Chcac317a v2 Support The Older Person To Maintain Their Independance

Training Division
CHC30212 Certificate III in Aged Care
CHCAC317A
SUPPORT OLDER PEOPLE TO MAINTAIN THEIR INDEPENDENCE
Learning Materials
TABLE OF CONTENTS
Welcome ........................................................................................................................................................................ 3 Competency ................................................................................................................................................................... 3 Assessment .................................................................................................................................................................... 3 Essential knowledge:...................................................................................................................................................... 5 Essential skills:................................................................................................................................................................ 5 RANGE STATEMENT ....................................................................................................................................................... 6 EVIDENCE GUIDE ............................................................................................................................................................ 7
INTRODUCTION .................................................................................................................8
Ageing and aged care as a focus of national interest .................................................................................................... 8 Demography of ageing ................................................................................................................................................... 9 Economic context of ageing ........................................................................................................................................... 9 Ageing in place ............................................................................................................................................................... 9 Care plans .................................................................................................................................................................... 10
SUPPORT THE OLDER PERSON WITH THEIR ACTIVITIES OF DAILY LIVING ...........11
Encourage older people to get support to maintain ADLs .......................................................................................... 11 Explaining the support to be provided to the older person ........................................................................................ 15 Getting information about the older persons support needs ..................................................................................... 18 Making sure services meet routines and customs ....................................................................................................... 19 Respecting the clients home and personal space ........................................................................................................ 20 Allowing the older person to direct their own support ............................................................................................... 20 Following workplace policy and procedure ................................................................................................................. 21 Using equipment to help older people with ADLs ...................................................................................................... 21
CHECKING AN OLDER PERSONS ABILITY TO DO DAILY ACTIVITIES .....................23

Monitoring the older persons ADLS ............................................................................................................................ 23 Reporting changes in the older persons support needs .............................................................................................. 25 Supporting the older person to modify their activities and adapt their environment ................................................ 28 Finding out and learning about aids and equipment to help older people ................................................................. 28
MAKING SURE THE PERSONS ENVIRONMENT IS SUITABLE, SAFE AND SECURE 30

Support the person to maintain their own environment ............................................................................................ 30 Helping the older person keep themselves safe .......................................................................................................... 30 Working with an older person to adapt their environment to keep them safe and comfortable ............................... 31 Fixing hazards............................................................................................................................................................... 32
SUPPORTING THE PERSON EXPERIENCING LOSS AND GRIEF ...............................35

Psychological needs and the older person................................................................................................................... 35 Grief and Bereavement ................................................................................................................................................ 35 Using appropriate communication skills ...................................................................................................................... 38 Principles for bereavement support programs ............................................................................................................ 41 Providing clients and their support networks with relevant information ................................................................... 41
CHARLTON BROWN Page 2 of 43 CHCAC317A Version 2 (August 2012)
WELCOME
Welcome to this unit of study. As you work through the learning guide and assessment, you will be developing knowledge about this unit of study. If you do not understand an activity, ask questions and discuss any queries with your trainer, mentor or supervisor. It is important that you develop skills in a work situation, or, in a simulated situation which approximates the workplace as closely as possible. We encourage you to contact us for assistance at any time. Simply call or email and CHARLTON BROWN will be able to assist you.
COMPETENCY
In order to be assessed as competent (C), you will need to provide evidence which demonstrates that you have the essential knowledge and skills to successfully complete the unit to the required standard. Competency is simply being able to demonstrate that you can do the task, not just once, but with confidence, repeatedly. Please read the beginning of this unit, it will tell you about the elements and the performance criteria you will be assessed against. It will also inform you of the knowledge and skills you require to successfully complete the unit. If you can already demonstrate such knowledge and skills you can undertake these skills you should talk to your trainer. Marking guide at the end of each unit you will find a marking guide. This is designed to assist you.
ASSESSMENT
1. 2.
Complete all the assessment tasks in the unit. You will find these at the end of the unit. Have your supervisor sign the statement of validation that you can undertake these skills in the workplace. Complete the Assessment Cover Sheet and sign all sections. Check the marking guide to ensure you have covered all elements of the assessment. The marking guide is used by the assessor to mark off your competency.
3.
The evidence you need to provide for an assessment of competence in this unit will be based on, but not limited to: Successful completion of assessment. Verbal discussion and questioning by assessor. Mentor / supervisor / workplace coach verification of skills. Any other evidence you or your assessor has gathered. Any other activities your assessor considers necessary.
You are required to submit your work in a neat, orderly, detailed and organized manner. Use references in all your work.
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CHCAC317A Version 2 (August 2012)
This unit describes the knowledge and skills required by the worker to support the older person to maintain their independence with activities of living ELEMENT Elements define the essential outcomes of a unit of competency. 1. Support the older person with their activities of living PERFORMANCE CRITERIA The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement. 1.1 1.2 1.3 1.4 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 accommodate 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 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 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 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
1.5 1.6 1.7 1.8
2.
Recognise and report changes in an older persons ability to undertake activities of living
2.1
2.2 2.3 2.4 3. Support the older person to maintain an environment that maximises independence, safety and security 3.1 3.2 3.3 3.4 4. Support the older person who is experiencing loss and grief 4.1 4.2
4.3
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ESSENTIAL 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
ESSENTIAL 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: - 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
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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: Individuals living in residential aged care environments Individuals living in the community Contexts may include: The older persons own dwelling Independent living accommodation
Residential aged care facilities Activities of living may include: 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 Report may be and include: Verbal: - telephone - face-to-face Non-verbal (written): - progress reports - case notes
incident reports Aids and/or equipment may include: Domestic appliances utilised for cleaning, laundering and meal preparation Gardening equipment Personal and security alarms
Mobility devices Hazards may include: 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
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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: 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
Access and equity considerations: 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
Context of and specific resources for assessment: 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
Method of assessment may include: Observation in the workplace Written assignments/projects Case study and scenario analysis Questioning Role play simulation
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INTRODUCTION ................................................................................................
Working in aged care can be rewarding. However, the challenges can be unique and it requires a dedicated worker to be able to apply your skills and knowledge and meet client need appropriately within service guidelines. When older clients are in need of support it is generally because they are unable to attend to their usual activities of daily living without some difficulty. In your work you will meet many older people with a wide variety of needs. Guidelines indicate that the client must have complex care needs how complex is interpreted across services varies, but is generally understood as meaning, requiring three or more services to function as independently as possible You will meet clients in a number of settings including: In their own home. Independent living accommodation. Respite and day services. Residential care.
It is very important to fully understand your role and the boundaries involved in caring for older people. Their needs can be complex and involve physical and emotional support, safety, and sexual need, social, religious and cultural preferences. If one of these needs is not met it can impact on another. Meeting these needs requires a collaborative approach and teamwork.
AGEING AND AGED CARE AS A FOCUS OF NATIONAL INTEREST

During the 1980s and 1990s there were a series of Commonwealth government studies and reports which established the framework for the funding and provision of aged care in Australia. Support for our ageing population is now seen to involve:
More consideration of the issues affecting the older persons ability to be independent. A focus on social and family networks providing increased support. Increased assistance for the older person to remain at home leading as active a life as possible. Increased recognition of the rights of the aged. Education of the aged to pursue their rights Free access to multi-disciplinary health assessment. Use of institutional care only as a final resort. Varied institutional settings allowing for high level care only when necessary. Emphasis on preventive programs.
CHARLTON BROWN
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DEMOGRAPHY OF AGEING
Australia's population, like that of most developed countries, is ageing as a result of sustained low fertility and increasing life expectancy. This is resulting in proportionally fewer children (under 15 years of age) in the population. The median age (the age at which half the population is older and half is younger) of the Australian population has increased by 4.8 years over the last two decades, from 32.1 years at 30 June 1990 to 36.9 years at 30 June 2010. Between 30 June 2009 and 2010 the median age remained relatively steady at 36.8 years. Over the next several decades, population ageing is projected to have significant implications for Australia, including for health, labour force participation, housing and demand for skilled labour ( Australia to 2050: Future Challenges, January 2010 (Intergenerational Report 2010), Attorney-General's Department).
ECONOMIC CONTEXT OF AGEING

Aged care in Australia is big business and an important part of the economy. It is a major employer of around 537,000 people, 40% being doctors and nurses. Aged care provision is a mix of Government, State, religious, charitable and private enterprise. The private sector operates just over one quarter of residential care services and almost half of all high care services and is very active in community care. Governments and the media are now alert to the potential economic impact of the greying of Australia as a result of the ageing Baby Boomer.
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 residents. 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 that cannot be managed, or if you need acute care and need to go to hospital.
The principles of Ageing in Place aims to provide a homelike environment for ageing people that ensures companionship and choices about the individuals lifestyle. The formal principles of the Ageing in Place are: to address the three plagues of residential care: loneliness, helplessness and boredom. to provide close and continuing contact with children, plants and animals. to provide easy access to human and animal companionship. to balance giving and receiving. to trust in each other. to provide a life worth living. that medical treatment should be the servant of genuine human caring, never its master. to be honoured and respected. to provide for human growth. to provide wise leadership. Refer to Department of Australian Health and Ageing (Accreditation Standards and Principles)
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MAINTAINING INDEPENDENCE
Part of your role to support independence is to develop strategies to help people perform their ADLs (activities of daily living) and engage in community activity outside the home. Some of the tasks you may need to help people achieve may be: Prepare meals. Help with banking and bill paying. Personal matters. Maintain their home and garden. Participate in the community.
Socialisation and activity is a way to help older people meet their emotional and recreational needs. Without it, they can become: Lonely and isolated. Less physically active. Depressed and anxious. More dependent of family. Withdrawn and less willing to communicate.
Activity can be formal or informal, structured or semi structured. The type of activity you support your client with will be with their consent and will be documented on the care plan or you will need to report and document impromptu activities. Older peoples preferences for activities may include: Volunteer activities. Recreation and hobbies. Music and theatre type activity. Activities that contribute to learning. Community action groups. Special interests.
In supporting your clients independence you need to consider their dignity, their rights and their choice of dignity of risk. However you need to be able to maintain a balance between these tasks and ensure their safety by minimising risk and hazards. To support your clients appropriately you need to know what kinds of services are available to them in the local area.
CARE PLANS
In your work with older people you need to ensure that you follow the individual care plan. A care plan clearly explains: The tasks you will be undertaking. Areas the client requires support with. The desired goal / outcome. Any interventions and alerts you may need to know about. People responsible for carrying out the tasks outlined in the plan.
Make sure you understand your organisations policy and procedures.
CHARLTON BROWN
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SUPPORT THE OLDER PERSON WITH THEIR ACTIVITIES OF DAILY LIVING ...............................................................................................
Independence is important. It enables people to feel like they have some control of their lives and gives them choices about what kind of support they consent to and how and when they will do certain activities. Independence gives people confidence and builds self-esteem. As people get older they experience difficulties doing the tasks they are usually able to do independently. They may have to rely on help to do the shopping, take care of the home and garden, cook for themselves and manage their personal affairs. This can affect their ability to remain independent. The Commonwealth governments policy is to encourage older people to remain at home and access community services to maintain their independence. This is called Ageing in place. This means older people can be supported to stay in their own homes for as long as possible. More information about ageing in place can be found at this link. http://www.agedcareaustralia.gov.au/internet/agedcare/Publishing.nsf/Content/ageing+in+place By the end of this unit you will be able to: Encourage older people to get support to maintain ADLs . Explain the support they will receive with ADLS. Access information about an older persons support needs. Ensure services meet the older person routines and customs. Respect the older persons home. Allow the older person to direct their own support. Follow workplace policy and procedure. Use equipment to help older people with their ADLS.
ENCOURAGE OLDER PEOPLE TO GET SUPPORT TO MAINTAIN ADLS

The tasks that people undertake every day are called activities of daily living. These are the things they do to attend to their personal hygiene needs and keep their living environment clean, safe and organised. Daily activities The following list describes the types of activities that people do:
Activity of Daily Living

Home maintenance
Example
Cleaning windows Fixing locks Leaking taps Pruning Weeding Watering plants Lawn mowing Driving Using public transport Going to clubs, attending social groups Some domestic task are limited regulations Vacuuming and mopping Cleaning the bathroom Changing bed linen Dusting and cleaning mirrors Washing Hanging clothes on the line Ironing
Lawn and garden maintenance
Transport
Domestic cleaning
by
OHS
Domestic laundry
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Meal preparation Shopping Bill paying and banking Personal care
Pet care
Medication
Peeling and preparing vegetables Cooking Shopping for food and clothing Paying household bills in person Withdrawing money from ATMs Showering Getting dried Dressing and undressing Shaving Hair and makeup Oral and nail care Feeding Watering Cleaning Depending on organisational policy and procedure Assistance with medication via a Webster Pak or dosette box Eye and ear drops Creams and lotions
Many older people can do much for themselves, others very little. It is important to know why the person cant do an activity anymore. It may be a physical limitation or a memory problem, for example, if they have a hearing or visual impairment it may be unsafe for them to drive their car anymore. There are a number of informal ways an older person can get support to complete some activities of daily living like shopping. Friends, family and neighbours can help and some people may be eligible for help from volunteer or charitable groups. The services and help they can get will depend on whether they live at home, in a community setting or an aged care facility.
Help with home and garden maintenance

An older person who lives at home may find it very difficult to physically undertake yard and garden maintenance or it may be beyond their skill to do minor jobs such as changing a light globe or fixing a tap washer. There are a number of options available to an older person to get help with these tasks and they can include: Private business and franchises that do lawn and garden maintenance. Organisations that are funded by the state and federal government to provide lawn and garden maintenance. In-service programs that provide lawn and garden maintenance as part of a larger funded community care program. Friends, family, neighbours and volunteers.
It is important to observe older people as you visit them to see whether their needs are increasing as they age or if they need extra help.
Transport and social support

Anyone should be able to go out when they want to or need to and older people are no different. Driving and transporting clients is a key service which allows many aged persons to maintain their independence. Community service organisations have a range of policies and procedures which cover this HACC service depending on whether the personal carer uses a service vehicle or their own. It may be part of your role to help people with transport needs to things such as social activities, appointments and shopping. It is important to older people who cannot go out on their own to get to the places they need to or want to. They may not be able to drive anymore, get on and off buses or trains or they may need someone to be with them, particularly if they are unsteady on their feet and use a mobility aid or are visually impaired.
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Residential facilities usually provide transport for residents to access to social outings and appointments in the community if there is no family member to take them. Often health professionals visit older people in their home at the facility so they dont need to travel. Some of the community transport options are: Courtesy buses. Local HAAC funded transport. Taxis. Volunteer transport. Subsidised transport schemes.
Many state transport authorities have subsidy schemes that provide older and disabled people access to cheaper taxi which aims to improve the mobility options for disabled and aged people. If you have an elderly client that you think may be eligible for a taxi subsidy they need to contact their local transport authority.
Activity 1
Do some research and find one community transport service available in your local area. You will need to find out the answers to the questions and bring it back to the class and discuss how many different services you can find. Type of transport Name of the Organisation Eligibility criteria Contact person Phone No Address Cost Does it provide assistance to the client to get in and out of the vehicle? Some people need someone to go out with them for a number of reasons: They cannot drive a car anymore. Cannot walk or use public transport unless they have someone with them. Need assistance with directions due to poor eyesight or memory. May need help to find, see or reach grocery items off shelves. They cannot carry shopping bags. Your role may be to accompany the older person to go out or help them arrange alternate transport. Collaboration on determining service needs is discussed in CHCIC302A Participate in individual care planning.
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Helping to maintain a clean and safe home environment

Older people find it difficult to complete household tasks, such as vacuuming floors, cleaning the shower recess and hanging washing on the line. They may be able to do parts of some tasks but not others. Two examples are: When preparing meals, you may need to cut up vegetables and get heavy pans out of high or low cupboards, and then they can complete the task.
To clean dirty clothes, they can collect them and put them in the washing machine, but may not be able to start it if the knobs need pulling. They may be able to get the wet clothes out of the washing machine, but not be able to carry the basket out to the line or hang them to dry.
Family is sometimes able to provide help, but if they cannot, they may be eligible for services such as home and community care programs (HACC) or a Community Aged Care Packages (CACP). There are many private services that provide meals and domestic services but they are expensive and unsubsidised. It may be your job to go to the homes of older people and help them with household tasks such as cleaning, cooking, transport and laundry. Elderly people that live in residential care often have all their cooking, cleaning and laundry done by staff. In the community it is your job to assist with these tasks for older people.
Personal and financial matters

Older people often have trouble with their eyesight, their hand movements or memory. When this happens, they will need help with reading and writing, paying bills and banking. Specialist support services can help with visual aids. If there is no family support they may be able to access HACC services or if the support they require is complex (needs three or more services to remain at home) they may be eligible for a CACP and would need to be referred to the ACAT (Aged Care Assessment Team) by a GP or Health Specialist for a comprehensive assessment. They can also be referred to ACAT by a family member or advocate. ACAT is part of the public hospital system. It is important to know how much help the client needs. This ensures they dont get too much help and can retain as much independency as possible. It is important to support them to do the part of the task they can do well and practice the ones they cant. This helps with their self esteem and makes them feel more independent. There are a number of ways you can find out the level of support your client needs: Ask family members, friends and neighbours what they have been helping with. Ask the client how much help they want. Observe the client undertake the activity so you can see where they need help. Pay attention to what they do well.
Once you know the level of support you need to provide you can match these with the most appropriate service. You need to maintain open communication with your supervisor so you can implement the most appropriate service into the individualised care plan. Some of the services the client may require you may not be able to provide yourself and you may need to refer the client to another service. As a diligent worker you will get to know the services older clients need in your field of work. Your supervisor will usually have a list of other services or a resource folder of community services targeted to meet the individual needs of clients and incorporate it into the care plan. Some community services have a Communication Book in the home where everyone involved in the clients care can communicate messages about the clients care such as appointments. Some older people will not ask for help and prefer to think they can still do the jobs they used to do. They just dont want to give up their privacy and independe nce or make extra work for families and friends. If you notice a client is struggling with things they were doing and seem unwilling to ask for extra support, ask them why they feel this way. Encourage then to look at the different ways they can get help and that it means they can stay independent for longer. Talk to them about the services they might need and emphasise that services promote independence. Make sure you are not pushing them into anything. Choice of services must be made independently. As an aged care worker, organisational policy and procedure requires you to report on the outcomes of the time you are with the client. Procedures for reporting vary across service providers.
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EXPLAINING THE SUPPORT TO BE PROVIDED TO THE OLDER PERSON

There are many organisations that provide different services to older people. Workers need to know if other workers from the same organisation provide a component of the care plan or if another service participates in meeting client needs. Complex service provision can be confusing for many clients and it is important that you tell them what organisation you come from and what you will be doing with them. The following examples demonstrate the differences in support to the two clients.
Beryl is an 84 year old woman who lives under her sons home. Twice a week Jeanine an aged care worker goes to help Beryl with her laundry. Beryl is able to wash her own clothes in the washing machine but hasnt the strength to take the sheets off the bed or hang clothes on the line. As soon as Jeanine gets there she takes Beryls clothes and hangs them on the line, she then strips Beryls bed and puts the sheets and towels in the washing machine. While they are washing she remakes the bed with fresh sheets and cleans the shower recess. She then takes the washing out and puts it on the clothes line, Jeanine then leaves. Beryls son takes the washing off the line when he gets home from work. On the next visit she folds the larger items that Beryl cant do like sheets before they g o shopping.
Eve is an older disabled client who lives in public housing and is fiercely independent. Kate visits one day a week and carries the wet washing out to a courtyard where Eve hangs her personal items on two clothes airers while Kate hangs the larger items like sheets and towels on to the outside clothesline. Kate then proceeds to clean the bathroom and toilet, and vacuums and mops the floors. She then has a cup of tea and a talk with Eve till her rostered time is up.
The two examples not only demonstrate the different ways a similar task is undertaken, it demonstrates a clients ability to be independent where possible and the limit of the workers involvement.
Meeting the older persons needs

Older people need different levels of support and types of support - someone with a memory problem requires different support to a client with a pain and back problem. People with hearing or vision problems need different support to people who have had a stroke. Below are two examples of people who require support with meals. Both examples show that the same ADL requires different types of support.
Mrs Collins has dementia. She doesnt know what time of the day it is, and often does the same thing more than once. She is often confused but currently attends to her own domestic tasks. The Carer and family write reminders on a white board to help her through the day. Mrs Andrews has chronic arthritis in her hands. She cannot turn on knobs, peel vegetables or open cans and jars. She has trouble holding onto cups and containers with small handles or anything too heavy.
Both ladies need support with meal preparation. However the support they need is different. Mrs Collins needs prompting and reminders of when to eat and how to do it, while Mrs Andrews would need full assistance to prepare the meal.
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Workplace policy and procedure

Your workplace will have written policies, procedures and protocols. These guidelines will outline how quality care support should be delivered to ensure the safety of both clients and staff. As a worker you must ensure that you follow procedures so that you do not get injured while performing your duties. Your employer has a duty to ensure you and your clients are safe. To secure your safety you may not be allowed to: Change light globes. Climb ladders. Use electrical appliances without using a cut off cord. Use bleach based products. Move heavy pieces of furniture. For example:
Ann works for a local HACC service and supports clients by providing them with basic house cleaning. She is not allowed to clean anything that is higher than where she can reach from standing on the floor. This means she is not allowed to climb ladders to do any cleaning. Tom works at a nearby residential facility. He does cleaning at the facility and did a special course in ladder safety; he can use a ladder to clean where he cannot reach from the floor.
In the next few pages is an example of a HACC Workplace Health and Safety Policy Statement. Briefly explain what the policy says you can and cannot do.
Activity 2 Find another policy from your workplace that relates to the work you do and copy it. Bring it to class to share your findings. If you do not yet work you can find other templates for your research at this website. http://www.health.qld.gov.au/hacc/serviceprovider_information/NatStanPolicys2.asp
Workplace Health and Safety Policy Policy Statement: The [Agency Name] considers its responsibility for Workplace Health and Safety to be the equal of other key service goals. It is our policy to conduct our activities in such a way that protects the health and safety of all employees, volunteers, clients and visitors at the place of work and to actively encourage safe work practices.
Rationale: To ensure all services and work practices are undertaken in a safe and healthy environment.
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ACTION: PROCESS To achieve this policy, specific responsibilities as detailed below will be implemented. The Management Committee of [Agency Name] will: Comply with all relevant legislation and statutory requirements, codes of practice and industry standards and make adequate provisions of resources to meet those requirements; Promote health and safety awareness and develop healthy and safe working procedures; Provide adequate protective equipment; Provide information, training, instructions and supervision on the use of protective equipment; Consult with staff members on health and safety matters and on ways to reduce workplace hazards and improve work systems; Maintain effective accident and incident analysis and hazard reporting systems; Encourage rehabilitation of injured employees; and Set health and safety objectives and regularly review performance against these objectives. Employees and volunteers will: Comply with all relevant legislation and statutory requirements, codes of practice and industry standards; Comply with healthy and safe working practices; Wear appropriate protective equipment; Report and participate in analysis of any hazards, accidents and incidents at their place of work; and Accept responsibility for protecting themselves and others in the workplace.
CONTENT On orientation to [Agency Name] all new staff and volunteers will be provided with relevant information and appropriate training on matters relating to Workplace Health and Safety including: o Current legislation and statutory requirements; o Current codes of practice; o Current industry standards; o Safe practice; o Fire and evacuation procedures; o Safety and security when dealing with aggressive and challenging behaviours; o Reporting of accidents, incidents and hazards; o Participation in analysis of trends in accidents, incidents and hazards; and o Attendance and participation in training and information sessions related to Workplace Health and Safety. [Agency Name] will ensure annual Workplace Health and Safety Audits are conducted to determine the extent of conformity to workplace health and safety practices and to encourage development of systems to improve risk management risks in the workplace. [Agency Name] will ensure annual fire and evacuation training and audits. All employees and volunteers, on identification of a hazard, incident or accident, will immediately inform their supervisor or management representative and where appropriate, take steps to minimise any immediate danger and alert other staff members about the nature of the problem. On identification of a hazard, the employee will fill out the Hazard Report Form to notify the employer or Workplace Health and Safety Officer of any hazardous condition, or work practice. In the event of an accident or incident management will ensure the Workplace Incident/Accident Report is filled out and sent to the appropriate Office of Workplace Health and Safety Queensland. Where appropriate, a risk management strategy should be developed for all service activities which includes the areas of: o Manual handling; o Hazardous substance; o Plant and equipment; o Noise; o Workplace environment; and o Security. Risk management processes will include: o o Identification of current practices; Assessment of the risk of injury or unsafe practice;
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o Adoption of measures to reduce or eliminate the risks identified; and o Review of the effectiveness of any modifications to practice. (Where appropriate), [Agency Name] will enable a Workplace Health and Safety Representative(s) to represent staff on health and safety issues. The Workplace Health and Safety Representative(s) will be responsible for: o o o o o Conducting regular workplace health and safety inspections; Assisting in resolution of workplace health and safety issues; Reporting any issue relating to workplace health and safety to Management of (Agency Name) and/or the Workplace Health and Safety Officer; Attending any established Workplace Health and Safety meeting; and Attending any prescribed training and information sessions relating to areas of responsibility. Date Approved: _______________________
Approved By: _______________________________ To be reviewed:_______________
Contact Officer:______________________________________________________
Explaining how services are delivered.

Once a clients needs are known, the information is recorded in the individual care plan. You should receive a care plan for every client you work with. It describes the areas the older person needs help with and it should also indicate how the task is to be done. When you give the older person, family member or advocate a copy of the care plan it tells them what they will be receiving in support. It is important that the older person knows the following things:
The support service What the service is What will be done and what will not be done.
Example Going shopping The worker prepares a shopping list with the client. The worker goes to the shops and buys the things on the list Every Friday at 11 am and has 2 hours to do the task The aged care worker
When the service will happen Who will be helping them
GETTING INFORMATION ABOUT THE OLDER PERSONS SUPPORT NEEDS

Understanding the care plan
Care plans describe the care requirements of the older person. It is prepared in collaboration with the client and any family members or advocates. The care plan can have different names ONA (ongoing needs analysis), service plan among others. They must be updated regularly to ensure they meet the ongoing needs of the older person. Needs can change and it is important you monitor their changing needs and regularly read the care plans. Clarify any information you are unsure about.
Talking to your supervisor about clients

There will be times when you will need to talk to your supervisor about the clients you provide service to. They will have more information about the clients personal history and may have visited the client during the assessment process. They may also be able to share information about the client from other carers.
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Confer with your supervisor to help you plan for your client. They will have more knowledge about organisational policy and procedure. They can also help you identify where you might need more training. Talk to your supervisor about new clients and report to them if you feel your client needs more support. Remember your supervisor is there to help you provide the best possible support. Discuss any concerns with them. The care plan may need more detail so workers are clearer about what to do.
MAKING SURE SERVICES MEET ROUTINES AND CUSTOMS

Most people have daily routines. We get up the same time every morning; have the same breakfast every day. We might attend a recreation activity with the same friends at the same time and day each week; we may observe the same religious customs every Easter. Almost everyone likes to keep the same routine and stick to it. A change in routine can be hard for some people and make them upset. It is important that services support older peoples routines as much as possible and workers should be aware of their clients routines so services can be sure they are meeting the needs of their clients. Services and workers need to be flexible so they can be changed to fit around the persons routine if necessary.
Maintaining a routine
We all feel more independent when we dont have to ask other people to help. We feel more in control of our lives when we are able to make choices about the things we want to do and how we want to do it - when we know what is happening next and how we will do it. Our regular appointments keep us connected to our friends and family. An older person can feel they are losing control over their lives the more support they require to assist with ADLs. It is important to make them feel confident about the help you will be giving them. The task you will help them with assists in them being independent even though they must do the task when the person who is helping them is available. Maintaining the client s routine assists them to feel like they have some control over their lives.
Maintaining an older person customs

Many people have religious and cultural preferences. The services you provide must take into account these customs and arrange services around the customs that maintain a person s routines: For example: you may have to visit someone after they have been to church, after they have celebrated a birthday with family or you may have to observe preferences relating to diet. Workers must be aware of a clients customs so they can work in a way that best meets the client needs.
Maintaining routines in residential care

Older people in residential care must follow the routines set down by the facility for meals, personal care and activity. However, the facility must meet the individual need of the client as much as possible and it is not always possible to maintain the same routines the client had at home, as staff require time to perform the tasks for all the clients living in the facility. Facilities have an open-house policy regarding visitors and allow residents to have visitors any time they like. Facilities ensure people have control over their lives through assessment and care planning. When an older person moves into residential care, staff need to know what their routines are. Facilities try to match their routines to lifestyle choices, e.g. if a client has a scotch before they go to bed to help them sleep, this may be implemented into the care plan. If they have lunch with old friends once a month, the facility will arrange for this to happen and manage care routines around this. Case Study Melissa is an aged care worker in an aged care facility. She goes to Mr. Somers room to help him get dressed and ready for the day. Mr. Somers care plan says that he likes to get up at 8:00 am. 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 up buttons up and putting on socks. Melissa arrives at Mr. Somers room at 7:30 am. 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 she then 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, Melissa makes sure he is comfortable in his arms chair and serves him a cup of tea.
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What things did Melissa do that were not part of Mr. Somers routine?
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

Talk with a classmate, colleague or your trainer about how this may have made Mr. Somers feel. Make some notes below.
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
RESPECTING THE CLIENTS HOME AND PERSONAL SPACE

You may work in a number of aged care environments. You may work in a client s home, in a facility or in day respite centre. If you work in a facility, different jobs are allocated to a specific staff member. In community work you may provide support with personal care, meals, laundry. It is important that you are flexible in the delivery of care needs. Regardless of where you provide support to the client, it should not differ just because the environment is less formal. Always ask your client for permission if you are going to use something they own. Remember your workplace is the clients home and it is important to be polite, respectful and courteous to clients and residents.
ALLOWING THE OLDER PERSON TO DIRECT THEIR OWN SUPPORT

Once you know what support your client needs, make sure they are in control of how and when the care will be provided to them. It helps them maintain some independence. Make sure clients understand what you will be doing with them. Ask them what they would like done first, let them make as many decisions as possible about how, when and where they will receive support.
Example:
Mr Smith needs support with the following identified needs. Putting on his PJs, making a cup of tea, getting into bed and feeding his cat. Ask him what he would like to do first. He can have his cup of tea anytime, but he cant get into bed before he puts his pyjamas on.
Helping clients direct their own support

Once you have identified the tasks that the older person can control and those that must be done a certain way or in a timeframe, you can talk to the client about how and when you will both do it. In order to help Mr Smith direct the tasks for the evening you could say: Hello Mr Smith. I am here to help you into bed tonight. Would you like a cup of tea now while the news is on, and Ill feed the cat or afterwards you can hop into bed? The example demonstrates Mr Smith being giving a choice in the order of the tasks for that evening. The worker can then provide the support in the order chosen by Mr Smith.
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FOLLOWING WORKPLACE POLICY AND PROCEDURE

Aged care industry standards and guidelines provide a benchmark for the provision of quality care . The care you implement has to comply with the laws and standards set by the government. You must perform your duties with safety, and workplace policy and procedure makes sure these things happen. One of the biggest areas you will need to comply with in the workplace is WHS (Workplace Health & Safety) regulations. You should always follow workplace procedure and you need to know the main principles of the Workplace Health and safety laws; and in addition, any special areas that apply to the aged care industry. Some safety measures of which you should be aware are: infection control. proper disposal of waste. safe manual handling practices. safe use of equipment. safe storage and handling of hazardous substances. wearing of protective clothing. prevention of falls and accidents. flammable materials. fire procedures. emergency procedures. evacuation procedures. smoking policy. threats to personal safety (including action to be taken when dealing with aggressive residents or HACC clients). immunisation of health care workers. incident and accident reporting. If you are unsure about any area of your work you should seek advice from a supervisor.
USING EQUIPMENT TO HELP OLDER PEOPLE WITH ADLS

As a worker you need to know the different type of equipment that older people use. Often the equipment is similar to what you use at home - it is just modified. It may also be a special type of aid that workers use to assist older people. You may need training to use the equipment with safety. Read the equipment manual, it tells you how the equipment is to be used and make sure there is a procedure at your workplace on the use of the equipment. Make sure you are confident when you are using any equipment. Most service providers do not allow carers to do home and garden maintenance. These types of services usually need to be done by specialist workers due to the degree of safety required to operate machinery and plant. If your client needs support with home and garden maintenance, you need to talk to your supervisor about other service options that are available to the client for these services. In residential care, maintenance books or log, record any repairs that need to be done and a suitably qualified person undertakes these repairs and maintenance. It is up to every employee to record and documents faults with equipment and plant.
Transport
Driving and transporting clients is a key service which allows many aged persons to maintain their independence. HACC service organisations have a range of policies and procedures which cover this HACC service depending on whether the personal carer uses a service vehicle or their own vehicle. You need to be alert to the common potential hazards associated with driving in general for example, poor road conditions, poor weather conditions and poor driver behaviour. However, there are particular potential hazards associated with transporting clients. These include:
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hazards associated with loads for example, loading and unloading shopping, wheel chairs or other client related equipment; and problems with unsecured loads. hazards associated with assisting the client often frail aged or disabled in and out of the vehicle. http://www.nohsc.gov.au/PDF/Standards/manual handling_cop2005_1990.pdf http://www.nohsc.gov.au/PDF/Standards/manual handling_cop2005_1990.pdf http://www.nohsc.gov.au/PDF/Standards/manual handling_cop2005_1990.pdf http://www.nohsc.gov.au/PDF/Standards/manual handling_cop2005_1990.pdf http://www.dir.qld.gov.au/workplace/law/codes/handlingpeople/index.htm http://www.safework.sa.gov.au/contentPages/docs/resCOPManual Handling.pdf http://www.nohsc.gov.au/PDF/Standards/manual handling_cop2005_1990.pdf http://www.workcover.vic.gov.au/vwa/home.nsf/pages/so_manualhandling http://www.safetyline.wa.gov.au/pagebin/pg000030.htm
National National Code of Practice for Manual Handling ACT - National Code of Practice for Manual Handling NSW - National Code of Practice for Manual Handling NT National Code of Practice for Manual Handling QLD People Handling Advisory Standard SA Code of Practice for Manual Handling TAS - National Code of Practice for Manual Handling VIC Code of Practice for Manual Handling WA Code of Practice: Manual Handling
Each State has laws that relate to manual handling codes of practice it is important that you are aware of how to look after your back. Many services require you to have manual handling training. If you are helping people with meal preparation, you will have to know how to use familiar equipment like microwaves, ovens and vacuum cleaners. This equipment can be hazardous if used incorrectly. You also need to check for frayed cords and any damage. Make sure you tell your supervisor or enter repairs into maintenance log books. Make sure you know; Your workplace policy and procedure for using equipment in people s homes. What equipment you are allowed to use.
Other equipment
Other equipment you may need to use includes aids specifically designed to help older people in the kitchen such as: Knives with special grips. Jar openers. Talking appliances. Liquid level sensor. Make sure you and the client know how to use the aids safely.
Activity 3 Research three aids that a client could utilise to assist with daily tasks. Visit www.ilcaustralia.org.au Independent Living Centre Australia to find them or visit a local supplier that provides these aids.
Get a picture of the aid or draw it and write down what it is used for?
Activity 4
Describe and compare the potential risks for carers in residential care to those carers in an HACC environment?
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CHECKING AN OLDER PERSONS ABILITY TO DO DAILY ACTIVITIES ...........................................................................................

As people age they have more difficulty doing their activities of daily living. It is your role to monitor these difficulties and tell others when their ability changes.Many older peoples condition is progressive - meaning the condtion gradually gets worse over time. Examples of progressive diseases are Alzhiemers, Parkinsons , Huntingtons and arthritis. Some conditons are temporary like the flu or a skin tear. Change is difficult to detect especially when a clients deterioration is slow. In this section you will learn about:
Monitoring a clients ADLs and the environment to identify changes in support needs. Report changes in the older persons needs. Support the older person to modify activity to promote optimum independence. Find out what equipment and aids help the person.
MONITORING THE OLDER PERSONS ADLS

A worker providing support to a client will be in regular contact with them. You will be required to get to know your client and their routines and what is normal for them. It is important to monitor any changes and when they need more support. You also need to take notice of their living environment. Changes may indicate the clients condition has declined and they are less able to do all their activities of daily living.
Case Study
Richard visits Mr Bunny once a week to take him shopping and help him with his laundry. Mr Bunny has some health issues related to being a Vietnam War veteran. Richard knows that this is the only regular help Mr Bunny gets and he seems capable of maintaining his home satisfactorily and caring for his cat. Over the past month Richard has noticed dirty dishes piling up and Smoky the cat is always looking for food from Richard when he visits and his water bowl is always empty. Discuss Mr Bunnys case with the class and how you would approach him about the things you have observed. Write down some questions that would ask him about the way he is feeling and how you would suggest he accept more service.
Looking for signs

When working with an older person you need to be alert and observant about the condition of the client and the home. Look for things that appear different and why this might be. Things you may observe could be:
Clothing looks dirty. Personal hygiene is questionable. Food spoiling. Dirty kitchen. The house and yard looks untidy. Home maintenance has been neglected.
Any one or combinations of these things are indicators that the client requires additional assistance with ADLs. Keep in mind that everyone lives differently and you need to monitor changes in the individuals preferred environment. Some people dont keep an immaculate home or like to cook.
Activity 5
Think about the way you organise your life. Write down what your own environment looks like. Be honest with yourself about the things you do regularly and the things you dont when maintaining your own ADLs.
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Asking about their ability

Another way to tell if a client is feeling ok about themselves is to ask. Be empathetic when asking questions, they may be embarrassed that they cannot do things the way they used to. Talk to friends and family and find out if they have the same concerns. Say things like: Do you need help to have a shower? or Why havent you done the dishes, thats not like you? Pay attention to how the client responds when you are assisting them. Do they complain about pain; are they slower than before? Do they remember things as well as they did? All these things give you information about how the client is managing and whether you should talk to your supervisor about additional support.
The individual care plan

The most important tool for establishing appropriate work practices in the aged care workplace is the individual care plan. Care Plans are the formal expression of a process of needs assessment and negotiated individual responses to the identified needs. An individual program of care is negotiated with each client. This helps to establish a sense of purpose essential to the development of self-confidence and self-esteem. Regular monitoring of the client and review of the plan involves the client and the workers. Below is an example of a care plan. Personal Details Surname: Given name: Preferred name: Carer in charge: Supervisor: Doctor: Allergies: Care issue 1. Physical Difficulty rising from chair. 2. Psycho-social Limited social contacts. Goals Determine mobility status. Increase socialisation. Interventions Occupational therapist to assess on Wed 3 Feb. Introduce to volunteer for 10 minute conversation daily. Place regularly with Eva for lunch. Set up a family interview by 10 Feb. Ask volunteer document. to Evaluation Staff/Signature Carer RN DOB: Room No: Aids Used Hearing aid Glasses Dentures Walking stick Walking frame Wheelchair
3. Family No family visits in last month. Care Plan review Date: Outcome:
Encourage family to visit more often.
DON
One of the ways to check on a client s condition is to look at the care plan. You need to ask yourself, is the care plan current? Have the activities on the care plan changed to some degree? Does the client need more
assistance than what is indicated on the care plan? Sometimes small changes may occur without you noticing. Changes to an older person s condition will be slow. They will gradually need more help and it is important that you monitor and report this progress so that care plans can be updated for every one s information. Extra help will assist the person to be independent.
REPORTING CHANGES IN THE OLDER PERSONS SUPPORT NEEDS

When you observe changes in ADLs they must be reported. Some workers change support needs without telling anyone. Doing this means:
They are the only one who knows about the changes. Other workers who assist the client will not know about any changes. The care plan will not be up to date. The client may be getting services they are not eligible for.
Reporting on client needs and the services that need to be provided may be in various formats, including: Specific function charts are part of residential care ongoing resident assessment. Face to face usually apply to areas of client care that do not require an urgent response. Urgent responses require telephone contact with your supervisor.
Progress notes should be progressive and record information about the clients support needs. Here is an example of a progress report.
Progress Notes Client name: Beryl Elms Date 10.12.09 Time 11.00 Notes Beryl was not ready to go shopping today. She was still in her pyjamas and said she would rather stay home and rest. We prepared a list together, she gave me $100 and I went shopping for her. When I get back from shopping, Beryl was lying on the bed still in a towel and there was blood all over the bed and a trail of blood from the bathroom to the bedroom. Beryl told me she had tried to have a shower and when getting out had slipped and cut her leg on the bottom rail of the shower recess. I stopped the flow of blood from her leg to find a 2cm skin tear on her shin. I telephoned my supervisor and she rang Beryls daughter to ask her to come and take Beryl to the doctor. I waited till she arrived and assisted Beryl to get ready to go to the doctor. I cleaned up the blood from the bathroom and carpet as best I could use gloves. When Beryls daughter arrived she said she would get the carpet cleaner in to clean the carpet. I arrived to help Beryl shower today, and we talked about the probability of getting Home Modifications to install hand rails in the bathroom for her. She agreed and I told her I would refer this request to the supervisor. Signature Designation M Blundell AIN and
11.12.09
8.30
M Blundell AIN
Thorough documentation using the appropriate organisational reporting tools should be followed up using other supporting documentation as in the care note sample and incident report below. Hazard reports document situations where there is potential risk of injury to either the worker or the client.
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INCIDENT / INJURY REPORT

Status: Employee Client Home care Visitor Resident Contractor Student Phone: (h) (w) Sex: M Date of Birth: 20.05.1922 st 1 Language: English 3-5 years 5 years plus Casual Permanent P/T Volunteer Date: 10.12.09
1. Details of injured person: Surname: Elms First Name: Beryl Address: Experience in job: 0-3 months 4-12 month 1-2 years
Full-time Other
2. Details of witnesses: Name: Mandy Blundell Phone: (h) (w) Address: Name: Phone: (h) (w) Address: 3. Details of incident or accident: Date: 10.12 09 Time of injury: 12.30 Activity engaged in: Client showering Location of incident / accident: In their home Describe how and what happened (please give full details & include a diagram, if appropriate. Use a separate sheet if necessary. Please include car registration number if reporting a Motor Vehicle Accident) : I left Beryl at home while I went to do her shopping. Beryl told me she slipped getting out of the shower.
4. Details of injury (the assistance of a supervisor may be required to complete this section) Nature of injury / illness (e.g. burn, sprain, cut etc): 2cm skin tear on the shin of her right leg How (e.g. fall, grabbed by person, muscular stress): Fall Location on body (e.g. back, right thumb, left arm etc): Right shin
What (e.g. furniture, another person, hot water): Aluminium slider on bottom of shower recess
5. Treatment administered: First Aid Administered: Yes No Treatment: Stopped bleeding, put a dressing on the wound Referred to: Supervisor First Aid Attendant (Print Name): Mandy Blundell (Signature):
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This page to be completed by the Senior Staff Member on duty 6. Did the injured person stop work: Yes No If yes, state date: Outcome: Treated by Doctor OHS Authority notified Hospitalised Lodged Workers Comp Claim Returned to normal duties Returned to alternative duties
Time:
Referred to RTW Coordinator Referred to OHS Coordinator &/or OHS Committee
7. Incident or accident investigation (Comments to include identified causal factors): Proposal to have shower rails installed at Mrs Elms home. Referral to be made to Home Modifications
Name & Signature of Supervisor: 8. Remedial actions: Conduct task analysis Re-instruct persons involved
Date:
Improve design / construction / guarding Add to inspection program Improve communication / reporting procedures Improve security Temporarily relocate employees involved Falls Prevention Assessment Request MSDS (Materials Safety Data Sheet)
Conduct hazard systems audit Develop/ review tasks procedures Improve work environment Review WHS policy/programs Replace equipment / tools Improve work organization Develop and/or provide training
Improve resident /staff skills mix Provide debriefing and/or counselling Request maintenance Improve personal protection Improve work congestion/ housekeeping Investigate safer alternatives Other (specify)
What, in your own words, has been implemented or planned to prevent recurrence: Referral made to Occupational Therapist for referral to Home Modifications for the installation of hand rails. Educational information in Falls Prevention given to the client. Extra service support for the client till she recovers and feels confident to shower independently.
9. Remedial actions completed: Signed (Supervisor): 10. Review comments H.R. Manager: OHS Committee Meeting:
Title:
Date:
Reviewed by CEO / OHS Coordinator (Signed):
Date:
If you compare both documents: the progress notes and the incident report, you will notice that the information matches on both documents ensuring accuracy of the information and how the clients
environment was to be adapted for them to be able to maintain optimum independence. The intervention for Beryl to receive shower assistance is a short-term solution to her need. When the rails are installed Beryl should be able to return to showering independently.
SUPPORTING THE OLDER PERSON TO MODIFY THEIR ACTIVITIES AND ADAPT THEIR ENVIRONMENT
Once you have observed the change and reported it, the support you provide will also change. An older person living at home will have to move into an aged care home if they cannot receive the support they need to remain independent at home. Changes in the provision of the support will not only have to come from the worker but from the client.
Case study
Mr Johnson is an older man who lives in his own home. He does most of his housework, but lately has had trouble doing his laundry. The worker who comes to take him shopping has talked to him about it and has found that he can no longer negotiate the path down to the clothes line. There are steps and the pavers are broken in places and he is worried he will fall carrying the clothes basket up and down the pathway. Mr Johnson has plenty of money and is happy to go with the idea to have to pathway concreted and hand rails put in to make the pathway to the clothesline safer for him. You refer the conversation to your supervisor and she talks to the Occupational therapist about Mr Johnsons need. You can see from the case study above how the living environment can be adapted so the client can still do the tasks independently. Another outcome of this case study could have been that Mr Johnson still does his washing and the worker could hang it on the clothesline before they went shopping and get it off when they got home. There are many ways which activities can be adapted to enable the client can continue to do them. An Occupational Therapist or Physiotherapist is the best qualified professional to intervene in client practices and living environment so that is the most appropriate strategy for the client or resident .
FINDING OUT AND LEARNING ABOUT AIDS AND EQUIPMENT TO HELP OLDER PEOPLE
There are many different types of aids and equipment for people who have difficulties with ADLs. Some types of equipment need to be fitted to the person s individual need and as well as some training in safe practices in the use of the equipment. These aids are designed to assist people to undertake daily activities they would otherwise be unable to do or find very difficult to do. Information from government initiatives such as Independent Living Centres Australia provides information about the types of aids available. The website for finding an independent living centre is www.ilcaustralia.org.au Some of the more common types of aids are: Jar grips for opening jars. Liquid sensors. Long handles brooms and mops. Non slip mats. Covers for handles that assist with gripping. Small raised knobs and labels for ovens, stove tops and microwave.
Activity 6
Find out about a local service that provides specialist equipment that assists older people from the above website that is in your area and find out their contact number and address and list 5 types of equipment that would help clients with their ADLs. Find out if they will go to the clients home to show them what they sell. Gardening can be very physically demanding. You need either to get down onto the ground or reach up high. There is a range of specialist gardening aids such as kneepads and kneeling boards with handles to assist to get up. There are also long handled tools and pickups, trolleys and small wheelbarrows can help to carry equipment. Personal safety is an issue for a client if they are aware that they are putting themselves at risk in performing some
tasks. There are a number of personal security alarms on the market that can assist a client to get emergency help if
they need it at home. They can be worn as a wristband or around their neck and can be activated from outside the house if the client has an accident in their yard.
Call bells and alarms in residential care are a bell that calls staff if the resident is in difficulty. They can be worn on the person or attached to the wall or on a cord that can be reached from the bed or chair. Mobility equipment can also help the client feel more confident about moving around safely. They may have difficulty getting up out of chairs, out of bed or off the toilet and have difficulties walking. Without specialist equipment, some people may not be able to continue to live in their own home or they may take additional risks to perform their ADLs. The following table shows the most commonly used mobility aids. Equipment Walking stick Walking frames Wheelie walkers Wheelchairs How it helps Helps with balance and weakness when walking Helps with getting up, walking and balance Assist with walking and carrying Helps a person who cannot walk or has difficulty walking and moving around independently Helps a person get to the shops or to appointments and to social engagements, for a person who cannot walk long distances.
Motorised chairs and scooters Client needs a cognitive and sensory assessment for OHS around client safety & ability
Class discussion
Isnt it the supervisors job to think of ways to modify activities to help the older person, its my job to do what I am told? Discuss this in terms of Duty of Care and negligence as well as accountability.
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MAKING SURE THE PERSONS ENVIRONMENT IS SUITABLE, SAFE AND SECURE ................................................................................................
An important part of your role is to ensure that your work environment is safe and that your client s home is safe, secure and comfortable, so that they feel happy and confident that their environment is free from anything that will cause harm or put them in danger. In this section you will learn about: Supporting the client to maintain their own environment. Help them to keep their home environment secure. Work with older people to adapt their environment for safety and comfort. Recognise and fix hazards.
SUPPORT THE PERSON TO MAINTAIN THEIR OWN ENVIRONMENT

Older people should be encouraged to keep their environment in a way that makes life as easy as possible for them. This may take some creative thought and because of the nature of the progressive condition of the older person they may need some support to monitor this. An older persons environment not only means their home, it can also mean other places they frequent and spend a lot of time. They have much less control over these places and support workers need to encourage older people to be aware of the different environments they visit. Help them to manage and think through their activities and plan their home so that tasks can be done safely and maintain their independence to their best ability without too much intervention. Below is a table that shows the ways environment can play in the management of tasks. Situation Assistance Reason Loose electrical cords across Move the electrical cords from Falls risk walkways walkways by moving them to go behind furniture Frayed cords on appliances Get them fixed or replace appliance Electrocution Loose mats and frayed carpet Remove mats and ask the client to get Trips and falls the carpet repaired Chairs and beds too low Have them raised Talk to supervisor about and refer to OT. Microwave too high Move it onto the bench Risk of burns Kitchen utensils either too high or Move them to a cupboard that is more Breakages, muscle strain or injury. too low easily accessible for the client Loss of independence. It is a good idea to encourage the client to look at their own home and consider the things they could do to make things easier for themselves.
HELPING THE OLDER PERSON KEEP THEMSELVES SAFE

Older people feel more vulnerable and this has an impact on their level of independence. Everyone is entitled to feel safe and secure and older people need to feel protected from harm. This is particularly important for people living alone. Part of your role is to make them feel more secure whether you work in residential care or the community. For most people, feeling secure at home means feeling safe from intruders, fire and other serious events that could cause physical or emotional harm. Promoting feelings of security may involve:
Ensuring any environmental risks have been addressed. That clients have control over their ADLs. Those clients are fully informed about the support they are to receive.
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For residents in facility care, feeling secure means ensuring they have their own private space. Areas for dining and sometimes bathrooms and toilets are shared, and often the only private space they have is their bedroom. Older people feel more secure in their own private space if surrounded by their belongings and knowing that no one can enter their room without their permission. Sometimes feeling secure may depend on the persons health or mental status. People with a hip or knee condition need to know that they can get support to do tasks like changing the bed and keeping the home clean. For someone with memory loss it may be about being able to keep appointments and trusting a worker to remind them of these things. It can be challenging to provide care to people with a memory problem as the following example demonstrates. Case study Mrs Higgins is a 70 year old lady in the early stages of Alzheimers disease. She is still able to live on her own but receives service 3 days a week for shopping, cleaning and social support. She also has two sons who visit on the weekends. When the worker visits Mrs Higgins she is often agitated and stressed because she doesnt know if anyone is coming to take her shopping. She always rings her so ns repeatedly to ask them who are taking her shopping. Stephanie talks to her supervisor and the sons about how to help her feel more secure. They decide a diary might help and the youngest son will ring her each morning to cross off the days and make sure she is on the right day and can see what she is doing for the day. After a week or so this strategy seems to be working. Mrs Higgins phone calls to her sons have lessened and Mrs Higgins knows when the worker is coming to take her shopping. By providing Mrs Higgins with a tool to assist with her memory she feels more secure as she can refer to the diary whenever she gets confused. Some older people dont realise that some strategies are implemented for their well being and safety so it is important to explain to them why things are to be done a certain way. Many people have security measures on their homes like security screens, locks and motion lights. People feel secure if they know locks and doors are in good condition. Remember to record any home maintenance in your reporting so that things that are broken and present a security risk are fixed as soon as possible. What makes each client feel secure is individual, so take the time to talk to your client about safety issues that concern them or have come to your attention.
WORKING WITH AN OLDER PERSON TO ADAPT THEIR ENVIRONMENT TO KEEP THEM SAFE AND COMFORTABLE
Being safe is being free from harm, injury or risk. It is similar to feeling secure. Being comfortable is being pain free and suffering from no anxiety or stress. In the community setting older people are encouraged to adapt their environment to meet their need for comfort as much as possible. They make the decisions about how to make their home safe and with support from the worker and service provider these choices can be implemented to promote independence. An aged care facility is maintained by a team of staff and health care workers. However every effort should be made to encourage the client to participate in making sure their room is accessible and to ensure they keep walkways clear.
Making the environment safe and comfortable

You can adapt the clients environment to ensure it is safe in many ways including: Remove tripping hazards from around the home. Check locks and doors and windows and make sure the client can use them. Check appliances and cords for faults. Make sure the temperature is at a comfortable level and that living areas are well ventilated even if it is when you are there. Make sure the client can access their health appointments. Check that the food they are eating is fresh and they drink plenty of liquids.
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Make sure their bills are being paid.
It is not your clients responsibility to maintain the footpath and areas outside their home. If they use the public area outside their homes, safety risks must be reported to the appropriate authority for maintenance. If you have to negotiate unsafe public areas you must make a plan for the safe access of the area for your client. The plan should include the following; The order of the task. The best time of the day to do it. The mode of transport. What you need to carry. Anything that would make the task easier. Sometimes it can be difficult to adapt an older persons environment. They do not want big changes or cannot afford to have modifications to their home. Any changes should not be disruptive to the client or cause them to be upset. The support worker may have to talk to them about how to make the adaption another way. Talking about safety and comfort It is very important to talk to the older person about the ways that their environment can be adapted to make it safer and more comfortable for them. You should never change anything in a client s home without asking them and talking to them about the safety aspects of it. Some older people dont like change: it makes them feel like they have lost control over their home and privacy. They must be approached with respect and be sensitive about their feelings and how you speak to them. Make sure they understand they have choices and that making their environment safe helps to maintain their independence. Sometimes it may be a slow process of change. You may need to offer gentle hints over a period of time before making a suggestion. Always make sure the client feels they are in control, talk calmly about the issues and dont make them feel rushed or over whelmed with too much information.
FIXING HAZARDS
Things that can be perceived as being dangerous or can cause injury are called hazards. Hazards that can affect a clients environment can also affect their level of independence. Part of your role as an aged care worker is to recognise hazards and make them as safe as possible. There are many different types of hazards in an aged care environment that effect safety. Some of them are outlined below. Hazard Poor lighting Slippery and uneven floors Physical obstructions like furniture Inadequate heating or cooling What can happen Can result in slips, trips, falls. Falls Fall or hurt themselves squeezing through small spaces The older person may suffer from dehydration or hypothermia. Trips and falls, too hot or too cold What to do Make sure the lighting is appropriate to client need Make sure the client is aware of the hazard and report it. Move the furniture to make areas more accessible. Ensure the older person has enough warm clothing and bedding. Possibly install appropriate appliances Make sure your clients clothing is appropriate to the weather and fits well enough to avoid getting caught on handles or under foot.
Inappropriate footwear and clothing
Identifying hazards
Most workplaces have procedures that do regular checks (reviews) of the clients home environment. When you start a job, you will be given a procedure of what to do if you identify a hazard that cannot be rectified by
the service provider. In most instances you will always be required to report to your supervisor: referrals for the maintenance of a home appliance are usually referred to a family member. The best way to identify hazards is to always keep safety in mind.
Reporting and addressing hazards

After you identify a hazard you must do something about it by fixing the immediate risk e.g. unplug and put away a dangerous appliance or make sure the floor you have just mopped is dried with a cloth before you leave a clients home. Your workplace will have a procedure for reporting hazards. You will need to complete a hazard or incident form. Different workplaces have different forms. Below is an example of one type of form you may encounter. Hazard Report Name of person involved: Address: Contact: Next of kin: Contact number: Reported by: Signature:
Description of hazard: include area and task involved, any equipment or people involved. Immediate Action:
How do you propose the hazard to be addressed for the long term safety?
Reported to: Action by:
Signature: Signature and date
Review date (must be within 3months of actioning): As a community worker you will be issued with an electrical cut off switch. You will be required to use it on any appliance you use in carrying out your duties in the clients home. This is to protect you from faulty electrical appliances.
Following workplace policy and procedure

It is important to have workplace policy and procedure as they provide guidelines for workers to be able to deal with hazards and identify the risks that accompany them. Policy and procedure ensures workers are aware of their responsibility in duty of care and the provision of a safe work environment. They also make sure there is a way for safety issues to be communicated to the appropriate people. Documentation provides a way to track hazards from the moment they are identified. This involves: Describing the hazard. Deciding what action to take. Identifying who is to take the action. Taking note of when the hazard was addressed and if it is safe again.
Workplace procedure relating to hazards also provides data to be able to analyse hazards. They look at many indicators which provide benchmarks for the assessment of safer work practices and client care as well as the possibility of eliminating the hazard altogether. If you are unsure about workplace policy and procedure you should always talk to your supervisor.
Good documentation Good documentation involves the following principles: Write legibly and in pen. Write neatly and ensure copies of reports are legible. Use biro and write on a firm surface for multiple copies. Document your observations and actions accurately and factually. State what you saw or did and use plain language. Avoid jargon and idiosyncratic abbreviations. Be brief, simple, relevant, to the point and concise in your recording. Record observations and events as soon as possible whilst you still remember them clearly. Record date, time and sign entries with your designation. Print your name if it is not easy to read your signature. Check the clients identification of the record before making an entry. Try to use correct spelling and grammar. Consider the reader of your reports: o o o What do they want or need to know? What do you want to say? What are you asking to be done?
Check previous entries, particularly in progress notes to ensure any follow-up requested is carried out. Be clear about your purpose. Is it to report, to present ideas or to ask for follow-up? Rule out any errors, write correction and initial it. Do not use white out to correct documents.
Questions (Class Discussion)

1. Why does an aged care worker have to be flexible and multi skilled?
2.
How do I complete forms to a quality standard?
CHARLTON BROWN
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SUPPORTING THE LOSS AND GRIEF
PERSON
EXPERIENCING
................................................................................................
We all experience grief at some time in our lives. For some people grief and loss is more difficult to cope with or it may have impacted on them more often than others. Support workers can support their clients during times of grief and loss; it is not possible to make the grieving process stop, but it possible to support people when they need the support. It often makes them sad, distressed and angry. You need to be able to recognise the signs of grief and it is useful to understand the stages people can go through. You will then be able to work out ways to support them. In this section you will learn about: Recognising the signs of grief. Use the appropriate strategies to deal with grief and loss. Provide clients and their support network with relevant information.
PSYCHOLOGICAL NEEDS AND THE OLDER PERSON

The psychological changes faced by the older person might typically include: Normal mental changes associated with age. The short-term memory area is typically affected, as we get older it takes us longer to respond to questions. It is important to view this as a normal feature of ageing and not as a mental illness. Increased stress experienced by the older person as they deal with the physical issues of ageing: with the loss of a partner; with the changed relationships of a grown up family; and with changed financial and social circumstances associated with retirement. Increasing challenges to self-esteem. Many of the securities upon which we have relied in our lives job, family, partner, social position change or disappear as we age.
GRIEF AND BEREAVEMENT

The loss of a partner or other loved ones in old age typically results in the older person suffering grief and bereavement. Bereavement describes the event of loss such as the death of a loved one and the state of thought, feeling and activity that follows loss. Grief is the personal and individual experience of loss. Grief is demonstrated through responses of helplessness, loneliness, hopelessness, sadness, guilt and anger. Mourning is the process of adaptation and incorporation of the experience of loss into ones life. This includes working through grief. Anticipatory grief is the process of grieving before the actual death of the person. Complicated grief is when the process of grief does not progress and the person does not manage to work through the loss. Normal grief is when a person progresses through the grieving process and is able to get on with their life.
Loss through the death of a loved one requires adaptation through grieving processes. Loss and grief after a terminal illness can affect the clients carers, family and friends. As a support worker, in dealing with bereavement you need to know: The process of normal grief. Risk factors which may cause complications. Access to information to help deal with bereavement.
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Help from community resources.
Normal grief processes

The table below shows three theories representing the stages of grief that a person may pass through following loss.
Major theories of grief and loss

Five stages of grieving (Kubler-Ross 1973) Denial Anger Bargaining Depression Disorganisation and despair Working through the pain of grief Adjusting to the environment without the deceased Reorganisation Acceptance Emotionally relocating the deceased and moving on with life The attachment theory (Bowlby 1980) Numbing Yearning and searching Four tasks of mourning (Worden 1991) Accepting the reality of loss
Complicated grief
Most people work through grief but some will suffer prolonged grief which is associated with health risks. This complicated grief has health risks in that it may: increase the risk of physical or mental illness. worsen any existing illness. lead to compensatory behaviours such as excess smoking, drinking and drug use. lead to depression.
The common risk factors that might be identified leading to complicated grief include: the nature of death (whether sudden or traumatic). the nature of the relationship, particularly if dependent. individual history of bereaved with risk factors such as anxiety and depression. feelings of support. ability to share feelings. previous losses. life events at the time of loss. if anticipatory grieving has occurred.
The older client experiencing loss and grief needs to be monitored for the intensity of their distress and adaptiveness of coping behaviour. There is no set time for each stage of grief. If there is concern about poor coping or depression then you should consult with your supervisor about seeking medical or psychological interventions.
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How to know when your client is grieving

It is important to know the stages of grief however you must also understand that people are individuals and will react in different ways. Shock is not just a surprise or fright, symptoms of clinical shock may be: pale, cool clammy skin. thirst. rapid shallow breathing. rapid weak pulse. nausea or vomiting. collapsing and unconscious. progressive shutdown of vital functions. A person who appears to be in shock should receive medical help as soon as possible. Emotional releases or outbursts may happen when a person first learns of the loss. It can also be seen as crying, screaming, anger and possibly even uncontrolled laughter. Physical distress can cause symptoms such as; insomnia or lack of sleep. restless. poor concentration. loss of appetite. upset stomach. chest pain (seek help). Often people can feel numb or as if they are on autopilot. Panic often overwhelms people when they feel they have lost control over things that are going on around them. They may not be able to see how they are going to go on. Panic doesnt always make sense; it is the persons reaction to the loss. Physical symptoms of panic can be: breathlessness. sweating. shaking. chest pains (seek help). Guilt for some people can be the experience of feelings of guilt related to the loss. They feel they should have been able to do something to prevent the loss. In some cases this may be true, in other cases not. Either way, once the loss has occurred there is little anyone can do to change it. Feelings of guilt can make people unwell. Hostile and destructive behaviour may be related to the stages of anger and depression. When a person becomes angry, they get hostile, they try and break things and hit out at other people. Hostility associated with anger is an indicator of a mental health issue; they may be less able to control their anger. With depression, a person may feel they do not care what happens to them and may display self-destructive behaviours. They may indulge in risk taking behaviours and start abusing drugs and alcohol or stop eating and looking after his or herself. Lack of interest and apathy are also indicators of a depression. When a person no longer cares what happens to them they lose interest in what is going on around them and feel apathetic. They may lose contacts with friends and alienate themselves from family. They rarely leave the house and may not maintain personal hygiene and appearance.
CHARLTON BROWN
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What to do As an aged care worker you need to recognise the signs of grief in your clients. If you recognise these signs there are a few things you should do to get your client the help they need: listen to your clients. complete care notes or an incident report if your client does something. tell your supervisor about the clients loss. work together with family, friends and co-workers to manage the problem. refer the client for further help if you think they need it.
Act immediately Report any signs of grief immediately: If your client suffers from chest pain or shortness of breath. If they become hostile or destructive. If you feel your safety is at risk call the police. Fill in an incident report and report what happened in the clients progress notes.
Report to an appropriate person Below is a list of people you may consider can offer support to a person who has suffered a loss and is grieving: Supervisors can tell you what to do. Clergy and pastoral workers. Support associations. Support groups that are specific to a diagnosis. Veterans and War Widows organisations.
USING APPROPRIATE COMMUNICATION SKILLS

Conveying information Communication needs a sender or encoder. The sender of a message must let others know the information, otherwise the receiver may: Guess. Speak for you. Ignore you. Do the wrong thing.
Communication needs a receiver or decoder. When the workplace is noisy and busy it is important the sender is heard accurately. This involves the receiver listening. Listening to what others are saying is an important work skill just like giving accurate information. Communication needs a message. For you to receive information you have to be able to get the message. One-way communication Although communication needs a sender and a receiver, the sender can act as though there were no feedback so the flow of information is only one way.
SENDER/ENCODER CHANNEL RECEIVER/DECODER
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One-way communication is often used by health workers. It may include communications such as: Memos. Announcements. Notes. Charts. Orders. Prescriptions. Client information and education. Shift reports.
There are lots of disadvantages to this one-way communication, the most important being whether the message is properly understood as the feedback is lacking. Two-way communication The two-way process involves feedback from the receiver, and listening and flexibility by both the sender of the message and the listener. Two-way communication in working with your clients allows therapeutic communication. You become actively involved in the communication process, listening to your client and modifying your next message based o n the clients response. Two-way communication is typically a complex process. Effective communication
Communication is effective when both the sender and receiver have the same understanding of the message being passed.
The message can be confused by many different influences even though it is clearly heard or seen. These influences might include: different dialects that might confuse the meaning of words. words change meanings within cultural groups. jargon and slang are used that not everyone understands. acronyms are often employed that are very specific to certain groups. modern words are introduced into the language constantly which the older person does not necessarily understand. technical terms.
Here are two main ways we communicate verbal and non-verbal. Verbal communication usually makes up only about a third of all communication.
Listening skills
Active listening means letting clients know that you are hearing what they are saying, and understanding the emotion they are feeling. Active listening is a courteous and caring way to listen to your clients
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The following are ways in which you can show you are listening: Pay attention give the client your full attention, face the client, try to be on the same level as the client and look him/her in the eye. Listen carefully to the message without interrupting and observe any non-verbal signs the client may express. Never presume you know what the client is going to say or finish sentences for him/her.
Acknowledgement recognising the clients contribution to the communication gives the message that
the carer is listening and is valuing the contribution.
Listening skills
Restating repeating to the client the main content to check the message has been received correctly. Reflecting try to direct back to the client their content and/or their feelings. You can show the person that you understand, empathise with, or can guess at how they must be feeling, e.g. That must have made you feel very happy. Make listening responses show the speaker that you are giving him or her your full attention by using the following techniques: Lean slightly towards the person. Make eye contact without staring. Use responses such as yes, mmm, oh etc. Use head nods to show you are paying attention. Face the person while speaking.
Clarifying making every attempt to understand the message by seeking more information or asking the client to make certain points clearer. Summarising making a summary of the clients communication will help check that it was understood properly and may remind the client of any points he/she has forgotten. Questioning skills Closed-questions are those which can be answered with a yes or no, or which require a brief factual answer. You use closed questions to get a specific piece of information. Closed-questions would be asked when you are recording a clients history for his or her medical records .
How many children have you?
How old are you?
Closed Questions
Do you wear glasses for reading? Have you brought your glasses with you?
CHARLTON BROWN
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PRINCIPLES FOR BEREAVEMENT SUPPORT PROGRAMS

Palliative Care Australia has developed principles for bereavement support programs appropriate for palliative care services in Australia. They aim to support the bereaved to adjust to life without the deceased, to assist the bereaved through the normal process of grief and reduce the risk of complications associated with grief. Services should be provided by staff and volunteers who have been appropriately trained in bereavement support, grief and loss. The principles are based on the following services: To ensure volunteers and staff involved in bereavement support receive ongoing education and training, supervision and support. To ensure people with, or at risk of, complicated grief reactions are offered bereavement counselling or referred to specialist bereavement counsellors for follow-up. To use a risk assessment tool to identify people with or at risk of complicated grief reactions. To begin assessing families and carers for risk as soon as possible after first contact is made with the client. To ensure that the bereaved are informed about services available to them including notices regarding events such as memorial services and group meetings. To provide education about loss and grief to the community.
HACC and the CALD carer

There is concern in the health care industry for CALD carers. This is because the CALD carer not only assumes the difficult role of primary carer but also conducts this role with the additional difficulties inherent in cultural difference. The problems which a clients primary carer may be facing include: Isolation even from within their own community. Lack of access to information: English language difficulties result in a lack of access to services. Research has shown that CALD communities have lower access rates to care services than the full Australian community Caring as a duty not a choice: a number of our CALD communities place demands upon children to look after their elderly parents or relatives. For the carer in this circumstance their role is sometimes one of duty rather than choice. Some community workers have noted that this cultural expectation can diminish if the dependency cycle engendered by dislocation and anxiety can be broken by adequate care provision.
If you are a HACC worker and have clients form CALD backgrounds it is important that you seek the appropriate support services that are culturally and linguistically appropriate. It is important to respect that all people express loss and grief in different ways and not to judge other cultures by their need to express themselves in their own way.
PROVIDING CLIENTS AND THEIR SUPPORT NETWORKS WITH RELEVANT INFORMATION

Your clients may need extra support to cope with loss and grief. It may be that they need professional assistance but are unable to find the most appropriate service. A support network is not the same as a social network. A support network may include: Family members. Advocates or legal guardians. Support workers and supervisors. Friends. Clergy.
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CHARLTON BROWN
Understanding individual differences

You must take into consideration individual need when planning an approach to supporting the client. People also suffer different losses. One may be sad because they have to move into care, the other may be because they have a cancer diagnosis. The range of events that affect feelings of loss are many and you need to empathise with each one and find the right kind of support. Always talk to your supervisor about your clients; they are the best person to offer advice for the most appropriate support service to meet the individual clients need.
Providing information in a useful manner

As a care worker, you need to make sure that clients receive the information about services in a way that is useful. Some ways you can forward information is in: Telephoning the service and asking them to post brochures and other information to the client. Asking the service to contact the client. Writing down the contact details for the client. Finding the brochures in an appropriate language. Organising large print copies.
The Australian Carer Helen Croft 2008 http://www.agedcareaustralia.gov.au www.ilcaustralia.org.au
CHARLTON BROWN
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CHARLTON BROWN
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Chcac317a v2 Support The Older Person To Maintain Their Independance

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Training Division

CHC30212 Certificate III in Aged Care

SUPPORT OLDER PEOPLE TO MAINTAIN THEIR INDEPENDENCE

CHECKING AN OLDER PERSONS ABILITY TO DO DAILY ACTIVITIES .....................23

MAKING SURE THE PERSONS ENVIRONMENT IS SUITABLE, SAFE AND SECURE 30

SUPPORTING THE PERSON EXPERIENCING LOSS AND GRIEF ...............................35

CHCAC317A Version 2 (August 2012)

1.5 1.6 1.7 1.8

CHCAC317A Version 2 (August 2012)

CHCAC317A Version 2 (August 2012)

CHCAC317A Version 2 (August 2012)

CHCAC317A Version 2 (August 2012)

AGEING AND AGED CARE AS A FOCUS OF NATIONAL INTEREST

CHCAC317A Version 2 (August 2012)

ECONOMIC CONTEXT OF AGEING

CHCAC317A Version 2 (August 2012)

Make sure you understand your organisations policy and procedures.

CHCAC317A Version 2 (August 2012)

ENCOURAGE OLDER PEOPLE TO GET SUPPORT TO MAINTAIN ADLS

Activity of Daily Living

Lawn and garden maintenance

CHCAC317A Version 2 (August 2012)

Meal preparation Shopping Bill paying and banking Personal care

Help with home and garden maintenance

Transport and social support

CHCAC317A Version 2 (August 2012)

CHCAC317A Version 2 (August 2012)

Helping to maintain a clean and safe home environment

Personal and financial matters

CHCAC317A Version 2 (August 2012)

EXPLAINING THE SUPPORT TO BE PROVIDED TO THE OLDER PERSON

Meeting the older persons needs

CHCAC317A Version 2 (August 2012)

Workplace policy and procedure

CHCAC317A Version 2 (August 2012)

CHCAC317A Version 2 (August 2012)

Approved By: _______________________________ To be reviewed:_______________

Explaining how services are delivered.

When the service will happen Who will be helping them

GETTING INFORMATION ABOUT THE OLDER PERSONS SUPPORT NEEDS

Talking to your supervisor about clients

CHCAC317A Version 2 (August 2012)

MAKING SURE SERVICES MEET ROUTINES AND CUSTOMS

Maintaining an older person customs

Maintaining routines in residential care

CHCAC317A Version 2 (August 2012)

________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

RESPECTING THE CLIENTS HOME AND PERSONAL SPACE

ALLOWING THE OLDER PERSON TO DIRECT THEIR OWN SUPPORT

Helping clients direct their own support

CHCAC317A Version 2 (August 2012)

FOLLOWING WORKPLACE POLICY AND PROCEDURE

USING EQUIPMENT TO HELP OLDER PEOPLE WITH ADLS

CHCAC317A Version 2 (August 2012)

CHCAC317A Version 2 (August 2012)

CHECKING AN OLDER PERSONS ABILITY TO DO DAILY ACTIVITIES ...........................................................................................

MONITORING THE OLDER PERSONS ADLS

Looking for signs

CHCAC317A Version 2 (August 2012)

Asking about their ability

The individual care plan

Encourage family to visit more often.

REPORTING CHANGES IN THE OLDER PERSONS SUPPORT NEEDS

Approved By: _________________ To be reviewed:_