Aged Care in Australia a guide for aged care workers Study Guide 3RD EDITION Training and Education Support, Industry Skills Unit, Meadowbank Department of Education and Communities
ACKNOWLEDGEMENTS This study guide builds on the combined support and efforts of many people who were involved in the development of the second edition of the textbook, Aged Care in Australia: a guide for aged care workers. To those people who generously allowed us to include their photos and stories, we are especially grateful. Project manager and editor Gail Horwood Education Programs Manager, TAFE NSW Writers Anthony Rogers, Head Teacher, TAFE NSW Susan Barrett, Teacher, TAFE NSW Contributing reviewers/writers Mary Ann Swanson Katrina Bryan Janice Loftus Jeanette McGuiggan Jane Chamberlain Jane Elliott Kylie Brennan Wendy Reilly Robyn Ringwood Wendy Howe Helen Underwood Annie Bracken Monica Hourmozi Kerry Barlow Illustrations Julie Hulsman Creative Hitch Cover design and desktop publishing Monique Dovey and Betty Cheung Publisher: TAFE NSW - Training and Education Support, Industry Skills Unit, Meadowbank. Printed by: Ligare Pty Ltd, 138 Bonds Road Riverwood NSW 2210 Available from: www.vetres.net.au ISBN: 978-1-74236-238-0 TAFE NSW (Training and Education Support, Industry Skills Unit Meadowbank) 2011. Reprinted 2012. Copyright of this material is reserved to TAFE NSW Training and Education Support, Industry Skills Unit Meadowbank. Reproduction or transmittal in whole or in part, subject to the provisions of the Copyright Act, is prohibited without the written authority of TAFE NSW Training and Education Support, Industry Skills Unit Meadowbank. In compiling the information contained in this publication the Training and Education Support, Industry Skills Unit, Meadowbank has used reasonable endeavours to ensure that material contained therein is provided in good faith without any express or implied warranty and: was accurate at the time it was developed was not in infringement of any third party copyright was intended for education and training purposes only. To the extent permitted by law, the Department of Education and Communities (DEC) and the NSW Commission of TAFE (TAFE NSW) and its employees, agents and consultants exclude all liability for any loss or damage (including indirect, special or consequential loss or damage) arising from the use of, or reliance on the information contained herein whether or not caused by any negligent act or omission. If any law prohibits the exclusion of such liability, DEC and TAFE NSW limit their liability to the extent permitted by law, for the re-supply of the information. TES ISU Product Code 5422
INTRODUCTION iii TABLE OF CONTENTS Note to assist the trainer, assessor or workplace supervisor...................................iv Introduction....................................................................... iv Aim............................................................................. v Tips to assist you.................................................................... v How to write your answers............................................................ vi Section 1 CHCCS411C Work effectively in the community sector...................... 1 Section 2 CHCAC318B Work effectively with older people........................... 57 Section 3 HLTHIR403C Work effectively with culturally diverse clients and co-workers.... 103 Section 4 CHCWHS312A Follow WHS safety procedures for direct care work............ 119 Section 5 HLTAP301B Recognise healthy body systems in a health care context........ 141 Section 6 CHCICS302B Participate in the implementation of individualised plans....... 169 Section 7 CHCICS303A Support individual health and emotional well being............ 193 Section 8 CHCAC317A Support older people to maintain their independence.......... 219 Section 9 CHCICS301B Provide support to meet personal care needs................. 233 Section 10 CHCAC319A Provide support to people living with dementia............... 273 Section 11 CHCCS305C Assist clients with medication............................. 291 Section 12 CHCPA301B Deliver care services using a palliative approach............... 313 Model answers................................................................... 333
iv STUDY GUIDE NOTE TO ASSIST THE TRAINER, ASSESSOR OR WORKPLACE SUPERVISOR The purpose of the study guide is to assist participants with their learning through activities and reflection, in conjunction with facilitation from trainers, assessors and workplace supervisors. It has not been designed to act as an assessment tool but it could be used as partial summative assessment evidence. For activities that require reflection on personal thoughts, feelings or belief it is recommended that trainers, assessors or workplace supervisors advise participants that they may choose whether or not to record their responses. Responses may be found not only in the textbook, Aged care in Australia: a guide for aged care workers, second edition, but also in the glossary and via the internet. Participants are advised to access websites for current information on aged care developments. Some of these websites can be found in the textbook and within the study guide. It is recommended that you check these periodically for currency. You may wish to provide supplementary sites. Participants with a learning disability may benefit from clustering of information, colour highlighting, use of icons or the removal of a section at a time from the study guide. INTRODUCTION PURPOSE STATEMENT Welcome to the study guide for the third edition of Aged Care in Australia: a guide for aged care workers. This study guide has been developed to support you if you are undertaking the CHC30212 Certificate III in Aged Care. The activities in this guide have been aligned to the units of competency for this qualification. Each section provides a variety of activities that are related to the chapters in the second edition of the textbook, Aged Care in Australia: a guide for aged care workers. The study guide activities in each of the sections relate to the following units of competency: CHCCS411C CHCAC318B HLTHIR403C CHCWHS312A HLTAP301B CHCICS302B CHCICS303A CHCAC317A CHCICS301B CHCAC319A CHCCS305C CHCPA301B Work effectively in the community sector Work effectively with older people Work effectively with culturally diverse clients and co-workers Follow WHS safety procedures for direct care work Recognise healthy body systems in a health care context Participate in the implementation of individualised plans Support individual health and emotional well being Support older people to maintain their independence Provide support to meet personal care needs Provide support to people living with dementia Assist clients with medication Deliver care services using a palliative approach.
INTRODUCTION v AIM The aim of the study guide is to support you: prior to enrolling in the Certificate III in Aged Care during the course through completing activities for each unit of competency in reviewing and evaluating your learning as a form of self assessment. The study guide has model answers for some of the activities so that you can assess your progress. However, there are some activities that will not have model answers but require you to access information to support your learning. It is important that you are aware that completion of this study guide does not automatically entitle you to receive a qualification or a statement of completion of the unit of competency. TIPS TO ASSIST YOU The following tips will assist you when working through the sections in the study guide. Ensure that you have a current copy of the second edition of the TAFE NSW textbook, Aged Care in Australia: a guide for aged care workers. Check at the beginning of each section of the study guide which chapter or chapters in the textbook that you need to refer to in order to access information to complete the activities. Internet access may also provide you with additional information where websites are identified as part of the activity. Refer to the index and/or glossary at the back of the textbook for locating and defining key terms. Use the model answers to assess your progress. Talk to your trainer, assessor or workplace supervisor if you need any assistance. You may prefer to work in small groups with other class or work colleagues, if this is appropriate. Check with your trainer, assessor or workplace supervisor.
vi STUDY GUIDE HOW TO WRITE YOUR ANSWERS For those who are new to studying or who are studying via distance modes of learning it can be difficult to work out how to respond appropriately to the activities. The following pages provide you with some general principles and examples of how to respond to the activities in this study guide. All activities use words such as list, name, outline, describe, define, explain. These words indicate how to structure your response. LIST Your answer should be a simple list. Use bullet points if you like. There is no need to explain or describe any of the points in detail. Example: List the major functions of the skin. Satisfactory answer - protects the body from infections - helps regulate skin temperature - protects organs from injury - enables sensations, for example touch - helps with the formation of Vitamin D - helps regulate fluid balance NAME Your answer should be a single name or list of names. Example: Name the layers of the skin. Satisfactory answer - epidermis - dermis - subcutaneous Unsatisfactory answer The skin covers the body and is the body s largest organ. The skin is made up of three layers; the epidermis, the dermis and the subcutaneous layer. (This example is incorrect as it has provided a brief description of the skin but has failed to list the functions of the skin.) Unsatisfactory answer The epidermis (This example is only partially correct as not all layers of the skin have been named.) OUTLINE Your answer should be an overview of the key points. Sometimes a list can be appropriate, but short sentences are often required. Example: Outline the age-related changes that occur in the skin. Satisfactory answer Unsatisfactory answer The skin loses its elasticity which leads to loose skin, wrinkles and sagging of the skin. Changes occur in skin colour and lumps, bumps and spots are more common. The skin becomes thinner and tears more easily. The skin becomes drier and is prone to irritation. - wrinkles - thins - lumps - bumps - spots - tears (This example is incorrect as it has provided a list that does not give the reader any idea about the changes that occur in the skin.)
INTRODUCTION vii DESCRIBE Your answer should be in sentence structure and cover as much detail as possible. Tip: the number of lines or space provided below the question will give you an idea of how much to write. Example: Describe why maintaining good skin integrity is so important for older people. Satisfactory answer Unsatisfactory answer Good skin integrity is important for older people as they are at a high risk of skin breakdown because their skin can be easily injured. Broken skin (tears or wounds) will often heal more slowly and the risk of getting an infection is higher. Wounds and tears to the skin can also cause discomfort, pain and immobility. Maintaining good skin care is essential to comfort, hygiene and quality of life. - wash the skin daily - use low/no perfume soaps - ensure you pat skin dry - wash and dry all creases and crevices - apply moisturising lotions as needed/prescribed (While this example provides a list of principles for skin care, it does not answer the question...why is good skin integrity so important?) EXPLAIN Your answer should be in sentence structure and it should provide details (an explanation) for the answer given. Example: Explain why heavily perfumed soaps should not be used during routine skin care of older people. Satisfactory answer Unsatisfactory answer Heavily perfumed soaps tend to dry the skin Heavily perfumed soaps should not be used. and cause irritation. The older person should be advised of this and encouraged to choose soaps that are gentler on the skin, however you must (While correct in a sense, this example provides no explanation for the remain mindful to accept and respect the person s individual preferences. reasons why perfumed soaps should be answer and does not show that the participant fully understands the discouraged.) HOW TO ANSWER QUESTIONS THAT ASK FOR YOUR PERSONAL OPINIONS, BELIEFS OR FEELINGS Some of the activities in this study guide ask you to write about your personal opinions, beliefs or feelings. It is important that your answer reflects what YOU think or believe and not what is stated in the textbook or in any other printed material. Example: Describe how you would feel if you were socially isolated. Satisfactory answer Unsatisfactory answer I think I would get bored very quickly as I have a very active social life and I am used to having people around me all day (with 4 young children it is hard to avoid). After the initial boredom I think I would get depressed. I am not very good at spending time on my own and I would definitely miss the love and attention that my children show me. Being socially isolated can increase risks of depression and can lead to other changes in emotional and mental health. Being actively engaged in a social life is an important aspect of holistic health. (While aspects of this answer are correct, it does not provide any insight into the person s own beliefs or feelings.)
viii STUDY GUIDE CASE STUDIES Case studies are short stories that help put information into a meaningful context. While some case studies are based on real life events, others are stories that have been made up by the writer. Case studies are used frequently throughout this study guide to help give examples of situations that affect older people, the types of complex situations that can arise in the workplace and to help you put yourself in the role of an aged care worker. When answering case studies it is important to focus on the person or events described in the story but NOT to add to them. It is a common mistake for many participants to exaggerate the situation or give characteristics and details to the person or events that never existed. It is also common for participants to want more information about the case or more details about the person but this is not necessary. Your answers should be based entirely on the information provided in the case study and the knowledge that you have gained during your studies and life or work experience. Example case study: You are working in a residential aged care facility. You have been looking after Mrs Peterson for the past 2 weeks. While helping Mrs Peterson to prepare for her shower you observe that she is unable to get from a laying to sitting position in bed and she states that she feels dizzy and tired. This is not normal behaviour for Mrs Peterson. Describe how you would respond to this situation. Satisfactory answer First I would make sure that Mrs Peterson is safe and comfortable in her bed. I would ask her to rest for the moment and let her know that I will help her to shower when she is feeling better. Next I would ask Mrs Peterson if she knows of any reason why she feels this way and if she can tell me anything that might help me to understand the situation better. Then I would seek her permission to take some basic observations such as temperature, pulse, respirations and blood pressure (blood glucose levels too if Mrs Peterson has diabetes.) As soon as I had gathered the information I would report to the supervisor Mrs Peterson s change in condition and make an appropriate entry into her records. I would read the past 24 hours of her records to see if any other health concerns were noted. I would follow any of the directions or changes provided by the supervisor and ensure that I check on Mrs Peterson regularly throughout the day. Unsatisfactory answer Because Mrs Peterson is probably a diabetic I would take her Blood Glucose Level (BGL) reading. If that was low I would give her glucose (she prefers a cup of tea with 4 sugars) followed by a small sandwich. After 30 minutes I would retake her BGL. Now that it is normal and she is feeling fine I would continue to help her with her morning shower. I would document her BGL in the care record and let the supervisor know what happened. At 3pm I would tell the other staff that Mrs Peterson had a low blood sugar level in the morning and to watch her closely this afternoon. In this answer the participant has made assumptions that Mrs Peterson is a diabetic (which was not mentioned in the case study) and has failed to consider many other actions that would be required of the aged care worker. The answer has also provided solutions now that it is normal and given the person characteristics that may not be true (she prefers tea with 4 sugars), all of which are unnecessary when compiling the case study. DEFINE Your answer should be a sentence that describes the term. The term itself should not be included in the answer. Personal points of view should not be used. Example: Define grief. Satisfactory answer The process of recovery from a loss that can affect a person psychologically, emotionally, physically and spiritually. Unsatisfactory answer You feel sad because of the grief you experience mostly after someone has died.
Study Guide SECTION 1 CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR Activities contained within this unit of competency will assist you to: work ethically communicate effectively in a community work or service delivery setting work effectively within the community services system demonstrate commitment to relevant values and philosophy underpinning work in the sector maintain work standards take responsibility for personal skill development reflect on own practice. To help you prepare for this unit of competency and the associated activities it is recommended that you read the following chapters in the aged care textbook, Aged care in Australia: a guide for aged care workers, second edition: Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Services for older people Working in aged care Providing support in the community Cultural diversity Effective communication Documentation To locate specific information or topic areas refer to the index or glossary section at the back of the textbook. For ease of studying, this unit has been divided into the following four (4) parts: Part A Introduction to the community sector Part B Legal and ethical framework of the community sector Part C Your role in the community sector Part D Communicating effectively in the community sector
2 SECTION 1 STUDY GUIDE Part A Introduction to the community sector Activity 1 Reading Read the following introduction to the community sector. The community services sector in Australia consists of an array of government, for-profit and not-for-profit organisations that provide a diverse range of services to meet the needs of individuals, families and our urban, rural and remote communities. These organisations include private businesses, faith-based services, charitable and community-managed agencies, all of which may range from very small providers to large national and multinational organisations. In Australia the community sector has heavily relied on charitable and welfarebased organisations to supplement existing government programs. While the financial arrangements of these service providers may vary widely, much of the funding is provided through charitable fund-raising and government grants. While the government may provide some services directly to the community, the government has overall responsibility for providing the legislative framework, much of the funding, strategic policy, planning and monitoring for the community services sector. The community services industry is large and has many different sectors, these include but are not limited to: aged care disability services family and domestic violence mental health community development community advocacy children s services employment services home and community care alcohol and other drugs relationship counselling housing community work youth work and juvenile justice child protection and child welfare information and referral services. While some service providers may focus on a single aspect or sector, many community service organisations provide services across multiple sectors. See pages 32-33 in the textbook for an overview of the Australian aged care services sector.
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 3 Activity 2 Research a) Research and describe a current issue influencing community work and/or service delivery. You could access peak body websites, government websites or policy papers, industry magazines/journals or media releases. b) Using the internet or other information sources conduct some research on three (3) different government departments involved in the delivery or administration of community services. As an example, here are a few Australian Government departments that are involved in the delivery and/ or administration of community services, and their associated website addresses. WWW WWW Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) www.fahcsia.gov.au Australian Government Department of Health and Ageing www.health.gov.au For each of your selected government departments, complete an entry in the following table by inserting information about that department s roles, responsibilities, services and career opportunities.
4 SECTION 1 STUDY GUIDE DEPARTMENT NAME: WEBSITE: OVERVIEW OF THE DEPARTMENT S MAJOR ROLE AND RESPONSIBILITIES OUTLINE OF A RANGE OF SERVICES THAT THE DEPARTMENT DELIVERS AND/OR SUPPORTS SERVICE NAME SERVICE DESCRIPTION CAREER PATHS/JOB OPPORTUNITIES
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 5 DEPARTMENT NAME: WEBSITE: OVERVIEW OF THE DEPARTMENT S MAJOR ROLE AND RESPONSIBILITIES OUTLINE OF A RANGE OF SERVICES THAT THE DEPARTMENT DELIVERS AND/OR SUPPORTS SERVICE NAME SERVICE DESCRIPTION CAREER PATHS/JOB OPPORTUNITIES
6 SECTION 1 STUDY GUIDE DEPARTMENT NAME: WEBSITE: OVERVIEW OF THE DEPARTMENT S MAJOR ROLE AND RESPONSIBILITIES OUTLINE OF A RANGE OF SERVICES THAT THE DEPARTMENT DELIVERS AND/OR SUPPORTS SERVICE NAME SERVICE DESCRIPTION CAREER PATHS/JOB OPPORTUNITIES
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 7 Activity 3 Local community services profile Using local resources (for example: telephone book, services directory, internet, information brochures) list and describe five (5) different community services that are available to support people in your neighbourhood. For each service you will also need to assign a service type. Types can include: government, charitable, not-for-profit, for-profit, faith-based or other. TIP Ensure that you cover a range of services, for example; children s services, disability services, supported housing, home and community care, alcohol and other drug services, aged care services, counselling and mental health services. GEOGRAPHICAL REGION: Example: SERVICE NAME SERVICE DESCRIPTION TYPE Tweed Valley Respite Service Offers quality respite care, skills development and support to people with disabilities, people who are frail aged and people with dementia and related disorders, and carers of all these groups. Services include day respite, in-home respite, community participation programs and social activities. Not-for-profit community organisation
8 SECTION 1 STUDY GUIDE Activity 4 Service delivery models When an organisation delivers services to the community, they usually do so through a chosen service delivery model. Work models help guide and direct services toward a goal and help align the service to particular social values and philosophies. For example, many community sector agencies use a person-centred approach as their service delivery model. Some of the different types of service delivery models used in the community sector include: person-centred approach participatory model community centred approach advocacy model working with families approach developmental model community development model case management approach inter-agency approach active service model Conduct some research on the person-centred approach and one (1) other service delivery model. Describe the model and its key aspects in the spaces provided. NAME OF MODEL: Person-centred approach MODEL DESCRIPTION KEY ASPECTS OF THIS MODEL
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 9 NAME OF MODEL: MODEL DESCRIPTION KEY ASPECTS OF THIS MODEL
10 SECTION 1 STUDY GUIDE Activity 5 Values and philosophies underpinning work in the sector While there is a vast range of job types and skills required of workers in the community sector, there are some core values and philosophies to service delivery that underpin much of the work that is undertaken by the community services sector. Listed below is a selection of the core values and philosophies of a large community service provider. For each, outline how you could incorporate these values and philosophies into your approach to work. Philosophy of community services a) A commitment to upholding the rights of individuals b) A commitment to promote well being and independence c) A focus on solutions and abilities, rather than problems and causes d) A commitment to an inclusive and non-discriminatory approach to service delivery that promotes access and equity
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 11 e) A commitment to a person-centred approach f) A commitment to empowering the person and/or the community g) A commitment to a holistic approach to service delivery h) A commitment to culturally safe working practices i) A commitment to working within a social justice framework
12 SECTION 1 STUDY GUIDE Part B Legal and ethical framework of the community sector Activity 1 Definitions Using your own words, define the following terms: TERM DEFINITION Accreditation Act Advocacy Breach or non adherence Code of practice or ethics Confidentiality Consent Duty of care Ethics Guardianship Guidelines Human rights Law Legislation Standards
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 13 Activity 2 Legislation, standards and guidelines a) Describe the purpose of legislation. b) Name and describe an Australian Government law that relates to the community services sector. c) Name and describe a State law that relates to the community services sector. d) Describe the purpose of standards or guidelines. Each sector of the community services industry has its own set of standards or guidelines. Select one of the following sectors and answer the questions below. home and community care sector aged care sector f) Name two (2) relevant standards, legislation or guidelines for the sector. 1. 2.
14 SECTION 1 STUDY GUIDE g) Describe how services are measured against the standards or guidelines. h) Describe what can happen if a standard or guideline is not being met. i) Describe how service providers ensure that they comply with the relevant standards or guidelines. j) Outline what options are available for a service user (an older person or carer) who believes that their service delivery is below the standards.
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 15 Activity 3 Duty of care and negligence a) Explain what is meant by the term duty of care, and how it relates to your legal responsibilities in the community services sector. Refer to pages 56-59 of the textbook. b) Describe three (3) examples of how a worker may be in breach of their duty of care. Example 1 Example 2 Example 3 c) Define negligence. d) Outline the four (4) elements that constitute negligence (often referred to as the 4Ds). D D D D
16 SECTION 1 STUDY GUIDE e) Describe three (3) examples of how a worker could be seen as being negligent. Example 1 Example 2 Example 3 f) Read Melissa s case study on page 57 of the textbook. Explain what Melissa should have done differently to avoid being negligent in her duty of care. Describe why the reporting and recording of this incident is essential. g) Outline the possible consequences of being found as negligent in your role as a worker in community services. h) Define vicarious liability. Refer to page 57 of the textbook.
CHCCS411C WORK EFFECTIVELY IN THE COMMUNITY SECTOR 17 Activity 4 Consent and guardianship a) Explain consent and why it is so important in community services. Refer to pages 59-61 of the textbook. b) Describe the three (3) different types of consent. TYPE OF CONSENT DESCRIPTION c) Outline the four (4) elements to valid consent. 1. 2. 3. 4. d) Describe three (3) examples of situations where you would seek the older person s consent. Example 1
18 SECTION 1 STUDY GUIDE Example 2 Example 3 e) Define guardianship. f) Explain why an older person might require a guardian. g) Outline the role and function of a power of attorney and enduring power of attorney.