Chcage001 - WKB

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CHCAGE001 – Facilitate tat
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the empowerment of the
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older people po
Candidate’s Workbook we
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CHCAGE001 - Facilitate the empowerment of older people e
Candidate’s Workbook the
Editor: Corinne Ryan
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Author: Lesley A Kane R.N.
Copyright
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Text copyright © 2014, 2015 by John N. Bailey. rm
Illustration, layout and design copyright © 2014, 2015 by John N. Bailey. ent
Under Australia’s Copyright Act 1968 (the Act), except for any fair dealing
of
for the purposes of study, research, criticism or review, no part of this book old
may be reproduced, stored in a retrieval system, or transmitted in any form
or by any means without prior written permission from John N. Bailey. All er
inquiries should be directed in the first instance to the publisher at the
address below. pe
Copying for Education Purposes opl
The Act allows a maximum of one chapter or 10% of this book, whichever
is the greater, to be copied by an education institution for its educational
e
purposes provided that the educational institution (or the body that
administers it) has given a remuneration notice to John N. Bailey.
Disclaimer
All reasonable efforts have been made to ensure the quality and accuracy
of this publication. John N. Bailey assumes no responsibility for any errors
or omissions and no warranties are made with regard to this publication.
Neither John N. Bailey nor any authorised distributors shall be held
responsible for any direct, incidental or consequential damages resulting
from the use of this publication.
Published in Australia by:

Real Learning Solutions Pty Ltd, t/as JNB Media
PO Box 6214
Yatala, QLD, 4207
Australia
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Candidate’s Personal Details the
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Unique Student Identifier (USI): po
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Family Name: ent
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Given Name/s: old
Address:
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RTO/LTO:
Address:
Contact number:
Email:
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CHCAGE001 - Facilitate the the
empowerment of older people em
Contents po
MODIFICATION HISTORY10 we
Application:11
Unit Sector: Community Services11
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Introduction11
This Learning Guide covers:11
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Learning Program11 of
Additional Learning Support13
Facilitation13 old
Flexible Learning14
Space14 er
Study Resources14
Time14 pe
Study Strategies15
Using this learning guide:15 opl
THE ICON KEY16 e
How to get the most out of your learning guide18
Additional research, reading and note taking18
PERFORMANCE EVIDENCE20
ELEMENTS AND PERFORMANCE CRITERIA21
KNOWLEDGE EVIDENCE23
ASSESSMENT CONDITIONS24
1. DEVELOP RELATIONSHIPS WITH OLDER PEOPLE25
INTRODUCTION.25
Aged care in Australia26
My Aged Care28
Working Definitions28
Family Caregiver28
Care Recipient28
Caregiver Assessment28
1.1 CONDUCT INTERPERSONAL EXCHANGES IN A MANNER THAT PROMOTES EMPOWERMENT AND DEVELOPS AND
MAINTAINS TRUST AND GOODWILL30
Table 1: Ageing and empowerment32
Learning Activity 1:34
1.2 RECOGNISE AND RESPECT OLDER PEOPLE’S SOCIAL, CULTURAL AND SPIRITUAL DIFFERENCES37
Partners in Culturally Appropriate Care38
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Learning Activity 2:41 e
1.3 MAINTAIN CONFIDENTIALITY AND PRIVACY OF THE PERSON WITHIN ORGANISATION POLICY AND PROTOCOLS42
Privacy and Confidentiality44 the
1.4 WORK WITH THE PERSON TO IDENTIFY PHYSICAL AND SOCIAL ENABLERS AND DISABLERS IMPACTING ON HEALTH em
OUTCOMES AND QUALITY OF LIFE46
Table 2: Ten Principles of a Positive Ageing Strategy48 po
Table 3: Ten Priority Goals of a Positive Ageing Strategy48
Table 4: Advocacy contact details (as listed by myagedcare.gov.au)51 we
1.5
ENCOURAGE THE PERSON TO ADOPT A SHARED RESPONSIBILITY FOR OWN SUPPORT AS A MEANS OF ACHIEVING
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BETTER HEALTH OUTCOMES AND QUALITY OF LIFE55
Caring is about empathy.56
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Growing old presents a variety of threats to independence56
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2. PROVIDE SERVICES TO OLDER PEOPLE63 old
2.1 IDENTIFY AND DISCUSS SERVICES WHICH EMPOWER THE OLDER PERSON63 er
Ageing in Australia65
Residential Aged Care65 pe
Community Care67
LEARNING ACTIVITY 6:68 opl
2.2 SUPPORT THE OLDER PERSON TO EXPRESS THEIR OWN IDENTITY AND PREFERENCES WITHOUT IMPOSING OWN VALUES
AND ATTITUDES70 e
Our Attitudes71
Table 5: Cultural Awareness73
73
The Role of the Family73
Table 6: Critical Thinking73
Caregiver Choices73
Gerontophobia75
Table 7 Ageing: Myth Versus Fact75
Ageism77
2.3 ADJUST SERVICES TO MEET THE SPECIFIC NEEDS OF THE OLDER PERSON AND PROVIDE SERVICES ACCORDING TO THE
OLDER PERSON’S PREFERENCES82
Palliative Approach84
2.4 PROVIDE SERVICES ACCORDING TO ORGANISATION POLICIES, PROCEDURES AND DUTY OF CARE REQUIREMENTS86
Code of Practice86
Duty of Care86
Duty of Care and Negligence87
Breach of Duty of Care87
Duty of Care Dilemmas87
3. SUPPORT THE RIGHTS OF OLDER PEOPLE89
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3.1 ASSIST THE OLDER PERSON TO UNDERSTAND THEIR RIGHTS AND THE COMPLAINTS MECHANISMS OF THE e
ORGANISATION89
Complaints mechanisms89 the
Figure 1: Sample complaints/suggestions form91
3.2 DELIVER SERVICES ENSURING THE RIGHTS OF THE OLDER PERSON ARE UPHELD94 em
In Australia an older person receiving a service from a community service provider has the rights to:94
3.3 IDENTIFY BREACHES OF HUMAN RIGHTS AND RESPOND APPROPRIATELY96 po
Human Rights – Anti-discrimination97
Learning Activity 11:98 we
3.4 RECOGNISE SIGNS CONSISTENT WITH FINANCIAL, PHYSICAL OR EMOTIONAL ABUSE OR NEGLECT OF THE OLDER PERSON
AND REPORT TO AN APPROPRIATE PERSON99
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Forms of Elder Abuse99
Figure 2: Signs of physical abuse99 ent
Table 8: Reporting Elder Abuse contact details100
Case Study102
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Forms of Abuse - Sexual102
Signs of sexual abuse104
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Case study104
Forms of Abuse - Financial105
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Financial abuse105
Case Study 1106
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Case Study 2106
Forms of Abuse - Psychological/Emotional108
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Psychological/Emotional Abuse108
Figure 2: Abusive psychological/emotional behaviour108
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Figure 3: Signs of psychological abuse108
Case Study109
Forms of Abuse - Social Abuse111
Abusive social behaviour111
Signs of social abuse111
Case study111
Forms of Abuse - Neglect111
Signs of neglectful behaviour113
Case study113
Barriers to Detecting Elder Abuse of Older People113
LEARNING ACTIVITY 12:115
Compulsory reporting and protection requirements117
1. Introduction117
2. The 5 key elements to compulsory reporting requirements117
3. What is a reportable assault?118
3.1 Unlawful sexual contact118
3.2 Unreasonable use of force119
4. Reporting to the Department of Health and Ageing119
5. Approved provider responsibilities regarding compulsory reporting of assault on a resident120
5.1.1 Reporting reportable assaults120
5.2 Requiring staff members to report reportable assaults120
5.3 Special circumstances where there is a discretion not to report121
5.3.1 Assaults perpetrated by a resident with cognitive or mental impairment122
5.3.2 Appropriate health professionals to assess cognitive and mental impairment122
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5.3.3 Similar or previously reported incidents123
6. Responding to allegations of assault on a resident123
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6.1 Role of the Department in receiving and responding to a suspected or alleged assault on a resident123
6.2 Role of the Agency in monitoring compliance with the compulsory reporting requirements124
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6.3 Procedures for Approved Providers in responding to a suspected or alleged assault on a resident125
7. Protection for reporting assaults126
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8. Record keeping and privacy129
Appendix A131
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Template for keeping consolidated records of all incidents131 we
Appendix B131
Template for providing information to the Department for Compulsory Reporting of assault131 rm
3.5 ASSIST THE PERSON TO ACCESS OTHER SUPPORT SERVICES AND THE COMPLAINTS MECHANISMS AS REQUIRED134 ent
4. PROMOTE HEALTH AND RE-ABLEMENT OF OLDER PEOPLE138
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4.1 ENCOURAGE THE OLDER PERSON TO ENGAGE AS ACTIVELY AS POSSIBLE IN ALL LIVING ACTIVITIES AND PROVIDE THEM old
WITH INFORMATION AND SUPPORT TO DO SO138
Exercise And Recreational Needs140 er
Recreation140
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4.2 ASSIST THE OLDER PERSON TO RECOGNISE THE IMPACT THAT CHANGES ASSOCIATED WITH AGEING MAY HAVE ON
THEIR ACTIVITIES OF LIVING142
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Caring is about empathy.144
Growing old presents a variety of threats to independence144
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4.3 IDENTIFY STRATEGIES AND OPPORTUNITIES THAT MAXIMISE ENGAGEMENT AND PROMOTE HEALTHY LIFESTYLE
PRACTICES151
Effects Of Ageing151
Learning Activities 17:154
Case Study: Henrietta155
4.4 IDENTIFY AND UTILISE AIDS AND MODIFICATIONS THAT PROMOTE INDIVIDUAL STRENGTHS AND CAPACITIES TO ASSIST
WITH INDEPENDENT LIVING IN THE OLDER PERSON’S ENVIRONMENT156
Table 9: Mobility Aids157
Equipment to Support Residents/Clients/residents in Accommodation Services160
Table 10:160
Table 11: Aids that assist with independence163
4.5 DISCUSS SITUATIONS OF RISK OR POTENTIAL RISK ASSOCIATED WITH AGEING165
RESOURCE EVALUATION FORM173
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Modification History the
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Release Comments
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Release 1 This version was released in CHC Community Services
Training Package release 2.0 and meets the requirements rm
of the 2012 Standards for Training Packages.
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Significant change to the elements and performance criteria.
New evidence requirements for assessment including of
volume and frequency requirements. Significant changes to
knowledge evidence. old
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CHCAGE001 - Facilitate the the
empowerment of older people em
Application: po
This unit describes the skills and knowledge required to respond to the
goals and aspirations of older people and provide support services in a we
manner that focuses on improving health outcomes and quality of life,
using a person-centred approach.
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This unit applies to support workers in residential or community contexts. ent
The skills in this unit must be applied in accordance with Commonwealth of
and State/Territory legislation, Australian/New Zealand standards and
industry codes of practice. old
Unit Sector: Community Services er
Introduction
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As a worker, a trainee or a future worker you want to enjoy your work and
become known as a valuable team member. This unit of competency will opl
help you acquire the knowledge and skills to work effectively as an
individual and in groups. It will give you the basis to contribute to the goals e
of the organisation which employs you.
It is essential that you begin your training by becoming familiar with the
industry standards to which organisations must conform.
This unit of competency introduces you to some of the key issues and
responsibilities of workers and organisations in this area. The unit also
provides you with opportunities to develop the competencies necessary for
employees to operate as team members.
This Learning Guide covers:
Developing relationships with older people
Providing services to older people
Supporting the rights of older people
Promoting health and re-enablement of older people
Learning Program
As you progress through this unit you will develop skills in locating and
understanding an organisations policies and procedures. You will build up
a sound knowledge of the industry standards within which organisations
must operate. You should also become more aware of the effect that your
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own skills in dealing with people has on your success, or otherwise, in the e
workplace.
Knowledge of your skills and capabilities will help you make informed
the
choices about your further study and career options. em
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Additional Learning Support e
To obtain additional support you may: the
 Search for other resources in the Learning Resource Centres of your
learning institution. You may find books, journals, videos and other em
materials which provide extra information for topics in this unit.
 Search in your local library. Most libraries keep information about
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government departments and other organisations, services and
programs.
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 Contact information services such as the Equal Opportunity rm
Commission, and Commissioner of Workplace Agreements. Union
organisations, and public relations and information services provided ent
by various government departments. Many of these services are listed
in the telephone directory. of
 Contact your local shire or council office. Many councils have a old
community development or welfare officer as well as an information
and referral service. er
 Contact the relevant facilitator by telephone, mail or facsimile.
Facilitation
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Your training organisation will provide you with a flexible learning facilitator. opl
Your facilitator will play an active role in supporting your learning, will make
regular contact with you and if you have face to face access, should
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arrange to see you at least once. After you have enrolled your facilitator
will contact you by telephone or letter as soon as possible to let you know:
 How and when to make contact;
 What you need to do to complete this unit of study;
 What support will be provided;
 Here are some of the things your facilitator can do to make your study
easier;
 Give you a clear visual timetable of events for the semester or term in
which you are enrolled, including any deadlines for assessments;
 Check that you know how to access library facilities and services;
 Conduct small ‘interest groups’ for some of the topics;
 Use ‘action sheets’ and website updates to remind you about tasks you
need to complete;
 Set up a ‘chat line”. If you have access to telephone conferencing or
video conferencing, your facilitator can use these for specific topics or
discussion sessions;
 Circulate a newsletter to keep you informed of events, topics and
resources of interest to you;
 Keep in touch with you by telephone or email during your studies.
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Flexible Learning e
Studying to become a competent worker and learning about current issues
in this area, is an interesting and exciting thing to do. You will establish
the
relationships with other candidates, fellow workers and clients. You will
also learn about your own ideas, attitudes and values. You will also have
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fun – most of the time. po
At other times, study can seem overwhelming and impossibly demanding,
particularly when you have an assignment to do and you aren’t sure how to
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tackle it…..and your family and friends want you to spend time with
them……and a movie you want to watch is on television….and….
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Sometimes being a candidate can be hard. ent
Here are some ideas to help you through the hard times.
effectively, you need space, resources and time.
To study of
Space old
Try to set up a place at home or at work where: er
 You can keep your study materials; pe
 You can be reasonably quiet and free from interruptions, and;
 You can be reasonably comfortable, with good lighting, seating and a opl
flat surface for writing;
 If it is impossible for you to set up a study space, perhaps you could e
use your local library. You will not be able to store your study materials
there, but you will have quiet, a desk and chair, and easy access to the
other facilities.
Study Resources
The most basic resources you will need are:
 a chair;
 a desk or table;
 a reading lamp or good light;
 a folder or file to keep your notes and study materials together;
 materials to record information (pen and paper or notebooks, or a
computer and printer);
 reference materials, including a dictionary
Do not forget that other people can be valuable study resources. Your
fellow workers, work supervisor, other candidates, your flexible learning
facilitator, your local librarian, and workers in this area can also help you.
Time
It is important to plan your study time. Work out a time that suits you and
plan around it. Most people find that studying in short, concentrated blocks
of time (an hour or two) at regular intervals (daily, every second day, once
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a week) is more effective than trying to cram a lot of learning into a whole e
day. You need time to “digest” the information in one section before you
move on to the next, and everyone needs regular breaks from study to the
avoid overload. Be realistic in allocating time for study. Look at what is
required for the unit and look at your other commitments. em
Make up a study timetable and stick to it. Build in “deadlines” and set po
yourself goals for completing study tasks. Allow time for reading and
completing activities. Remember that it is the quality of the time you spend we
studying rather than the quantity that is important.
Study Strategies
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Different people have different learning 'styles'. Some people learn best by ent
listening or repeating things out loud. Some learn best by 'doing', some by
reading and making notes. Assess your own learning style, and try to
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identify any barriers to learning which might affect you. Are you easily old
distracted? Are you afraid you will fail? Are you taking study too seriously?
Not seriously enough? Do you have supportive friends and family? Here er
are some ideas for effective study strategies:
Make notes. This often helps you to remember new or unfamiliar
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information. Do not worry about spelling or neatness, as long as you can opl
read your own notes. Keep your notes with the rest of your study materials
and add to them as you go. Use pictures and diagrams if this helps. e
Underline key words when you are reading the materials in this learning
guide. (Do not underline things in other people's books.) This also helps
you to remember important points.
Talk to other people (fellow workers, fellow candidates, friends, family,
your facilitator) about what you are learning. As well as helping you to
clarify and understand new ideas, talking also gives you a chance to find
out extra information and to get fresh ideas and different points of view
Using this learning guide:
A learning guide is just that, a guide to help you learn. A learning guide is
not a text book. This learning guide will
 describe the skills you need to demonstrate to achieve competency for
this unit;
 provide information and knowledge to help you develop your skills;
 provide you with structured learning activities to help you absorb the
knowledge and information and practice your skills;
 direct you to other sources of additional knowledge and information
about topics for this unit
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The Icon Key the
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Key Points
Explains the actions taken by a competent person.
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Example rm
Illustrates the concept or competency by providing examples. ent
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Learning Assessment
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Provides learning assessment activities to reinforce understanding
of the action. This is called formative assessment er
Formative assessment pe
The goal of formative assessment is to monitor your learning to
provide ongoing feedback that can be used by your trainer to opl
improve their teaching and so you can improve your learning.
More specifically, formative assessments:
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 help you identify your strengths and weaknesses and target
areas that need work
 help your trainer recognise where you are struggling and
address problems immediately
Chart
Provides images that represent data symbolically. They are used
to present complex information and numerical data in a simple,
compact format.
Intended Outcomes or Objectives

Statements of intended outcomes or objectives are descriptions of
the work that will be done. These are also known as your
Performance Criteria
Assessment
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Strategies with which information will be collected in order to e
validate each intended outcome or objective. This is called
summative assessment. the
Summative assessment em
The goal of summative assessment is to evaluate your learning at
the end of an instructional (learning) unit by comparing it against po
some standard or benchmark. we
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How to get the most out of your learning guide e
1. Read through the information in the learning guide carefully. Make sure
you understand the material.
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Some sections are quite long and cover complex ideas and information. If em
you come across anything you do not understand:
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 talk to your facilitator
 research the area using the books and materials listed under we
Resources
 discuss the issue with other people (your workplace supervisor, fellow rm

workers, fellow candidates)
try to relate the information presented in this learning guide to your own
ent
experience and to what you already know of
Ask yourself questions as you go: For example “Have I seen this
happening anywhere?” “Could this apply to me?” “What if….?” This will
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help you to make sense of new material and to build on your existing
knowledge.
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2. Talk to people about your study. pe
Talking is a great way to reinforce what you are learning. opl
3. Make notes. e
4. Work through the activities.
Even if you are tempted to skip some activities, do them anyway. They are
there for a reason, and even if you already have the knowledge or skills
relating to a particular activity, doing them will help to reinforce what you
already know. If you do not understand an activity, think carefully about
the way the questions or instructions are phrased. Read the section again
to see if you can make sense of it. If you are still confused, contact your
facilitator or discuss the activity with other candidates, fellow workers or
with your workplace supervisor.
Additional research, reading and note taking
If you are using the additional references and resources suggested in the
learning guide to take your knowledge a step further, there are a few
simple things to keep in mind to make this kind of research easier.
Always make a note of the author’s name, the title of the book or article,
the edition, when it was published, where it was published, and the name
of the publisher. If you are taking notes about specific ideas or information,
you will need to put the page number as well. This is called the reference
information. You will need this for some assessment tasks and it will help
you to find the book again if needed.
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Keep your notes short and to the point. Relate your notes to the material e
in your learning guide. Put things into your own words. This will give you a
better understanding of the material. the
Start off with a question you want answered when you are exploring
additional resource materials. This will structure your reading and save
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you time. po
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Performance Evidence the
The candidate must show evidence of the ability to complete tasks outlined
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in elements and performance criteria of this unit, manage tasks and
manage contingencies in the context of the job role. There must be
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evidence that the candidate has: we
 responded to the goals and aspirations of at least 2 older people, 1 in a rm
simulated environment and 1 in the workplace:
 employing flexible, adaptable and person-centred approaches to ent
empower the individual
 recognising and responding appropriately to situations of risk or of
potential risk
 used oral communication skills to maintain positive and respectful old
relationships er
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Elements and Performance the
Criteria em
CHCAGE001 - Facilitate the empowerment of older people po
Element
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1. Develop relationships with older people
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1.1
Conduct interpersonal exchanges in a manner that promotes
empowerment and develops and maintains trust and goodwill
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Recognise and respect older people’s social, cultural and spiritual
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1.2 differences er
1.3
Maintain confidentiality and privacy of the person within pe
organisation policy and protocols
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Work with the person to identify physical and social enablers and
1.4 disablers impacting on health outcomes and quality of life e
Encourage the person to adopt a shared responsibility for own
1.5 support as a means of achieving better health outcomes and
quality of life
2. Provide services to older people
2.1 Identify and discuss services which empower the older person
Support the older person to express their own identity and

2.2 preferences without imposing own values and attitudes
Adjust services to meet the specific needs of the older person and
2.3 provide services according to the older person’s preferences
Provide services according to organisation policies, procedures

2.4 and duty of care requirements
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3. Support the rights of older people
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Assist the older person to understand their rights and the
3.1 complaints mechanisms of the organisation em
3.2 Deliver services ensuring the rights of the older person are upheld po
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3.3 Identify breaches of human rights and respond appropriately
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Recognise signs consistent with financial, physical or emotional
3.4 abuse or neglect of the older person and report to an appropriate ent
person
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3.5
Assist the person to access other support services and the
complaints mechanisms as required
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4. Promote health and re-ablement of older people
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Encourage the older person to engage as actively as possible in all
4.1 living activities and provide them with information and support to
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do so e
Assist the older person to recognise the impact that changes
4.2 associated with ageing may have on their activities of living
Identify strategies and opportunities that maximise engagement

4.3 and promote healthy lifestyle practices
Identify and utilise aids and modifications that promote individual

4.4 strengths and capacities to assist with independent living in the
older person’s environment
4.5 Discuss situations of risk or potential risk associated with ageing
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Knowledge Evidence the
The candidate must be able to demonstrate essential knowledge required
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to effectively complete tasks outlined in elements and performance criteria
of this unit, manage tasks and manage contingencies in the context of the
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work role. This includes knowledge of: we
 structure and profile of the aged care sector: rm
 residential aged care sector
 home and community support sector ent
 current best practice service delivery models
 relevant agencies and referral networks for support services of
 key issues facing older people, including:
 stereotypical attitudes and myths
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 the impact of social devaluation on an individual’s quality of life er
 implications for work in the sector, including:
 concepts of positive, active and healthy ageing pe
 rights-based approaches
 person-centred practice opl
 consumer directed care e
 palliative approach
 empowerment and disempowerment
 re-ablement and effective re-ablement strategies
 the ageing process and related physiological and psychological
changes, including sexuality and gender issues
 strategies that the older person may adopt to promote healthy lifestyle
practices
 legal and ethical considerations for working with older people,
including:
 codes of practice
 discrimination
 dignity of risk
 duty of care
 human rights
 privacy, confidentiality and disclosure
 work role boundaries – responsibilities and limitations
 work health and safety
 indicators of abuse and/or neglect, including:
 physical
 sexual
 psychological
 financial
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 reporting requirements for suspected abuse situations e
 the impact of own attitudes on working with older people
the
em
po
we
rm
Assessment Conditions ent
All aspects of the performance evidence must have been demonstrated of
using simulation prior to being demonstrated in the workplace. The
following conditions must be met for this unit: old
 use of suitable facilities, equipment and resources, including: er
 relevant organisation policies and procedures
 relevant aids to assist with independent living pe
Assessors must satisfy the Standards for Registered Training opl
Organisations (RTOs) 2015/AQTF mandatory competency requirements
for assessors. e
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the
1. Develop relationships with em
older people po
we
Conduct interpersonal exchanges in a manner that
1.1 promotes empowerment and develops and maintains trust rm
and goodwill
ent
1.2
Recognise and respect older people’s social, cultural and
spiritual differences
of
Maintain confidentiality and privacy of the person within
old
1.3 organisation policy and protocols er
Work with the person to identify physical and social pe
1.4 enablers and disablers impacting on health outcomes and
quality of life opl
Encourage the person to adopt a shared responsibility for e
1.5 own support as a means of achieving better health
outcomes and quality of life
Introduction.
The Australian Institute of Health and Welfare, explains Aged Care as:
In Australia, the aged care system offers a range of care options to meet
the different care needs of each individual. Two mainstream care options
are available for older people: residential aged care and community-based
aged care.
Often people first enter the aged care system through community-based
care, before eventually progressing to permanent residential care. Respite
care in a residential aged care facility can also be a step along the way to
permanent care.
Residential aged care provides care within a supported accommodation
setting for those whose care needs can no longer be met within their own
homes. There are two types of care offered in residential aged care
facilities:
 Permanent care offers ongoing care in a residential aged care facility,
tailored to an individual's needs. While permanent care was previously
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offered at two levels—low and high care—this distinction was removed e
from 1 July 2014.
 Respite care offers temporary, short-term care in a residential aged the
care facility to support both older people and their carers to live at
home for as long as possible. Unlike permanent care, respite care em

continues to be offered as either low care or high care.
po
From 2015, two main programs deliver community-based care for older we
Australians:
rm
 The Commonwealth Home Support Programme (CHSP) commenced
on 1 July 2015. It consolidated four existing programs and provides ent
entry-level support services for older people who need some
assistance with daily living in order to live independently at home. In of
Victoria and Western Australia, these services continue to be offered
through the joint Commonwealth-state funded Home and Community
old
Care (HACC) Program. er
The Home Care Packages Programme provides more complex,
coordinated and personalised care at home, and offers four levels of care pe
packages to progressively support people with basic, low, intermediate and
high care needs. From 1 July 2015, consumer-directed care applied to all
opl
packages. e
In addition to these mainstream options, there are several flexible care
programs which provide care for special groups or circumstances in mixed
settings. These include the Transition Care Program, the Multi-Purpose
Services Program and the Veteran's Home Care Program. More
information on these programs is available from Aged care in Australia.
However, caring for older people and people with disability in the
community often depends on the availability of informal carers to take on a
caring role. These are unpaid carers (family, friends, or neighbours) who
have assumed responsibility for another's physical, emotional, or
developmental wellbeing.
Aged care in Australia
7.8% of the Australian population aged 65 and over, or 270,559 people,
were in residential aged care at some point over the 2013–14 financial
year.
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the
em
po
2.4% of the Australian population aged 65 and over, or 83,481 people,
received home care at some point over the 2013–14 financial year. we
rm
ent
of
old
263,788 Government-subsidised operational places were available in er
Australian aged care at 30 June 2014, a 3.5% increase from the previous
year.
pe
opl
e
2 in 3 people in permanent residential aged care at 30 June 2014 (69%)

were women. The average age for women was 85.8, compared to 81.6 for
men.
More detailed information about Australia's aged care system can be found
in the AIHW's annual web reports on aged care:
 Residential aged care and Home Care 2013–14
 Residential aged care and aged care packages in the community 2012–13
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 Residential aged care and aged care packages in the community 2011–12 e
the
My Aged Care
My Aged Care is the Australian Government's online gateway to access
em
Australian Government-funded aged care. My Aged Care provides po
information on the cost and accessibility of aged care, the services and
providers available, and how to navigate the aged care system. we
http://www.aihw.gov.au/aged-care/ rm
http://www.myagedcare.
ent
Working Definitions
of
Family Caregiver is broadly defined and refers to any relative, partner, old
friend, or neighbour who has a significant personal relationship with, and
provides a broad range of assistance for, an older person or an adult with er
a chronic or disabling condition. These individuals may be primary or
secondary caregivers and live with, or separately from, the person
pe
receiving care. opl
Care Recipient refers to an adult with a chronic illness or disabling
condition or an older person who needs ongoing assistance with everyday e
tasks to function on a daily basis. These tasks may include managing
medications, transportation, bathing, dressing, and using the toilet. The
person needing assistance may also require primary and acute medical
care or rehabilitation services (occupational, speech, and physical
therapies).
Caregiver Assessment refers to a systematic process of gathering

information that describes a caregiving situation and identifies the
particular problems, needs, resources, and strengths of the family
caregiver. It approaches issues from the caregiver's perspective and
culture, focuses on what assistance the caregiver may need and the
outcomes the family member wants for support, and seeks to maintain the
caregiver's own health and well-being.
A caregiver is a person who provides for the needs of a relative or friend
who is ill or disabled. The person being cared for may need help due to
physical illness or injury, mental illness, memory problems, or some
combination of these. The caregiver is often an adult daughter or daughter-
in-law and may be an older adult herself. Many caregivers are also caring
for young children or grandchildren as well.
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A caregiver's job can be very rewarding but may also be frustrating and e
stressful. Most caregivers are not specifically prepared or trained for the
role. It is a role some people assume reluctantly because there appears to the
be no other choice.
em
po
we
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ent
of
old
er
pe
opl
e
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1.1 Conduct interpersonal exchanges in a manner that promotes the
empowerment and develops and maintains trust and goodwill
Empowerment is about control. The Aged and/or their cares in Australia
em
now have the power to make their own decision about the type of care they
want, e.g. be it at home or in a residential facility.
po
Australians are living longer and healthier lives, and it is important that as we
Australians age, they retain control over choices about their care. We are
implementing a system that is responsive and flexible, which meets the
rm
needs of older Australians, and empowers them to receive the services
they want. At the same time, it strengthens the aged care system to deliver
ent
higher quality and more innovative services, now and into the future. of
The Government have announced that from February 2017, funding for
Home Care Packages will follow the consumer so they are free to select
old
any provider to deliver their care. er
Eligible consumers will be able to select any provider to deliver their care,
with funding for the package paid to the provider selected by the pe
consumer. Packages will be portable, allowing consumers to change their
service provider, including where the consumer moves to another location.
opl
These changes will give older Australians greater choice in deciding who e
provides their care, and will establish a consistent national approach to
prioritising access to care.
Importantly, there will be increased competition, leading to enhanced
quality and innovation in service delivery, and reduced regulation and red
tape for providers. These changes are a key step in moving to a less
regulated, more consumer-driven and market based aged care system.
Home Care Providers will also benefit from reduced red tape as they will
not have to apply for home care packages through the annual Aged Care
Approvals Round after 2015.
From July 2018, the Government intends to combine Home Care
Packages and the Commonwealth Home Support Programme into a single
integrated care at home programme.
These changes represent a significant shift in how care and support is
delivered to older people and will involve consultation with stakeholders on
the implementation and transitional arrangements.
The changes that were announced in the 2015 Budget are ensure the
aged care system in Australia continues to meet the needs of an ageing
population. The Government’s Aged Care Agenda will progressively move
aged care from a welfare-style system to one that empowers older
Australians to choose their own care services, through a market-based
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system. This will encourage care providers to offer competitive, high- e
quality and innovative services.
Change in attitude towards ageing and affirmation of the rights of older
the
people is necessary for empowerment of people as they age to become
the norm.
em
Empowerment links to inequality, because inequality tends to become po
more pronounced at both ends of the life-course. The negative impact of
inequality is a barrier to reducing absolute poverty and hinders the
we
fulfilment of a variety of human rights, including the capacity to be heard.
Empowerment also determines ability to extend opportunity and to
rm
enhance capabilities. ent
Disempowerment is closely connected to the denial of human rights, which
is linked to loss of autonomy. The diminishing capacity to make decisions
of
for oneself, either because of infirmity or because younger generations old
may assume that older people are incapable of making decisions, is one of
the defining features of (very) old age and is a key concern for older er
people’s human rights.
Dealing with the autonomy question is therefore critical to any discussion
pe
of how to empower older people and ensure that even the oldest and the opl
frailest are empowered. Research suggests that the biggest threat to an
older person’s autonomy (regardless of income levels) may come from e
family members who begin to make decisions on behalf of the older person
and thereby disempower them.
A positive approach to empowerment in old age will require us to identify
the features that disempower and to adopt practices and behaviours
alongside policy prescriptions that work to empower.
Examining empowerment in old age requires an approach that is able to
track and analyse a range of enabling and constraining interactions in the
personal, social, economic, political, physical and legal sphere which
confer dignity, agency and status on the older person3.
A useful model to describe these relationships can be found in the 2011
study of the Joseph Rowntree Foundation, entitled ‘A Better Life – what
older people with high support needs value’. This report and others
highlight the importance of ensuring government responses which are
known to preserve autonomy and enhance social and economic
empowerment.
These include policies that confer status and provide security of the person
within families (such as the pension) and promote health, rights and well-
being (responsive health care, livelihood support including credit and
insurance, legal recognition).
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Table 1: Ageing and empowerment the
em
po
we
The
new
rm
meanin ent
g of the
concep of
t of
empow old
erment,
include er
s
mainly
pe
referen
ces to
opl
power e
that
develo
ps and
is
acquire
d.
People
are
managing to gain more control over their lives, either by themselves or with
the help of others. The form to be empowered relates to what is both a
process and an outcome—to the effort to obtain a relative degree of ability
to influence the world (Staples, 1990).
Empowerment is an interactive process which occurs between an
individual, others and or the environment.
At a minimal level, trust is the absence of fear in a relationship:
 it’s knowing that you won’t intentionally hurt me.
But at a higher level, it’s a reliance - knowing that:
 you will be there for me when I need you
 you won’t sacrifice me for your self interest
 you can be counted on to work for my best interests as well as yours
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 ultimately I will be better off from having trusted you e
the
Communication with the aged:
em
It is important to remember that while communication with the elderly or po
disabled may be more challenging, it will prove to be worth the effort. we
By maintaining open, clear communication lines, you will gain and maintain
trust and goodwill with your client or resident. rm
It is also a good idea to do some preparation before you meet your ent
client/resident for the first time as it can be helpful. It would be
inappropriate to assume your client is of the same culture as you and that of
their disability has no impact upon their ability to communicate. Before you
meet, you will need some background information about their health, old
culture or any barriers so that you may be better prepared to communicate
with them.
er
During your interpersonal exchanges with your resident or client it is pe
important to remember to introduce yourself when meeting them for the
first time. opl
When you meet your client for the first time the important points to e
remember are:
 Face your client squarely and use open body posture and appropriate
facial expressions. Ensure there are no barriers between you and your
consumer, such as a desk, and that you are on the same eye level.
 Call your client by their name, state your name, who you are and
where you are from. For example, ‘Good morning, Reg, my name is
Ken from … and I’m your new support worker. I’m replacing Fred Nurk.
How are you today?’
 Offer to shake hands, if appropriate, by extending
your hand. Some people with a disability might not be able to shake
hands. Others may have pain that is made worse by touch.
 Provide the person with your business card (if you
have one).
 Speak clearly. Speaking clearly, but not too slowly,
helps get the message across.
 Use eye contact if culturally appropriate. There are some cultures,
including many Aboriginal people in NSW, who do not make direct eye
contact with the person talking to them as a sign of respect. Find out
about the person’s culture, so that you do not upset them by using eye
contact wrongly.
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Gerard Egan, in his book People Skills, uses the acronym SOLER which e
stands for the process used to develop rapport with others:
the
S O L E R em
Sit or stand
SQUARLEY
Use an OPEN
posture at all
LEAN slightly Maintain
appropriate Take a po
toward the RELAXED
to the person
– usually at a
times to ensure
you do not set
person to
show you are
EYE contact.
You will need approach. If you we
up any physical are relaxed,
5 o’clock
position so as barriers to
interested and
engaged in
to consider
any cultural then the other
person will be
rm
not to startle communication. needs here.
them. For example,
the
conversation For example, as well. ent
don’t cross your you would
arms
with them
make less eye
contact with an
of
Indigenous
Australian.
old
er
Consulting with your client/resident is important to affirm their preferences pe
about how you fulfill their needs.
opl
For example:
 Ask if they like their shower in the morning or afternoon.
e
 Do they prefer a mug or cup for their tea or coffee
 When they would like their hair washed
These examples are only a few of an extensive list.
Learning Activity 1:
As part of your learning journey you have discussed how to promote
empowerment while developing trust and goodwill.
Describe in your own words some of the steps of how you can gain the
trust of your client/resident; and explain why this is so important.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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___________________________________________________________ e
___________________________________________________________ the
___________________________________________________________
___________________________________________________________
em
___________________________________________________________ po
we
By giving choices of their preferences, do you believe this empowers
them? Why?
rm
___________________________________________________________ ent
___________________________________________________________ of
___________________________________________________________ old
___________________________________________________________
___________________________________________________________
er
___________________________________________________________ pe
___________________________________________________________ opl
Once you have answered the questions, check with your facilitator or
assessor to see if you are on the right track.
e
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1.2 Recognise and respect older people’s social, cultural and spiritual the
differences
Older people that we know are generally valued and respected. But our
em
attitude toward other ‘oldies’ in the community may be different. In many
tradition societies, their ‘elders’ are respected and cared for in the home.
po
However, in other societies and communities aged men and women are we
less respected and often neglected.
Ageist attitudes also often portray older people as frail, physically weak,
rm
mentally slow, disable or helpless, unable to work and ‘past their used by
date’. These stereotypes often prevent older women and men from
ent
participating in social, cultural, spiritual activities because organisers of
believe because of their age and abilities they are unable to contribute
which then puts invisible barriers up to participation. old
The Social Policy Research Centre (SPRC) in partnership with the
Benevolent Society has noted the growth in number of older Australians
er
from non-English speaking countries is faster than the growth of the older pe
population as a whole, largely because of the ageing of post-war migrants
who arrived as adults. opl
Australia-wide, the largest birthplace groups are from Italy, Greece, the
Netherlands, China, Croatia and Poland. In 2004, it was estimated that 50
e
countries of birth, 34 languages and 30 religions were represented in the
older population from a cultural and linguistically diverse (CALD)
background (AIHW 2004). By 2026, the number from CALD backgrounds
is projected to approach a million people.
It is estimated that slightly more than one in four people aged 80 and over
will be of CALD background by 2026, and number more than a quarter of a
million (Productivity Commission 2008)
Recognising and understanding that older people you care for come from
diverse cultures and spiritual differences is crucial to meeting their care
needs. Like the older population in general, most older people of CALD
background live independently and do not have care needs.
Most are part of reciprocal networks of informal family care and community
support and prefer to stay in their own homes, close to their known social
and physical environments (Rowland, 2007). Again, like the older
population as a whole, some need formal supports and services to allow
them to continue to live independently within the community.
When caring for an older person from a cultural and linguistically diverse
(CALD) background, it is important to know that there are aged care
services designed specifically for you that take this diversity into account.
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Organisations that promote access to aged care information and services e
for culturally diverse communities are encouraged by the Australian
Government. Many organisations now cater to specific diets, activities, the
languages or spiritual needs, whatever your cultural, linguistic or spiritual
background. em
po
we
The Government also encourages activities that:
rm
 link diverse communities and service providers ent
 educate other sectors of the community involved with aged care. of
old
If you need access to a translator or interpreter, call the Translating and
Interpreting Services (TIS National) on 131 450. TIS covers more than 100 er
languages and is available 24 hours a day, 7 days a week, for the cost of a
local call.
pe
In December 2012, the Australian Government released the National opl
Ageing and Aged Care Strategy for People from Culturally and
Linguistically Diverse (CALD) Backgrounds. The strategy will help the e
government respond to the needs of older people from CALD backgrounds
and better support the aged care sector to deliver care that is sensitive and
appropriate.
Partners in Culturally Appropriate Care

To help aged care providers deliver culturally appropriate care to older
people, there are state-based organisations that work as part of the
Partners in Culturally Appropriate Care (PICAC) program.
Aged care providers can find out more from each state’s PICAC
organisations listed below:
 New South Wales and Australian Capital Territory – Multicultural
Communities Council of Illawarra:
www.picacnsw.org.au
 Northern Territory – Council on the Ageing Inc (COTA):
www.cotant.org.au
 Queensland – Diversicare:
www.diversicare.com.au
 South Australia – Multicultural Aged Care:
www.mac.org.au
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 Tasmania – Migrant Resource Centre (Southern Tasmania) Inc: e
www.mrchobart.org.au
 Victoria – Centre for Cultural Diversity in Ageing: the
www.culturaldiversity.com.au
 Western Australia – Independent Living Centre of WA:
em
www.ilc.com.au po
When working with children, families or co-workers from culturally and
we
linguistically diverse backgrounds in your workplace, you have to be rm
respectful of their religious and cultural beliefs. This may mean rethinking
about what types of meat are served, being flexible around prayer times so ent
you don't plan activities or events which will disrupt their important or
necessary routines. of
Other things that can be distressing to the older person from old
different cultures include:
Referring to people by their first names may be disrespectful to some.
er
Make sure you ask people how they want to be addressed. This can be pe
included in the interview stage or on a registration form for induction.
Other issues that may cause problems with CALD clients could be:
opl
 Women supervising male staff e
 Young people supervising older staff
 Touching another person
 Holding a person's gaze when they are speaking
 Coughing and blowing one's nose
 Dress codes
 Different ways of greeting people
Another cultural difference which can cause a lot of frustration is when you
realise people who say yes actually mean no. This is a common dilemma
when working with cultures that favour politeness over frankness.
Particularly in Asian countries, it is common for people to agree to do a
task even when they don’t know what they're supposed to do rather than
ask for further instructions.
To avoid not really knowing whether a person understands what you are
asking of them, ask them to repeat back the instructions. This way you can
work out whether you need to change what you are saying to get your
message across. It is also worth remembering that politeness over
frankness generally means you will find it difficult to have discussions and
feedback.
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em
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er
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opl
e
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Learning Activity 2: the
As part of your learning journey you have been discussing respect for the
older person’s social, culture and spiritual differences. em
In your own words describe why it is important to understand and respect po
the diversity in culture for the people you care for.
___________________________________________________________
we
___________________________________________________________ rm
___________________________________________________________ ent
___________________________________________________________
of
___________________________________________________________
___________________________________________________________
old
___________________________________________________________ er
___________________________________________________________ pe
___________________________________________________________ opl
What is the acronym CALD?
e
___________________________________________________________
___________________________________________________________
Once you have answered the questions check with your facilitator or
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1.3 Maintain confidentiality and privacy of the person within organisation
policy and protocols
the
Policies and procedures are developed in response to the organisation's em
legal obligations. Therefore, you can meet many of your legal obligations
by following the policies and procedures of your organisation.
po
we
rm
ent
of
Confidentiality, as opposed to privacy, is where a health care professional old
has access to client/residents records is obliged to hold that information In
confidence,
er
Privacy is where the client/resident/family have the right to make decisions pe
about how their information is shared.
opl
Staff will ensure that confidentiality is observed in work practice at all
times. All staff who handle files are responsible for ensuring that the files e
are properly stored and that no file containing confidential information is
left where there is unrestricted access.
It is an obligation of all healthcare workers at all levels to be aware of the
legalities or the privacy and confidentiality laws.
Governing bodies such as Commonwealth Department of Health and Aged
Care Documentation and Accountability Manual gives the professional
requirements of responsible and accountable aged care practices. Then
there is the Australian Nursing and Midwifery Council and there is a
Nursing and Midwifery Board for each state and territory in Australia which
have professional standards and codes of conduct/practice that need to be
complied with.
Each organisation will have guidelines for completion of documentation so
that consistency and continuity of care can be maintained. The National
Framework for Documenting Care in Residential Aged Care Services
(NATFRAME) is a manual that has been prepared by the Ageing and Aged
Care Division of the Department of Health and Ageing.
The NATFRAME has been designed to help organisations communicate
and deliver high-quality care for older people. It provides for initial
assessment of those entering care, and for continuing evaluation,
reassessment and planning of care throughout their residency.
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Privacy and Confidentiality the
It is essential that all staff with access to the residents’ clinical records are
aware of the Privacy Act 1988 and the National Privacy Principles, privacy em
policy and privacy code of conduct of the organisation. In addition, staff
need to be aware that, under the Aged Care Act 1997 Commonwealth po
approved providers (and therefore their staff) also have responsibilities to
protect residents’ personal information which is covered by Commonwealth
we
privacy legislation. rm
Therefore, it should be ensured that all staff have received education and
information on the implications of privacy (and aged care) legislation and ent
clinical care practice, particularly in relation to consent, both expressed or
implied.
of
NATFRAME has been developed to provide a generic, multi-facility/multi- old
role documentation option which is specific to an Australian setting and is a
common framework applicable to (and transferable within) a range of
er
providers. pe
These guiding principles support nurses, employers, policy makers and
managers in documentation practices and policies that demonstrate opl
professional obligation, accountability and legal requirements to
communicate and record client information and nursing and midwifery
e
practice. It should be assumed that any and all nursing or midwifery
documentation will be scrutinised at some point.
There will be an organisational policy and procedures manual that will
outline what the expectations are to meet legislative requirements and
legal requirements in documenting care. The policies and procedures will
outline how to complete forms, the acceptable abbreviations, colour of pen
to write with; the guiding principles for documentation and other important
information that needs to be complied with as all forms and written
information are legal documents for proof of what has been done for that
client care.
Organisational documentation promotes:
 Compliance with the ANMC (Australian Nurses and Midwives Council)
competency standards for nurses and midwives
 A high standard of care
 Evidence of nursing and midwifery care
 Continuity of care
 Improved communication and dissemination of information between
and across services providers
 An accurate account of assessment, care planning, treatment and care
evaluation
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 Improved goal setting and evaluation of care outcomes e
 Improved early detection of problems and changes in health statu
the
Any and all forms of documentation by a nurse or a midwife recorded in a em
professional capacity in relation to the provision of nursing or midwifery
care and includes written and electronic health records, audio and video
po
tapes, emails, facsimiles, images (photographs and diagrams), observation
charts, check lists, communication books, shift/management reports,
we
incident reports and nursing or midwifery anecdotal notes or personal rm
reflections (held by the nurse or the midwife) or any other type or form of
documentation pertaining to that care. ent
The following simple guidelines can help you maintain client
confidentiality:
of
 Client information should never be discussed with friends or relatives in old
a social setting. er
 Material kept in files about clients should generally relate only to the
service delivery being offered to that client and factors that may affect pe
service delivery.
opl
 Confidential documents must be out of sight and reach in public areas.
This includes vehicles. Keep any identifying documents in a locked bag e
or case.
 Client information should never be disclosed to neighbours or family,
who may be contacting the service to find out whether the person is a
client of the service.
 Client information should never be disclosed to other agencies that are
not involved with the client. For example, the Department of Housing
may want to report their concerns about a tenant who may or may not
be a client of the service. In this situation, it is possible to receive
information about the person, but not confirm whether the person is
known to the service, without the client signing consent to release of
information.
 Names and other personal details of clients should not be revealed in
public forums such as meetings, conferences, workshops or seminars.
On this learning journey you have learned the importance of maintaining
your client/residents privacy and confidentiality.
Name two simple guidelines that can assure privacy of your client/resident:
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1. _________________________________________________________ e
___________________________________________________________ the
___________________________________________________________
2. _________________________________________________________
em
___________________________________________________________ po
___________________________________________________________ we
Once you have answered the question, check with your facilitator or
assessor to ensure you are on the right track.
rm
1.4 Work with the person to identify physical and social enablers and ent
disablers impacting on health outcomes and quality of life of
The aged are a diverse group, having different preferences, backgrounds,
functional capacities, living arrangements, income and wealth. Reflecting old
this diversity, older Australians enter the aged care system at different
points, requiring different levels of care and combinations of services in a
er
range of different settings. pe
Three important points of diversity that drive much of the variation in
demand for aged care services are differences in older people’s need for opl
care, their income and wealth, and accommodation arrangements.
e
As a support worker working with the aged or disabled it is necessary to
note that your client, as a result of the ageing process or disability will have
physical changes which can result in no longer being able to enjoy or be
involved in social and physical activities they once enjoyed.
The lack of involvement can cause a lack of confidence, which may result
in social isolation and even physical decline. Care providers have a ‘duty of
care’ and legal responsibility to have services in place to avoid this
happening (as a support worker, you have a legal and moral responsibility
to keep your clients safe from harm whilst they are using a service. This
responsibility is known as 'duty of care'). Care plans require to be
developed to meet the relevant care needs of the individual addressing the
physical, cognitive, emotional, social, and spiritual with the assistance of
family members and assessments.
Prevention of this decline in social and physical involvement of course, is
early detection. If it is obvious that your client is not enjoying or unable to
participate in the activity as they used to, and this is affecting their quality
of life, then it is time to look at a new activity or social group that is within
their capabilities, and will enable them to socialise and interact with others.
Because most old people lead active and healthy lives, the focus of this
plan is on promoting and supporting actions which contribute to
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maintaining such a positive approach. This will provide benefits to the e
whole community.
Sexuality and the Ageing:
the
Like all persons, the elderly may experience sexual dysfunction due to em
boredom, fear, fatigue, grief, or other factors (e.g., intrinsically low sexual
desire, physical disability). Sexuality in the elderly is particularly affected by po
problems that are common in this age group: e.g., depression, medical
disorders, incapacitation or death of a partner.
we
Ageing has a powerful impact on the quality of relationships and sexual rm
functioning. The psychological impact of ageing after midlife is a timely
topic given improved understanding of sexuality in both women and men, ent
as well as more effective treatment for age-related sexual dysfunctions. of
Sexual dysfunction can be a serious matter to many people and can affect
their ageing process. old
er
Positive ageing on a personal level is pe
about getting the most out of life. opl
e
Positive Ageing involves:
 Understanding the process of ageing and getting older
 Participating in a society which values and respects your contributions
as an older person
 Being independent and enjoying a good quality of life
 Being able to pursue social, cultural, educational and recreational
opportunities; and
 Having the opportunity to choose from a variety of aged care options or
remaining at home with community care appropriate to need.
As individuals we experience the process of ageing differently. We don’t all

have the same experience at the same time. As individuals there are many
steps we can take to ensure that we are taking good care of ourselves and
getting the most out of life. Organisations of all kinds can also assist by
promoting positive experiences of becoming older and by providing
appropriate services and facilities.
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Table 2: Ten Principles of a Positive Ageing Strategy e
1. Empower older people to make choices that enable them to live a the
satisfying life and lead a healthy lifestyle.
em
2. Providing opportunities for older people to participate in and
contribute to family and community
po
3. Reflect positive attitudes to older people
we
rm
4. Recognise the diversity of older people and ageing as part of a
normal part of the life cycle ent
5. Affirm the values and strengthen the capabilities of older indigenous of
and ethnic groups and their extended family
old
6. Recognise the diversity and strengthen the capabilities of older
people
er
7. Appreciate the diversity of cultural identity of older people living in
pe
Australia. opl
8. Recognise the different issues facing men and women e
9. Ensure older people in both rural and urban areas live with
confidence in a secure environment and receive the services they
need to do so.
10. Enable older people to take responsibility for their personal growth
and development through changing circumstances.
Table 3: Ten Priority Goals of a Positive Ageing Strategy
Income Secure and adequate income for older

1
people
Health Equitable, timely, affordable and accessible

2
health services for older people
Housing Affordable and appropriate housing options

3
for older people
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Transport Affordable and accessible transport options e
4
for older people the
5
Ageing in Place Older people feel safe and secure and can
age in place
em
po
Cultural Diversity A range of culturally appropriate services
6
allows choices for older people we
Rural Older people living in rural communities are rm
7
not disadvantaged when accessing services
ent
8
Attitudes People of all ages have positive attitudes to
ageing and older people
of
old
Employment Elimination of ageism and the promotion of
9
flexible work options er
10
Opportunities Increasing opportunities for personal growth pe
and community participation
opl
The above strategy should be developed to create a plan to outline the
possible actions, projects and activities that will improve the wellbeing of
e
older people. It should propose a process whereby other agencies and
organisations will commit to working together to deliver and implement the
action plan.
If your client/resident is concerned about issues related to their care and
don’t feel comfortable speaking to you or your supervisor, encourage them
to speak to an advocacy service, the services are free, confidential and
independent from the care provider.
An Advocacy service can:

 Give information about their rights and responsibilities
 Listen to their concerns
 Help resolve problems or complaints with their service provider
 Speak to your service provider for them
 Refer you to other agencies when required.
Who is entitled to advocacy services?
Anyone who receives:
 Residential care
 A Home Care Package
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 Transition care e
 Has been assessed by an Aged Care Assessment Team (ACAT)
 Has previously received an aged care service the
 Is representing the interest of the person receiving aged care services.
em
Some aged care programs provided by the Department of Social Services po
may also be able to give you some help and support if you care for
somebody who is not aged. For example, the National Respite for Carers we
Program provides respite, information and other support for carers of older
people and, in some instances, younger people with a disability.
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Table 4: Advocacy contact details (as listed by myagedcare.gov.au) e
the
The Aged-care
Service Inc.
Rights
Phone: (02) 9281 3600 or 1800 424 079
em
New South Wales
Level 4 (freecall) po
418a Elizabeth Street Email: tars@tars.com.au we
SURRY HILLS NSW 2010 Website: www.tars.com.au
Victoria
rm
Elder Rights Advocacy Phone: (03) 9602 3066 or 1800 700 600
Level 2 (freecall)
ent
85 Queen Street Email: era@era.asn.au of
MELBOURNE VIC 3000 Website: www.era.asn.au old
South Australia
Aged Rights Advocacy Phone: (08) 8232 5377 er
Service Inc.
16 Hutt Street
or 1800 802 030 (freecall)
pe
Email: aras@agedrights.asn.au
ADELAIDE SA 5000
Website: www.sa.agedrights.asn.au
opl
e
AdvoCare Inc. Phone: (08) 9479 7566 or 1800 655 566
Western Australia
Unit 1/190 Abernethy Road (freecall)
BELMONT WA 6104 Email: rights@advocare.org.au
Queensland Aged and Phone: (07) 3637 6000 or 1800 818 338
Disability
Queensland (freecall)
Advocacy Inc
Email: info@qada.org.au
GEEBUNG QLD 4034
Website: www.qada.org.au
Darwin Phone: (08) 8982 1111 or 1800 812 953

Northern Territory
Darwin Community Legal (freecall)
Service Aged/Disability Email: info@dcls.org.au
Rights
Website: www.dcls.org.au
8 Manton Street
DARWIN NT 0801
Alice Springs
Phone: (08) 8958 2400 or 1800 354 550
Catholic Care NT
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6 Hartley Street (freecall) e
ALICE SPRINGS NT 0871 Email: alicesprings@catholiccarent.org.au
the
Website: www.catholiccarent.org.au
em
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e
Australian Capital
Territory
Disability, Aged and Carer
Advocacy Service
Phone: (02) 6242 5060 or 1800 700 600
(freecall)
the
Suite 104, Block C
Canberra Technology Park
Email: adacas@adacas.org.au
Website: www.adacas.org.au
em
Phillip Avenue
WATSON ACT 2602
po
we
As part of your learning journey you have discussed how to assist your
rm
client/resident identify physical and social enablers and disablers that can ent
impact on their health outcomes and quality of life.
Describe in your own words how you can assist your client/resident in
of
enabling them to quality of life. old
___________________________________________________________
___________________________________________________________
er
___________________________________________________________
pe
___________________________________________________________ opl
___________________________________________________________ e
___________________________________________________________
___________________________________________________________
Now, describe what influences disable their quality of life.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
How can an advocate empower the elderly?

___________________________________________________________
___________________________________________________________
___________________________________________________________
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___________________________________________________________ e
___________________________________________________________ the
Once you have answered the questions above, check with your facilitator
or assessor to see that you are on the right track. em
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1.5 Encourage the person to adopt a shared responsibility for own e
support as a means of achieving better health outcomes and quality
of life the
As people grow old, the likelihood of experiencing age-related losses, for em
example loss of personal identity, physical mobility and social autonomy,
increase. Such losses may affect a person’s ability to acquire or maintain po
the relationships they want, and to maintain their independence and self-
determination in caring for themselves, resulting in a higher incidence of we
depression. rm
Depression is generally recognised as one of the principal mental
disorders afflicting older people. The manifestation of depression in the ent
elderly, however, calls for our close attention. This is mainly because there
are certain uncertainties about how common it is, and health as well as of
welfare professionals and government departments do not fully recognise
the prevalence of depression.
old
The reality is that older people are faced with a number of medical, social, er
economic and attitudinal problems. These are frequently accompanied by
events such as bereavement and loss of independence, accompanied by
pe
emotions such as grief, loneliness, hopelessness, helplessness and
powerlessness. Furthermore, the suppressive effects of society, the culture
opl
of professional practice, and government policies and directives are added
causes of such depression.
e
The question needs to be asked: ‘Is the depression experienced by elderly
people the result of unavoidable life circumstances?’ or is it thrust upon the
person by society, by professionals involved in their care, and by
government policies and local procedures which affect individuals
adversely and may restrict their independence and freedom of mobility?
Investigating the occurrence of depression is important in the care of older
people because feelings of identity and integrity are important for an
elderly person to be able to maintain a healthy lifestyle. There is a
connection between the traditional diagnosis of clinical depression and the
notion of oppression, giving a definition of social depression.
The culture of practice in aged care needs to be reflected upon and
strategies implemented in order to avoid creating social depression. We
need to empathise with this and develop sensitivity to what is occurring.
A rigorous approach needs to be taken towards empathy. Empathy is a
fundamental component of any interaction between professionals and an
elderly person, and will be conducive to a contemporary culture of care.
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Caring is about empathy. e
It is not about skill in procedures, which is easier for professionals to
acquire. What is more complex than acquiring skills is the development of
the
the caring attitude and the personal philosophies that promote effective
professional practice?
em
You need to reflect on opportunities in your professional practice. It also po
gives you an opportunity to decide how much the culture underlying what
you do needs to be changed.
we
It has been demonstrated that Australia and New Zealand’s populations rm
are growing older. This trend is also evident in the Client population in the
health care and welfare sectors. Hospital clients are seen as older and ent
suffer from more acute illnesses. Elderly people in the community at large
and using social and community support are also perceived by health care
of
and welfare professionals to be older and suffering from severe chronic old
illnesses and severe disabilities.
Growing old presents a variety of threats to independence
er
Growing old presents a variety of threats to independence. Many older pe
people are faced with multiple medical and surgical interventions and with
changes in lifestyle. Two common examples of possible stressors that may opl
handicap older people or limit their options in life are illness and retirement.
The degree of physical and mental illness experienced by elderly people
e
will determine the level of dependence necessary on carers, family
members and professionals. The older person’s autonomy is thus
threatened, and their ability to maintain control over their general activities
and decisions is challenged and seen to be threatened.
A few elderly people in such situations respond with optimism and vigour,
but most begin to feel that the future as bleak. Those who have enough
energy, vigour and determination are able to deal effectively with the
stressors, thus achieving a greater degree of emotional and physical well-
being. Here are several suggested hypotheses to explain the increased
use of passive strategies of coping by these older people.
They state that the current generation of older people does not cope with
problems in ways which are based on orientation to action. They also
assert that there is a developmental hypothesis which suggests that as
people age, events within or outside their domain result in a more passive
approach to solving problems. In addition, the researchers claim that the
experience of losses and negative stereotyping lead older people to
believe that there are fewer positive outcomes available to them, so they
should not invest too much energy attempting to resolve their problems.
It can be readily stated that loneliness, helplessness, hopelessness and
powerlessness are common feelings expressed by the elderly and that
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these feelings do have a profound effect on both their physical and e
psychosocial experiences and well-being. These are all negative emotions,
often associated with low self-esteem and lack of hope and positivity. the
For example, loneliness can threaten feelings of personal worth,
undermine confidence in interpersonal relationships and disrupt decision-
em
making abilities and thought processes. 1 po
Powerlessness is generally described as a feeling of lack of control over a
current situation or immediate happening, in which one’s actions are not
we
seen as significantly affecting the income. rm
Hopelessness may be described as a state in which the individual elderly
person sees very limited or no alternatives or personal choices. It is ent
observed that when people feel hopeless they are passive and cannot
mobilise resources on their own behalf Loneliness can be defined as the
of
painful awareness that one’s social relationships are deficient, causing one old
to feel excluded, unloved, constricted and alienated.
Loneliness is commonly defined as ‘the unpleasant experience that occurs
er
when a person’s network of social relationships is deficient either pe
qualitatively. Loneliness related to separation from family, friends and
spouses was evident in these narratives. opl
Social loneliness generally results from the older person’s lack of affiliation
and identification with an acceptable family member, friend or spouse.
e
Their feelings of boredom and aimlessness lead to an anxious search for
company and activities. Emotional loneliness is clearly evident in all those
who have lost their partners or for those who talk and think about the loss
of their partner. Coupled with declining health, separation from this person
and was seen to increase the likelihood of hopelessness, helplessness
and powerlessness.
Hopelessness was found to be closely linked to loneliness. Older people
generally perceived that being without hope for the future believed that life
could not possibly improve. Losses are viewed as being irrevocable, and
their problems as unsolvable. Hopelessness and loneliness can occur
separately, alternately, or consecutively. The occurrence of hopelessness
may precipitate or increase the likelihood of loneliness.
These feelings of grief, loneliness, helplessness and hopelessness can be
related to culture. The organisation of society and the culture within
professional practices, and the values of both, influence the well-being of
older people. The relevance of culture to the well-being of the older person
must be included.
1
Copel, L.C. 1988, ‘Loneliness’, Journal of Psychosocial Nursing, vol 26, no. 1, pp. 14-19.
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Australia’s multicultural society has citizens from all parts of the world, e
including its own indigenous Aboriginal culture. Despite Australia’s diverse
population, the country has largely developed a post-modern western way the
of life which includes its attitudes to human rights issues. As an advanced
western society Australia enjoys all of the acquired benefits of longevity em
and health.
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Some might even argue that Australia exceeds other western cultures by e
offering a lifestyle to its habitants which enhances their quality of life. If one
is to believe these statements and the connection they have to longevity the
and the issues of health, then Australia is certainly a country where older
adults have the opportunity to live full and complete lives well into their em
seventies, eighties and nineties.
po
This perception of healthy ageing depends on our personal views of how
we live out the later years of our life. Some people believe that because of we
healthier lifestyles more people live longer and have fewer years spent in
disability and major illness. rm
Others, however, argue that with the advance of medical technology ent
people may live longer but may experience longer periods of chronic
illness and disabling conditions. The third option is that both groups will of
exist simultaneously, meaning there will be a group of healthy people living
into their advanced years whilst another group will experience prolonged old
illness and disability.
er
What might be considered an example of successful ageing is offered by
Ford and Oliver (1995)2. They described the journey of Bill Ford, an older pe
adult who experienced a stroke which left him with a serious physical
disability. Their paper challenges the negative imaging of ageing and opl
disability, and instead focuses on personal growth, challenges and
courage. According to Ford and Oliver, neither age nor disability could
e
diminish Bill Ford. He transcended the negative aspect of his physical
disability by writing to his family and sharing his experiences, feelings,
struggles, and joys through letters and poetry which have since been
complied into a book titled Stroke of Genius.
The importance of socialisation and visiting with family and friends cannot
be overemphasised. For some older adult groups, the strongest predictors
of life satisfaction are their interaction and socialising with others. Many
people participate in leisure activities for the sole purpose of the social
benefits.
For older adults living in rural areas of Australia social interactions with the
local community may very well be the major source of their leisure activity.
As service providers, we need to maintain an open mind, recognising the
unique characteristics of each individual’s life. We have never walked in
their shoes, and therefore we do not know all about who they are, how
they feel, who is closest to them.
2
Ford. D. & Oliver. J. 1995, ‘Stroke of Genius’, Proceedings of the National Rural Conference on Ageing – Re-
writing the Future, ed. C. Saw, Charles Sturt University, Albury, New South Wales.
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There are instances where it may not be a family member, but a close e
member who is always there for them. This person fulfills the role of
advocate and should not be overlooked. the
Family members have a history, which we cannot possibly begin to know
about. After traumatic childhoods siblings may never have expected to
em
spend time with their brother or sister with a disability. Problems occur as po
the parents age and want to plan for their son or daughter – but who will
care for them? we
rm
ent
Now that you have considered who your clients are, the different contexts
in which you might be providing care, the standards for that care and your of
duty of care, you can look at how you demonstrate an understanding of the
physical and psychosocial aspects of ageing. Your task is to: old
 outline strategies that the older person may adopt to promote healthy er
lifestyle practices
 take into account physical changes associated with ageing when pe
delivering services when developing these strategies
 recognise and accommodate the older person’s interests and life
opl

activities when delivering services in these strategies
using these strategies develop an outline to assist the older person to
e
recognise the impact physical changes associated with ageing may
have on their activities of living.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
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_____________________________________________________________ e
_____________________________________________________________ the
_____________________________________________________________
_____________________________________________________________
em
_____________________________________________________________ po
_____________________________________________________________ we
_____________________________________________________________ rm
_____________________________________________________________
ent
_____________________________________________________________
_____________________________________________________________
of
_____________________________________________________________ old
_____________________________________________________________ er
_____________________________________________________________
pe
_____________________________________________________________
_____________________________________________________________
opl
_____________________________________________________________ e
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Once you have answered the questions check with your facilitator or
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2. Provide services to older the
people em
2.1
Identify and discuss services which empower the older po
person
we
Support the older person to express their own identity
2.2 and preferences without imposing own values and
rm
attitudes ent
Adjust services to meet the specific needs of the older of
2.3 person and provide services according to the older
person’s preferences old
2.4
Provide services according to organisation policies, er
procedures and duty of care requirements
pe
2.1 Identify and discuss services which empower the older person
opl
In today’s world our elderly generally lives longer. In Australia, in the 60’s,
life expectancy from birth for girls was 74 years, for boys 67 years. The e
latest data shows that girls born in 2013 can expect to live until they are 84
years old and boys until they are 80. And most Australians have a higher
standard of living and better access to high-quality healthcare (Australian
Institute of Health and Welfare, 2015).
This also means that the proportion of older people—that is, people aged
65 and over—in the Australian population is increasing. The number of
people aged 65 and over has more than tripled over fifty years, rising to
3.4 million in 2014. There has also been a ninefold increase in the number
of people aged 85 and over, to 456,600 in 2014. Based on population
projections by the Australian Bureau of Statistics, there will be 9.6 million
people aged 65 and over and 1.9 million people aged 85 and over by
2064.
While longer lives are a positive outcome for individuals, at the population
level, increased lifespans and older age generally result in increased ill
health. Many health conditions and associated impairments, such as
arthritis, dementia, and hearing loss, become more common as people get
older.
However, most older Australians consider themselves to be in good health.
This enables people to enjoy a good quality of life for longer and to
participate fully in the community. It also reduces the general demand for
health and aged care services.
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Ageing in Australia e
7 in 10 - people (72%) aged 65 and over living in households in 2011–12
rated their health as excellent, very good or good according to the
the
Australian Health Survey. This survey did not include older people living in
institutions, such as residential aged care.
em
2 in 5 - hospitalisations in 2013–14 (40%) were for people aged 65 and po
over, who account for 13% of Australia’s population. we
Half - of older Australians (53%) reported a disability in 2012, compared
with almost 1 in 6 Australians (14%) aged 15–64. However, only 1 in 5 rm
older Australians (20%) had a severe or profound core activity limitation
(sometimes or always need assistance with at least one core activity—self- ent
care, mobility or communication). of
3 in 10 - deaths (29%) in older Australians in 2013 were due to one of
three underlying causes—coronary heart disease, cerebrovascular old
diseases (including stroke) or dementia and Alzheimer disease.
er
4 in 10 - Australians aged 65 and over in 2014 (37%) were born
overseas—14% in main English–speaking countries (the United Kingdom, pe
Ireland, New Zealand, Canada, the United States, and South Africa) and
23% in non–English speaking countries. opl
Authoritative information and statistic to promote better health and e
wellbeing http://www.aihw.gov.au/aged-care/. 2014
Residential Aged Care
A special-purpose facility which provides accommodation and other types
of support, including assistance with day-to-day living, intensive forms of
care, and assistance towards independent living, to frail and aged
residents. Facilities are accredited by the Aged Care Standards and
Accreditation Agency Ltd to receive funding from the Australian
Government through residential aged care subsidies.
The Aged Care Act 1997 (Division 41, section 3) defines the meaning of
residential aged care but does not define the place in which this care is
offered, other than as a 'residential facility'. The Act defines residential
aged care as follows:
(1) Residential care is personal care or nursing care, or both personal care
and nursing care, that:
(a) is provided to a person in a residential facility in which the person is
also provided with accommodation that includes:
(i) appropriate staffing to meet the nursing and personal care needs of
the person; and
(ii) meals and cleaning services; and
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(iii) furnishings, furniture and equipment for the provision of that care and e
accommodation; and
(b) meets any other requirements specified in the Residential Care
the
Subsidy Principles. em
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The Act also defines what is not residential care: e
(2) Residential care does not include any of the following: the
(a) care provided to a person in the person's private home;
(b) care provided in a hospital or in a psychiatric facility;
em
(c) care provided in a facility that primarily provides care to people who are po
not frail and aged;
we
(d) care that is specified in the Residential Care Subsidy Principles not to
be residential care. rm
Residential care and supported accommodation for aged persons are also ent
defined in terms of the level of care provided, as assessed through the
Aged Care Funding Instrument (ACFI), which assesses care needs as a of
basis for allocating Australian Government funding.
(Source – Australian Institute of Health and Welfare)
old
Community Care er
There are many services available to assist the elderly live independent pe
productive lives.
These different service are able to support them stay in their own
opl
home longer, some of these services include: e
 help with housework
 help with personal care e.g. bathing and dressing
 assistance with meals and food preparation
 help to stay physically active
 social support and activities
 help with transport
 nursing care
 allied health support such as physiotherapy, podiatry or a
dietician
 house maintenance and modification
 aids and equipment to help
 counselling services
 interpreters
Many of these services are subsidised by the Australian Government
depending on your personal financial circumstances. Fees, eligibility and
expected contributions will be discussed with the service provider prior to
receiving any service.
The Australian Government Department of Social Services, My Aged Care
helps you find the information your client will need about aged care
services.
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Example: e
 different types of aged care services the
 eligibility for services
 how to understand their aged care needs and help them find local em
services to meet their needs – they are able to select their own service
provider. po
 Costs of their aged care services, including fee estimators.
we
My Aged Care. Information available from http://www.myagedcare.gov.au/ rm
or call centre
ent
As part of your learning journey you have been discussing different areas of
of care that are available. old
Describe what care a Residential Facility offers.
___________________________________________________________
er
___________________________________________________________ pe
___________________________________________________________ opl
___________________________________________________________ e
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Describe in your own words what Community Care can offer to maintain
independence.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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___________________________________________________________ e
___________________________________________________________ the
Once you have completed this activity, check with your facilitator or
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assessor to see if you are on the right track. po
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2.2 Support the older person to express their own identity and e
preferences without imposing own values and attitudes
What do you expect at your age?
the
You're not getting any younger! Do em
these statements sound familiar?
They are unjust generalisations
po
and prejudicial statements that
assume all older adults naturally
we
become weak, sick and forgetful. rm
Older people get sick from disease,
not "old age"
ent
The aged are a diverse group, of
having different preferences,
backgrounds, functional capacities,
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living arrangements, income and
wealth.
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pe
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Let’s have a quick look at your Current Knowledge About Ageing
Respond to the following questions to the best of your knowledge.

a. You are old at age? _______________________
b. There are _______________ older adults in Australia. Most older

people live in _____________________
c. Economically, older people are __________________________
d. With regard to health, older people are ___________________
e. Mentally, older people are _____________________________
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Our Attitudes e
the
Our attitudes are the product of our knowledge and values. Our life
experiences and our current age strongly influence our views about Ageing em
and old people. Most of us have a rather narrow perspective, and our
attitudes may reflect this. We tend to project our personal experiences onto po
the rest of the world. we
Because many of us have a somewhat limited exposure to Ageing, we are
likely to believe quite a bit of inaccurate information. When dealing with rm
older adults, our limited understanding and vision can lead to serious
errors and mistaken conclusions. If we view old age as a time of physical ent
decay, mental confusion, and social boredom, we are likely to have
negative feelings toward Ageing.
of
Conversely, if we see old age as a time for sustained physical vigour, old
renewed mental challenges, and social usefulness, our perspective on
Ageing will be quite different.
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It is important to separate fact from myth when examining our attitudes pe
about Ageing. The single most important factor that influences how poorly
or how well a person will age is attitude. This statement is true not only for opl
others but also for ourselves.
e
Throughout time, youth and beauty have been desired (or at least viewed
as desirable), and old age and physical infirmity have been loathed and
feared. Greek statues portray youths of physical perfection. Artists' works
throughout history have shown heroes and heroines as young and
beautiful, and evildoers as old and ugly.
Little has changed to this day (Cultural Awareness and Critical Thinking
boxes, below). Few cultures cherish their older members and view them as
the keepers of wisdom. Even in Asia, where tradition demands respect for
older adults, societal changes are destroying this venerable mindset.
For the most part, mainstream Australian society does not value its elders.
Australia tends to be a youth-oriented society in which people are judged
by age, appearance, and wealth. Young, attractive, and wealthy people are
viewed positively; old, imperfect, and poor people are not. It is difficult for
young people to imagine that they will ever be old.
Despite some cultural changes, becoming old retains many negative
connotations. Many people continue to do everything they can to fool the
clock. Wrinkles, gray hair, and other physical changes related to Ageing
are actively confronted with makeup, hair dye, and cosmetic surgery. Until
recently, advertising seldom portrayed people older than 50 years of age
except to sell eyeglasses, hearing aids, hair dye, laxatives, and other
rather unappealing products.
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The message seemed to be, "Young is good, old is bad; therefore e
everyone should fight getting old." It is significant that trends in advertising
appear to be changing. As the number of healthier, dynamic "senior the
citizens" with significant spending power has increased, advertising
campaigns have become increasingly likely to portray older adults as the em
consumers of their products, including exercise equipment, health
beverages, and cruises. Despite these societal improvements, many
po
people do not know enough about the realities of Ageing, and because of
ignorance, they are afraid to get old.
we
rm
Table 5: Cultural Awareness ent
of
The Role of the Family
old
Cultural heritage may work as a barrier to getting help for an older parent. er
Many cultures emphasise the importance of intergenerational obligation
and dictate that it is the role of the family to provide for both the financial
pe
and personal assistance needs of older adults. This can lead to high stress
and excessive demands, particularly on lower-income families.
opl
Nurses need to recognise the impact culture has on expectations and e
values and how these cultural values affect the willingness to accept
outside assistance. Nurses need to be able to identify the workings of
complex family dynamics and determine how decision making takes place
within a unique cultural context.
Table 6: Critical Thinking
Caregiver Choices
 What expectations does your cultural heritage dictate regarding
obligations to frail older family members?
 Who in your family culture makes decisions regarding the care of

older family members?
 Should Medicare or insurance plans pay low-income family

members to stay at home and provide care for infirm older adults?
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 To what extent should family members sacrifice their personal lives e
to keep frail or infirm older adults out of institutional care?
the
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Gerontophobia em
The fear of Ageing and the refusal to accept older adults into the
mainstream of society is known as gerontophobia. Both senior citizens and
po
younger persons can fall prey to such irrational fears (Table 5).
Gerontophobia sometimes results in very strange behaviour. Teenagers
we
buy anti-wrinkle creams. Thirty-year-olds consider facelifts. Forty-year-olds rm
have hair transplants. Long-term marriages dissolve so that one spouse
can pursue someone younger. Too often these behaviors may arise from ent
the fear of growing older.
Table 7 Ageing: Myth Versus Fact
of
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MYTH er
 Most older people are pretty much alike. pe
 They are generally alone and lonely.
opl
 They are sick, frail, and dependent on others,
 They are often cognitively impaired.
e
 They are depressed.
 They become more difficult and rigid with advancing years.
 They barely cope with the inevitable declines associated with
Ageing.
 Elderly people don’t like sex.
FACT
 They are a very diverse age group.
 Most older adults maintain close contact with family.
 Most older people live independently.
 For most older adults, if there is decline in some intellectual
abilities, it is not severe enough to cause problems in daily living.
 Community-dwelling older adults have lower rates of diagnosable
depression than younger adults.
 Personality remains relatively consistent throughout the life span.
 Most older people successfully adjust to the challenges of Ageing
 The elderly do not lose their desire for intimacy or sex.
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3
The official citation that should
http://www.apa.org/pi/Ageing/olderadults.pdf.
be used in referencing this material is em
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3
http://www.apa.org/pi/Ageing/olderadults.pdf.
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Ageism em
The extreme forms of gerontophobia are ageism and age discrimination.
Ageism is the disliking of Ageing and older people based on the belief that
po
Ageing makes people unattractive, unintelligent, and unproductive. It is an
emotional prejudice or discrimination against people based solely on age.
we
Ageism allows the young to separate themselves physically and rm
emotionally from the old and to view older adults as somehow having less
human value. Like sexism or racism, ageism is a negative belief pattern
ent
that can result in irrational thoughts and destructive behaviors such as
intergenerational conflict and name-calling. Like other forms of prejudice,
of
ageism occurs because of myths and stereotypes about a group of people old
who are different from ourselves.
The combination of societal stereotyping and a lack of positive personal
er
experiences with the elderly effects a cross section of society. Many
studies have shown that health care providers share the views of the gen-
pe
eral public and are not immune to ageism. opl
Few of the "best and brightest" nurses and physicians seek careers in
geriatrics despite the increasing need for these services. They erroneously
e
believe that they are not fully using their skills by working with the Ageing
population. Working in intensive care, emergency departments, or other
high technology areas is viewed as exciting and challenging.
Working with the elderly is viewed as routine, boring, and depressing. As
long as negative attitudes such as these are held by health care providers,
this challenging and potentially rewarding area of service will continue to
be underrated and the elderly will suffer for it.
Ageism can have a negative effect on the way health care providers relate
to older clients, which in turn can result in poor health care outcomes in
these individuals.
Research by the National Institute on Ageing reports that;
(1) older clients receive less information than do younger clients with
regard to resources, health management, and illness management;
(2) less information is provided to older adults on lifestyle changes such
as weight reduction and smoking cessation;
(3) limited rehabilitation is available for older adults with chronic disease,
despite studies demonstrating that individuals older than 85 years of
age do benefit from rehabilitation programs; and
(4) only 47% of physicians feel that older adults should receive the same
evaluation and treatment for acute illness as their younger
counterparts.
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Because an increasing portion of the population consists of older adults, em
health care providers need to do some soul searching with regard to their
own attitudes. Furthermore, they must confront signs of ageism whenever po
and wherever they appear.
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Activities such as increased positive interactions with older adults and em
improved professional training designed to address misconceptions
regarding ageing are two ways of fighting ageism. The Nursing po
Competence in Ageing (NCA) initiative, which was started in 2002, focuses
on enhancing competence in geriatrics by expanding nurses' knowledge, we
skills, and attitudes. Research coming from this initiative can help nurses
regardless of their area of practice. rm
Age discrimination reaches beyond emotions and leads to actions. Age ent
discrimination results in different treatment of older people simply because
of their age. Refusing to hire older persons, barring them from approval for of
home loans, and limiting the types or amount of health care they receive
are all examples of discrimination that occur despite laws prohibiting them. old
Some older individuals respond to age discrimination with passive
acceptance, whereas others are banding together to speak up for their
er
rights. pe
The reality of getting old is that no one knows what it will be like until it
happens. But that is the nature of life-growing older is just the continuation opl
of a process that started at birth. Older adults are fundamentally no
different from the people they were when they were younger. Physical,
e
financial, social, and political conditions may change, but the person
remains essentially the same.
Old age has been described as the "more-so" stage of life because some
personality characteristics may appear to amplify. Old people are not a
homogenous group. They differ as widely as any other age group. They
are unique individuals with unique values, beliefs, experiences, and life
stories. Because of their extended years, their stories are longer and often
far more interesting than those of younger persons.
Ageing can be a freeing experience. Ageing seems to decrease the need
to maintain pretenses, and the older adult may finally be comfortable
enough to reveal the real person that has existed beneath the facade. If a
person has been essentially kind and caring throughout life, he or she will
generally reveal more of these positive personal characteristics as time
marches on.
Likewise, if a person was miserly or unkind, he or she will often reveal
more of these negative personality characteristics as he or she grows
older. The more successful a person has been at meeting the develop-
mental tasks of life, the more likely he or she will be to face ageing
successfully. Perhaps the best advice to all who are preparing for old age
is contained in the Serenity prayer:
“O God, give us the serenity to accept what cannot be changed;
courage to change what should be changed; and wisdom to
distinguish one from the other.” - Reinhold Niebuhr
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em
Sexuality and the Elderly
po
Getting ‘old’ does not mean you lose the desire for intimacy. Sexual
intimacy in the aged, is a subject that is not discussed openly, so the wide we
spread population believe because it is not talked about, that it doesn’t
happen. Younger people believe that as you get older, you lose interest in rm
sex and should be asexual.
ent
"There is no age limit on sexuality and sexual activity," reports Stephanie
A. Sanders, PhD, associate director of the sexual research group The of
Kinsey Institute. While the frequency or ability to perform sexually will
generally decline modestly as seniors experience the normal physiological old
changes that accompany aging, reports show that the majority of men and
women between the ages of 50 and 80 are still enthusiastic about sex and
er
intimacy. pe
"Use it or lose it," says geriatrics expert Walter M. Bortz, 70, author of
three books on healthy aging as well as several studies on seniors' opl
sexuality. Dr. Bortz, a professor at Stanford Medical School, is past
president of the American Geriatrics Society and former co-chair of the
e
American Medical Association's Task Force on Aging.
"If you stay interested, stay healthy, stay off medications, and have a good
mate, then you can have good sex all the way to the end of life," he says.
A Duke University study shows that some 20 percent of people over 65
have sex lives that are better than ever before, he adds.
And although not everyone wants or needs an active sex life, many people
continue to be sexual all their lives. "There's strong data all over: It's a
matter of survival," says Dr. Bortz. "People that have sex live longer.
Married people live longer. People need people. The more intimate the
connection, the more powerful the effects."
But older people may encounter an obstacle they hadn't expected: their
adult children, who may be less than pleased to see their aging parents as
sexual beings. Such judgmental attitudes prevent many older people from
moving in with each other or even having their partner over, according to
Dr. Jack Parlow, a retired clinical psychologist in Toronto. "This attitude
creates a block to many seniors who want to be sexually active," he says.
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Learning Activity 8: em
As part of your learning journey this unit has discussed how to support the
older person to express their own identity and preferences without
po
imposing own values and attitudes. we
For the most part, mainstream Australian society does not value its elders.
Australia tends to be a youth-oriented society in which people are judged rm
by age, appearance, and wealth.
ent
Do you agree with the statement above?
YES NO
of
In your own words explain your answer: old
___________________________________________________________ er
___________________________________________________________ pe
___________________________________________________________
___________________________________________________________
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___________________________________________________________ e
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
"There is no age limit on sexuality and sexual activity,"

True or False
Once you have answered these questions, check with your facilitator or
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2.3 Adjust services to meet the specific needs of the older person and em
provide services according to the older person’s preferences
Living in the place you've called home for many years needn't be a chore.
po
With the right support, you can continue to stay in the place you love. we
Home support services are offered by service providers using person-
centred care, meaning your client/resident has a choice of the kind of rm
support or services they receive e.g. when they receive it and from who.
This puts the care recipient/carer/family at the centre of the decision
ent
making process, making them experts, working alongside allied health and of
professions to get the best outcome.
The Australian Government subsidies many different types of aged care
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support services. Commonwealth Home Support Programme provides
entry level services for older people who are still able to live at home but
er
don’t need higher level of care. Each individual is required to be assessed pe
to determine the level of assistance required and which care package they
are eligible for. opl
As your clients’ health, mobility and need for care or assistance changes,
the service provider has to adjust the services required.
e
For example;
 Domestic assistance like cleaning, laundry or meal preparation
• Transport to appointments or shopping
• Personal assistance like showering and dressing
• Health and wellbeing services like physiotherapy
• In-home safety assessment
• Gardening and home maintenance
• Medication management
Services that also may be required if your client has a particular health
problem, e.g. speech or mobility or increased care needs for the short
term, as a result of surgery or accident are:
 physiotherapy (exercises, mobility, strength and
balance)
 podiatry (foot care)
 speech pathology
 occupational therapy (help to recover or maintain your
physical ability)
 advice from a dietitian (healthy eating).
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If your clients health is progressively declining, it may be necessary for em
them to be assessed by the Aged Care Assessment Team (ACAT) to
determine if they have complex aged care needs. This assessment will po
accurately establish the care services required e.g. if it is time to consider
moving into an age care facility, so 24 hour care can be delivered. we
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Palliative Approach em
It is a fact that people who move into an aged care facility are no longer
able to look after themselves at home. Many residents lead productive
po
and fulfilling lives in care. However, there is a number of elderly people
enter aged care for end of life care. My Aged Care describes Palliative
we
care as the best care to achieve the best possible quality of life for the rm
person with a life-limiting illness and provide support for their family and
carers. ent
Palliative care: of
 affirms life and treats dying as a normal process
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 neither hastens or delays death
 provides relief from pain and other distressing symptoms
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 integrates the physical, psychological, social, emotional and spiritual pe
aspects of care, with coordinated assessment and management of
each person’s needs opl
 offers support to help people live as actively as possible until e
death
 offers support to help the family during the person’s illness
and in their own bereavement.
Some of the common medical conditions of people requiring palliative care
include: cancer, HIV/AIDS, motor neurone disease, muscular dystrophy,
multiple sclerosis and end-stage dementia.
There are a number of people who may support someone approaching the
end of their life and help them to feel as comfortable as possible.
Such people might include:
 doctors, including general practitioners, palliative care specialists and
other specialist physicians
 nurses, including general and specialised nurses in the community,
hospitals, palliative care units and aged care homes
 allied health professionals, including social workers, physiotherapists,
occupational therapists, psychologists, pharmacists, dietitians and
speech pathologists
 support workers, such as assistants in nursing, personal care
attendants and diversional therapists
 therapists skilled in music, massage, aromatherapy or colour
 bereavement counsellors
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 spiritual advisers from different pastoral, spiritual and cultural em
backgrounds
 workers who have language skills and knowledge of various cultures
po
 Aboriginal or Torres Strait Islander health workers we
 volunteers. rm
ent
Family members are also an important part of the support team,
of
particularly if a person has chosen to receive palliative and end of life care
in their own home.
old
Many people find that administrators or business managers can also er
provide essential support to the end of life care team. Experts in financial
planning and legal issues can also provide support.
pe
There are many resources and organisations available around Australia opl
that can provide support for people who are involved with palliative care,
whether as a patient, a carer, a family member or a friend.
e
A few of these organisations are listed below:
 Advance Care Planning Australia – this website provides information
on advance care planning.
 Palliative Care Australia – the peak national body for palliative care.
Each state and territory has a local branch.
 Multilingual resources – Palliative Care Australia produces online
resources about end of life care in 21 languages.
 Palliative Care Knowledge Network – CareSearch - A one-stop online
resource for palliative care information.
 National Palliative Care Service Directory – Palliative Care Auatralia
provides an online search of organisations that provide palliative care
services and support, as well as access to information about these
services.
 World Health Organisation (WHO) – the WHO provides a definition of
the palliative care approach.
 Decision Assist – information, training and advice on palliative care and
advance care planning for health professionals working with
consumers of aged care services
Report to your supervisor and document when you believe your
client/resident is deteriorating.
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Learning Activity 9: em
As part of your learning journey you have been given information about
services available to your client/resident.
po
Give 3 examples of where you could direct your client services to meet we
their particular needs.
rm
1. _________________________________________________________
___________________________________________________________
ent
2. _________________________________________________________ of
___________________________________________________________ old
Once you have answered this question, check with your facilitator to see if
you are on the right track. er
pe
2.4 Provide services according to organisation policies, procedures and opl
duty of care requirements
e
Code of Practice
Worksafe Australia and Comcare, state that a code of practice applies to
anyone who has a ‘duty of care’, they say that, following a code of practice
would achieve compliance with the health and safety duties in the WHS
Act and Regulations.
Duty of Care
Duty of care is a term that refers to the legal requirement that places
responsibility on everyone that is, employers, employees and others-to
follow healthy, safe and considerate work practices.
Duty of care is a legal term and describes a duty to work responsibly
where your action(s) may foreseeably affect someone else.
Duty of care is part of the legal concept of negligence covered by common
law. A duty of care exists when someone's actions or failure to perform
actions could reasonably be expected to affect another person.
You are in a position where someone else is likely to be affected by what
you do, or do not do, and where, if you are not careful, it is reasonably
predictable that the other person might suffer some harm. You have a duty
to be careful, as what you do (or do not do) might affect your client.
You therefore need to:
 ensure you understand exactly what the support you are providing is
and how it affects the client and that the client knows the nature of the
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No: Modified May-
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support and its consequences and agrees with provision of the em
support.
To be successful in a claim for negligence a client must show:
po
 you owed them duty of care we
 that you breached duty of care rm
 that they, as the client, have suffered some loss as a result of this ent
which was foreseeable.
Difficulties arise in practice because it is difficult to decide what is of
reasonable in particular cases to avoid foreseeable harm. If you find
yourself in such difficulties, immediately refer your concerns to your
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supervisor for advice. er
Duty of Care and Negligence
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So what does duty of care really mean in a nursing home? For health care
opl
professionals to be liable they must be lacking in their duty to the resident,
such that it can be said that the defendant acted in breach of a duty to
e
provide the resident with care, which was reasonable in the circumstances.
Health care workers can normally be expected to perform in certain ways.
When a support worker fails to perform as required by the job that person
is guilty of negligence.
For example, you would be guilty of negligence if your facility had a policy
that bed rails should be up at night and you forgot-allowing a resident to
fall out of bed and injuring themselves. The resident's rights give
assurance that care will be given properly, privacy be respected and there
will be no abuse. Residents will be treated as respected individuals,
capable of handling their own affairs and making their own decisions.
Breach of Duty of Care

This is the term used when there is a failure to meet the relevant standard
of care. This might be a support worker or carer doing something they
should not have done, or failing to do something they should have done.
Again, it will depend on whether or not the mistake was reasonable in the
circumstances.
Duty of Care Dilemmas

These may arise when a support worker or carer is unsure about the
capacity of the client to make their own decisions. Informed decision-
making must be voluntary and there must be an understanding of the
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consequences of the decision. The law assumes all adults are competent em
unless legally found not to be so.
Judging a client's competence is not the support worker or carer's role. In
po
such dilemmas there may be a number of rights involved. There could, for
example, be an issue between safety and restraint or privacy and safety.
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No: Modified May-
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3. Support the rights of older po
people we
3.1
Assist the older person to understand their rights and rm
the complaints mechanisms of the organisation
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Deliver services ensuring the rights of the older person
3.2 are upheld of
Identify breaches of human rights and respond
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3.3 appropriately er
Recognise signs consistent with financial, physical or pe
3.4 emotional abuse or neglect of the older person and
report to an appropriate person opl
3.5
Assist the person to access other support services and e
the complaints mechanisms as required
3.1 Assist the older person to understand their rights and the complaints
mechanisms of the organisation
Complaints mechanisms
Clients have a right to make either an internal complaint direct to the
organisation or an external complaint to the Aged Care Complaints
Commissioner. Organisations must provide a process for addressing
complaints and making sure that people are aware they can complain
externally.
Complaints can be made about any area of care or services from an
Australian Government subsidised service provider.
Areas may include:
 quality of care
 choice of activities
 personal care
 meals
 communication between self and staff/management
 physical environment
Figure 1, is an example of complaint/suggestion form available.
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No: Modified May-
Date: 19

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Figure 1: Sample complaints/suggestions form em
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CONFIDENTIAL
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Fitzroy Falls Aged Care Facility ent
MESSAGE TO MANAGEMENT
COMPLANTS AND SUGGESTIONS
of
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Name: Date:
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Complex/Wing:
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 Complaint  Suggestion
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Complaint/Suggestion:
Suggested Solution:
Final Action:
Outcome/Evaluation:
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Signature: Date: em
Effective:
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 Yes  No Date:
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No: Modified May-
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Employees should be aware that comments and complaints represent em
opportunities for service improvement and are an important part of quality
control. po
They can be resolved in a number of ways, including: we
 Informal - for straightforward comments, staff can generally resolve
these issues. rm
 Formal - for more serious matters that need to be passed to a ent
designated complaints person or committee.
of
 External review - where complaints cannot be resolved internally.
Management should have a policy on handling complaints that encourages
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feedback from residents. Residents should be given clear information on
how to make a complaint and be assured that complaints are handled
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fairly, promptly and confidentially. The complaints policy should assure pe
residents they are protected from any repercussions, reprisals or
victimisation. opl
e
Comments and complaints systems should include:
 positive conflict resolution strategies;
 sound policies and procedures;
 ongoing staff education and training;
 consumer information and education;
 recording and monitoring of comments and complaints;
 timely action on comments and complaints to improve service delivery.
Figure 1 above is a sample of a Complaints/Suggestions Form typical of
such documentation.
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3.2 Deliver services ensuring the rights of the older person em
are upheld
The Australian Human Rights Commission have stated, human rights are
po
about everyone, and they are very important for older people in Australia. we
We are all entitled to the enjoyment of human rights without discrimination
of any kind, including discrimination on the basis of our age. rm
There are certain human rights and freedoms that are particularly
relevant to older people, including the right to:
ent
 an adequate standard of living including access to adequate food, of

clothing and housing
the highest possible standard of physical and mental health
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 work and fair working conditions er
 be safe and free from violence
 be free from cruel, inhuman or degrading treatment pe
 privacy • family life.
opl
In Australia an older person receiving a service from a community
e
service provider has the rights to:
 to be treated as any other member of society
 to be treated and accepted as an individual
 have a copy of their care plan
 have their privacy and dignity be respected
 personal information kept private and confidential
 have care that is delivered with respect
 not be made or obliged to feel grateful to those delivering care
 to be treated without neglect, exploitation, abuse and discrimination
 they and/or their representative involved in the decision making in
regards to care needs.
 have information explained clearly e.g. financial/fees
 not have services refused because of inability to pay
 be given a copy of the Charter of Rights and Responsibilities for
Community Care
 be given information on how to make a compliant or comment about
services received
 be given information regarding Advocacy Services available
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No: Modified May-
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A resident of an aged care facility also has rights; the rights are very em
similar to the rights of a consumer of a community service.
Below is a list of added rights for an aged care facility resident:
po
 to live in a safe, secure homelike environment, being able to move we
freely within or outside of the facility without undue restriction
 without discrimination, able to practice cultural, religious and spiritual
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
practices
freedom of speech
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 able to maintain personal relationships and maintain social activities of
and associations in the community out of the facility
 given choices old
 maintain independence even if the task holds an element of risk, and
the resident is aware of and willing to accept er
 to complain without reprisal pe
 access to advocates
The National Aged Care Advocacy Program (NACAP) was established to opl
contribute to improving the quality of life of consumers of aged care
services and to the protection of their rights.
e
If at any time, as a support worker you feel or have been informed by your
client/resident or advocate, that their ‘rights’ are being abused, it is to be
reported to your supervisor as soon as possible
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3.3 Identify breaches of human rights and respond em
appropriately
The relevant provision of the UN Principles of Older Persons (1991)
po
states: we
Older persons should be able to enjoy human rights and fundamental
freedoms when residing in any shelter, care or treatment facility, including
rm
full respect for their dignity, beliefs, needs and privacy and for the right to
make decisions about their care and the quality of their lives.
ent
In Australia, human rights are protected in different ways. Unlike most of
similar liberal democracies, Australia has no Bill of Rights to protect human
rights in a single document.
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Rather rights may be found in the Constitution, common law and legislation er
- Acts passed by the Commonwealth Parliament or State or Territory
Parliaments. pe
However, The Australian Human Rights Commission discuss Human rights opl
and the older people.
Human rights are about everyone, and they are very important for older
e
people in Australia. We are all entitled to the enjoyment of human rights
without discrimination of any kind, including discrimination on the basis of
our age.
1. There are certain human rights and freedoms that are particularly
relevant to older people, including the right to:
 an adequate standard of living including access to adequate food,
clothing and housing
 the highest possible standard of physical and mental health
 work and fair working conditions
 be safe and free from violence
 be free from cruel, inhuman or degrading treatment
 privacy
 family life.
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2. Some of the major human rights problems faced by older people em
in Australia include:
 workplace discrimination – older people may face prejudice when po
applying for jobs, seeking promotions, accessing training or may be
harassed in the workplace we
 balancing paid work with caring responsibilities – older people often
care for adult children, grandchildren, spouses and/or elderly parents
rm
 access to appropriate and adequate aged care facilities and health
care
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 abuse – including financial, physical and psychological abuse of elderly of
people
 homelessness, poor living standards and dependency on social old
security payments
 barriers in accessing government services and other opportunities to
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participate in community/public life pe
Human Rights – Anti-discrimination
opl
Over the past 30 years the Commonwealth Government and the state and e
territory governments have introduced laws to help protect people from
discrimination and harassment.
The following laws operate at a federal level and the Australian Human
Rights Commission has statutory responsibilities under them:
 Age Discrimination Act 2004
 Australian Human Rights Commission Act 1986
 Disability Discrimination Act 1992
 Racial Discrimination Act 1975
 Sex Discrimination Act 1984.
The following laws operate at a state and territory level, with state
and territory equal opportunity and antidiscrimination agencies
having statutory responsibilities under them:
 Australian Capital Territory – Discrimination Act 1991
 New South Wales – Anti-Discrimination Act 1977
 Northern Territory – Anti-Discrimination Act 1996
 Queensland – Anti-Discrimination Act 1991
 South Australia – Equal Opportunity Act 1984
 Tasmania – Anti-Discrimination Act 1998
 Victoria – Equal Opportunity Act 2010
 Western Australia – Equal Opportunity Act 1984.
Commonwealth laws and the state/territory laws generally overlap and
prohibit the same type of discrimination.
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As both state/territory laws and Commonwealth laws apply, you must em
comply with both. Unfortunately, the laws apply in slightly different ways
and there are some gaps in the protection that is offered between different po
states and territories and at a Commonwealth level. To work out your
obligations you will need to check the Commonwealth legislation and the we
state or territory legislation in each state in which you operate.
rm
Barnett and Hayes (Not seen and not heard: Protecting elder human rights
in aged care Michael Barnett and Robert Hayes 2010) have stated that ent
elderly people should have a right not to be exposed to violence and
abuse, cruel, inhumane or degrading treatment, poor hygiene and neglect, of
indignity, and invasion of privacy. Indeed, the paramount, if not sole,
objective of any aged care system should be to guarantee that elderly old
people have high quality care and quality of life. er
As a support worker, you are also an advocate for your client/resident, as
often they are unaware or too frightened to voice that their needs are not pe
being met. Report to your supervisor at any time you may think your
client/resident is vulnerable. opl
e

As part of your learning journey you have learnt how to identify any
breaches of human right and the appropriate way to respond.
Do you believe that human rights are about everyone?
Yes or No
Give 2 examples how certain human rights and freedoms are particularly
relevant to older people.
1 __________________________________________________________
___________________________________________________________
___________________________________________________________
2 __________________________________________________________
___________________________________________________________
___________________________________________________________
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No: Modified May-
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3.4 Recognise signs consistent with financial, physical or emotional em
abuse or neglect of the older person and report to an appropriate
person po
No older person should be subjected to any form of abuse, often referred we
to as ‘Elder abuse’. Elder abuse can take various forms such as physical,
psychological or emotional, sexual or financial abuse. It can also be the rm
result of intentional or unintentional neglect.
Elder abuse can be defined as “a single, or repeated act, or lack of
ent
appropriate action, occurring within any relationship where there is an of
expectation of trust which causes harm or distress to an older person”
(World Health Organization). old
If you are concerned about elder abuse you may want information about er
the issue, or the opportunity to talk to someone independently about your
concerns and the options for getting help. Each state and territory provides pe
information about abuse, abuse prevention and useful contacts.
Definition of abuse:
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Abuse of an older person "is any act occurring within a relationship where e
there is an implication of trust, which results in harm to an older person.
Abuse may be physical, sexual, financial, psychological, social and/ or
neglect.
Elder abuse is a mandatory reporting issue – this is explained thoroughly
later in this unit.
Forms of Elder Abuse
Forms of Abuse – Physical
Physical Abuse
A non-accidental act which results in physical pain or injury, it includes
physical coercion and physical restraint.
Abusive Physical Behaviour
Includes hitting, slapping, burning, pushing, punching, pinching, biting, arm
twisting, cutting, hair pulling, forced confinement to room, chair or bed.
Figure 2: Signs of physical abuse
These signs could indicate

abuse:
Injuries in different stages of healing Unexplained hair loss
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Abrasions Bruises em
Welts Burn blisters
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Rashes Contusions
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Swelling Tenderness
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Lacerations Pain or restricted movements
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Lack of awareness Drowsiness
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Cringing or acting fearful
Noticeable change in physical well
being
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Weight loss Broken or healing bones
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Agitation
e
Table 8: Reporting Elder Abuse contact details
State/territory Organisation or resource Contact
Older Persons Abuse

Australian Capital Prevention Referral and
02 6205 3535
Territory Information Line (APRIL)
NSW Elder Abuse

New South Wales 1800 628 221
Helpline
Northern Territory Northern Territory Police 131 444
Elder Abuse Prevention

Queensland 1300 651 192
Unit
Aged Rights Advocacy

Service Alliance for the 08 8232 5377 (Adelaide)
South Australia
Prevention of Elder 1800 700 600 (rural)
Abuse
Tasmanian Elder Abuse

Tasmania 1800 441 169
Helpline
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No: Modified May-
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Victoria Seniors Rights Victoria 1300 368 821 em
Advocare Inc. 1300 724 po
Western Australia 1800 655 566 (Rural)
697 (Perth)
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No: Modified May-
Date: 19

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Case Study em
Within Mountains Residential Care Unit care staff had observed Mrs..... F
cry out in pain that her arm hurt when helping her dress. The support care
po
staff noticed some new and unusual bruising on Mrs..... F arm and asked
how this had happened. When questioned Mrs..... F became extremely
we
agitated and said she didn't know how it happened. Following the homes rm
Policies and Procedures on Compulsory Reporting the care staff
immediately reported the conversation and incident to the Director of ent
Nursing (DON).
The Director of Nursing, without delay, met and spoke with Mrs..... F and
of
raised the issue of the bruising on her arm to try and determine what had old
happened. Mrs..... F said to the DON that she did not want to discuss why
or how she had bruising. er
The DON gently informed Mrs..... F that there had been changes to the
Aged Care Act (1997). This change now required the provider of the Aged
pe
Care service, or their nominated staff person to take action if they receive opl
an allegation of or start to suspect on reasonable grounds, that a resident
has experienced unreasonable use of force or an assault. e
This action, the DON continued, meant that a report of the assault had to
be reported to the police and the Department via the Aged Care
Complaints Scheme within 24 hours. On hearing this information Mrs..... F
said that she had had a visit from her grand-daughter the previous day.
Mrs..... F. started to cry and said her grand-daughter wanted her jewellery
and some money.
Mrs..... F stated she gave her grand-daughter some money but this was
not enough and her granddaughter forcefully tried to remove her watch
and rings and had hurt her. Mrs..... F said she wanted to help her grand-
daughter and still have the visits to continue but did not want to be hurt by
her.
The DON reported the situation to the police and the Department via the
Complaints Investigation Scheme within the 24 hours as required by the
Act. In order to keep Mrs..... F safe, and still fulfil her wishes to see her
grand-daughter, it was arranged by the DON that visits would now occur in
a room where supervision by care staff was possible.
Mrs..... F was advised by the police to make a police report of the incident
(without pressing charges). Although Mrs..... F did not wish to pursue this
option, she was assured that she could do so at a later stage.
Forms of Abuse - Sexual

 Non-consensual sexual contact, language or exploitative behaviour.
Date: May.
19

No: Modified May-
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 Abusive Sexual behaviours em
 Includes rape, indecent assault, sexual harassment, sexual
interference. po
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No: Modified May-
Date: 19

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Signs of sexual abuse em
These signs could indicate abuse:
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 Unexplained sexually transmitted disease or infections
 Bruising in genital areas or inner thighs we


Bleeding from the genital area
Difficulty in walking or sitting not associated with a medical condition
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 Fear ent
 Agitation
 Disturbed sleep of
 Withdrawal
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Case study: Ruby
er
Staff at the Nursing Home took little notice of Bob’s attentive behaviour pe
towards Ruby. Ruby, who had early Alzheimer’s disease had been
residing at the facility for over a year. Bob who had recently suffered a opl
stroke was a new resident. Each day staff would see Ruby and Bob sitting
or walking together.
e
On several occasions staff had seen Bob walking with Ruby into her room,
closing the door and not coming out for some time. No one questioned
anything was wrong with their friendship until it was reported by a staff
member, to her team leader, that she had showered Ruby that morning
and had noticed bruising on her breasts.
Later, on the same day of the staff persons report to her team leader, the
Director of Nursing (DON) was approached by Ruby’s son who said that
he had just come from his mother’s room where he had witnessed his
mother trying to push Bob away. He said his mother’s top was undone
and Bob had his mother pinned against the wall and his hand on her
breast.
The son said he was able to intervene and get Bob out of his mother’s
room. He also said he had not been happy with Bob’s attention towards
his mother and had thought that there might have been an alternative
motive, and what he witnessed today proved it. The DON went with the
son to Ruby’s room where she found her crying and very upset. Ruby told
the DON that Bob had demanded more than friendship and today he force
himself on to her and she had been trying to push him away when her son
came in. Ruby said she was now frightened of Bob.
The DON informed Ruby that what Bob had done, in accordance with the
Act was seen as unlawful sexual contact towards a resident and had to be
reported as part of the Compulsory Reporting requirements. The Director
of Nursing explained to Ruby and her son the Changes to the Aged Care
Date: May.
19

No: Modified May-
Date: 19

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Act and the approved provider’s responsibilities to provide a safe and em
secure facility for care recipients under the Act.
po
we
On hearing this Ruby said that she did not want to get Bob into trouble and rm
thought that he might not have known what he was doing. The DON
reassured Ruby that she has a duty of care to make sure that others are ent
not hurt by Bob and that the Dr will now have to be immediately involved to
assess Bob’s capacity and behaviour as she has to make sure that Bob of
does not do this again and all residents are safe.
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The Director of Nursing reported the situation to the police and the
Department of Health and Ageing within 24 hours as required by the Aged er
Care Act 1997.
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Forms of Abuse - Financial opl
Financial abuse e
The illegal, improper use and/or mismanagement of a person's money,
property or resources.
Abusive financial behaviour includes:
 Fraud
 Stealing
 Forgery
 Embezzlement
 Reluctance to pay for accounts or debts
 Unwillingness to bring items in for the older person
 Withholding funds from the older person
 Resident forced to hand over management of their finances
 Forced changes to a Will
 Enduring Power of Attorney's refusal to provide information about
financial affairs to the older person
 Pressure from others to hand over money or items
 An unprecedented transfer of money or property to another person
 Unwillingness of others to repay money loaned
Date: May.
19

No: Modified May-
Date: 19

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Signs of Financial abuse em
 These signs could indicate abuse:
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 Older person frequently changing their mind about their Enduring
Power of Attorney Lack of money for items needed we
 Loss of jewellery or personal belongings rm
 Older person expresses fear and anxiety when discussing finances ent
 Unexplained amounts of money missing from bank accounts
of
 Unpaid accounts
 Receiving accounts for items not belonging to the person
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 Loss of trust er
 Confusion over ownership of assets, property etc pe
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Case Study 1
e
Mrs.... S lived in a rural township, and was no longer able to live at home
due to Alzheimer's disease. Relatives agreed that she required nursing
home care. When Mrs.... S entered the nursing home, a daughter who had
not been heard of for thirty years, suddenly began visiting. Although Mrs....
S's dementia was advanced, her daughter engaged a solicitor to draw up
documents appointing her as her mother's Enduring Power of Attorney
(EPA).
The daughter visited her mother with a solicitor to get her mother to sign
the document. When the Director of Nursing was presented with the EPA
document by the daughter she became alarmed and decided to contact
Mrs.... S's nephew who was documented by the nursing home as Mrs....
S's EPA. By contacting the nephew the Director of Nursing enabled an
urgent application for financial management to be made to the
Guardianship Board by the nephew, thus managing to uphold Mrs.... S's
original decision to have her nephew manage her finances and property.
Case Study 2
Mr. R had been worried for some time
that his son, whom he had appointed as
his Power of Attorney may be taking
money from his account without his
consent. On several occasions Mr. R
approached his son to ask if he could
look at his bank statement. On each
occasion the son became cross, and said
Date: May.
19

No: Modified May-
Date: 19

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that he would post him a copy of his bank statement. It never came. em
Over the period of three months Mr. R became anxious and frightened
about his money situation, and care staff noticed a decline in Mr. R's
po
appearance, as well as an unwillingness to be involved in social activities,
or to have contact with other residents. This was out of character for Mr..
we
R. The care staff raised those concerns with the Director of Nursing at the rm
Hostel who in turn talked to Mr. R. Mr. R was able to make his own
decisions and decided that he would like some independent advice. The ent
Director of Care organised this for Mr. R so that he could make new
arrangements for the management of his finances. of
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Date: May.
19

No: Modified May-
Date: 19

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em
Forms of Abuse - Psychological/Emotional
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Psychological/Emotional Abuse
Psychological abuse is language or actions designed to intimidate another
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person and is usually characterised by a pattern of behaviour repeated rm
over time, intended to maintain a 'hold of fear' over the older person.
ent
Figure 2: Abusive psychological/emotional behaviour of
Psychological abuse may be verbal or non-verbal and can include: old
 Treating the older person like a child  Humiliation er
 Emotional blackmail  Blaming pe
 Intimidation  Name calling
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 Threats of restricting access to
e
 Insults
others
 Threats of punishment or
 Silence
abandonment
 Withdrawal of affection  Shouting
 Denying the older person their rights  Coercing
 Forced to collude in family

 Witnessing family arguments
conflict
Figure 3: Signs of psychological abuse

 Fearfulness  Helplessness
 Hopelessness  Withdrawal
 Reluctance to make decisions  Appearing shamed
 Loss of interest in self, activities or  Low self esteem
Date: May.
19

No: Modified May-
Date: 19

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environment em
 Change in appetite  Passivity po
 Depression  Confusion we
 Insomnia  Sleep deprivation
rm
ent
 Agitation  Anger
of
 Anxiety  Mental anguish
old
 Nervousness in the presence of a particular individual
er
pe
Case Study
opl
Mrs.... K was on respite care at Sandyside Hostel. She presented as a
cheerful person who was adjusting well to respite care in the hostel. One- e
day Mrs.... K's daughter, her carer, visited her while she was eating her
meal in the dining room and after speaking to Mrs.... K she abruptly
proceeded to tell all the other residents eating their lunch that their meal
looked foul and she would not expect her mother to eat it.
She then threw her mother's meal in the bin and escorted her mother to
her room. Care staff immediately reported the incident to the Director of
Care. The Director of Care went to Mrs.... K and her daughter to see if
everything was all right, to which Mrs.... K replied that, yes everything was
OK.
Once the daughter left the facility and Mrs.... K was alone, the Director of
Care went back to Mrs.... K and spoke to her about the incident. The
Director of Care informed Mrs.... K that she was concerned for her, and
that her daughter's outbursts had frightened other residents.
The Director of Care indicated that she would need to inform her daughter
of her concerns and clarify with her what was expected of visitors to the
hostel. Mrs.... K started crying and told the Director of Care that she was
ashamed and felt afraid of her daughter as her daughter often became
angry towards her and yelled at her for no reason at all.
The Director of Care explained to Mrs.... K that while she was in the Hostel
this was her home and it was important for her to feel safe. The Director of
Care also expressed concern to Mrs.... K about her safety when she
returned to her daughter's care and asked Mrs.... K whether she would like
Date: May.
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No: Modified May-
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to speak to someone confidentially to try and resolve her situation with her em
daughter.
Mrs.... K agreed for the Director of Care to organise for a social worker to
po
visit and plan for extra assistance and respite when Mrs.... K returned to
her own home. The Director of Care referred to the local Domiciliary Care
we
social worker. rm
ent
of
old
er
pe
opl
e
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No: Modified May-
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Forms of Abuse - Social Abuse em
Restricting or stopping social contact with others and stopping or restricting
activities.
po
Abusive social behaviour we
Includes being discouraged or stopped from seeing other people e.g. rm
family or friends Prevented from joining in any activities in or outside the
residential care facility. ent
Signs of social abuse of
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 Loss of interaction with others
 Sadness and grief of people not visiting er
 Worried or anxious after a particular visit by specific person(s)
 Appears shamed pe
 Low self esteem, or is very sad opl
 Withdrawn
 Passive (not wanting to participate; listless, uninvolved) e
Case study
Mrs.... W was admitted to a Nursing Home unable to speak due to a
stroke. Her husband relied on his wife's two sons to take him to visit his
wife. The sons refused to take their stepfather to visit his wife. The
husband phoned the home very upset and seeking assistance. Mrs.... W's
sons had advised the home that they did not want their stepfather to visit
because he was abusive towards their mother.
Faced with this dilemma, the Director of Nursing spoke to Mrs.... W, who
was able to indicate that she would like to have her husband visit her. The
Director of Nursing informed the sons that their mother had indicated that
she wanted to see her husband and reassured the sons that she would
monitor the situation.
Forms of Abuse - Neglect
Neglect is the failure of a care giver in a relationship of trust to provide
necessities or blocking the provision of basic needs being provided.
Neglect can be deliberate or unintended.
Abusive neglectful behaviour Includes:
 Not providing adequate clothing, and personal items
 Unwillingness to allow adequate medical or dental care or personal
care
 Over or under or inappropriate use of medication
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 Refusal to permit other people to provide adequate care e.g. food or em
drinks
po
we
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ent
of
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er
pe
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No: Modified May-
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Signs of neglectful behaviour em
po
 Poor hygiene or personal care
 Absence of health aids e.g. dentures, hearing aids, glasses and we
mobility equipment
 Unkempt appearance, inappropriate, or lack of, clothing
rm
 Weight loss ent
 Secretiveness or agitation
 Lack of personal items e.g. photos, ornaments of
Case study old
It came to care staff attention that Mr.. P, a resident at Hills Hostel, needed
to have new dentures fitted and a hearing aid provided. The care staff er
member approached Mrs.... P about her husband's dental and hearing
needs, for Mr. P had dementia, and his wife possessed an Enduring Power
pe
of Attorney for him. Mrs.... P indicated to the care staff that she would
attend to his needs. A month passed and care staff again noted that Mr.. P
opl
did not have new dentures or hearing aid. Again care staff approached e
Mrs.... P and asked how things were going with regards to Mr.. P's dental
and hearing needs. Mrs.... P once again indicated she was looking into it
but had more important things to consider at the moment.
The care staff member was concerned about how Mrs.... P was prioritising
her husband's medical needs and discussed the issue with the Director of
Care. The Director of Care had discussed Mr.. P's need for clothing,
personal items and pocket money with Mrs.... P a number of times. After
seeking independent advice about Mr. P's rights, the Director of Care
arranged a meeting with Mrs.... P to discuss Mr. P's needs.
At the meeting, she highlighted the benefits of new dentures and a hearing
aid for her husband, and stressed the health and social ramifications if he
did not get these items. The Director of Care also stated that unless Mr.
P's health needs were addressed she would have no choice but to refer to
the Guardianship Board. After the meeting with Mrs.... P it was clear to the
Director of Care that Mrs.... P had no intention of purchasing items for her
husband, as she hadn't on any of the previous occasions, which were all
documented in Mr. P's case notes. The Director of Care used these notes
to prepare an application to the Guardianship Board for an Administration
Order.
Barriers to Detecting Elder Abuse of Older People
In some situations, it can be difficult to recognise or verify abuse, as some
forms of abusive behaviour against an older person are often subtle or
intentionally hidden.
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No: Modified May-
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Making a person feel safe may assist them to raise their concerns about em
an abusive situation. There are many reasons why older people, or others,
may not be raising the issue of abuse. Being aware of why abuse is being po
kept a secret will assist the Director of Care to raise the issue with
sensitivity. Note if the older person is assessed as not having the ability to we
make decisions in relation to the abuse, staff will have a responsibility to
report and take action. rm
Abuse may not be reported because: ent
 Unwillingness to disclose that the abuse is occurring and/or has
occurred
of
 The older person is unable to disclose the abuse due to lack of mental
old
capacity er
 Health professionals, care staff or the public being unaware that abuse
of older people needs to be a consideration pe
 Signs and symptoms of abuse may be difficult to detect. Many of the opl
signs of abuse are wrongly attributed to changes associated with
ageing or physical or mental illness e
The older person may be reluctant to discuss the abuse:
 Due to denial, or not wanting to admit to themselves that there is a
problem
 Due to wanting to protect the alleged abuser e.g. from perceived
punishment, loss of standing in the community or embarrassment
 Due to feelings of shame or guilt at being judged as "bad" for allowing
the abuse to happen to them
 Due to a fear of retaliation or punishment from the alleged abuser, or a
fear of harming others i.e. family or experiencing further abuse, change
to the abuse, loss of contact
 Due to fear of not being believed or of being accused of lying
 Because they have doubts about confidentiality being maintained, or
believe that there is no one in whom they can confide
 Because they consider the abuse to be normal behaviour
 Because they believe they need to resolve matters by themselves and
not involve "others"
 Because they believe that nothing will change
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 Or they are unable to communicate or express what is happening to em
them due to confusion, language difficulties, depression, physical or
mental illness. po
 Because of different cultural perceptions we
 As they are unaware of the law, changes to the Aged Care Act (1997)
and Compulsory Reporting requirements of and approved provider
rm
 As they are unaware of their rights, or where help is available ent
 As they have sought assistance in the past and the response has been of
unsuccessful or caused further harm
 Why others may be reluctant to report abuse
old
Family members, staff, banking officers, GPs, friends, visitors to the home er
or other residents may suspect abuse of an older person, but may be
reluctant to raise their concerns:
pe
 Due to not wanting to interfere opl
 That the older person may lose trust and/or not confide in them any e
further
 As they are unaware of services, who they can to talk to, or what action
they can take in relation to the abuse
 For they believe that they lack the knowledge to intervene, particularly
about successful strategies
 As they believe that nothing will improve the situation
 As they believe that any action will be heavy handed, insensitive and
lead to further harm to the older person
 As they may be unaware that older people do take action to stop
abuse, if appropriately supported
As part of this learning journey you have been discussing in class elder
abuse.
Describe in your own words what ‘elder abuse is’:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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the
___________________________________________________________ em
___________________________________________________________
po
___________________________________________________________
___________________________________________________________
we
___________________________________________________________ rm
ent
Name the forms of ‘elder abuse’. of
___________________________________________________________
___________________________________________________________
old
___________________________________________________________ er
___________________________________________________________ pe
___________________________________________________________ opl
Once these questions have been answered, check with your facilitator or
assessor to see if you are on the right track. e
Date: May.
19

No: Modified May-
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Compulsory reporting and protection requirements em
As a support worker you may be the first person to suspect or become
aware or witness that your client/resident is a victim of abuse.
po
we
1. Introduction rm
Compulsory reporting and protection requirements commenced on 1 July
2007 following amendments to The Aged Care Act 1997 (the Act).
ent
These Guidelines explain the compulsory reporting requirements for of
approved providers to:
old
 report to the police and to the Department of Health and Ageing (the
Department), incidents involving alleged or suspected reportable er
assaults. The report must be made within 24 hours of the allegation, or
when the approved provider starts to suspect a reportable assault. A pe
reportable assault is defined in sub section 63–1AA(9) of the Act and in
section 3 of these Guidelines and includes unlawful sexual contact and opl

unreasonable use of force;
take reasonable measures to ensure staff members report any
e
suspicions or allegations of reportable assaults to the approved
provider (or other authorised person), to the Police or the Department;
and
 take reasonable measures to protect the identity of any staff member
who makes a report and protect them from victimisation.
The compulsory reporting requirements are one part of an approved
provider's responsibilities under the Act to provide a safe and secure
environment.
2. The 5 key elements to compulsory reporting requirements
2.1 All approved providers of Australian Government subsidised
residential aged care must encourage staff to report alleged or suspected
reportable assaults to enable approved providers to comply with their
responsibility under the Act. This requirement recognises that in many
cases, it may be staff who first notice assaults. The legislation therefore
requires that approved providers not only give staff information about how
to report assault, but also to actively require staff to make reports if they
see, or suspect, an assault on a resident.
2.2 The Act requires that, except in very specific and sensitive
circumstances, all approved providers of residential aged care must report
all allegations or suspicions of reportable assaults. The discretion not to
report applies to circumstances involving residents affected by an
assessed cognitive or mental impairment, and where there are repeated
allegations of the same assault. An approved provider should not wait until
Date: May.
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the
an allegation is substantiated – the fact that a person has alleged that em
someone has assaulted a resident is sufficient to trigger the reporting
requirements. po
2.3 Reports must be made to both the Police and the Department
within 24 hours of the allegation being made or the approved provider
we
starting to suspect on reasonable grounds, that a reportable assault may rm
have occurred. These tight timeframes ensure that alleged assaults are
acted upon immediately. ent
2.4 If a staff member makes a disclosure qualifying for protection under
the Act, the approved provider must protect the identity of the staff member
of
and ensure that the staff member is not victimised. This is important in old
encouraging ongoing reporting by staff members.
2.5 If an approved provider fails to meet compulsory reporting
er
requirements, the Department may take compliance action. pe
Compliance with the compulsory reporting requirements will be monitored
by the Department and the Aged Care Standards and Accreditation opl
Agency.
e
3. What is a reportable assault?
A reportable assault as defined in the Act (section 63–1AA) means:
 unlawful sexual contact with a resident of an aged care home; or
 unreasonable use of force on a resident of an aged care home.
This definition captures assaults ranging from deliberate and violent
physical attacks on residents to the use of physical force on a resident.
The definition of reportable assault used in the Act provides a simple,

readily understood and universally accepted definition. It avoids the
difficulties of applying legalistic definitions that vary widely throughout
Australia.
3.1 Unlawful sexual contact
The term "unlawful sexual contact" is intended to capture any sexual
contact, without consent, that is unlawful under any Commonwealth, State
or Territory law.
The legislation is intended to cover any unlawful, or unwanted, sexual
contact with residents for which there has been no consent. If the contact
involves residents with an assessed cognitive or mental impairment, it
should be noted that the resident may not have the ability to provide
informed consent.
Date: May.
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The term "unlawful sexual contact" has been used to avoid the use of em
specific terms, such as sexual intercourse, rape and sexual assault which
are all defined differently in different pieces of Commonwealth, State and po
Territory legislation and to ensure that all unlawful sexual conduct, no
matter how described, is captured. It is not intended to cover situations we
where there is no physical contact.
rm
3.2 Unreasonable use of force
ent
Unreasonable use of force as defined in the Act is intended to capture
assaults ranging from deliberate and violent physical attacks on residents of
to the use of unwarranted physical force on a resident. For example, the
definition captures hitting, punching or kicking a resident regardless of old
whether this in fact causes visible harm, such as bruising.
er
It is recognised that in the aged care environment, there may be
circumstances where a staff member could be genuinely trying to assist a pe
resident, and despite their best intentions the resident is injured because
the person bruises easily or has fragile skin. Injury alone therefore may not opl
provide conclusive evidence of either the use of unreasonable force or the
seriousness of an assault.
e
The definition in the Act:
 captures use of force where such force is not warranted; and
 avoids difficulties associated with utilising legalistic definitions.
A range of material and resources have been developed by the industry
that may assist providers to identify signs of abuse.
For example:
 the Benevolent Society has developed Policy and Procedures for
Residential Aged Care –Preventing and Responding to Abuse and
these are available for downloading on the Internet at:
http://www.bensoc.org.au/
 Aged and Community Care Victoria (AACV), in collaboration with
Victoria Police, has developed the ACCV Compulsory Reporting
Resource Guide. AACV members can download the guide at
http://www.accv.com.au/
4. Reporting to the Department of Health and Ageing
Compulsory reports are made to the Department via the Aged Care
Complaints Investigation Scheme on 1800 550 552. This line also receives
external information about Australian Government subsidised aged care
services and any concerns and complaints about such services.
Departmental Officers manage the line from 8:30am – 5.00pm AEST
Monday to Friday and 10.00am – 5.00pm AEST Saturday, Sunday and
Date: May.
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Public Holidays. Outside these hours, an answering machine is available em
for people to leave a message.
The Department may receive information about alleged or suspected
po
assaults on a resident through varied means; for example, from an
approved provider, from a staff member either anonymously, confidentially
we
or openly, from residents and their families and from other health rm
professionals.
5. Approved provider responsibilities regarding compulsory reporting of
ent
assault on a resident of
5.1.1 Reporting reportable assaults
old
Under 63–1AA of the Act an approved provider is responsible for reporting
an alleged or suspected reportable assault as soon as reasonably er
practicable and in any case within 24 hours, to:
(a) the local police service,
pe
And; opl
(b) The Department (1800 550 552).
The requirement for an approved provider to report as soon as they 'start
e
to suspect' on reasonable grounds that a reportable assault has occurred
is to ensure that both allegations and suspicion are reported.
An allegation usually requires a claim or accusation to have been made to
the approved provider and can be associated with physical evidence or the
witnessing of an assault.
Reporting suspicion allows reports to be made where there is no actual
allegation or where an actual assault may not have been witnessed and
where staff observe signs that an assault may have occurred.
5.2 Requiring staff members to report reportable assaults
Under the Act, the approved provider is responsible for taking reasonable
measures to require each of its staff members who provide a service
connected with the aged care home, and who suspect, on reasonable
grounds, that a reportable assault has occurred, to report the suspicion
within 24 hours.
Reports may be made to one or more of the following persons
chosen by the staff member and as directed by the approved
provider:
a. the approved provider;
b. one of the approved provider's key personnel;
c. another person authorised by the approved provider to received
reports of suspected reportable assaults;
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d. a Police Officer with responsibility relating to the area including the em
place where the assault is suspected to have occurred; and
e. the Department.
po
The Act allows staff members to report directly to the Police or the we
Department. This may occur, for example, if a staff member does not feel
comfortable reporting alleged incidents that may directly involve the rm
home's personnel or the approved provider.
ent
In relation to b) and c) above, approved providers must ensure that
authorised people are identified in relation to the services operated by the of
approved provider and that staff are aware of who these people are.
old
5.3 Special circumstances where there is a discretion not to report er
The legislation allows limited circumstances where there is a discretion not
to report.
pe
These relate to: opl
• alleged assaults that are perpetrated by residents with an assessed e
cognitive or mental impairment; and
• subsequent reports of the same or similar incident
These alternative arrangements focus on an approved provider's
responsibility to provide a safe environment for all residents. This includes
managing the behaviour of a resident who has an assessed cognitive or
mental impairment and may have committed an assault.
These discretionary circumstances do not prevent an approved provider

from reporting an assault to the Police or the Department, where this may
be the most appropriate response. Depending on the level of severity of an
assault on a resident and in cases where a resident is seriously harmed,
the Department strongly encourages providers to report.
Date: May.
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No: Modified May-
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5.3.1 Assaults perpetrated by a resident with cognitive or mental em
impairment
In applying the discretion not to report in these circumstances, the
po
approved provider is required to meet the following conditions that
are detailed in the Act:
we
a. within 24 hours of receiving an allegation or the start of the suspicion, rm
the approved provider forms an opinion that the assault was committed
by a resident; and
ent
b. prior to the receipt of the allegation, the resident has been assessed by of
an appropriate health professional as suffering from a cognitive or
mental impairment; and old
c. the approved provider puts in place, within 24 hours of receiving the er
allegation of an assault, or of suspecting an assault has occurred,
arrangements for management of the resident's behaviour; and pe
d. the approved provider has: opl
(i) a copy of the assessment (or other documents) regarding the
resident's cognitive or mental impairment; and
e
(ii) a record of the behaviour management strategies that have been
put in place under paragraph (c) above.
A behaviour management plan must be developed, documented and
regularly reviewed by a suitably qualified health professional and
include information regarding:
 the environmental factors which could contribute to or cause the
behaviour;
 the possible health or medical factors which could contribute to or
cause the behaviour;
 the possible communication needs of the person which may be
contributing to the behaviour; and
 what interventions are being trialled, or are in place, including
alternatives to restraint, for managing the behaviour.
5.3.2 Appropriate health professionals to assess cognitive and
mental impairment
An assessment of a resident's cognitive or mental impairment for the
purposes of applying the discretion under the Act could be
undertaken by one of more of the following:
 an Aged Care Assessment Team (ACAT);
 a resident's GP;
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 a registered nurse (RN); em
 another health professional with the appropriate clinical expertise, e.g. po
such as geriatrician, psycho–geriatrician, geriatric nurse, and clinical
psychologist. we
It is important to note also that an assessment may have been undertaken
in a community and/or hospital setting.
rm
5.3.3 Similar or previously reported incidents ent
The requirement to report reportable assaults under section 63–1AA
of the Act does not apply to later allegations which could include the
of
following: old
a. related to the same, or substantially the same, factual situation or
event as an earlier allegation;
er
b. has previously been reported to a Police Officer and the Department pe
under section 63–1AA of the Act;
opl
c. where different people report the same event; and/or
d. the same person makes allegations repeatedly where these allegations
e
have been followed up.
Approved providers have obligations to keep records in relation to the
above circumstances and in accordance with section 19.5A of the Records
Principles.
A template (register) that approved providers could adapt for internal use is
provided at Appendix A for recording all incidents of assault.
6. Responding to allegations of assault on a resident
6.1 Role of the Department in receiving and responding to a
suspected or alleged assault on a resident
When incidents of alleged assault are reported, investigation of the
incident is the responsibility of the Police. The Police will determine
whether the incident is criminal in nature and what further police action is
required. Only the Police should investigate criminal activity.
The role of the Department is to ensure that the approved provider
has met its responsibilities under the Act, to ensure that:
 the victim of the alleged or suspected assault has received appropriate
care and support;
 residents are safe;
 compulsory reporting requirements are complied with; and
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 the provider has appropriate internal systems and protocols in place for em
compulsory reporting.
When an alleged or suspected assault is reported, the Department
po
will undertake the following key steps: we
 Establish the details of the alleged or suspected assault, including
when it took place (and if it has been reported within 24 hours);
rm
 Establish if the alleged or suspected assault has been reported to the ent
Police. If it has not, the Department will make a referral to the relevant
state/territory police service; of
 Advise any staff member or approved provider who makes a report of
the protections in place, and whether and how the discloser qualifies old
for protection;
 Establish that residents are not at further risk from the alleged er

perpetrator;
Undertake an investigation to ensure that the approved provider has
pe
met its responsibilities under the Act. This includes ensuring
appropriate medical care and support for the victim and notifying legal
opl
representatives or family members if required. e
Appendix B shows the type of information the Department will require.
The Department may take compliance action where approved providers do
not meet the compulsory reporting requirements under the act. This
includes when an alleged incident is known but is not reported within 24
hours or where the provider is not otherwise meeting their responsibilities
under the Act.
6.2 Role of the Agency in monitoring compliance with the compulsory

reporting requirements
The Aged Care Standards and Accreditation Agency (the Agency)
monitors an approved provider's compliance with the compulsory reporting
requirements. The Agency does this through its usual audit and
accreditation processes.
These include:
 monitoring that processes are in place to encourage staff to report
allegations or suspicions of incidents of assault on a resident;
 monitoring that the approved provider is keeping records of all
incidents of assault;
 reviewing an approved provider's application of the discretion not to
report an incident of assault; and
 informing the Department where a breach is identified.
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6.3 Procedures for Approved Providers in responding to a suspected em
or alleged assault on a resident
Approved providers should have internal policies and processes in place
po
aimed at creating a culture of reporting and responding to alleged or
suspected assaults on residents and documenting critical incidents.
we
rm
A range of guides and checklists that approved providers could consider
adapting have been developed by the industry. ent
Such documents can be found at: of
 The Benevolent Society – http://www.bensoc.org.au; and
 Aged & Community Services Australia – http://www.agedcare.org.au
old
6.4 Raising Awareness of Compulsory Reporting Requirements er
Approved providers should ensure that their staff are trained and familiar
with issues such as recognising if an assault may have occurred and how
pe
to respond. opl
e
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This includes awareness of the following: em
 the requirement and procedures for reporting any alleged or suspected
incidents of assault on a resident as soon as practicable and who they
po
should report to; we
 the option to report to the Department where they may be concerned
about anonymity, or where the manager or approved providers may be rm
the subject of the allegation;
 the protections in place and the circumstances in which they would ent
qualify for protection; and
 that providing false or misleading information is a prosecutable offence;
of
7. Protection for reporting assaults old
The Act actively requires approved providers to report assaults. This is not
discretionary – approved providers must report any allegations or
er
suspicions of reportable assault. pe
In recognition that staff will be more likely to report incidents of assault
where they do not fear reprisal from their employer, or other staff, section
opl
96–8 of the Act establishes a range of protections for staff and approved
providers who report alleged or suspected assaults.
e
A staff member may also report anonymously or confidentially to the
Department's Aged Care Complaints Investigation Scheme. However, the
protections outlined in section 96–8 of the Act would not apply in this
circumstance.
Under the compulsory reporting requirements, the Act states that a
disclosure of information by a person qualifies for protection if:
a. The person is an approved provider of residential aged care or a staff
member of such an approved provider.
b. The disclosure is made to one or all of the following:
 a Police Officer;
 the Department;
 the approved provider;
 one of the approved provider's key personnel; and/or
 another person authorised by the approved provider to receive such
reports.
c. The discloser informs the person to whom the disclosure is made of
their name before making the disclosure.
d. The discloser has reasonable grounds to suspect that the information
indicates that a reportable assault has occurred.
Date: May.
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No: Modified May-
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e. The discloser makes the disclosure in good faith. em
po
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While approved providers should ensure that staff are made aware that rm
providing false or misleading information is a prosecutable offence, staff
should be encouraged to raise suspicions of assault internally to the ent
home's authorised persons for consideration and necessary action.
The provisions are based on the protected disclosure provisions contained
of
within the Corporations Act 2001 and the Workplace Reactions Act 1996. old
The approved provider or staff member who makes a protected
er
disclosure is protected in a number of different ways: pe
 The staff member (or approved provider) is protected from any civil or
criminal liability for making the disclosure. The discloser also has opl
qualified privilege in proceedings for defamation relating to the
disclosure, and is not liable to an action for defamation relating to the
e
disclosure.
 It is important to note that this provision does not exempt a person from
any civil or criminal liability for conduct of the person that is revealed by
the disclosure. For example, if a person themselves assaulted a
resident and told the Department that they did so, this would not
protect the person from prosecution for the assault. The person is only
protected from liability in relation to the making of the disclosure, as
opposed to the conduct that the disclosure reveals.
 A discloser is protected from someone enforcing a contractual or other
remedy against that person based on the disclosure. A contract to
which the discloser is a party cannot be terminated on the basis that
the disclosure constitutes a breach of the contract.
For example, if a staff member is a party to a contract of employment
that specifies that the staff member must not discuss issues that arise
in an aged care home with anyone outside the home, a disclosure by
the staff member that qualifies for protection under this section would
not give the employer the right to terminate the contract.
However, a disclosure to a person who is not specified in the list of
people to whom a qualified disclosure may be made might potentially
expose the staff member to termination of their employment or other
disciplinary action by the employer.
 A discloser is protected from victimisation. A person must not cause
detriment to a person who makes a disclosure or threaten the person
because they made a disclosure that qualifies for protection. If the
other person is a staff member of an approved provider, the provider
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has a responsibility to ensure, as far as reasonably practicable, em
compliance with this requirement. Compliance action may be taken if
the provider does not comply with this responsibility. po
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No: Modified May-
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 If a court is satisfied that an employee has made a protected disclosure em
and the employer (be it the approved provider or a recruitment agency
who employs the person on behalf of the approved provider) has po
terminated the discloser's contract of employment on the basis of the
disclosure, the court may order that the employee be reinstated or we
order the employer to pay the employee compensation in lieu of
reinstatement. rm
Residents of aged care homes, their families and advocates, visiting ent
medical practitioners, other allied health professionals, volunteers and
visitors are not required under the Act to compulsorily report assault and of
therefore are not afforded statutory protection under the legislation.
old
However, these people are strongly encouraged to report incidents of
abuse or neglect of an aged care resident to the Department's Aged Care er
Complaints Investigation Scheme. The person providing information may
do so openly, anonymously, or may ask the Scheme to keep their identity pe
confidential.
opl
Further, these people also have access to existing protections from
defamation action through common law. As such persons are often well e
placed to identify if an assault of a resident is reasonably likely to have
occurred, an approved provider should consider establishing visitor
policies and protocols encouraging reporting where it is in the best
interests of the residents.
8. Record keeping and privacy
Approved providers must keep consolidated records of all incidents
involving allegations or suspicions of reportable assaults. As these records
will be subject to monitoring by the Department and the Agency, these
records must be distinguishable from other incident records, be retained in
one central place and be accessible to the Department and Agency when
required.
The record for each incident must include:
a. the date when the approved provider received the allegation, or started
to suspect on reasonable grounds, that a reportable assault had
occurred;
b. a brief description of the allegation or the circumstances that gave rise
to the suspicion; and
c. information about whether a report of the allegation or suspicion has
been made to a Police Officer and the Department; or whether the
allegation or suspicion has not been reported to a Police Officer or the
Department because the discretion under subsection 63–1AA (3) of the
Act applies.
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No: Modified May-
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Approved providers also have a responsibility to ensure that they em
have in place systems and procedures that will allow them to meet all
of their responsibilities under the Act, including: po
a. complying with requirements in relation to protection of personal
information (in section 62.1 of the Act), and
we
b. ensuring compliance with all relevant legislation and regulatory rm
requirements in relation to privacy issues, including State/ Territory or
Commonwealth legislation, i.e. the Privacy Act 1988.
ent
Appendix A of
Template for keeping consolidated records of all incidents old
In accordance with section 19.5AA of the Records Principles,
consolidated records kept by approved providers should include the
er
following details: pe
 Record/File number – indicate where the original incident report is filed.
 Date received allegation – date the approved provider received an opl

allegation or started to suspect a reasonable assault.
Description – provide a brief description of the allegation or of the
e
circumstances that gave rise to the suspicion.
 Information on reports made – this should include date reported, to
whom it was reported i.e. Police and the Department, and any
record/report number given by Police or Department.
 Information on why reports were not made – this should include a brief
description on the reasons as to why a report was not made.
 Action date and brief description – record the date in which the incident
or suspicion was resolved as well as a brief description of the outcome
and or actions involved.
Appendix B
Template for providing information to the Department for Compulsory
Reporting of assault
The Department will require the following information when receiving a
report of an alleged or suspected assault on a resident of an Australian
Government subsidised aged care home:
 What relationship does the discloser have with the provider? E.g. key
personnel, authorised person, staff member, ex–staff member or other
persons.
 Name of the alleged offender – if known.
 Alleged offender relationship to resident e.g. staff, relative, other
resident or unknown.
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 What has the approved provider done to protect other residents from em
the alleged offender?
 Were there any witnesses? po
 When did the incident occur?
 Where did the incident occur?
we
 Who has been advised? E.g. police, family, medical adviser. rm
 When did the approved provider become aware of the incident?
 Who else is aware of the ent
incident?
 Where is the care recipient? of
location of the resident, i.e. still in
care, hospitalised. old
 Has the approved provider made er
counselling or support available to
relevant parties? – if so, provide pe
details.
 Protection? – a Departmental opl
Officer will determine if the discloser meets the requirements for
protection. If the discloser indicates that they are concerned that e
reporting this issue will affect their employment, the Officer will explain
the protections to them.

Learning about mandatory reporting is very important. It is crucial you
know and understand what is expected of you.
What is the first step you take if you believe one of your clients is
potentially a victim of elder abuse?
___________________________________________________________
___________________________________________________________
What is the time frame of reporting to the relevant departments?

___________________________________________________________
___________________________________________________________
What are the relevant departments that a mandatory report is reported to?
___________________________________________________________
___________________________________________________________
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3.5 Assist the person to access other support services and the em
complaints mechanisms as required
It may be identified that your client/resident requires specialised services
po
that does not fall in the scope of service provider you work for is unable to we
assist in areas such as drug and alcohol support.
The Australian Government, Department of Social Services (DSS) aims to
rm
encourage older people to live active and independent lives. The
Department works to deliver quality, affordable and accessible aged care
ent
and carer support services for older people, through subsidies and grants, of
industry assistance and training and regulation of the aged care sector.
(https://www.dss.gov.au/ageing-and-aged-care) old
My Aged Care (https://www.myagedcare.gov.au or phone 1800 200 422) is
a government initiated service available to assist the elderly to find the
er
information they need about aged care services. Information regarding pe
services that they are eligible for and how to go about the process required
to access these services. opl
The Australian Government recognises the challenges for people from
diverse background and provides services for all members of the
e
community and, depending on the individual’s circumstances and specific
needs, they may be able to assist in tailoring support for people who are
financially disadvantaged or people living with a disability.
There are programs and information available for Aboriginal and/or Torres
Strait Islander people; people from culturally or linguistically diverse
backgrounds; people who are lesbian, gay, bisexual, transgender and
intersex; or Care-Leavers to help make living and caring easier.
Reminder: Always report to your supervisor and document any requests
or changes of service requirements.
Complaints mechanism
If your client/resident or family confide in you that they are wishing to make
a complaint about the service being provided and ask for information on
the process, always notify your supervisor as often the problem or issue
can be addressed and sorted out before formal complaint is lodged.
There are two ways to make a complaint:
 By speaking to the service provider
 Or make a formal complaint to Aged Care Complaints Commissioner
(Complaints Commissioner)
If the complaint is made to the service provider either in writing, verbally or
anonymously, the service provider must deal with it.
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If the complaint cannot be resolved with the service provider or the client or em
family are not comfortable raising their concerns directly to the supervisor
or manager, they have the right to contact the Aged Care Complaints po
Commissioner.
we
rm
Contact details for the Aged Care Complaints Commissioner can be ent
made:
Online – agedcarecomplaints.gov.au
of
Telephone – call 1800 550 552 old
In writing – address your written complaint to: er
Aged Care Complaints Commissioner
GPO Box 9848
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(Your capital city and state/territory) opl
If your client or family make a complaint over the phone, they will be
guided through the process and told what kind of information they need to
e
give.
If the complaint is being made by writing a letter it is important to
include:
 Name and address of the complainant
 Date the complaint is being lodged
 Details of the complaint, including specific dates and the events
 The name of the service provider and the state or territory located
 The name of the person receiving care.
Contact will be made to the complainant to discuss the complaint. First
contact is generally by telephone.

As part of your learning journey, it has been discussed how you can assist
your client/resident to access other support services and the complaints
mechanisms as required.
In your own words how would you do this?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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___________________________________________________________
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___________________________________________________________
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No: Modified May-
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What are the two ways to make a complaint? How would you advise your em
client/resident to make an initial complaint?
___________________________________________________________
po
___________________________________________________________ we
___________________________________________________________ rm
___________________________________________________________
ent
___________________________________________________________
___________________________________________________________
of
___________________________________________________________ old
er
Who would you report to if your client/resident has informed you they are
considering making a complaint about the service?
pe
___________________________________________________________ opl
___________________________________________________________ e
___________________________________________________________
___________________________________________________________
Once you completed this activity, check with your facilitator or assessor to
see if you are on the right track.
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4. Promote health and re- po
ablement of older people we
Encourage the older person to engage as actively rm
4.1 as possible in all living activities and provide them
with information and support to do so ent
Assist the older person to recognise the impact that of
4.2 changes associated with ageing may have on their
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activities of living
Identify strategies and opportunities that maximise

er
4.3 engagement and promote healthy lifestyle pe
practices
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Identify and utilise aids and modifications that
4.4
promote individual strengths and capacities to assist e
with independent living in the older person’s
environment
Discuss situations of risk or potential risk

4.5 associated with ageing
4.1 Encourage the older person to engage as actively as possible in all

living activities and provide them with information and support to do
so
It is recommended that the older person should do some form of physical
activity, not matter what age, weight, abilities or health problems that they
have.
Outcomes for health and well-being have occurred with regular physical
activity.
Definition of Physical activity: Any bodily movement produced by skeletal
muscles that requires energy expenditure and produces progressive health
benefits’ (National Institute of Health Consensus Conference Statement,
1996). Physical activity includes everyday activities like walking to the shop
or gardening through to a wide range of organised activities, such as
exercise classes.
These outcomes may include:
 maintain or improve physical function and independent living;
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 improve social interactions, quality of life, and reduce depression; em
 build and maintain healthy bones, muscles and joints, reducing the risk
of injuries from falls; and po
 reduce the risk of heart disease, stroke, high blood pressure, type II
diabetes, and some cancers we
rm
When encouraging your client/residents to participate in physical
activities, ask them to take into consideration that:
ent
 physical activities as opportunities for fun with a partner, friends or of

family members
eating healthy nutritious food in conjunction with being physically active
old
will help to obtain the best health outcomes. er
 Drinking water during and after physical activity will avoid dehydration
 having a short period of warm up exercises/muscle stretching at the pe
start and at the end of physical activity will help the body adjust to
starting or finishing activities that place a physical demand on the body opl
 have some outdoors physical activity, although where possible keep
this to a minimum in the hottest part of the day.
e
 Should use appropriate safety and protection equipment to maximise
safety and minimise risk of injury during physical activity, for example,
use supportive footwear for walking, and a helmet for bicycle riding.
Recommendations on physical activities for health for the older Australian
are outlined on the Department of Health website
(http://www.health.gov.au/internet/main/publishing.nsf/content/phd-
physical-rec-older-guidelines)
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Exercise And Recreational Needs

Residents in long-term care facilities need the stimulation of planned
recreation and exercise. The type of activity must be carefully tailored to
the needs and abilities of the residents. Health workers in these facilities
are often responsible for coordinating this aspect of care.
Recreation
It is important for those who do the activity planning to keep in mind:
 The age and possible physical limitations of the participants.
 The fact that older people have less coordination and are more apt to
have hearing and vision deficiencies.
 The fact that recreation with a purpose is considered the most
stimulating and enjoyable by mature people.
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 That activities planned by the participants are generally the most em
successful. Shows and skits call for many different talents. Exhibits,
sales, and making gifts for others are some other examples of po
activities that combine recreation with purpose. These types of
activities are usually enjoyed by everyone. Most facilities have a we
special room where out-of-bed residents can gather.
rm
With care, activities that meet special rehabilitation objectives can be
planned. For that reason, the occupational therapist is a valuable person ent
who can serve in a consultant capacity, both in care facilities and
recreational centers. Recreational planning can thus combine physical and of
rehabilitative activities with enjoyment.
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 Exercising, singing, and clapping hands to music can be enjoyed by
bed residents, wheelchair residents, and those who are confused er
 For residents who are ambulatory, dancing can be stimulating as well pe
as enjoyable.
 Handicrafts, games, television, and conversation all offer a measure of
opl
entertainment to the less active. e
As part of your learning journey you are learnt how to apply your
understanding of the physical and psychosocial aspects of ageing.
When encouraging your client/residents to participate in physical activates,
what is it that is important for them to take into consideration? Give 2
examples:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Once you have answered this question, check with your facilitator or
accessor to see that you are on the right track.
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4.2 Assist the older person to recognise the impact that changes em
associated with ageing may have on their activities of living
As people grow old, the likelihood of experiencing age-related losses, for
po
example loss of personal identity, physical mobility and social autonomy, we
increase. Such losses may affect a person’s ability to acquire or maintain
the relationships they want, and to maintain their independence and self- rm
determination in caring for themselves, resulting in a higher incidence of
depression. ent
Depression is generally recognised as one of the principal mental of
disorders afflicting older people. The manifestation of depression in the
elderly, however, calls for our close attention. This is mainly because there old
are certain uncertainties about how common it is, and health as well as
welfare professionals and government departments do not fully recognise er
the prevalence of depression.
pe
The reality is that older people are faced with a number of medical, social,
economic and attitudinal problems. These are frequently accompanied by opl
events such as bereavement and loss of independence, accompanied by
emotions such as grief, loneliness, hopelessness, helplessness and e
powerlessness. Furthermore, the suppressive effects of society, the culture
of professional practice, and government policies and directives are added
causes of such depression.
The question needs to be asked: ‘Is the depression experienced by elderly
people the result of unavoidable life circumstances?’ or is it thrust upon the
person by society, by professionals involved in their care, and by
government policies and local procedures which affect individuals
adversely and may restrict their independence and freedom of mobility?
Investigating the occurrence of depression is important in the care of older
people because feelings of identity and integrity are important for an
elderly person to be able to maintain a healthy lifestyle. There is a
connection between the traditional diagnosis of clinical depression and the
notion of oppression, giving a definition of social depression.
The culture of practise in aged care needs to be reflected upon and
strategies implemented in order to avoid creating social depression. We
need to empathise with this and develop sensitivity to what is occurring.
A rigorous approach needs to be taken towards empathy. Empathy is a
fundamental component of any interaction between professionals and an
elderly person, and will be conducive to a contemporary culture of care.
Date: May.
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Caring is about empathy. em
It is not about skill in procedures, which is easier for professionals to
acquire. What is more complex than acquiring skills is the development of
po
the caring attitude and the personal philosophies that promote effective
professional practice?
we
You need to reflect on opportunities in your professional practice. It also rm
gives you an opportunity to decide how much the culture underlying what
you do needs to be changed.
ent
It has been demonstrated that Australia and New Zealand’s populations of
are growing older. This trend is also evident in the Client population in the
health care and welfare sectors. Hospital clients are seen as older and old
suffer from more acute illnesses. Elderly people in the community at large
and using social and community support are also perceived by health care
er
and welfare professionals to be older and suffering from severe chronic
illnesses and severe disabilities.
pe
opl
Growing old presents a variety of threats to independence e
Growing old presents a variety of threats to independence. Many older
people are faced with multiple medical and surgical interventions and with
changes in lifestyle. Two common examples of possible stressors that may
handicap older people or limit their options in life are illness and retirement.
The degree of physical and mental illness experienced by elderly people
will determine the level of dependence necessary on carers, family
members and professionals. The older person’s autonomy is thus
threatened, and their ability to maintain control over their general activities
and decisions is challenged and seen to be threatened.
A few elderly people in such situations respond with optimism and vigour,
but most begin to see the future as bleak. Those who have enough energy,
vigour and determination are able to deal effectively with the stressors,
thus achieving a greater degree of emotional and physical well-being.4
have suggested several hypotheses to explain the increased use of
passive strategies of coping by these older people.
They state that the current generation of older people does not cope with
problems in ways which are based on orientation to action. They also
assert that there is a developmental hypothesis which suggests that as
4
Folkman, S., Lazarus, R.S., Pimley, S. & Novacek, J. 1987 ‘Age differences in stress and coping processes’.
Psychology and Aging, vol 2, pp. 171-84.
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people age, events within or outside them result in a more passive em
approach to solving problems.
In addition, the researchers claim that the experience of losses and
po
negative stereotyping lead older people to believe that there are fewer
positive outcomes available to them, so they should not invest too much
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energy attempting to resolve their problems. rm
ent
of
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No: Modified May-
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It can be readily stated that loneliness, helplessness, hopelessness and em
powerlessness are common feelings expressed by the elderly and that
these feelings do have a profound effect on both their physical and po
psychosocial well-being. These are all negative emotions, often associated
with low self-esteem. For example, loneliness can threaten feelings of we
personal worth, undermine confidence in interpersonal relationships and
disrupt decision-making abilities and thought processes. 5 rm
Powerlessness is generally described as a feeling of lack of control over a ent
current situation or immediate happening, in which one’s actions are not
seen as significantly affecting the income. of
Hopelessness may be described as a state in which the individual elderly old
person sees very limited or no alternatives or personal choices. It is
observed that when people feel hopeless they are passive and cannot er
mobilise resources on their own behalf Loneliness can be defined as the
painful awareness that one’s social relationships are deficient, causing one pe
to feel excluded, unloved, constricted and alienated.
opl
Loneliness is commonly defined as ‘the unpleasant experience that occurs
when a person’s network of social relationships is deficient either e
qualitatively. Loneliness related to separation from family, friends and
spouses was evident in these narratives.
Social loneliness generally results from the older person’s lack of affiliation
and identification with an acceptable family member, friend or spouse.
Their feelings of boredom and aimlessness lead to an anxious search for
company and activities. Emotional loneliness is clearly evident in all those
who have lost their partners or for those who talk and think about the loss
of their partner. Coupled with declining health, separation from this person
and was seen to increase the likelihood of hopelessness, helplessness
and powerlessness.
Hopelessness was found to be closely linked to loneliness. Older people
generally perceived that being without hope for the future believed that life
could not possibly improve. Losses are viewed as being irrevocable, and
their problems as unsolvable. Hopelessness and loneliness can occur
separately, alternately, or consecutively. The occurrence of hopelessness
may precipitate or increase the likelihood of loneliness.
These feelings of grief, loneliness, helplessness and hopelessness can be
related to culture. The organisation of society and the culture within
professional practices, and the values of both, influence the well-being of
5
Copel, L.C. 1988, ‘Loneliness’, Journal of Psychosocial Nursing, vol 26, no. 1, pp. 14-19.
Date: May.
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older people. The relevance of culture to the wellbeing of the older person em
must be included.
Australia’s multicultural society has citizens from all parts of the world,
po
including its own indigenous Aboriginal culture. Despite Australia’s diverse
population, the country has largely developed a post-modern western way
we
of life which includes its attitudes to human rights issues. As an advanced rm
western society Australia enjoys all of the acquired benefits of longevity
and health. ent
Some might even argue that Australia exceeds other western cultures by
offering a lifestyle to its habitants which enhances their quality of life. If one
of
is to believe these statements and the connection they have to longevity old
and the issues of health, then Australia is certainly a country where older
adults have the opportunity to live full and complete lives well into their er
seventies, eighties and nineties.
This perception of healthy ageing depends on our personal views of how
pe
we live out the later years of our life. Some people believe that because of opl
healthier lifestyles more people live longer and have fewer years spent in
disability and major illness. e
Others, however, argue that with the advance of medical technology
people may live longer but may experience longer periods of chronic
illness and disabling conditions.
The third option is that both groups will exist simultaneously, meaning
there will be a group of healthy people living into their advanced years
whilst another group will experience prolonged illness and disability.
What might be considered an example of successful ageing is offered by
Ford and Oliver (1995)6. They described the journey of Bill Ford, an older
adult who experienced a stroke which left him with a serious physical
disability. Their paper challenges the negative imaging of ageing and
disability, and instead focuses on personal growth, challenges and
courage.
According to Ford and Oliver, neither age nor disability could diminish Bill
Ford. He transcended the negative aspect of his physical disability by
writing to his family and sharing his experiences, feelings, struggles, and
joys through letters and poetry which have since been complied into a
book titled Stroke of Genius.
The importance of socialisation and visiting with family and friends cannot
be over-emphasised. For some older adult groups, the strongest predictors
6
Ford. D. & Oliver. J. 1995, ‘Stroke of Genius’, Proceedings of the National Rural Conference on Ageing – Re-
writing the Future, ed. C. Saw, Charles Sturt University, Albury, New South Wales.
Date: May.
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of life satisfaction are their interaction and socialising with others. Many em
people participate in leisure activities for the sole purpose of the social
benefits. po
For older adults living in rural areas of Australia social interactions with the
local community may very well be the major source of their leisure activity.
we
As service providers, we need to maintain an open mind, recognising the rm
unique characteristics of each individual’s life. We have never walked in
their shoes, and therefore we do not know all about who they are, how
ent
they feel, who is closest to them. There are instances where it may not be
a family member, but a close member who is always there for them. This
of
person fulfills the role of advocate and should not be overlooked. old
Family members have a history, which we cannot possibly begin to know
about. After traumatic childhoods siblings may never have expected to
er
spend time with their brother or sister with a disability. Problems occur as
the parents age and want to plan for their son or daughter – but who will
pe
care for them? opl
e
Now that you have considered who your clients are, the different
contexts in which you might be providing care, the standards for that
care and your duty of care, you can look at how you demonstrate an
understanding of the physical and psychosocial aspects of ageing.
Your task is to:
 Outline strategies that the older person may adopt to promote healthy
lifestyle practices
 Take into account physical changes associated with ageing when
delivering services and when developing these strategies
 Recognise and accommodate the older person’s interests and life
activities when delivering services in these strategies
 Using these strategies, develop an outline to assist the older person to
recognise the impact physical changes associated with ageing may
have on their activities of living.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Date: May.
19

No: Modified May-
Date: 19

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Date: May.
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No: Modified May-
Date: 19

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Once you have completed the above task, ask your facilitator or assessor
to check to see if you are on the right track.
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Date: May.
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4.3 Identify strategies and opportunities that maximise engagement and em
promote healthy lifestyle practices
As in the acute care facility (public or private hospital), the support worker
po
(or assistant nurse, personal carer) in aged care carries out the procedures we
as taught, assisting in the activities of daily living and health care needs of
residents under the direct supervision of a nurse. Basic physical care, as rm
well as special procedures, will be done to help these residents reach their
maximum degree of well-being. ent
To be successful in this setting, you must: of
 be kind and caring. old
 understand the character of the older age group.
er
 be able to care for persons who may be your own age and have
chronic illnesses. pe
 be comfortable with the thought of your own ageing. opl
 have the stamina to provide the assistance needed by the residents.
e
 be able to derive satisfaction front being part of a slow progress and
small, if any, gains.
 have a sense of humor.
 be able to communicate effectively with all aged groups and people
from diverse cultures
These attributes are important in any health setting, but in the long-term
residential care they become imperative.
Many of the residents will remain under your care for long periods of time,
even for years. You will develop relationships that become important to
both caregiver and care receiver. In those circumstances, communications
take on greater importance. Greater significance may be attached to the
attention to care or even the way thoughts are expressed in words. Thus,
the long-term caregiver is a very special person, who works in an important
area of health care.
Effects Of Ageing
Many residents in residential facilities are advanced in age and have one
or more chronic, somewhat debilitating (weakening) conditions. Some are
are mentally alert. Others are contused and disoriented. Many have
dementia and Alzheimer’s.
There are, however, some features of Ageing that are characteristic for
most elderly residents. Do not expect every resident to exhibit the same
characteristics at the same chronologic (year) age. Remember that Ageing
Date: May.
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Date: 19

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is a natural, progressive process that begins at birth and extends to death. em
Remember also that every resident is unique and must he treated with
dignity and respect. po
To promote a healthy lifestyle for residents in the community, or in a
residential facility is easier if you have an understanding of their lifetime
we
experiences. In their lifetime they have made choices and had experiences rm
that have defined their likes and dislikes. If your client has dementia do not
take it for granted they should not be entitled to making choices about their ent
activities.
To improve a person’s lifestyle, it is necessary to know how and when to
of
involve them in different experiences. old
Common problems of how to engage your client/resident in healthy
practices are:
er
 Lack of knowledge of a person: their likes, dislikes and wants pe
 Lack of a home-like setting to support independence, mobility and
joining in
opl
 Restricted options for interesting daily life events e
 Daily experiences that do not mesh with a person’s life experiences
To improve engagement, it is important to include:
 physical and social life experiences
 experiences to build on people’s existing strengths and past histories
 experiences reflecting different areas of life
 everyday life experiences around daily routines
 planned activities needing special spaces, equipment or events
Diversional Therapy
The Aged Care Standards and the Accreditation Agency have recognised
the importance of resident lifestyle by including ‘leisure and lifestyle in the
accreditation process. This ensures residential facilities provide for the
resident’s, access to a range of activities that promote healthy lifestyle
practices.
In all aged care residential settings, there is a diversional therapist (DT) or
activities coordinator, the role of a diversional therapist is to work with
people of all ages and abilities to design and facilitate leisure and
recreation programmes. Activities are designed to support, challenge and
enhance the psychological, spiritual, social, emotional and physical
wellbeing of individuals.
Diversional Therapy Australia describe diversional therapy as having a
goal to facilitate the process of empowerment and to enable participants to
make choices and decisions which maximises participation in leisure
Date: May.
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Date: 19

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experiences that suit individual needs and wants. This is achieved through em
the facilitation, co‐ordination and planning of leisure and recreational
programmes that are designed to support, challenge and enhance the po
psychological, social, emotional, spiritual, cognitive and physical
well‐being. we
Utilising an understanding of human behaviour and functioning, we rm
develop programs to overcome physical or cognitive barriers to leisure
activities. The therapy may involve individual and/or group sessions. ent
Fundamental to our profession are motivational strategies to rouse interest
and engagement. of
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Date: May.
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Date: 19

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Suitable application of leisure programs with constant sensitivity to client em
variation in mood and orientation is yet another vital component for clients
with dementia. The golden rule of Diversional Therapy is that you cannot po
judge a book by its cover. The most helpless looking person may well be
the most intelligent person in the facility - including the staff. we
They, and many others, need a recreation program that includes rm
intellectual options. Equally, clients with dementia require and have the
right to best practice care with options for leisure choices tailored achieve ent
pleasure and satisfaction. This vocation is practiced in a variety of care
spheres including rehabilitation, disabilities, and Aged Care in both the of
community and residential care.
old
As a support worker you will see there is no time is available for even
casual leisure pursuits after the allotted tasks are performed. Essentially all er
social interactions and recreation activities are carried out by family and
friends, or the Diversional Therapy team, (also known as the DT, pe
recreation or lifestyle team).
opl
If family, feel that their loved one is not receiving the stimulation or
activities specific to their needs they need to be encouraged to speak to e
the facility manager or the diversional therapist to see if activities of their
choice are offered.
Study shows improving cardiovascular and mental health not only keeps
us physically healthy but helps prevent dementia, and reveals why mental
exercise helps fortify our intellect against the effect of small cerebral
accidents.
Learning Activities 17:

As part of your learning journey, you have identified strategies and
opportunities that maximise engagement and promote a healthy lifestyle
for the older person.
Describe in your own words what is required of you, as a support carer, in
order to enhance your client’s lifestyle.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Date: May.
19

No: Modified May-
Date: 19

Sequence: 154
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___________________________________________________________
e
___________________________________________________________
___________________________________________________________
Once you have completed the above learning assessment, check with your
trainer/ facilitator to obtain feedback.
Case Study: Henrietta
Henrietta, is a 76 year old woman, lives on her own and receives
assistance with her ADL’s 3 times a week from a community service
provider. Henrietta also has 6 hours a week to help her do her washing,
vacuuming and buy groceries. Henrietta has rheumatoid arthritis, her
hands and knees are very disfigured, uses a wheelie walker for mobility
and she suffers a lot with chronic pain.
Henrietta is an independent lady, she always has a cup of tea waiting for
the support workers who assist her, and would prefer the workers to sit
and chat with her rather than do the duties that are outlined in Henrietta’s
individual care plan, insisting she is able to shower, and do her house
duties with no aid. Henrietta likes to go shopping and get ‘get out in the
world’ but does not go anywhere else due to not being able to drive and
not having any close friends or family close by.

What is it, that as an individual support worker can you do to assist
Henrietta socialise with other people?
Date: May.
19

No: Modified May-
Date: 19

Sequence: 155
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4.4 Identify and utilise aids and modifications that promote individual pe
strengths and capacities to assist with independent living in the older
person’s environment opl
As discussed in CHCCCS023 – Support independence and well-being. e
Most adults do not achieve the levels of physical capabilities currently
recommended for a healthy lifestyle. Population surveys suggest that there
is a linear decline of activity levels with age, yet physical activity has
many health benefits for older adults. If these are to be more widely
adopted among older people, health policy and promotion require an
understanding of the factors that influence decreasing activity with age.
A study examined the patterns of physical activity of 699 participants in the
West of Scotland Twenty-07 Study who were aged 60 years when
interviewed in 1991 and followed up four to five years later. It examined the
factors that influenced whether or not the subjects achieved currently
recommended levels of activity, by applying random effects models with a
seasonal adjustment.
It was found that higher levels of physical activity associated with a
healthier lifestyle, and that socio-economic factors played a minor role in
determining the level of physical activity. A substantial amount of physical
activity occurred at work but was lost by those who had retired, for while
those who were not working were more physically active at home or at
leisure than those in work, the majority of the sample did too little physical
activity outside work to compensate for the loss of work-based activity.
One conclusion is that health promotion initiatives that encourage people
to become more physically active should be targeted at those who are
about to retire.
Date: May.
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Date: 19

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Table 9: Mobility Aids
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Individual Aid Category we

Communication

Speech aids and boards etc.
Communication software
rm
Aids and
Appliances: to  Talking equipment ent
assist  Equipment for producing, reading, or storing
clients/residents to alternate format information
of
express themselves,
make choices and  Electronic or microcomputer based old
communication aids
interact with others.
 Software designed to function as Augmentative
er
Communication Aid on a computer pe
 Assistive listening devices,
 amplifiers and electronic aids to assist speech
opl
intelligibility e
 Hearing aids if not eligible through Australian
Hearing Service.
Individual Aid Category
Personal Care  Pressure care cushion

Pressure  Sheep skins: for skin protection and comfort
Reduction: to
reduce pressure
injuries and ensure
physical comfort.
Personal Care  Pressure relief mattresses,
Beds and Sleeping  eggshell and under-lays
Equipment: to  Electrically operated hi/low, adjustable beds, 24
assist client’s sleep hour positioning sleeping systems
and ensure physical  Bed cradle or bed rails
comfort and safety.  Posturepaedic mattresses
Personal Care  Prescribed seating system
Seating and  Specialised car seats
Positioning Aids:  Geriatric, reclining, raised or ejector chairs,
Date: May.
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No: Modified May-
Date: 19

Sequence: 157
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to assist saddle chairs em
clients/residents  Alternative positioning systems, side layers,
comfort and posture supine positioners, tilt tables or standing frames. po
support whilst
awake. we
Personal Care rm
Nutrition, Feeding &  Supplementary feeding equipment including
Eating: to assist the Kangaroo, enteral feeding pumps, bags, stands, ent
client to maintain tubing, syringes, etc.
adequate nutrition by  Dressings for naso-gastric tubes of
the provision of 
drinking, eating or 
Tracheostromy tubes
Specialised cutlery, eating devices
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tube feeding aids and
equipment.
 Food & thickeners er
pe
Personal Care  Surgical stockings or garments
Pressure
 Prescription made.
opl
Garments: to
relieve or control e
pressure and fluids
in the limbs and
provide circulatory
support.
Personal Care  Wigs: synthetic

Prosthesis: to meet
 human hair
a clinical need for
 Artificial eyes
an artificial body
 Breasts
part
Mobility Aids: to Walking Aids

A
assist
p  Walking support systems
clients/residents to
p and mobilise
access  Walking frames, sticks
r the
within  Portable ramps
o
community or the Safety Harnesses and Tie downs
homep and maintain  In vehicles and chairs. Safety harnesses.
r
as high as possible
leveli of Wheel-chairs
a
independence.  with or without specialised seating.
t
 Electric Wheel-chair supplied when the client has
e
a severe mobility problem and requires an electric
nt Document1
wheel chair because it is essential for their
Created 27
mobility. Limited to10
Date: km per hour May.
19
Electric Scooters
No:  which may be provided
Modified in cases where there May-
is an
outstanding needDate:
Speed limited 10 km per hour19
Traffic Authority regulations apply.
Sequence: 158
Repairs and Modifications: to ensure that equipment is in working order. of
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aids are universally available from a number of suppliers which will aid in em
making the elderly feel more comfortable and safe.
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Date: May.
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No: Modified May-
Date: 19

Sequence: 159
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Equipment to Support Residents/Clients/residents in Accommodation em
Services
The items listed below are regarded as equipment that assists in the care
po
of clients/residents/residents. we
Where appropriate these items should be pooled and used when required
to ensure maximum usage. rm
ent
Table 10: of
Support Equipment Description old
Railings and Ramps:  Railings for bedroom, bathroom, showers er
and access areas.
to ensure the immediate safety pe
and protection of  Ramps for access from outside and inside
clients/residents in the external house. opl
and internal environment.
 Railings for recreation or outdoor areas. e
 Preventative Maintenance
 Program or Reactive Maintenance for
repairs.
Environmental Control Aids:  Devices may include, infra-red or vibrating

to allow independent access, features, assistive devices or mounts for
control and operation of domestic equipment etc.
appliances in a home setting.
 Large items may be funded through capital
 Low cost items may be funded through
HOA.
Tables: to assist client’s  Bedside tables, invalid tables, wheel chair

access to goods and food trays, adjustable tables etc.
support activities.
 May be funded through HOA
Wheel-Chair Hoists: to lift a  Wheel-chair lifts for vehicles are included

client in a wheel chair into a in the lease fee for the vehicle and paid for
vehicle from the HOA.
Client Transfer and Lifting  Portable electrical client lifting hoists

Appliances: to facilitate the
movement of  Fixed electrical ceiling hoists and tracking
clients/residents and reduce to assist in moving clients/residents
Date: May.
19

No: Modified May-
Date: 19

Sequence: 160
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the
likelihood of injury to client  Slings, transfer boards, slide sheets em
and staff.
 Items over $5000 including installation po
may be submitted for under Capital
Program. we
 Low cost items may be funded HOA.
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Date: May.
19

No: Modified May-
Date: 19

Sequence: 161
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Support Equipment Description em
Bathing Aids: to assist  Bath seat
po
clients/residents maintain
dignity, safety, hygiene and  Shower chairs we
independence when bathing  Hand showers rm
or drying.
 Grab rails ent
 Low cost items fund through HOA
of
Suction Aids: to maintain
clear air passages for
 Suction catheters, suction machines old
 Some, including low cost items, fund
clients/residents
through HOA
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pe
opl
Other items for the comfort of your client
e
 Apnoea Alarms  Infusion pumps
 Air Conditioners  Health monitoring equipment
 Batteries except electric  Hyperalimination or associated equipment
wheel-chair
 Laxatives, enemas, suppositories
 Bras
 Menstruation pads or panty liners
 Breast implants or shields
 Movement monitors
 Computers, upgrades,
 Oxygen
memory, processors,
printers or other  Pain monitoring implants
accessories
 Personal alarms
 Continence Alarms
 Post-acute pressure garments
 Dietary treatments
 Retail cushions, bean bags, supports
 Dialysis machines
 Special bedding (hypo allergy)
 Drug treatments
 Support mattresses
 Electro-drives
 Therapy costs
 Equipment rental costs
 Thermostatic valves
 Equipment solely for
 Total Parenteral Nutrition (PTN)
 entertainment or recreation
Date: May.
19

No: Modified May-
Date: 19

Sequence: 162
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 Feeding bags for Complan  Vapouriser em
 Flotrons po
 Food supplements
thickeners we
 Insulin pumps rm
Table 11: Aids that assist with independence ent
Many items are available to the elderly to assist in maintaining of
independence
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Button Hook
Glasses
er
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Pick-up/ Reacher Sock & stocking aid
Toe washer Long handle comb
Date: May.
19

No: Modified May-
Date: 19

Sequence: 163
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the
em
po
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of
Long handled brush Hearing aid
old
er
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opl
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During this learning journey you have discussed and become familiar with
aids that can assist the elderly with independence.
List the aids that you think would be beneficial to maintain independence in
the bathroom:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Living room:
___________________________________________________________
Date: May.
19

No: Modified May-
Date: 19

Sequence: 164
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the
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Bedroom:
___________________________________________________________
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___________________________________________________________ pe
___________________________________________________________ opl
___________________________________________________________
e
___________________________________________________________
___________________________________________________________
Once you have completed this task, check with your assessor or facilitator
to see if you are on the right track.
4.5 Discuss situations of risk or potential risk associated with

ageing
As we age, we make choices about our lifestyle, health care, personal
pursuits, and our plans for old age. A few "steps to successful aging" will
help guide us to healthy and active golden years.
Firstly, it is important your client/resident consider some or all of
these general safety guidelines:
 Have emergency numbers (police, fire, poison control and a nearby
family or neighbours phone number) readily available in case of
emergency. Suggestion: write these numbers on a sticker and put on
the receiver. Consider purchasing a programmable phone. Phones
Date: May.
19

No: Modified May-
Date: 19

Sequence: 165
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developed for those with low vision may be most appropriate for an em
older person no matter what their vision status, since they are easy to
use and have large high-contrast features. po
 Have at least one phone located where it is always accessible.
Suggestion: keep a cordless phone in your pocket. This is especially we
important if you fall and can’t get up to use the phone. Consider a
medical alert pendant and phone, this system is ideal for anyone at risk rm
or falls or having limited physical movement, with one push of the
button, the system puts you in touch with assistance. These are low-
ent
cost but work anywhere in the home, as long as the person is wearing of
the pendant
 Make sure smoke detectors work properly. old
 Avoid the use of space heaters and electric blankets; these are fire
hazards. er
 Make sure halls, stairways, and entrances are well lit. Install a night-
light in your bathroom and hallway. Make sure there is a light switch at
pe
the top and bottom of the staircase. Turn lights on if you get up in the
middle of the night. Make sure lamps or light switches are within reach
opl
of the bed if you have to get up during the night. e
 Make sure treads, rails and rugs are secure on all stairways. Install a
rail on both sides of the stairs. If stairs are steep, it may be helpful to
arrange most of your activities on the lower level to reduce the number
of times stairs must be climbed.
 Install metal handles on the walls next to doorknobs of all doors and
entrances to make it more secure as you travel through the doorway.
Living room/bedrooms
 Place furniture with wide spaces in between, giving you enough room
to move around. Establish a route through the living room that gives
you something to hold on to as you walk -- this will help you from falling
in case you lose your balance.
 If possible, arrange furniture so outlets are available for lamps and
appliances without the need for extension cords. If extension cords are
used, make sure they are secured with tape and out of the way so you
don’t trip on them.
 Use chairs with straight backs, armrests, and firm seats—this will make
it much easier for you to get up and sit down. Add firm cushions to
existing pieces to add height and make it easier to move.
 Install handrails along walls, hallways, and stairwells where there is
nothing to hold on to.
Bathroom
 Use an elevated toilet seat and/or safety rails to assist standing from a
low surface.
Date: May.
19

No: Modified May-
Date: 19

Sequence: 166
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 Do not use towel racks or bathroom tissue holders to help you stand. em
 Install grab bars inside and outside the bathtub or shower.
 Use a bathtub transfer bench or a shower chair with a back support. po
 Put extended lever handles on faucets to make them easier to turn.
 Install grab bars and put a non-skid mat or decals in the bath tub or
we

shower.
Get rid of small bathroom rugs that may cause you to trip. Instead,
rm
purchase a large rug that covers most of the floor and apply non-stick ent
backing, or install wall-to-wall carpeting.
Kitchen
of
 Install non-skid rubber mats near the sink and stove. Clean spills old
immediately.
 Place utensils, pots, pans, and measuring cups on a peg board or in an er
accessible cupboard instead of in lower cupboards which require
bending. Sit when getting things out of lower cupboards.
pe
 What are some ways my mother-in-law can maintain her balance to
prevent falls?
opl
 Keep at least one hand free at all times; try using a backpack or fanny e
pack to hold things rather than carrying them in your hands. Never
carry objects in both hands when walking, as this interferes with
maintaining balance.
 Attempt to swing both arms from front to back while walking. This may
require a conscious effort; however, it will help maintain balance,
posture, and reduce fatigue.
 Consciously lift feet off of the ground when walking. Shuffling and
dragging of the feet is a common culprit in losing your balance.
 When trying to navigate turns, use a "U" technique of facing forward
and making a wide turn, rather than pivoting sharply.
 Try to stand with feet shoulder length apart. When feet are close
together for any length of time, you increase your risk of losing your
balance and falling.
 Do one thing at a time! Don’t try to walk and accomplish another task,
such as reading or looking around. The decrease in your automatic
reflexes complicates motor function, so the less distraction, the better!
 Do not wear rubber- or gripping-soled shoes (such as Crocs™) as they
may "catch" on the floor and cause tripping.
 Move slowly when changing positions. Use deliberate, concentrated
movements and, if needed, use a grab-bar or walking aid. Count 15
seconds between each movement; for example, when rising from a
seated position, wait 15 seconds after standing to begin walking.
 If you become "frozen," visualise stepping over an imaginary object, or
have someone place his or her foot in front of yours to step over. Try
Date: May.
19

No: Modified May-
Date: 19

Sequence: 167
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the
not to have a caregiver or companion "pull" you; this may throw you off em
balance and even prolong the episode.
If balance is a continuous problem, you may want to consider a walking aid
po
such as a cane, walking stick or walker. we
Older adults are among the fastest growing age groups, and the first “baby
boomers” (adults born between 1946 and 1964) will turn 65 in 2011. More rm
than 37 million people in this group (60 percent) will manage more than 1
chronic condition by 2030.
ent
Older adults are at high risk for developing chronic illnesses and related of
disabilities.
old
These chronic conditions include:
 Diabetes mellitus
er
 Arthritis pe
 Congestive heart failure
 Dementia opl
 Depression and anxiety
Other factors that can increase an older person’s risk are:
e
 chronic pain
 side-effects from medications
 losses: relationships, independence, work and income, self-worth,
mobility and flexibility
 social isolation
 significant change in living arrangements e.g. moving from living
independently to a care setting
 admission to hospital
Where people have full mental faculties, & reasonable health, then having
more focus on freedom, & the right to take more risks, would surely be
important for one's mental health & well-being.
It becomes more difficult when the person has Alzheimer's, or other
causes of dementia though, & nursing homes have a duty of care towards
their residents to protect them. Even so, allowing some sense freedom of
choice, is vital for any person's well-being. Without any choices, or
interesting activities in life, it ceases to be worth living.

In your own words, discuss some potential risks or risks around the house
or aged care facility associated with ageing.
___________________________________________________________
Date: May.
19

No: Modified May-
Date: 19

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Once you have completed the above learning assessment, check with your
old
trainer/ facilitator to obtain feedback. er
Dignity of Risk and older adults:
pe
This term ‘dignity of risk’ was first coined around the issue of care for
people with intellectual disabilities in the 1970’s. At that time, people with opl
intellectual or developmental disabilities were often viewed as incapable of
living independently or making decisions for themselves – a view which e
often deprived them of many typical life experiences that others take for
granted.
The Dignity of Risk acknowledges that life experiences come with risk, and
that we must support people in experiencing success and failure
throughout their lives. However, it can be a challenge to support decisions
that we feel are risky, or with which we don’t agree, without our safety-
oriented health care culture.
In Australia dignity of risk is being integrated into the care for older adults
in residential care and community.
The UK, Australia and Canada have many similarities in their
understanding of the issue of decision making for older adults. We have
summarized these perspectives into four principles that we believe best
inform our view on the Dignity of Risk in older adults.
1. Adults have the right to make their own decisions, and to be assumed to
have capacity to do so unless shown otherwise – and capacity should be
viewed as decision-specific.
2. A person should be offered all reasonable support and assistance in
making and following through on their decisions before others step in to
make decisions for them.
3. People have the right to make decisions that others feel are unwise or
disagree with, the right to have a different tolerance for the risks
associated with a decision, and the right to fail after making a decision.
Date: May.
19

No: Modified May-
Date: 19

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Date: May.
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No: Modified May-
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Sequence: 170
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4. When others are involved in decision making with person, any decisions em
must be made with the person’s best interest and preferences at the
forefront, and must strive to infringe the least upon their basic rights and po
freedoms.
Of course, understanding the impact of these four statements in relation to
we
care of older adults, and then working to embed these principles into a rm
balanced approach to care is a complex issue that may often be
dependent on the setting in which the care occurs. For this reason, we ent
have designed – and are implementing and evaluating – participatory
workshops, that allow health care personnel to explore these issues and of
then create the methods for embedding them in their practice.
old
(Source - http://dignityofrisk.com/what-is-the-dignity-of-risk)
er
Learning Activity 21: pe
During this learning journey you have been learning about ‘duty of care’, opl
you have also learnt about ‘duty of risk’.
Explain in your own words what the difference is between them.
e
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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Once you have answered this question, check with your facilitator or
Date: May.
19

No: Modified May-
Date: 19

Sequence: 171
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Date: May.
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No: Modified May-
Date: 19

Sequence: 172
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Fa
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em
Resource Evaluation Form po
Please return to this page when you have finished working on this resource and complete this
form. Your feedback can assist us to continually improve this resource. we
Course Unit: CHCAGE001 – Facilitate the empowerment of older people rm
RTO: Date at finish of unit: ent
Please Circle of
Was your learning totally external, with occasional phone contact with a
designated trainer/teacher?
Yes No old
Was your learning externally supported by a study group of other
Yes No
er
candidates studying the same unit?
How many workshops were given to support your learning? (Please
pe
0 1 2 3
circle a number 0,1,2,3) opl
Did your learning involve class support material at your college? Yes No
e
Did you find this resource easy to use? Yes No
Any Comments?
Was the content useful/clear/relevant? Yes No

Any Comments?
Please comment on any ways this resource could be improved for future candidates
What other resources did you find that helped you with your studies?
Thank you for your time to give us your valuable feedback. Please give this to your
trainer/facilitator/teacher who can send it to us at the address below – or if you prefer you
can do it yourself.
Date: May.
19

No: Modified May-
Date: 19

Sequence: 173
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John N. Bailey em
PO Box 6214 Yatala, QLD, 4207 po
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Date: May.
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No: Modified May-
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Sequence: 174
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Intended Outcomes or Objectives

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2. Provide services to older people

Support the older person to express their own identity and

Provide services according to organisation policies, procedures

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Identify strategies and opportunities that maximise engagement

Identify and utilise aids and modifications that promote individual

4.5 Discuss situations of risk or potential risk associated with ageing

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2 in 3 people in permanent residential aged care at 30 June 2014 (69%)

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