete tasks, even simple ones inability to concentrate intense anger at the departed loved one loss of appetite mood swings from anger to guilt need to take care of others, to protect them need to tell and retell stories about their loved one and the death experience sensing or feeling the loved one's presence
sleep disruptions such as insomnia or extreme wakefulness tightness in the throat unexpected and unpredictable bouts of crying wandering aimlessly through the house or neighbourhood social withdrawal anxiety fear sadness guilt inadequacy loneliness lethargy
Recognizing the signs of a loss is the start of recognizing the signs of grief Loss may include the loss of: Independence Control Status Possessions Relationships Health and Significant others loved ones both human and animals.
Reaction to the loss can take the form of: Shock Physical Distress Panic Guilt Hostility / destructive behaviours Lack of interest and apathy Emotional Release
The signs of depression and grief can be similar. Many people who have experienced both talk about the sadness of grief compared with the numbness or almost non-feeling state of major depression. Grief is defined as the normal, internal feeling one experiences in reaction to a loss, while bereavement is the state of having experienced that loss. Although people often suffer emotional pain in response to loss of anything that is very important to them (for example, a job, a friendship, one's sense of safety, a home), grief usually refers to the loss of a loved one through death.
The potential negative effects of a grief reaction can be significant. For example, research shows that about 40% of bereaved people will suffer from some form of anxiety disorder in the first year after the death of a loved one, and there can be an up to 70% increase in death of the surviving spouse within the first six months after the death of his or her partner. In addition to grief as an initial reaction to loss, the process can be aggravated by events that remind the bereaved individual of their loved one or the circumstances surrounding their loss. This can be in the form of a particular date or anniversary, a location, a sound / song / smell / flower or even food. It would help to have an insight into the circumstances of the loss so that you can be prepared for the triggers and can suitably assist your client. Elisabeth Kubler-Ross (1969) is credited with awakening society's sensitivity to the psychological needs of dying people. She devised a theory of five typical responsesinitially proposed as stagesto the prospect of death and the ordeal of dying. According to Kubler-Ross, when family members and health professionals understand these responses, they are in a better position to provide compassionate support. Denial - On learning of the terminal illness, the person denies its seriousness to escape from the prospect of death. While the person still feels reasonably well, denial is self-protective. Denial is resistance and avoidance. Anger - Recognition that time is short promotes anger at having to die without being given a chance to do all one wants to do. Family members and health professionals are often targets of the client's rage, resentment, and envy of those who will go on living. Still, they must tolerate rather than lash out at the client's behaviour, recognising that the underlying cause is the unfairness of death. Bargaining - Recognition inevitability of death, the terminally ill person attempts to forestall it by bargaining for extra timea deal he or she may try to strike with family members, friends, doctors, nurses, or God. Listening sympathetically is the best response to these efforts to sustain hope. Depression - When denial, anger, and bargaining fail to postpone the course of illness. Kubler-Ross regards depression as necessary preparation for the last stage, acceptance. Acceptance - This is seen as achieving peace, accepting the present and not fighting or protesting the future.
Be aware people do not move through the stages outlined by KublerRoss in any fixed order. They may miss a stage, revisit a stage or experience several stages at the same time. Kubler-Ross stressed the importance of hope at all stages, of not crushing or denying peoples hope. She felt that even at the stage of acceptance, people hold some hope that their fate can be altered.
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Reporting Grief The aged care worker or community worker need to be aware that there are policies and procedures in place on what to do if a person is experiencing grief and loss. Generally, the supervisor is notified verbally and the worker will document in the progress or clinical notes what signs of grief the older person is displaying. It will also be verbally handed over to colleagues at handover. This is so staff are informed and to make sure that if the feelings of grief intensify then further steps may need to be taken such as, involving pastoral care, counsellors, family members and other professional as needed. Bereaved individuals who may have felt that the death of their loved one was either unexpected or violent may well be at greater risk for suffering from major depression, post-traumatic stress disorder (PTSD) or complicated grief. Major depression is described as a psychiatric disorder which can be characterized by depression and/or irritability that lasts at least two weeks in a row and is often accompanied by a number of other symptoms, such as: Problems with sleep, Loss of appetite, Loss of weight, Loss or lack of concentration, Decrease in energy level
It is very important that should you notice your client experiencing any of the above signs and symptoms that you document it accurately and appropriately and notify your supervisor. Major depression may also lead to the sufferer experiencing unjustified guilt, losing interest in activities he or she used to enjoy, or thoughts of wanting to kill them or someone else. PTSD refers to a condition that involves the sufferer enduring an experience that significantly threatened their sense of safety or well being (for example, the suicide or homicide of a loved one), They then re-experience the event through nightmares when they are asleep or flashbacks (feeling as if the trauma is happening again at times when the sufferer is awake), They also develop a hypersensitivity to events that are normal and they are very jittery and often tearful (for example, being quite irritable, getting startled very easily, having trouble sleeping, or difficulty trusting others), And they start avoiding things that remind the person of the traumatic event (for example, people, places, or things that the sufferer may associate with the death of their loved one).
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Activity 27 Is there a right or wrong way to grieve? Why/why not? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Grief is experienced emotionally, psychologically, physically and behaviourally. Give 5 examples of each: Emotional - _______________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Psychological - ____________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Physical - ________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Behavioural - _____________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Kubler-Ross created the Stages of Dying, what are they and outline the main characteristics of each stage
Stage
Main Characteristics
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4.2 Use appropriate communication strategies when older person is expressing their fears and other emotions associated with loss and grief.
Grief counseling helps mourners with normal grief reactions work through the tasks of grieving. Grief counseling can be provided by professionally trained people or in self-help groups where bereaved people help other bereaved people. All of these services may be available in individual or group settings. Personal assistance you can provide to your client includes: Grief is a very private and individual process. Everyone grieves in their own way and at their own time but you do not have to do it alone Grief can be physically exhausting: one hour of grieving can be comparable to several hours of hard physical labor. Talk to them. A grieving person needs the opportunity to talk about the loss. Recognize that loss can involve much more than death: divorce, mental health diagnoses, etc all involve loss. If the loss is a death, do not be afraid to mention the loved ones name and to ask about the death (e.g., how the death occurred, when it occurred). Give the bereaved person permission to grieve. Offer the person support, but also give them the time to think and grieve. Do not assume that someone is over their grief because they do not show outward signs. Check in with how they are feeling about the loss. When supporting someone grieving a death, recognize that anniversaries associated with the loss are common triggers. Ask how they coped or how they are coping now. The goals of grief counseling include: Helping the bereaved to accept the loss by helping him or her to talk about the loss. Helping the bereaved to identify and express feelings related to the loss (for example, anger, guilt, anxiety, helplessness, and sadness). Helping the bereaved to live without the person / pet who died and to make decisions alone. Helping the bereaved to separate emotionally from the person / pet who died and to begin new relationships. Providing support and time to focus on grieving at important times such as birthdays and anniversaries. Describing normal grieving and the differences in grieving among individuals.
Providing continuous support. Helping the bereaved to understand his or her methods of coping. Identifying coping problems the bereaved may have and making recommendations for professional grief therapy.
It can be tough to know what to say or do when someone you care about is grieving. Its common to feel helpless, awkward, or unsure. You may be afraid of intruding, saying the wrong thing, or making the person feel even worse. Or maybe you feel theres little you can do to make things better. While you cant take away the pain of the loss, you can provide muchneeded comfort and support. There are many ways to help a grieving friend or family member, starting with letting the person know you care. The death of a loved one is one of lifes most difficult experiences. The bereaved struggle with many intense and frightening emotions, including depression, anger, and guilt. Often, they feel isolated and alone in their grief. Having someone to lean on can help them through the grieving process. Dont let discomfort prevent you from reaching out to someone who is grieving. Now, more than ever, your support is needed. You might not know exactly what to say or what to do, but thats okay. You dont need to have answers or give advice. The most important thing you can do for a grieving person is to simply be there. Your support and caring presence will help them cope with the pain and begin to heal. Listen with Compassion Almost everyone worries about what to say to people who are grieving. But knowing how to listen is much more important. At times, wellmeaning people avoid talking about the death or mentioning the deceased person. However, the bereaved need to feel that their loss is acknowledged, its not too terrible to talk about, and their loved one wont be forgotten. While you should never try to force someone to open up, its important to let the bereaved know they have permission to talk about the loss. Talk candidly about the person who died and dont steer away from the subject if the deceaseds name comes up. This may include crying, fits of anger, screaming, laughing, expressions of guilt or regret, or engaging in activities that reduce their stress such as walking or gardening. When it seems appropriate, ask sensitive questions without being nosy that invite the grieving person to openly express his or her feelings. Try simply asking, Do you feel like talking? Accept and acknowledge all feelings. Let the grieving person know that its okay to cry in front of you, to get angry, or to break down. Dont try to reason with them over how they should or shouldnt feel. The bereaved should feel free to express their feelings, without fear of judgment, argument, or criticism. Be willing to sit in silence. Dont press if the grieving person doesnt feel like talking. You can offer comfort and support with your silent presence. If you cant think of something to say, just offer eye contact, a squeeze of the hand, or a reassuring hug.
Let the bereaved talk about how their loved one died. People who are grieving may need to tell the story over and over again, sometimes in minute detail. Be patient. Repeating the story is a way of processing and accepting the death. With each retelling, the pain lessens. Offer comfort and reassurance without minimising the loss. Tell the bereaved that what theyre feeling is okay. If youve gone through a similar loss, share your own experience if you think it would help. However, dont give unsolicited advice, claim to know what the person is feeling, or compare your grief to theirs. Concentrate your efforts on listening carefully and with compassion. Everyones experience of grief is unique, so let them grieve their own way. Dont judge or dispute their responses. Criticising the way they express their grief is hurtful and will make them less likely to share their feelings with you. If they dont feel like talking, dont press. Remember that you are comforting them just by being there. Sitting together in silence is helpful too. Dont forget the power of human touch. Holding the persons hand or giving them a hug offers emotional support. Comments to avoid when comforting the bereaved "I know how you feel." One can never know how another may feel. You could, instead, ask your friend to tell you how he or she feels. "It's part of God's plan." This phrase can make people angry and they often respond with, "What plan? Nobody told me about any plan." "Look at what you have to be thankful for." They know they have things to be thankful for, but right now they are not important. "He's in a better place now." The bereaved may or may not believe this. Keep your beliefs to yourself unless asked. "This is behind you now; it's time to get on with your life." Sometimes the bereaved are resistant to getting on with because they feel this means "forgetting" their loved one. In addition, moving on is easier said than done. Grief has a mind of its own and works at its own pace. Statements that begin with "You should" or "You will." These statements are too directive. Instead you could begin your comments with: "Have you thought about. . ." or "You might. . ." Shes lucky she lived to such a ripe old age. It was Gods will. You can always try for another baby. Hes happy in heaven. Be thankful theyre not in pain anymore. Try to remember the good times.

Youll feel better soon. Time heals all wounds. Count your blessings, you still have a lot to be grateful for. Youve got to pull yourself together and be strong.
Offer practical assistance Grief is a process and not an event. Coming to terms with the death of a loved one can take months and years, rather than days and weeks. Suggestions include: Dont shy away from your friend after the funeral. Keep in contact. Never suggest that its time they got over it and moved on with life. Appreciate that your friend may continue to grieve in subtle ways for the rest of their days. Dont change the subject if the deceased naturally comes up in conversation. Your friend needs to know that their loved one hasnt been forgotten. Use the name of the deceased in conversation. Remember there will be days in the year that will be particularly hard for your friend to bear, such as anniversaries, Christmas and the deceaseds birthday. Be sensitive to these times and offer your support.
Provide ongoing support Grieving continues long after the funeral is over and the cards and flowers have stopped. The length of the grieving process varies from person to person. But in general, grief lasts much longer than most people expect. Your bereaved friend or family member may need your support for months or even years. Continue your support over the long haul. Stay in touch with the grieving person, periodically checking in, dropping by, or sending letters or cards. Your support is more valuable than ever once the funeral is over, the other mourners are gone, and the initial shock of the loss has worn off. Dont make assumptions based on outward appearances. The bereaved person may look fine on the outside, while inside he or she is suffering. Avoid saying things like You are so strong or You look so well. This puts pressure on the person to keep up appearances and to hide his or her true feelings. The pain of bereavement may never fully heal. Be sensitive to the fact that life may never feel the same. You dont get over the death of a loved one. The bereaved person may learn to accept the loss. The pain may lessen in intensity over time. But the sadness may never completely go away. Offer extra support on special days. Certain times and days of the year will be particularly hard for your grieving friend or family member. Holidays, family milestones, birthdays, and anniversaries often
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reawaken grief. Be sensitive on these occasions. Let the bereaved person know that youre there for whatever he or she needs. Watch for warning signs Its common for a grieving person to feel depressed, confused, disconnected from others, or like theyre going crazy. But if the bereaved persons symptoms dont gradually start to fade or they get worse with time this may be a sign that normal grief has evolved into a more serious problem, such as clinical depression. Encourage the grieving person to seek professional help if you observe any of the following warning signs after the initial grieving period especially if its been over two months since the death. Difficulty functioning in daily life Extreme focus on the death Excessive bitterness, anger, or guilt Neglecting personal hygiene Alcohol or drug abuse Inability to enjoy life Hallucinations Withdrawing from others Constant feelings of hopelessness Talking about dying or suicide Anger Anxiety Change in worldview Confusion Sadness and depression Sleeping difficulties Drop in self-esteem Difficulties in concentration Feeling unable to cope Guilt and remorse Helplessness Hopelessness Loneliness Questioning of values and beliefs Relief Shock and disbelief.
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It can be tricky to bring up your concerns to the bereaved person. You dont want to perceive as invasive. Instead of telling the person what to do, try stating your own feelings: I am troubled by the fact that you arent sleeping perhaps you should look into getting help. Grief therapy is used with people who have more serious grief reactions. The goal of grief therapy is to identify and solve problems the mourner may have in separating from the person who died. When separation difficulties occur, they may appear as physical or behavior problems, delayed or extreme mourning, conflicted or extended grief, or unexpected mourning (this is seldom present with cancer deaths). Reporting your clients circumstances can be verbal / telephone / face to- face and in writing. Communication with the grieving needs to be in a variety of forms: Non judgmental - Non-judgmental is about being open-minded enough to understand that other people have different points of view, and that in their world-view, they may be correct Observing and listening - (facial expressions, gestures, raised eyebrows, eye contact, vocal utterances, and posture). (questions and answers, arguments and counterarguments, agreements and disagreements, challenged and compliances) Respect for individual differences Courtesy - excellence of manners or social conduct; polite behavior; a courteous, respectful, or considerate act or expression Empathy - is the capability to share your feelings and understand another's emotion and feelings. It is often characterized as the ability to "put oneself into another's shoes," or in some way experience what the other person is feeling Sympathy - is a social affinity in which one person stands with another person, closely understanding his or her feelings. It also can mean being affected by feelings or emotions. Thus the essence of sympathy is that one has a strong concern for the other person. Sympathy exists when the feelings or emotions of one person are deeply understood and appreciated by another person.
Activity 28: Case Study Sara has just returned to work having had some days off. Before long she notices the difference in the mood of the aged care facility. Jonas has contracted pneumonia and is likely to die over the next couple of days. Although Jonas has had emphysema for many years, this deterioration has happened very suddenly. All the staff members are extremely fond of Jonas, who has been a resident of the facility for eight years. He has a generous and friendly nature and a wonderful sense of humour. At times he has challenged the policies of the facility, but always with goodwill and in a constructive manner.
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Sara experiences a variety of strong emotions in response to Jonas's dying. She feels sadness at the prospect of losing him, and it also brings up memories of her own father's death. How should the staff act towards Jonas? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ What can be done to help Sara with her previous memories of grief and loss? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Are the feelings of staff towards Jonas normal? Why/why not? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ How can workers care for themselves in this type of situation? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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4.3 Provide older person and/or their support network with information regarding relevant support services as required.
Most of the support that people receive after a loss comes from friends and family. Doctors and nurses may and can also be a source of support. For people who experience difficulty in coping with their loss, grief counseling or grief therapy may be necessary. It is important for there to be a good support network available to help your clients through the stages of grief should the experience occur. The support network can include personnel such as: Advocates Family members Carers Friends Clergy or local church members Veterans / war widows associations Lions clubs and Community welfare organisations Health professionals (registered nurse, doctor, social worker, diversional therapists, and psychologists. National associations for loss and grief Palliative care associations
Support from family and friends is important People who have support from family and friends are less likely to suffer poor health as a consequence of bereavement and loss. However, some people may also benefit from support in the form of counselling. Bereavement counselling Grief support services provide counselling, support and education to bereaved individuals and families. The opportunity to talk things over with a trained counsellor can help you make sense of your feelings. Counsellors can offer you encouragement, support and advice through the grieving process. They will not tell you what to do or how you should be feeling, but they may put forward ideas and strategies to help you cope. Volunteer counsellors have often been through a similar experience. They can share their experiences and give practical advice and suggestions gained from their own bereavement journey.
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Support can help you cope with grief Grief support services aim to: Help and guide people through the grieving process Help with complicated grief issues to prevent physical and mental health problems occurring. Support is available in most communities Community organisations, agencies and groups are often involved in grief support services. These organisations may include: Hospitals and community health centres Palliative care agencies Volunteer groups Church and religious organisations. Specialist services
There are a range of specialist grief support services available. For example, if you have experienced the death of a child or baby, assistance is available from SIDS and Kids or SANDS (Stillbirth and Neonatal Death Support). There are also grief support groups for families of people involved in industrial or workplace accidents, victims of homicide and people experiencing trauma as a result of road accidents. Sometime specialist services are established in response to a particular traumatic event or disaster such as a bushfire or flood.
Where to get help Your doctor Your local community health centre A trained counsellor Australian Centre for Grief and Bereavement Bereavement Counselling and Support Service 1800 642 066 Australian Centre for Grief and Bereavement Kids Grieve Kids Help Line Tel. 1800 551 800 24 hours a day, seven days a week. Victims of Crime Helpline Tel. 1800 819 817
Things to remember Everyone experiences the pain associated with grief at some time in their life. Support from family and friends is important.
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Contact grief support volunteer groups, community or religious organisations, hospitals and palliative care agencies to access services Losing a loved one can be a shattering event that affects you emotionally, physically and spiritually. There is no one correct way to grieve. Misconceptions about the grieving process can cause difficulties for the bereaved person. The experience of grief depends on individual factors such as personality and age, the relationship with the deceased and spiritual beliefs.
It is important for there to be a good support network available to help your clients through the stages of grief should the experience occur. The support network can include personnel such as: Advocates Family members Carers Friends Clergy or local church members Veterans / war widows associations Lions clubs and Community welfare organisations Health professionals (registered nurse, doctor, social worker, diversional therapists, and psychologists). National associations for loss and grief Palliative care associations
Being able to care for a dying loved one tends to promote the healing process for those who are left behind. That care can either be provided at home, in the hospital, or in hospice care. A hospice is a program or facility that provides special care for people whose health has declined to the point that they are near the end of their life. Such programs or facilities also provide special care for their families. Moving on with life There is an expectation that accepting the death of a loved one means letting go of them and their memory. The reality is that many bereaved people continue to have a relationship with their loved ones for the rest of their lives through remembering them. Death ends a life, not a relationship. You may like to talk about your loved one in general conversation or commemorate special events like the deceaseds birthday. Keeping your relationship with the deceased alive is a healthy, normal response. On
the other hand, you may prefer to keep your memories to yourself and grieve more privately and thats healthy and normal too. Activity 29 As a care worker, you will care for residents/clients/older people who will die. List some strategies that could be utilised by workers, when preparing a dead body to be viewed by the family. _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ When working, you find an older person who has died, who do you notify? Do you need to document anything? Why/why not? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Who notifies the next of kin that an older person has died? _________________________________________________________ _________________________________________________________ If you have never prepared a dead person before, how do you find out what to do? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Activity 30 How would you as a carer recognise signs that older person is experiencing grief and report to appropriate person? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ What appropriate communication strategies could you use as a carer when an older person is expressing their fears and other emotions associated with loss and grief? Give details _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ How do you as a carer provide older person and/or their support network with information regarding relevant support services as required? _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
_________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________
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Resource Evaluation Form

Please come back to this page when you have finished working on this resource and complete this form. Your feedback can assist us to continually improve this resource. Course Unit: CHCAC317A - Support older people to maintain their independence RTO Date at finish of unit Please Circle Was your learning totally external, with occasional phone contact with a designated trainer/teacher? Was your learning externally supported by a study group of other learners studying the same unit? How many workshops were given to support your learning? (Please circle a number 0,1,2,3) Did your learning involve class support material at your college? Did you find this resource easy to use? Any Comments? Yes Yes 0 1 2 No No No No 3
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Please comment on any ways this resource could be improved for future learners
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Thank you for your time to give us your valuable feedback. Please give this to your trainer/facilitator/teacher who can send to us at the below address or if you prefer you can do it yourself
JNB Publications P.O. Box 268 Macarthur Square, NSW, 2560 Fax: 02-4627-0530
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Document Name: Document No: John Bailey 2009

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CHCAC317A. Support older people to maintain their independence Contents

Document Name: Document No: John Bailey 2009

CHCAC317A Support older people to maintain their independence Version No: V1

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Document Name: Document No: John Bailey 2009

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CHCAC317A. Support older people to maintain their independence

Document Name: Document No: John Bailey 2009

CHCAC317A Support older people to maintain their independence Version No: V1

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Document Name: Document No: John Bailey 2009

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Forms and Care Plans

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Employability Skills Certificate III in Aged Care

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Initiative and enterprise

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EMPLOYABILITY SKILLS Planning and organising

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