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Document Name: CHCAC317A Support older people to maintain their independence Created Date: 10 Dec 2008
Document No: Version No: V1 Last Modified Date: 23-Oct-13
© John Bailey 2009 Page Sequence: Page 2 of 158


CHCAC317A. Support older people
to maintain their independence
Author: John Bailey
Copyright

Text copyright © 2008 by John N Bailey.
Illustration, layout and design copyright © 2008 by John N Bailey.

Under Australia’s Copyright Act 1968 (the Act), except for any fair dealing
for the purposes of study, research, criticism or review, no part of this book
may be reproduced, stored in a retrieval system, or transmitted in any form
or by any means without prior written permission from John N Bailey. All
inquiries should be directed in the first instance to the publisher at the
address below.

Copying for Education Purposes
The Act allows a maximum of one chapter or 10% of this book, whichever
is the greater, to be copied by an education institution for its educational
purposes provided that that educational institution (or the body that
administers it) has given a remuneration notice to JNB Publications.

Disclaimer
All reasonable efforts have been made to ensure the quality and accuracy
of this publication. JNB Publications assumes no responsibility for any
errors or omissions and no warranties are made with regard to this
publication. Neither JNB Publications nor any authorized distributors shall
be held responsible for any direct, incidental or consequential damages
resulting from the use of this publication.


Published in Australia by:
JNB Publications
PO Box, 268,
Macarthur Square NSW 2560
Australia.



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CHCAC317A. Support older people
to maintain their independence
Contents
CHCAC317A. SUPPORT OLDER PEOPLE TO MAINTAIN THEIR INDEPENDENCE........................................... 2
Author: John Bailey .................................................................................................................................. 2
Copying for Education Purposes ............................................................................................................... 2
Disclaimer ................................................................................................................................................. 2
Description: ............................................................................................................................................... 7
Employability Skills: .................................................................................................................................. 7
Application: ............................................................................................................................................... 7
Introduction .............................................................................................................................................. 7
Learning Program ..................................................................................................................................... 8
Additional Learning Support ..................................................................................................................... 8
Facilitation ................................................................................................................................................ 8
Flexible Learning ....................................................................................................................................... 9
Space ......................................................................................................................................................... 9
Study Resources ........................................................................................................................................ 9
Time ........................................................................................................................................................ 10
Study Strategies ...................................................................................................................................... 10
Using this learning guide: ....................................................................................................................... 10
THE ICON KEY............................................................................................................................................ 11
THE SUPPLEMENTARY ICONS .................................................................................................................... 12
How to get the Most out of your learning guide .................................................................................... 13
Additional research, reading and note taking. ....................................................................................... 13
EMPLOYABILITY SKILLS – ........................................................................................................................... 14
CERTIFICATE III IN AGED CARE .................................................................................................................. 14
PERFORMANCE CRITERIA .......................................................................................................................... 18
SKILLS AND KNOWLEDGE .......................................................................................................................... 20
Required Skills ......................................................................................................................................... 20
Required Knowledge ............................................................................................................................... 21
RANGE STATEMENT .................................................................................................................................. 22
EVIDENCE GUIDE ....................................................................................................................................... 23
1. SUPPORT THE OLDER PERSON WITH THEIR ACTIVITIES OF LIVING. ................................................... 24
1.1 ENCOURAGE OLDER PEOPLE TO UTILISE SUPPORT SERVICES WHERE APPROPRIATE. ............................................ 24
Social Justice ........................................................................................................................................... 26
Aged Care Standards .............................................................................................................................. 27
Aged Care Assessment Teams ................................................................................................................ 28
Home & Community Care Program (HACC) ............................................................................................ 29
Community Aged Care Packages (CACP) ................................................................................................ 31
Extended Aged Care at Home (EACH) .................................................................................................. 31
Extended Aged Care at Home Dementia (EACH D) ................................................................................. 32
National Respite for Carers Program (NRCP) .......................................................................................... 33
Centrelink Assistance .............................................................................................................................. 34



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Commonwealth Respite and Carelink Program ....................................................................................... 35
Transition Care Program ......................................................................................................................... 35
Community nursing and Health Centres .................................................................................................. 37
Types of Care and Services ...................................................................................................................... 38
Hostel/accommodation services ............................................................................................................. 39
Low level Care .......................................................................................................................................... 40
Ageing in Place ........................................................................................................................................ 41
Extra Services ........................................................................................................................................... 41
End-of-life Care/Palliative Care ............................................................................................................... 42
How palliative care is managed in aged care homes? ............................................................................ 42
Short-term Care ....................................................................................................................................... 42
How does your client access respite care? .............................................................................................. 43
How much respite care can a client have? .............................................................................................. 43
What fees do they have to pay? .............................................................................................................. 43
Transition Care ........................................................................................................................................ 43
Cultural and Identified Needs .................................................................................................................. 44
Aboriginal and Torres Strait Islander people ........................................................................................... 44
Aged care homes for culturally and linguistically diverse people ............................................................ 45
Particular health conditions .................................................................................................................... 45
Independent Living Units ......................................................................................................................... 46
Home nursing .......................................................................................................................................... 47
What if your client is not happy with their care? .................................................................................... 47
Where else can they get help? ................................................................................................................ 47
Activity 1 .................................................................................................................................................. 48
1.2 CLEARLY EXPLAIN THE SCOPE OF THE SERVICE TO BE PROVIDED TO THE OLDER PERSON AND/OR THEIR ADVOCATE. ... 49
Informal Care ........................................................................................................................................... 50
Personal Cost of Caring ........................................................................................................................... 51
Carer Support .......................................................................................................................................... 52
Respite ..................................................................................................................................................... 52
Carer Resource Centres ........................................................................................................................... 52
Formal Care ............................................................................................................................................. 53
High level care ......................................................................................................................................... 54
Ageing in Place ........................................................................................................................................ 56
Activity 2: Case Study .............................................................................................................................. 57
1.3 IDENTIFY THE NEEDS OF THE OLDER PERSON FROM THE SERVICE DELIVERY PLAN AND FROM CONSULTATION WITH A
SUPERVISOR. .................................................................................................................................................... 58
Stages of Care Planning ........................................................................................................................... 60
Supervision .............................................................................................................................................. 61
Activity 3 .................................................................................................................................................. 65
Activity 4 .................................................................................................................................................. 65
Ensure visits and service delivery accommodate the older person’s established routines and
customs where possible. .......................................................................................................................... 66
Routine in an Aged Care Facility .............................................................................................................. 67
Activity 5: Case Study .............................................................................................................................. 67
Customs/Cultural needs .......................................................................................................................... 68
The Iceberg Model ................................................................................................................................... 69
Cultural communication .......................................................................................................................... 70
Co-workers............................................................................................................................................... 73
Activity 6 .................................................................................................................................................. 73
1.5 PERFORM WORK IN A MANNER THAT ACKNOWLEDGES THAT THE SERVICES ARE BEING PROVIDED IN THE CLIENT’S
OWN HOME. .................................................................................................................................................... 74
Carer attributes ....................................................................................................................................... 75
Working with Carers ................................................................................................................................ 75
Roles and Responsibilities ........................................................................................................................ 76
Limited Supervision.................................................................................................................................. 76
Documentation ........................................................................................................................................ 77
Activity 7 .................................................................................................................................................. 78



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1.6 PROVIDE SERVICES IN A MANNER THAT ENABLES THE OLDER PERSON TO DIRECT THE PROCESSES WHERE APPROPRIATE. ... 80
Meeting Care Needs ............................................................................................................................... 81
Home and Community Care (HACC) Services .......................................................................................... 81
Activity 8 ................................................................................................................................................. 84
Activity 9: Case Study .............................................................................................................................. 85
1.7 PROVIDE SUPPORT/ASSISTANCE IN ACCORDANCE WITH ORGANISATION POLICY, PROTOCOLS AND PROCEDURES. ..... 87
Activity 10 ............................................................................................................................................... 88
1.8 DEMONSTRATE APPROPRIATE USE OF EQUIPMENT TO SUPPORT/ASSIST THE OLDER PERSON WITH ACTIVITIES OF
LIVING WITHIN WORK ROLE AND RESPONSIBILITY. .................................................................................................... 89
Activity 11 ............................................................................................................................................... 93
Activity 12 ............................................................................................................................................... 94
2. RECOGNISE AND REPORT CHANGES IN AN OLDER PERSON’S ABILITY TO UNDERTAKE ACTIVITIES
OF LIVING. ................................................................................................................................................ 97
2.1 MONITOR THE OLDER PERSON’S ACTIVITIES AND ENVIRONMENT TO IDENTIFY INCREASED NEED FOR
SUPPORT/ASSISTANCE WITH ACTIVITIES OF LIVING. .................................................................................................. 97
Activity 13 ............................................................................................................................................... 99
Activity 14 ............................................................................................................................................. 102
2.2 REPORT TO A SUPERVISOR THE OLDER PERSON’S INABILITY TO UNDERTAKE ACTIVITIES OF LIVING INDEPENDENTLY. 103
Telephone ............................................................................................................................................. 103
Face to face/Verbally ............................................................................................................................ 104
Clinical notes/Progress notes/Care Plan ............................................................................................... 104
Activity 15 ............................................................................................................................................. 105
2.3 SUPPORT/ASSIST THE OLDER PERSON TO MODIFY OR ADAPT THE ENVIRONMENT OR ACTIVITY TO FACILITATE
INDEPENDENCE. ............................................................................................................................................. 107
Activity 16 ............................................................................................................................................. 109
Activity 17 ............................................................................................................................................. 110
2.4 SEEK AIDS AND/OR EQUIPMENT TO SUPPORT/ASSIST THE OLDER PERSON UNDERTAKE ACTIVITIES OF LIVING
INDEPENDENTLY. ............................................................................................................................................ 111
Figure 1: Safety ..................................................................................................................................... 111
Activity 18 ............................................................................................................................................. 115
Activity 19: Research ............................................................................................................................. 115
Activity 20 ............................................................................................................................................. 116
3. SUPPORT THE OLDER PERSON TO MAINTAIN AN ENVIRONMENT THAT MAXIMISES
INDEPENDENCE, SAFETY AND SECURITY. ................................................................................................ 118
3.1 ENCOURAGE AND SUPPORT/ASSIST THE OLDER PERSON TO MAINTAIN THEIR ENVIRONMENT. ............................ 118
Activity 21: Case Study .......................................................................................................................... 121
Activity 22 ............................................................................................................................................. 122
3.2 PROVIDE SUPPORT TO PROMOTE SECURITY OF THE OLDER PERSON’S ENVIRONMENT. ...................................... 123
Activity 23 ............................................................................................................................................. 127
3.3 ADAPT OR MODIFY THE ENVIRONMENT, IN CONSULTATION WITH THE OLDER PERSON, TO MAXIMISE SAFETY AND
COMFORT. .................................................................................................................................................... 129
Activity 24 ............................................................................................................................................. 132
3.4 RECOGNISE HAZARDS AND ADDRESS IN ACCORDANCE WITH ORGANISATION POLICY AND PROTOCOLS. ................. 134
Table 2: Hazards in the Environment .................................................................................................... 135
Activity 25 ............................................................................................................................................. 136
Activity 26 ............................................................................................................................................. 137
4. SUPPORT THE OLDER PERSON WHO IS EXPERIENCING LOSS AND GRIEF. ....................................... 139
4.1 RECOGNIZE SIGNS THAT OLDER PERSON IS EXPERIENCING GRIEF AND REPORT TO APPROPRIATE PERSON. ............. 139
Reporting Grief ..................................................................................................................................... 142
Activity 27 ............................................................................................................................................. 143
4.2 USE APPROPRIATE COMMUNICATION STRATEGIES WHEN OLDER PERSON IS EXPRESSING THEIR FEARS AND OTHER
EMOTIONS ASSOCIATED WITH LOSS AND GRIEF. .................................................................................................... 145
Listen with Compassion ........................................................................................................................ 146
Concentrate your efforts on listening carefully and with compassion. ................................................. 147



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Comments to avoid when comforting the bereaved ............................................................................. 147
Offer practical assistance ...................................................................................................................... 148
Provide ongoing support ....................................................................................................................... 148
Watch for warning signs ....................................................................................................................... 149
Activity 28: Case Study .......................................................................................................................... 150
4.3 PROVIDE OLDER PERSON AND/OR THEIR SUPPORT NETWORK WITH INFORMATION REGARDING RELEVANT SUPPORT
SERVICES AS REQUIRED. .................................................................................................................................... 152
Support from family and friends is important ....................................................................................... 152
Bereavement counselling ...................................................................................................................... 152
Where to get help .................................................................................................................................. 153
Things to remember .............................................................................................................................. 153
Moving on with life ................................................................................................................................ 154
Activity 29 .............................................................................................................................................. 155
Activity 30 .............................................................................................................................................. 156




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CHCAC317A. Support older people
to maintain their independence
Description:
This unit describes the knowledge and skills required by the worker to
support the older person to maintain their independence with activities of
living.

Employability Skills:
This unit contains Employability Skills.

Application:
This unit applies to workers in the aged care sector, or those working
with older people.

Introduction
As a worker, a trainee or a future worker you want to enjoy your work
and become known as a valuable team member. This unit of
competency will help you acquire the knowledge and skills to work
effectively as an individual and in groups. It will give you the basis to
contribute to the goals of the organization which employs you.
It is essential that you begin your training by becoming familiar with the
industry standards to which organizations must conform.
This unit of competency introduces you to some of the key issues and
responsibilities or workers and organizations in this area. The unit also
provides you with opportunities to develop the competencies necessary
for employees to operate as team members.

This Learning Guide covers:
 Support the older person with their activities of living.
 Recognise and report changes in an older person’s ability to
undertake activities of living.
 Support the older person to maintain an environment that maximises
independence, safety and security.
 Support the older person who is experiencing loss and grief.



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Learning Program
As you progress through this unit you will develop skills in locating and
understanding an organizations policies and procedures. You will build
up a sound knowledge of the industry standards within which
organizations must operate. You should also become more aware of
the effect that your own skills in dealing with people has on your
success, or otherwise, in the workplace.
Knowledge of your skills and capabilities will help you make informed
choices about your further study and career options.

Additional Learning Support
To obtain additional support you may:
Search for other resources in the Learning Resource Centres of your
learning institution. You may find books, journals, videos and other
materials which provide extra information for topics in this unit.
Search in your local library. Most libraries keep information about
government departments and other organizations, services and
programs.
Contact information services such as Infolink, Equal Opportunity
Commission, Commissioner of Workplace Agreements. Union
organizations, and public relations and information services provided by
various government departments. Many of these services are listed in
the telephone directory.
Contact your local shire or council office. Many councils have a
community development or welfare officer as well as an information and
referral service.
Contact the relevant facilitator by telephone, mail or facsimile.

Facilitation
Your training organization will provide you with a flexible learning
facilitator. Your facilitator will play an active role in supporting your
learning, will make regular contact with you and if you have face to face
access, should arrange to see you at least once. After you have
enrolled your facilitator will contact you be telephone or letter as soon as
possible to let you know:
 How and when to make contact
 What you need to do to complete this unit of study
 What support will be provided.
 Here are some of the things your facilitator can do to make your
study easier.
 Give you a clear visual timetable of events for the semester or term
in which you are enrolled, including any deadlines for assessments.
 Check that you know how to access library facilities and services.



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 Conduct small ‘interest groups’ for some of the topics.
 Use ‘action sheets’ and website updates to remind you about tasks
you need to complete.
 Set up a ‘chat line”. If you have access to telephone conferencing or
video conferencing, your facilitator can use these for specific topics
or discussion sessions.
 Circulate a newsletter to keep you informed of events, topics and
resources of interest to you.
 Keep in touch with you by telephone or email during your studies.

Flexible Learning
Studying to become a competent worker and learning about currents
issues in this area, is an interesting and exciting thing to do. You will
establish relationships with other candidates, fellow workers and clients.
You will also learn about your own ideas, attitudes and values. You will
also have fun – most of the time.
At other times, study can seem overwhelming and impossibly
demanding, particularly when you have an assignment to do and you
aren’t sure how to 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…. Sometimes being a candidate can be hard.
Here are some ideas to help you through the hard times. To study
effectively, you need space, resources and time.
Space
Try to set up a place at home or at work where:
 You can keep your study materials
 You can be reasonably quiet and free from interruptions, and
 You can be reasonably comfortable, with good lighting, seating and
a flat surface for writing.
 If it is impossible for you to set up a study space, perhaps you could
use your local library. You will not be able to store your study
materials there, but you will have quiet, a desk and chair, and easy
access to the other facilities.
Study Resources
The most basic resources you will need are:
 a chair
 a desk or table
 a reading lamp or good light
 a folder or file to keep your notes and study materials together
 materials to record information (pen and paper or notebooks, or a
computer and printer)
 reference materials, including a dictionary



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Do not forget that other people can be valuable study resources. Your
fellow workers, work supervisor, other candidates, your flexible learning
facilitator, your local librarian, and workers in this area can also help
you.
Time
It is important to plan your study time. Work out a time that suits you and
plan around it. Most people find that studying in short, concentrated
blocks of time (an hour or two) at regular intervals (daily, every second
day, once a week) is more effective than trying to cram a lot of learning
into a whole day. You need time to “digest” the information in one
section before you move on to the next, and everyone needs regular
breaks from study to avoid overload. Be realistic in allocating time for
study. Look at what is required for the unit and look at your other
commitments.
Make up a study timetable and stick to it. Build in “deadlines” and set
yourself goals for completing study tasks. Allow time for reading and
completing activities. Remember that it is the quality of the time you
spend studying rather than the quantity that is important.
Study Strategies
Different people have different learning ‘styles’. Some people learn best
by listening or repeating things out loud. Some learn best by doing,
some by reading and making notes. Assess your own learning style,
and try to identify any barriers to learning which might affect you. Are
you easily distracted? Are you afraid you will fail? Are you taking study
too seriously? Not seriously enough? Do you have supportive friends
and family? Here are some ideas for effective study strategies.
Make notes. This often helps you to remember new or unfamiliar
information. Do not worry about spelling or neatness, as long as you
can read your own notes. Keep your notes with the rest of your study
materials and add to them as you go. Use pictures and diagrams if this
helps.
Underline key words when you are reading the materials in this learning
guide. (Do not underline things in other 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. Your learning guide will
 describe the skills you need to demonstrate to achieve competency
for this unit,
 provide information and knowledge to help you develop your skills
 provide you with structured learning activities to help you absorb the
knowledge and information and practice your skills
 direct you to other sources of additional knowledge and information
about topics for this unit.



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The Icon Key

Key Points
Explains the actions taken by a competent person.

Example
Illustrates the concept or competency by providing examples.

Activity
Provides activities to reinforce understanding of the action.

Chart
Provides images that represent data symbolically. They are
used to present complex information and numerical data in a
simple, compact format.

Intended Outcomes or Objectives
Statements of intended outcomes or objectives are descriptions
of the work that will be done.

Assessment
Strategies with which information will be collected in order to
validate EACH intended outcome or objective.





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The Supplementary Icons

PowerPoint
Any PowerPoint associated with a unit will have this icon next to
them
Forms and Care Plans
If there is a form or care plan associated with a unit there will be
an icon like this with the relevant number of the form or care
plan in the format FFACF-015
Employability Skills
Where the employability skills are shown to be embedded in the
unit and relates to the table in the front of each unit eg: T1, S1,
E1.

Readings
Provides backup and reasoning to the underpinning knowledge
and skills


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

World Wide Web
Where the world wide web is used for an activity in the unit you
will find this icon.
Resource Document
Where the Resource documents are applicable there will be an
icon in the format RDN - XX



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How to get the Most out of your learning guide

1. Read through the information in the learning guide carefully.
Make sure you understand the material.
Some sections are quite long and cover complex ideas and information.
If you come across anything you do not understand:
 talk to your facilitator
 research the area using the books and materials listed under
Resources
 discuss the issue with other people (your workplace supervisor,
fellow workers, fellow candidates)
 try to relate the information presented in this learning guide to
your own experience and to what you already know.
Ask yourself questions as you go: For example “Have I seen this
happening anywhere?” “Could this apply to me?” “What if….?”
This will help you to make sense of new material, and to build on
your existing knowledge.
2. Talk to people about your study.
Talking is a great way to reinforce what you are learning.
3. Make notes.
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 you need to.
Keep your notes short and to the point. Relate your notes to the
material in your learning guide. Put things into your own words. This
will give you a better understanding of the material.
Start off with a question you want answered when you are exploring
additional resource materials. This will structure your reading and save
you time.



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Employability Skills –
Certificate III in Aged Care
EMPLOYABILITY
SKILLS
FACETS ADDRESSED: Industry/enterprise
requirements for this qualification include the
following facets:
Code
Communication
1. Listening to and understanding work instructions,
directions and feedback
C1
2. Speaking clearly/directly to relay information
C2
3. Reading and interpreting workplace related
documentation, such as prescribed programs
C3
4. Writing to address audience needs, such as forms,
case notes and reports
C4
5. Interpreting the needs of internal/ external clients
from clear information and feedback
C5
6. Applying basic numeracy skills to workplace
requirements involving measuring and counting
C6
8. Sharing information (eg. with other staff, working as
part of an allied health team)
C8
9. Negotiating responsively (eg. re own work role
and/or conditions, possibly with clients)
C9
11. Being appropriately assertive (eg. in relation to safe
or ethical work practices and own work role)
C11
12. Empathising (eg. in relation to others)
C12
Teamwork
1. Working as an individual and a team member T1
2. Working with diverse individuals and groups T2
3. Applying knowledge of own role as part of a team T3
4. Applying teamwork skills to a limited range of
situations
T4
5. Identifying and utilising the strengths of other team
members
T5
6. Giving feedback T6



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EMPLOYABILITY
SKILLS
FACETS ADDRESSED: Industry/enterprise
requirements for this qualification include the
following facets:
Code
Problem solving
1. Developing practical solutions to workplace problems
(i.e. within scope of own role)
P1
2. Showing independence and initiative in identifying
problems (i.e. within scope of own role)
P2
3. Solving problems individually or in teams (i.e. within
scope of own role)
P3
5. Using numeracy skills to solve problems (eg. time
management, simple calculations, shift handover)
P5
6. Testing assumptions and taking context into account
(i.e. with an awareness of assumptions made and
work context)
P6
7. Listening to and resolving concerns in relation to
workplace issues
P7
8. Resolving client concerns relative to workplace
responsibilities (i.e. if role has direct client contact)
P8
Initiative and
enterprise
1. Adapting to new situations (i.e. within scope of own
role)
I1
2. Being creative in response to workplace challenges
(i.e. within relevant guidelines and protocols)
I2
3. Identifying opportunities that might not be obvious to
others (i.e. within a team or supervised work
context)
I3
5. Translating ideas into action (i.e. within own work
role)
I5
6. Developing innovative solutions (i.e. within a team or
supervised work context and within established
guidelines)
I6









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EMPLOYABILITY
SKILLS
FACETS ADDRESSED: Industry/enterprise
requirements for this qualification include the
following facets:
Code
Planning and
organising
1. Collecting, analysing and organising information (i.e.
within scope of own role)
O1
2. Using basic systems for planning and organising (i.e.
if applicable to own role)
O2
3. Being appropriately resourceful O3
4. Taking limited initiative and making decisions within
workplace role (i.e. within authorised limits)
O4
5. Participating in continuous improvement and planning
processes (i.e. within scope of own role)
O5
6. Working within clear work goals and deliverables O6
7. Determining or applying required resources (i.e.
within scope of own role)
O7
8. Allocating people and other resources to tasks and
workplace requirements (only for team leader or
leading hand roles)
O8
9. Managing time and priorities (i.e. in relation to tasks
required for own role)
O9
10. Adapting resource allocations to cope with
contingencies (i.e. if relevant to own role)
O10
Self management 1. Being self-motivated (i.e. in relation to requirements
of own work role)
S1
2. Articulating own ideas (i.e. within a team or
supervised work context)
S2
3. Balancing own ideas and values with workplace
values and requirements
S3
4. Monitoring and evaluating own performance (i.e.
within a team or supervised work context)
S4
5. Taking responsibility at the appropriate level S5



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EMPLOYABILITY
SKILLS
FACETS ADDRESSED: Industry/enterprise
requirements for this qualification include the
following facets:
Code
Learning 1. Being open to learning new ideas and techniques) L1
2. Learning in a range of settings including informal
learning
L2
3. Participating in ongoing learning L3
4. Learning in order to accommodate change L4
5. Learning new skills and techniques L5
6. Taking responsibility for own learning (i.e. within
scope of own work role)
L6
7. Contributing to the learning of others (eg. by sharing
information)
L7
8. Applying a range of learning approaches (i.e. as
provided)
L8
10. Participating in developing own learning plans (eg.
as part of performance management)
L10
Technology 1. Using technology and related workplace equipment
(i.e. if within scope of own role)
E1
2. Using basic technology skills to organise data E2
3. Adapting to new technology skill requirements (i.e.
within scope of own role)
E3
4. Applying OHS knowledge when using technology E4



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CHCAC317A.Support Older People To Maintain Their Independence
Element
Performance Criteria
1.
Support the older person with their activities of living.

1.1
Encourage older people to utilise support services where
appropriate.
1.2
Clearly explain the scope of the service to be provided to the older
person and/or their advocate.
1.3
Identify the needs of the older person from the service delivery
plan and from consultation with a supervisor.
1.4
Ensure visits and service delivery accommodates the older
person’s established routines and customs where possible.
1.5
Perform work in a manner that acknowledges that the services are
being provided in the client’s own home.
1.6
Provide services in a manner that enables the older person to
direct the processes where appropriate.
1.7
Provide support/assistance in accordance with organisation policy,
protocols and procedures.
1.8
Demonstrate appropriate use of equipment to support/assist the
older person with activities of living within work role and
responsibility.
2.
Recognise and report changes in an older person’s ability to undertake
activities of living.

2.1
Monitor the older person’s activities and environment to identify
increased need for support/assistance with activities of living.
2.2
Report to a supervisor the older person’s inability to undertake
activities of living independently.
2.3
Support/assist the older person to modify or adapt the
environment or activity to facilitate independence.
2.4
Seek aids and/or equipment to support/assist the older person
undertake activities of living independently.



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3.
Support the older person to maintain an environment that maximises
independence, safety and security.

3.1
Encourage and support/assist the older person to maintain their
environment.
3.2
Provide support to promote security of the older person’s
environment.
3.3
Adapt or modify the environment, in consultation with the older
person, to maximise safety and comfort.
3.4
Recognise hazards and address in accordance with organisation
policy and protocols.
4.
Support the older person who is experiencing loss and grief.

4.1
Recognise signs that older person is experiencing grief and report
to appropriate person.
4.2
Use appropriate communication strategies when older person is
expressing their fears and other emotions associated with loss
and grief.
4.3
Provide older person and/or their support network with information
regarding relevant support services as required.




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Skills and Knowledge
Required Skills
It is critical that the candidate demonstrate the ability to:
 Apply demonstrated understanding of own work role and
responsibilities
 Follow organisation policies and protocols
 Liaise and report appropriately to supervisor
 Adhere to own work role and responsibilities
 Monitor older people’s ability to undertake instrumental activities
of living and providing support/assistance in accordance with
service delivery plans

In addition, the candidate must be able to demonstrate relevant task
skills; task management skills; contingency management skills and
job/role environment skills
These include the ability to:
 Accommodate older people’s established routines and customs
and right to direct service delivery processes
 Apply reading and writing skills required to fulfil work role in a
safe manner and as specified by the organisation/service:
 this requires a level of skill that enables the worker to follow
work-related instructions and directions and the ability to seek
clarification and comments from supervisors, clients and
colleagues
 industry work roles will require workers to possess a literacy level
that will enable them to interpret international safety signs, read
client’s service delivery plans, make notations in clients records
and complete workplace forms and records
 Apply oral communication skills required to fulfil work role in a
safe manner and as specified by the organisation:
 this requires a level of skill that enables the worker to follow
work-related instructions and directions and the ability to seek
clarification and comments from supervisors, clients and
colleagues
 industry work roles will require workers to possess oral
communication skills that will enable them to ask questions,
clarify understanding, recognise and interpret non-verbal cues,
provide information and express encouragement
 Apply numeracy skills required to fulfil work role in a safe manner
and as specified by the organisation:





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 industry work roles will require workers to be able to perform
basic mathematical functions, such as addition and subtraction
up to three digit numbers and multiplication and division of single
and double digit numbers
 Apply basic problem solving skills to resolve problems of limited
difficulty within organisation protocols
 Work effectively with clients, social networks, colleagues and
supervisors
Required Knowledge
The candidate must be able to demonstrate essential knowledge
required to effectively perform task skills; task management skills;
contingency management skills and job/role environment skills as
outlined in elements and performance criteria of this unit
These include knowledge of:
 Relevant policies, protocols and practices of the organisation in
relation to Unit Descriptor and work role
 The importance of community engagement and the ability to
undertake instrumental activities of living for older people
 Principles and practices of confidentiality and privacy
 Principles and practices associated with providing services in a
client’s own living environment
 Strategies for supporting/assisting an older person to undertake
instrumental activities of living independently
 Services and aids available to support independence with
instrumental activities of living
 Referral mechanisms
 Safety and security risks associated with ageing
 Hazards in an older person’s environment
 Strategies for minimising hazards in older person’s environments
 Stages of loss and grief and impact of ageing on person’s
experiences of loss and grief



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Range Statement
The Range Statement relates to the unit of competency as a whole. It allows for different work
environments and situations that may affect performance. Add any essential operating conditions
that may be present with training and assessment depending on the work situation, needs of the
candidate, accessibility of the item, and local industry and regional contexts.
Older people may include:
 Individuals living in residential aged care environments
 Individuals living in the community
Contexts may include:  The older person’s own dwelling
 Independent living accommodation
 Residential aged care facilities
Activities of living may
include:
 Home maintenance
 Garden maintenance
 Transport and attendance at appointments and social
and recreational activities
 Domestic cleaning
 Domestic laundry
 Meal preparation
 Shopping
 Attendance to financial matters and personal
correspondence
 Pet care
Report may be and
include:
 Verbal:
- telephone
- face-to-face
 Non-verbal (written):
- progress reports
- case notes
- incident reports
Aids and/or equipment
may include:
 Domestic appliances utilised for cleaning, laundering
and meal preparation
 Gardening equipment
 Personal and security alarms
 Mobility devices
Hazards may include:  Poor or inappropriate lighting
 Slippery or uneven floor surfaces
 Physical obstructions (e.g. furniture and equipment)
 Poor home and domestic appliance maintenance
 Inadequate heating and cooling devices
 Inappropriate footwear and clothing



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



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1. Support the older person with
their activities of living.

1.1
Encourage older people to utilise support services where
appropriate.
1.2
Clearly explain the scope of the service to be provided to the
older person and/or their advocate.
1.3
Identify the needs of the older person from the service delivery
plan and from consultation with a supervisor.
1.4
Ensure visits and service delivery accommodates the older
person’s established routines and customs where possible.
1.5
Perform work in a manner that acknowledges that the services
are being provided in the client’s own home.
1.6
Provide services in a manner that enables the older person to
direct the processes where appropriate.
1.7
Provide support/assistance in accordance with organisation
policy, protocols and procedures.
1.8
Demonstrate appropriate use of equipment to support/assist the
older person with activities of living within work role and
responsibility.

1.1 Encourage older people to utilise support services where
appropriate.
Being aware of ageism (the process of systematic stereotyping and
discrimination against older people simply because they are old),
stereotyping and the impact of attitudes on how services are delivered
will help aged care workers and carers to focus on their clients. Remem-
ber that the client — not the worker or anyone else — should be at the
centre of the service. Services must always focus on the individual client
and their needs, preferences and perspectives. To promote a client-
centred or person-centred approach and minimise ageism and
discrimination:
 assume that everyone is different
 check to see whether you use collective or childish names for older
clients, such as'duckie', 'sweetie' or 'old codger' — if you do, you
may think you are being very caring but you are also being ageist
 always use the person's preferred name, as this is an excellent start
to providing an individualised, non-stereotypical service



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 always ask the person what they need and how they would like
things done
 use good listening and communication skills to clarify information
and develop a working environment that is mutually respectful
 learn about and uphold client rights, and tell clients what their rights
are
 if the client is from a culturally and linguistically diverse (CALD)
community, use a trained interpreter — do not use a member of the
family, and do not try to guess what the person is saying
 let the older person be the judge of what is in their best interests.

The elderly have certain absolute rights that should be built into all
services that are provided. These rights include respect for their dignity,
the ability to make informed choices either directly or through a
guardian, and respect for their right to confidentiality and privacy and
these are found in state and federal legislation and acts such as the
Privacy Act and the Confidentiality Act.
Healthy ageing requires providing support to older people before they
experience physical or mental health crisis. The availability of accessible
transport and leisure and recreation programs is vital to realise the
expectation of a healthy and enjoyable old age, as is access to
information services such as computer and electronic media to assist in
maintaining social networks. Home support services such as home help,
personal care, home modification and home maintenance are important
in supporting older people to remain independent at home.
Health Ageing approaches:-
 research to identify causes of disease and the best way to deal with
them
 health promotion
 recognition of individualised needs, including cultural preferences,
beliefs and values
 physical activity to maintain fitness
 mental activity, including learning,
 recreation and social activity
 good nutrition
 regular health checks for the early identification of diseases
 immunisation programs
 revising lifestyle choices such as diet, exercise, drug and alcohol
use, smoking
 careful medication management
Quality Care Services for Older People
 affordable, accessible, appropriate, efficient and high-quality
services



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 planned, integrated, innovative, flexible and coordinated services
 a range of private and publicly funded services
 a trained workforce
 providing information to clients so that they can make informed
choices
 supporting the needs of carers
(Andrews 2001)

In 2001, the Australian government established the Commonwealth
Carelink Centre to help people locate the right services. Carelink
Centres provide information about community services, aged care
homes and other support services via a freecall number. These centres
have been successful in helping consumers understand how to use the
system and in referring them to relevant services in their area.
The expectations we have on services are:-
 Are reliable, dependable and on-going
 Meet the required government standards set by federal and state
legislation
 Empower older people to participate in the delivery of their care
 Are affordable and accessible
 Have a fair society in which, everyone is of equal worth and
everyone has an equal opportunity to succeed (social justice).
 Are holistic and individualized to promote a person-centred
approach.

Social Justice
Social justice is where everyone is of equal worth and everyone has an
equal opportunity to succeed. There are four key areas to consider:-
1. Fairness in the distribution of resources-services, housing, wealth
2. People’s rights are promoted
3. People have fair access to resources and services to meet their
basic needs and to improve their quality of life
4. People have better opportunities to participate and be consulted
about decisions that affect their lives.
As part of social justice comes access and equity is a commitment on
behalf of your client and their personal carers. This is demonstrated by
the work an aged care worker performs and aims to:-
 develop a client-centred culture based on responding to their
expressed needs and wants
 provide services that take a non-discriminatory approach to all
people using the service including clients, family and friends, co-
workers and the general public



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 undertake work that caters for individual differences including
cultural, physical, religious, economic, social, developmental,
behavioural, emotional and intellectual
 protect the rights of clients. These rights include rights to:
 privacy and confidentiality
 being treated with dignity and respect
 being safe and comfortable in the environment
 being able to express their feelings and concerns
 freedom of association and forming friendships
 choosing to participate
 having access to complaint mechanisms.
These rights should be referred to in all relevant documentation
including the clients' charter of rights and the Aged Care Act 1997 that
includes a quality system of accreditation as it relates to the Aged Care
Standards.
Aged Care Standards
There are four standards and up to 44 expected outcomes to continue to
receive funding from the government.
Standard 1: Management systems, staffing and organizational
development.
Among other things this standard ensures:
 homes have management and information systems that are
responsive to the needs of clients, representatives, staff and
stakeholders and the changing environment that the home
operates within
 continuous improvement
 that you have access to a complaints system
 that the staff who care for you are skilled, and
 that the home has the appropriate goods and equipment.
Standard 2: Health and personal care, and requires that:
 medication is managed safely and correctly
 clinical care meets your needs
 continence is managed effectively
 pain management
 continence management
 you are offered a varied, healthy and well-balanced diet
 oral and dental health is maintained, and
 your best level of mobility is achieved.



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Standard 3 is about lifestyle, and:
 maintaining your independence
 respecting your privacy, dignity and confidentiality
 encouraging your participation in decisions about services the
home provides
 fostering your cultural and spiritual life, and
 ensuring clients understand their rights and responsibilities.
Standard 4 requires a safe and comfortable environment that
ensures quality of life, your welfare and that of your visitors and
the home’s staff by:
 minimising fire, security and emergency risks
 Occupational Health and Safety
 having an effective infection control program, and
 providing catering, cleaning and laundry services to enhance
your client’s quality of life.
This part helps your client, you as the carer, your client’s family and
friends understand the various types of home help available – why your
client might want or need them, and how they can be arranged for your
client. Home help is often described as 'community care'.

Aged Care Assessment Teams
To work out if you're eligible for certain subsidised aged care services
you'll need to contact your client’s local Aged Care Assessment Team
(ACAT or ACAS in Victoria). These are teams of health professionals
who help decide on the types of care that will best meet your client’s
needs, such as home help or the support provided by an aged care
home.
Referrals to an ACAT can be made by anyone – you as a carer, your
client or a health professional such as your client’s doctor.
Once your client or their representative has made an appointment, a
member of your client’s local ACAT will visit them in their home, hospital
or elsewhere, ask your client a series of questions and discuss the
assessment with your client. You as carer are able to be involved in this
discussion. The ACAT member visiting your client may be a doctor,
nurse, social worker, physiotherapist, occupational therapist,
psychologist or other appropriate health care professional. Their job is to
discuss your client’s situation, give your client all the information your
client requires, and help your client make the best choices based on
their individual needs and the services available. There are no fees
charged for this assessment.
The ACAT is made up of health care professionals who have experience
with the system and can help you in many ways:



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 with decisions about whether your client can continue living at
home with home help or if your client should consider moving
into an aged care home
 by providing information about aged care homes and home care
services in your client’s area
 by assessing your client’s eligibility to receive aged care services
 by organising and approving care and support services
 by referring you to other services that may assist you, and
 by arranging short-term care, such as respite care, so you as
their carer or your client’s can take a break.

Home & Community Care Program (HACC)
If your client requires some basic help with everyday tasks, the Home
and Community Care (HACC) program can assist by supporting your
client’s independence at home and in the community. This is an ideal
solution if long-term care in an aged care home is inappropriate and
your client only needs low-level care. An assessment by an ACAT is not
necessary to access these services.
The primary aim of all home and community care is to maintain or
enhance the personal independence and quality of life of frail older
people, people with disabilities and their carers. Home and community
care services enable people to remain living at home rather than using
hospitals, residential or institutional-based care. Without access to home
and community care services many frail older people and people
disabilities would require placement in a residential facility much sooner.

The Home and Community Care (HACC) program aims to provide your
client with a basic range of maintenance and support services to help
your client stay at home. The services are provided by the community,
privately, and by church or charitable organisations throughout Australia.
The HACC Program can help your client with services such as:
 nursing care, including home nursing, assistance with continence
management, all in your client’s own home
 home help, such as housework, washing and shopping
 home maintenance and modification
 personal care, such as help with bathing, dressing and eating
 meals on wheels and day centre-based meals
 ancillary health services like podiatry and speech therapy
 community-based respite care (day care) transport
 assessment and/or referral services
 counselling, information and advocacy services
 social support (including neighbour aid), and
 carer support



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To access HACC your client can contact your local HACC provider
directly, such as Meals on Wheels service, to discuss your client’s
needs and adjust them as your client’s requirements change.
And remember, should your client develop more complex care needs
your client should enquire about other community services, such as
Community Aged Care Packages, Extended Aged Care at Home
(EACH) and EACH Dementia. EACH HACC service provider will
assess your client to determine the appropriate level of service for your
client.
To contact your client’s nearest HACC services, use the ‘Talk to
someone about this’ box in the right hand corner of this page, or call the
Commonwealth Respite and Carelink Centre on 1800 052 222 during
business hours or, for emergency respite support outside standard
business hours, call 1800 059 059.
HACC services are designed for people who need support to continue
living in the community and who are older and frail or who have a
disability. So if your client has difficulties with everyday tasks, such as
getting dressed or showering, this could well be the extra support your
client needs. HACC services are designed to reach people with the
greatest level of need, as decided by HACC service providers.
To be eligible for the HACC Program your client must:
 be living at home, be an older and frail person, or a person with a
disability and have difficulty doing everyday tasks such as
dressing or preparing meals,
 be a carer of a frail older person or person with a disability, or
 be likely to need to go into an aged care home or a hospital for
care if your client were not being provided with support from
HACC.

Some services charge a small fee that varies between states and
territories – check with your client’s local HACC service about the costs
of the particular services your client needs. These vary according to
your client’s income and the number of services your client uses.
Special arrangements may be made if your client cannot afford to pay.
Community care service providers are expected to comply with
obligations under laws such as the Aged Care Act 1997. Under these
laws your client has the right to be treated respectfully and be informed
and consulted about their care.
The HACC Program operates under a comprehensive quality framework
to ensure that acceptable standards of service provision and program
administration are maintained. The National Guidelines for HACC
Service Standards provide agencies with a nationally consistent
approach to the quality and delivery of all HACC funded services.
Agencies funded through the HACC Program are required to report on
aspects of quality, including standards. The Standards Instrument was
developed to provide a consistent method for evaluating and monitoring
the quality of service provision, as well as assist in the planning aspects
of the service delivery system on a regional, state, territory and national
level.



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Community Aged Care Packages (CACP)
This program provides a planned and managed package of community
care for your client if your client has complex low-level care needs but
can still live in their own home. To be eligible to receive a package, your
client must be assessed by an Aged Care Assessment Team (ACAT).
Your client’s CACP care manager’s role is to plan and manage your
client’s care package, tailoring it to your client’s individual needs. For
example, a package may give your client help with personal care such
as bathing and dressing, domestic assistance such as housework and
shopping, or possibly help participating in social activities
Other types of services that may be provided include:
 meal preparation
 laundry
 assistance with continence management
 transport
 personal care
 social support
 home help
 gardening, and
 temporary in-home respite care
To be eligible to receive a care package, your client must be assessed
by an Aged Care Assessment Team (ACAT or ACAS in Victoria) as
requiring the level of assistance this package delivers.

Extended Aged Care at Home (EACH)
Extended Aged Care at Home (EACH) is a program that provides your
client with high-level care at home if your client needs more assistance
than a Community Aged Care Package can provide. EACH is also an
individually planned package and is coordinated for your client.
An EACH package is highly flexible and includes qualified nursing input.
The services that may be provided as part of an EACH package include:
 care by an allied health professional such as a physiotherapist or
podiatrist
 personal care
 domestic assistance
 in-home respite
 transport
 social support
 home help, and
 assistance with continence management



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To receive an EACH package an Aged Care Assessment Team (ACAT
or ACAS in Victoria) must assess your client as needing high-level care
at home. Information on ACATS is available from Doctors, Hospitals and
Community Centres, or the Aged Care Information line on 1800 500 853
(free call), or Commonwealth Respite and Carelink Centres on 1800 052
222 (free call) during business hours or, for emergency respite support
outside standard business hours, call 1800 059 059 (free call).
Community care service providers are expected to comply with
obligations under laws such as the Aged Care Act 1997. Under these
laws your client has the right to be treated respectfully and be informed
and consulted about their care.
The Australian Government sets standards to ensure your client receive
quality care. For example, community care standards make sure that
your client receives a service that meets their individual needs and that
they have access to complaints procedures if they need them.
Services that provide EACH packages are required to take part in
Quality Reporting. It checks that services have systems and processes
in place to meet the care standards that are put in place by government
legislation.
Extended Aged Care at Home Dementia (EACH D)
If your client or someone your client cares for needs assistance because
of behavioural problems associated with dementia, including periods of
changes in behaviour, the Extended Aged Care at Home – Dementia
(EACH D) program can provide high-level care through an individually
tailored package
An EACH D package is highly flexible and includes qualified nursing
input. The services that may be provided as part of an EACH D package
include:
 linkages to government funded Dementia Behaviour Management
Centres
 care by an allied health professional such as a physiotherapist or
podiatrist
 personal care
 home help, and
 assistance with continence management
To receive an EACH D package, your client must first be assessed and
approved by an Aged Care Assessment Team (ACAT or ACAS in
Victoria) as a person who:
 is experiencing behaviours of concern and psychological symptoms
associated with dementia that significantly impact upon your client’s
ability to live independently in the community, and may impact on
functional capacity
 needs high level care in an aged care home
 prefers to receive EACH D, and
 is able to live at home with the support of an EACH D package.



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Community care service providers are expected to comply with
obligations under laws such as the Aged Care Act 1997. Under these
laws your client has the right to be treated respectfully and be informed
and consulted about their care.
The Australian Government sets standards to ensure your client
receives quality care. Recipients of an EACH D package of care (or their
representatives) are entitled to:
 quality services that meet their required needs
 where possible, their preferred level of social independence
 access information about the care options available and the facts
they may need to make informed choices
 access to details of the care being provided
 take part in developing a package of care that best meets their
needs.

National Respite for Carers Program (NRCP)
Caring for a frail or older person can be physically and emotionally
demanding. To make sure you as a carer get a break, the National
Respite for Carers Program (NRCP) provides day care centres, in-home
and activity respite programs. Your client does not need an ACAT
assessment for community based respite services – only if your client is
receiving respite in an aged care home.
There is a lot of assistance available for carers today, including timely,
quality information, carer education and support that’s both culturally
and linguistically sensitive. If your client cares for a family member or
friend to help them to continue living at home, your client may also be
interested in respite care opportunities, which give your client and the
person they're caring for the chance to take a short break.
The National Respite for Carers Program (NRCP) allows carers of older
people, people needing palliative care and people with disabilities to
have a break to look after their own health and well-being, with the
comfort of knowing that their client’s dependants are well looked after.

A range of community-based and residential respite is available and
includes:
 day care centres that provide respite for a half day or full day
 in-home respite services, including overnight, home care and
personal care services providing respite and support
 activity programs
 a break away from home, perhaps with a support worker
 respite for carers of people with dementia and challenging
behaviours
 respite in a residential aged care home or overnight respite in a
community setting, and
 respite for employed carers and for carers seeking to return to work.



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The NRCP can provide you as carer with specialised professional
counselling. These services are operated through Carers Australia and
The Network of Carer Associations, located throughout Australia. You
can call them on 1800 242 636.
Access to respite care is based on priority and need. For respite care in
your client’s home or in a day care centre, the respite service provider,
or the Commonwealth Respite and Carelink Centre will assess whether
you and your carer are eligible. The amount of care you receive will
depend on your needs, your eligibility, and the availability of respite care
services. You can contact the Commonwealth Respite and Carelink
Centres on 1800 052 222 during business hours or, for emergency
respite support outside standard business hours, call 1800 059 059.

To receive respite care in an aged care home, you will have to be
assessed by an Aged Care Assessment Team (ACAT or ACAS in
Victoria), except in emergency situations. Usually, you can have up to
63 days of government-funded respite care in any financial year, and it
may be possible to extend the care period by up to 21 days at a time, if
your ACAT considers this necessary. Commonwealth Respite and
Carelink Centres can help you with locating and booking a respite bed.


Centrelink Assistance
Financial assistance is available in many forms to help your client and/or
you including:
 the Disability Support Pension, available for people who are unable
to work for a prolonged period of time because of a disability
 the Mobility Allowance, paid to eligible disabled workers to meet the
extra cost of travel
 the Carer Payment, which provides an income support payment
(similar to a pension) for people whose caring responsibilities
prevent them from significantly participating in the workforce, and
 the Carer Allowance, which provides an income supplement for
people who provide daily care and attention at home for an adult or
child with a disability or severe medical condition.
Centrelink can also help with information about Rent Assistance, the
Age Pension and concession cards. It also provides the Financial
Information Service, a free and independent financial planning service
available whether or not your client is receiving a pension or benefit.
Community care service providers are expected to comply with
obligations under their funding agreements and to deliver quality
services that must meet national standards. Your client has the right to
be treated respectfully, be informed and consulted about their care, and
the right to make a complaint. In turn, your client has a responsibility to
treat their service provider with respect.
The Australian Government sets standards to ensure your client
receives quality care. For example, community care standards ensure
that your client receives a service that meets your client’s individual
needs. Your client has access to complaints procedures should they
require them.



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Commonwealth Respite and Carelink Program
The Commonwealth Respite and Carelink Program is a national network
of centres that provide up-to-date information on local community, aged
care and disability services in your client’s area that will help them
continue living at home.
The Commonwealth Respite and Carelink Program is a national network
of centres that maintains an extensive database. These centres can
provide your client with free and confidential information on:
 household help
 personal care
 home nursing
 meal services
 home modifications
 carer support
 short-term care
 day care centres
 day therapy centres
 special services for people with dementia
 services for people with incontinence and
 a range of allied health services.

There are 65 walk-in shopfronts throughout Australia, ensuring that the
Commonwealth Respite and Carelink Centre closest to your client will
know about the services in your client’s particular location. You or your
client can call Commonwealth Respite and Carelink Centres on 1800
052 222 (free call) or visit the Commonwealth Respite and Carelink
website.
Transition Care Program
The Transition Care Program is aimed at helping your client improve
their independence and confidence after a hospital stay, giving your
client and their family more time to determine whether they can return
home with additional support from community care services, or need to
consider the level of care provided by an aged care home. An ACAT
assessment and approval is required to access this service.
The Transition Care Program aims to help your client improve your
independence and confidence after a hospital stay. It provides a
package of services including low intensity therapy and personal and/or
nursing care as part of an ongoing but slower recovery process. This
means that your client and their family or carer has time to consider their
long-term care arrangements, which may include returning home with
community support or accessing the level of care provided by an aged
care home.



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Transition care is provided in their own home or in a ‘live-in’ setting.

Transition care can be provided for a period of up to 12 weeks, with a
possibility to extend to 18 weeks if your client is assessed as needing an
extra period of therapeutic care. The average period of care is expected
to be about seven weeks.
To be eligible for transition care, your client must be an older person and
an in-patient of a hospital. Your client must have completed their acute
and any necessary sub-acute care (eg rehabilitation).
While your client is still in hospital, they must be assessed by an Aged
Care Assessment Team (ACAT, or ACAS in Victoria) as someone who
would be suitable for transition care. This includes consideration of their
ability to benefit from the services transition care offers (eg low intensity
therapy such as physiotherapy and occupational therapy) within the
allowable time limits (a maximum of 12 weeks, with a possibility to
extend to 18 weeks if they are assessed as needing an extra period of
therapeutic care).
Transition care provides a package of services tailored to their needs.
This may include a range of low intensity therapy services and nursing
support and/or personal care services.

Examples of low intensity therapy services may include:
 physiotherapy
 occupational therapy
 dietetics
 podiatry
 speech therapy
 counselling, and
 social work.
Example of personal care services may include assistance with:
 showering, dressing
 eating and eating aids
 managing incontinence
 transport to appointments
 moving, walking, and
 communication.
Transition care can take place either at home or in a live-in setting.
When it’s offered in a live-in setting, it must be provided in a more home-
like, non-hospital environment that has space available for therapy.
Access to transition care is decided on a needs basis, not on your
client’s ability to pay fees. In determining their ability to pay fees, your
client’s transition care provider takes into account their other



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unavoidable expenses such as high pharmaceutical bills or fees that
your client still needs to pay to your aged care home.
While you’re in transition care you have rights, including the right to
have a Transition Care Recipient Agreement with the service provider.
You also have the right to:
 full and effective use of your client’s personal, civil, legal and
consumer rights
 be in a safe, secure and homelike environment
 be given enough information to make an informed choice about their
care
 have written information about their rights, care, accommodation and
any other information that relates to your client personally
 be involved in deciding on and choosing the care most appropriate
to your client’s needs
 receive care that takes account of their lifestyle, cultural, linguistic
and religious preferences
 be given a written plan of the services they will receive
 take part in social activities and community life as far as possible
 have their dignity and privacy respected
 complain about the care they’re receiving, including the manner in
which it’s being provided, without fear of losing the care or being
disadvantaged in any other way, and
 choose a person to speak on their behalf for any purpose.
It’s also good to know that the government has a quality framework in
place to monitor:
 the quality of transition care your client receives
 the qualifications of staff
 the building where transition care takes place
 the complaints procedure, and
 your client’s rights.

Community nursing and Health Centres
Community health centres aim to improve your client’s health and well-
being by:
 encouraging them to actively participate in their own health care
 working on their needs with other primary health care providers
 offering facilities for their local community groups
 encouraging active participation in the centre's activities, including
involvement in management, fundraising and volunteer work
 promoting prevention of lifestyle-related diseases and conditions,
and



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 developing health care programs and activities to improve social and
physical environments in the community.
Community health centres offer a range of services that can help your
client remain at home by supporting them and you as their carer. The
types of services that may be available at the local health centre include:
 medical services
 physiotherapy to help maintain their flexibility, strength and
movement
 podiatry for foot and lower limb problems
 nursing, including health advice, education, counselling and
monitoring
 speech pathology to help them communicate more effectively
should they have a speech disorder
 social workers to help them or you as their carer with problems
related to finances, accommodation or socialisation, and
 tailored programs for their specific dietary needs.

Types of Care and Services
High level care
High-level care is for people who need 24-hour nursing care. This may
be because they are physically unable to move around and care for
themselves, or because they have a severe dementia-type illness or
other behavioural problems. Clients in high care must receive additional
care and services at no additional cost.
All aged care homes must provide a specified range of care and
services at no additional cost to clients. These requirements vary
according to whether the client has ‘low-care’ or ‘high-care’ needs.
There are some specified care and services that all clients receive and
additional ones that are provided for high-level care clients.
If your client is unsure of whether they are receiving high-level care or
low-level care, you as advocate could assist in getting that information
by perhaps asking the manager of the aged care home.
The specified care and services that must be provided by the aged care
home at no additional cost are listed below. If a home provides the
required range of specified care and services but the client would like
certain other brands, or has individual specific needs, then the home
does not have to cover the cost of those products.



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Hostel/accommodation services
All clients receive specified care and services relating to:
 maintenance of buildings and grounds
 accommodation
 furnishings
 bedding
 cleaning services
 general laundry
 toiletries - bath towels, face washers, soap and toilet paper
 meals and refreshments
 social activities
 provision of staff on call to provide emergency help.

Additional requirements for high-level care
High care clients must be provided with additional items, care and
services such as:
 goods to help them move themselves e.g. crutches, walkers
 goods to assist with toilet and incontinence management
 more basic toiletries – such as tissues, toothpaste, denture cleaning
preparations, shampoo, conditioner and talcum powder.

Personal care and services
All clients receive specified care and services including:
 assistance with the activities of daily living, such as:
 bathing and grooming
 using the toilet
 eating
 dressing
 mobility
 maintaining continence or managing incontinence
 communicating with other people
 emotional support
 treatments and procedures (such as assistance with taking
medication)
 recreational activities
 rehabilitation support



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 assistance in obtaining health practitioner services and access to
specific therapy services, and
 support for people with memory loss or confusion.

Additional requirements for high-level care
High care clients must be provided with additional items, care and
services such as:
 Nursing services and equipment, such as equipment to assist with:
 mobility, continence aids, basic medical and pharmaceutical
supplies and equipment, helping with medications, provision of
therapy services and short term oxygen.
Homes must also meet the requirements under the Accreditation
Standards for Residential Aged Care.

Low level Care
Low-level care places are for people who need some help. Mostly,
people in low-level care can walk or move about on their own.

Low-level care focuses on personal care services (help with dressing,
eating, bathing etc.), accommodation, support services (cleaning,
laundry and meals) and some allied health services such as
physiotherapy. Nursing care can be given when required.

Most low-level aged care homes have nurses on staff, or at least have
easy access to them.
Low-level care is for people who need some help, but do not have very
complex ongoing care needs.
Low care includes:
 accommodation-related services — furnishings, bedding, general
laundry, some toiletries, cleaning services, all meals,
maintenance of buildings and grounds, and the provision of staff
on call to provide emergency assistance, and
 personal care services — assistance with the activities of daily
living, such as bathing, going to the toilet, eating, dressing,
moving around, maintaining continence or managing
incontinence, rehabilitation support, and assistance in obtaining
health and therapy services.



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Ageing in Place
Ageing in place refers to aged care homes that offer both high- and low-
level care, and to situations where it is possible to stay in the same
home if your care needs increase.
It is possible in some aged care homes for you to receive care at low-
level or high-level in the same place of residence. This means you don’t
need to move as a result of changing care needs. It is called ‘ageing in
place’.

An ageing in place policy is particularly beneficial for couples planning
for a move from the family home as it may enable them to remain
together even if their care needs significantly change over time. It also
means people can maintain the relationships they have developed with
staff and clients. The staff will be qualified and trained to support older
people needing varying styles of care, including nursing, if needed. The
ageing in place homes are designed to cater for people with a variety of
care needs.
Not all aged care homes offer ageing in place, with some providing for
either low-level or high-level care needs, but not both.
Also, a home may not be able to appropriately care for you in certain
circumstances – such as when behaviours of concern associated with
dementia develop, that cannot be managed, or if you need acute care
and need to go to hospital.

Extra Services
Some aged care homes may offer a higher standard of accommodation,
food and services for an additional daily fee. They may also charge an
accommodation bond for both low and high-level care when receiving
extra services.
Extra-service homes offer clients a higher standard of accommodation,
services and food (sometimes referred to as 'hotel' services) at a higher
fee.

As this amount varies from home to home, it’s best to check costs
directly with the aged care home. However, extra service does not mean
that clients will be provided with a higher level of care (such as nursing),
because all homes have to provide the same level of care to their
clients. If paying for extra service, a client may receive, for instance, a
bigger room, a wider choice of meals, or wine with meals.

If your client chooses to enter an extra-service aged care home, an
extra-service agreement must be made between the aged care provider
and the client, in addition to the normal client agreement. It should
specify what the home will provide at a higher standard, how much
those aspects will cost, how often the extra service fees can be
increased and by how much.




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End-of-life Care/Palliative Care
End-of-life care or palliative care is care provided for people who have a
life threatening illness, with little or no prospect of a cure, and for whom
the primary treatment goal is quality of life. Palliative care in aged care
homes aims to give the client the best possible quality of life, reducing
the need to move clients to another location such as a hospital or
hospice.
End-of-life care, or palliative care, is care provided for people who have
a life-limiting illness, with little or no prospect of a cure, and for whom
the primary treatment goal is quality of life.

Palliative care uses a holistic approach – managing pain and other
symptoms, whilst also addressing the physical, emotional, cultural,
social and spiritual needs of the person, their family and their carers. It
focuses on ‘living’ well until death.

How palliative care is managed in aged care homes?
Palliative care in aged care homes aims to give the client the best
possible quality of life. In fact, the approach of some aged care homes
reduces the need to move clients to another location such as a hospital
or hospice. This allows the client receiving care and their family to stay
in their familiar environment and to feel supported, safe and
comfortable.

Also, accreditation standards of aged care homes make them
responsible for ensuring that symptoms such as pain are managed, and
that the comfort and dignity of the client is maintained at all times.

In some cases, where clients have complex symptoms and the aged
care team within the home needs more specialist palliative support,
external palliative care services may be consulted.

The Guidelines for a Palliative Approach in Residential Aged Care
Facilities have been developed to provide support and guidance for the
delivery of a palliative approach in residential aged care homes across
Australia. All residential aged care homes in Australia have received a
copy of the guidelines and national workshops have been held across
Australia to raise the awareness of these guidelines and the benefits of
using a palliative approach to care.

Short-term Care
Respite care in an aged care home is short-term care on a planned or
emergency basis, where the person will ultimately return home.
Respite care in an aged care home is short-term care on a planned or
emergency basis, where the person will ultimately return home.



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How does your client access respite care?
Respite care can be provided at a low-level care or high-level care in an
aged care home once an Aged Care Assessment Team (ACAT or
ACAS in Victoria) has assessed you as needing one of these levels of
care. There are exceptions for emergency situations. Your regional
Commonwealth Respite and Carelink Centre help your client find respite
vacancies in an aged care home.

How much respite care can a client have?
Your client may have 63 days of respite care in a financial year, with the
possibility of extensions of 21 days at a time if an ACAT considers this
necessary.

Respite care in aged care homes assists frail older people who are living
at home and gives carers a break from their usual care arrangements.
Carers can use respite to help with stress, in the event of illness, for
holidays or the inability to provide care for other reasons. People who
live alone may also stay in an aged care home for a short break.

The availability of services may vary from region to region.

What fees do they have to pay?
If a person receives government-subsidised respite care in an aged care
home, they will be asked to pay a basic daily flat fee. A booking fee may
also be payable to assist in organising care. The booking fee is a
prepayment of respite care fees and not an extra payment. Respite
clients do not pay an accommodation charge or accommodation bond.
And they don’t have to pay any additional income-tested charges.

Transition Care
The Transition Care Program is aimed at helping your client improve
their independence and confidence after a hospital stay. It works by
providing low-intensity therapy and support as part of an ongoing but
slower recovery process, giving your client and their family more time to
determine whether they can return home with additional support from
community care services, or need to consider the level of care provided
by an aged care home.
The Transition Care Program aims to help you improve your
independence and confidence after a hospital stay. It provides a
package of services including low intensity therapy and personal and/or
nursing care as part of an ongoing but slower recovery process. This
means that your client and their family or carer have time to consider
their long-term care arrangements, which may include returning home
with community support or accessing the level of care provided by an
aged care home.
Transition care is provided in their own home or in a ‘live-in’ setting.

Transition care can be provided for a period of up to 12 weeks, with a
possibility to extend to 18 weeks if they are assessed as needing an



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extra period of therapeutic care. The average period of care is expected
to be about seven weeks.

Cultural and Identified Needs

Some aged care homes offer specialised services for particular groups
such as veterans, people who live in rural and regional areas, people
with a disability, people who are culturally and linguistically diverse,
Aboriginal and Torres Strait Islander people, and people who are
socially or financially disadvantaged.
Quality aged care is a basic right for all older Australians, whatever their
background, no matter where they live. There are many care and
support services that are designed to meet the needs of older
Australians. But some groups of people need additional services.

Veterans, Aboriginal and Torres Strait Islander people, those from
culturally and linguistically diverse backgrounds and people in rural and
remote areas – all have particular needs that must be provided for to
preserve and enhance their quality of life.
No matter what your gender, ethnicity, culture, language, economic
circumstance or geographic location, the Aged Care Act 1997 facilitates
their access to aged care.
People from different cultural, language or religious backgrounds are
able to access all aged care homes and the homes must acknowledge
and respect their cultural identity. But some homes provide additional
services that are specific to their individual needs as well.

Aged care homes will encourage and help clients to maintain existing
links with cultural, national or social communities, and to take part in the
social life of those communities. Aged care homes may arrange for a
translator, if your client needs one, to help explain their needs and
preferences.

People living in aged care homes have the right to practice their own
religion; some homes have their own chapel or quiet room. Some
homes have regular visits from clergy or can arrange transport to places
of worship.
Aboriginal and Torres Strait Islander people
Conditions associated with ageing generally affect Aboriginal and Torres
Strait Islander people earlier than other Australians. Planning for aged
care services is based on the Aboriginal and Torres Strait Islander
population aged 50 years or older, compared with 70 years or older for
other Australians.
Flexible models of care are provided under the National Aboriginal and
Torres Strait Islander Aged Care Strategy, often in remote areas where
no aged care services are otherwise available.




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Aged care homes for culturally and linguistically diverse people
People from different cultural, language or religious backgrounds are
able to access aged care homes. However, some homes provide
specific services to meet particular needs.
A number of aged care homes run by ethnic community organisations
receive public funding to improve the quality of life and care for older
people from diverse cultural and linguistic backgrounds.

Clustering brings together people who share similar cultural, language
or religious backgrounds within one aged care home. Other options
include multicultural services and services that are specific to a
particular nationality or language group.
The Partners in Culturally Appropriate Care (PICAC) program supports
aged care homes to provide culturally appropriate care.
The Community Partners Program (CPP) allows aged care homes and
culturally and linguistically diverse communities to work together to
establish and maintain links between people living in aged care homes
and their social, cultural and language networks.

Particular health conditions
Some aged care homes offer specialised facilities for particular
conditions, such as dementia, mental health, falls, and continence
management. If your client requires these services, they will need to
discuss them with the managers of homes they are considering.
Once an aged care home accepts your client, it must cater for their
particular health needs. These might include any one from a range of
conditions such as dementia, incontinence, and chronic, terminal or
mental illness. Some homes cater specifically for these particular needs.

Dementia
While all homes cater for clients with dementia, some provide more
targeted dementia services. These homes generally have staff who are
specially trained, and areas that have been specifically designed for
people with dementia.
Not all people with dementia require a specific dementia unit in an aged
care home. However, people with special care needs, such as those
who may not be safely accommodated in general residential facilities,
are best suited for these homes.
Alzheimer’s Australia produces a checklist that may help.



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Multipurpose services (MPS)
Multi-Purpose Services (MPS) are designed specifically for rural and
regional areas, and bring together a range of health and aged care
services under one management structure.
The Multi-Purpose Services Program is a joint Australian and
state/territory government initiative specifically designed for rural and
regional areas. The aim of the Program is to provide a coordinated and
cost-effective delivery of health services where separate health and
aged care services may not be viable. Australian Government funding
for flexible aged care is combined with State Government health
services funding. The multi-purpose service applies this combined
funding flexibly across health and aged care services to offer more
service choices specific to the needs of the local community and to be
innovative in service delivery. Services provided could include:
 aged care, both residential and home care,
 Home and Community Care (HACC) services including community
nursing, domestic assistance and meals on wheels,
 respite care,
 acute care,
 emergency services,
 mental health services, and
 a range of allied health services including physiotherapy and
podiatry
The National Aboriginal and Torres Strait Islander Aged Care Strategy
provides a culturally appropriate and flexible approach to the delivery of
aged care services for Indigenous Australians, mainly in rural and
remote areas.

Independent Living Units
Independent Living Units are residential communities that offer a range
of services for independent older people, and are regulated by state and
territory governments.
People who need less care than that offered by aged care homes may
wish to consider independent living units, or retirement villages. These
residential communities offer a range of services for independent older
people, and are regulated by state and territory governments.




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Home nursing
A nurse may also visit to help:
 restore health after an illness, and
 allow you to maintain the best level of independence.
They may also provide assistance with:
 personal hygiene
 medication
 injections, or
 changing dressings.
Care may be provided regularly or occasionally when your client needs
it.

What if your client is not happy with their care?
If your client feels that the facility is not responsive to their needs or that
they’re not getting the level of care they expect then they can get more
support by contacting:
 The Aged Care Information Line on 1800 500 853 who will tell them
about advocacy services in their state or territory, or
 The National Dementia Helpline on 1800 100 500.

Where else can they get help?
 doctor
 local community health service
 local council
 Carers Australia, phone 1800 242 636
 Dementia Helpline, phone 1800 100 500
 Carer Respite Centre, phone 1800 059 059
 Carers Resource Centres, phone 1800 242 636
 Aged Care Assessment Teams, or
 Aged Care Information Line, phone 1800 500 853.
Maintaining independence and feeling a sense of control is important for
all people but especially to the older person. This could be as simple as
maintaining the routine, desire to choose who to spend time with, the
types of clothing to wear, when and where they need privacy, the choice
of activity the person wants to participate in, ability to control their
immediate environment such as listening to music, opening a window, or
turning a fan or heater on/off. Remember, the older person is still a
person regardless of their ability to communicate, frailty and cognitive
ability. It is still important to offer choices whether it be simple or
complex, be treated with respect, dignity and courtesy, explain what you



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are doing and to help as much as possible with their activities of daily
living (ADLs).
Activities of daily living (ADLs) are similar shared needs that everyone
has such as, sleeping, eating, showering, dressing, grooming and
elimination (urinary & bowel).

Activity 1

What is Carelink?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Does an older person deserve the same rights’ as everyone else?
Why/why not?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

What are the Aged Care Standards?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

What does ACAT stand for?
_________________________________________________________
_________________________________________________________

In your own words, what does the Home and Community Care
(HACC)Program, provide to older people?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

List other services, programs or packages that older people can utilise?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________



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_________________________________________________________
_________________________________________________________

Name and summarise the types of care and services available
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

What does ADLs stand for?
_________________________________________________________


1.2 Clearly explain the scope of the service to be provided to the older
person and/or their advocate.
Independence is central to a well-developed sense of self. The ability to
live your life the way you want and to pursue your wishes, hopes and
desires, is the basis of a happy and fulfilling life. As a person gets older,
the ability and importance of controlling your own life should
remain unchanged. One of the key characteristics of an effective
aged care worker is the ability to think of ways in which we can support
people to do as much for themselves as possible. And where extra
support is required this needs to be provided in a manner that allows
people to maintain their dignity.
An advocate is a person who can provide support to the older person in
deciding and discussing what they want or how they will live. The
advocate may attend discussions about the older person’s support and
care. To make sure that the older person is able to say what they want
and receive the service they need.
People’s rights are important, and sometimes older people may need
support from the advocate to exercise their rights. Empowerment is the
process of supporting people to assert their own rights’, this is the
fundamental key of advocacy.
Many of the issues facing older people in our society are the very
issues facing the majority of the population. These include:
 coming to terms with the ageing process
access to family, friends and community
cultural isolation
 changing needs for physical comfort, sleep and rest
 general feelings of isolation and loneliness real or anticipated loss of
privacy



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 loss of home and loss of independence death, grieving and loss
 changes that ageing may bring to physical processes, memory,
intellectual
 function, personality and social interaction
 ageism
 fear of change itself

Informal Care
Informal care is the care provided by family and friends (often referred to
as carers) and it is by far the most common type of home care received.
Carers may be parents, partners, children, relatives or friends who
provide support to frail older people and people with a disability. Often
there is at least one carer who assumes responsibility for most of the
care provided; this person is referred to as the primary carer.
Being a primary carer can be as demanding as a full time job; however
many carers juggle their caring role with paid employment and/or the
responsibilities of caring for their children and grandchildren.
The difference between formal care and informal care is that carers
work in an unpaid capacity and the work they do is not regulated by
government bodies. Informal care is not considered to be volunteering,
as carers are generally not able to negotiate the terms of their
commitment. They often sacrifice a great deal of their time and quality of
life to care for someone else.
Many people who provide care do not identify them-selves as carers
because they take on their caring role as part of their family
responsibilities.
Facts about carers (Australian Bureau of Statistics 2003)
 In 2003, there were 2.6 million carers who provided some assistance
to those who needed help because of disability or age.
 About one in five carers are primary carers.
 Most primary carers (78%) cared for a person living in the same
household.
 Just over half (54%) of all carers were women.
 Twenty-four per cent of primary carers were aged 65 years and over,
compared to 13% of the total population
 37% of primary carers spent on average 40 hours or more per week
providing care and 18% spent 20 to 39 hours per week.

The current system of providing support to people who need care in
their home relies heavily on the role of carers. Carers in fact, deliver
more than 70% of all care to family members and friends needing care
and support. In many cases, the role of carers is paramount to the
success of the individual's ability to remain living at home.



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As Australia's population ages, the supply of carers cannot keep pace
with the increasing need for care. Without carers, many older people
and people with a disability may require institutionalised and long-term
residential care at great cost to society.
The amount and type of care provided by family and friends is diverse
and each care situation is different. The level of responsibility that carers
assume depends on the physical and psycho-social needs of the person
requiring care and the dynamics of the relationship between the carer
and the care recipient.
The level of support that carers offer may include some or all of the
following:
 personal care (bathing, dressing, toileting)
 domestic care (cleaning, meal preparation)
 auxiliary care (shopping, transportation, managing finances)
 social care (emotional support, informal counselling, social activities)
 complex and technical care (managing medications, catheters and
colostomies)
 specialised care (managing challenging behaviour and monitoring
mental health status).
Carers also provide an enormous amount of social and emotional
support, often on a daily basis, for some of the most vulnerable
members of our community. Please remember that a lot of carers are
not recognised as carers and will take care of a loved one regardless of
the slight remuneration they may get from the government.

Personal Cost of Caring
Caring for a person at home can affect family and friends in a number of
ways. This includes finances, time constraints, household layout and
most of all quality of life and lifestyle choices.
Becoming a carer may limit a person's ability to work or socialise outside
the home, or even perform routine tasks such as going shopping or
taking a walk.
Providing care frequently has a negative impact on the carer's quality of
life with many carers reporting anxiety, depression, ill health, physical
exhaustion, emotional exhaustion, fatigue, insomnia, weight loss and
burnout. Some carers experience a loss of privacy, loss of sleep,
psychological and emotional strain, physical tiredness and even injury
when their caring duties require them to lift or move the other person.
Carers themselves may need help and support from formal home and
community care services in addition to the services provided to the
person for whom they are caring. All services aim to support carers in
their caring role and many formal services offer carer respite.



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Carer Support
Carers play such a critical role in enabling frail older people and people
with a disability to remain living at home, it is just as important that
attention is given to the needs of the carer.
While formal carer support may come in the form of financial assistance,
access to information and respite services, services also need to be
ever mindful of meeting the needs of carers and working in partnership
with them.
The Australian Government provides financial support to carers through
the Carer Allowance or Carer Payment.
Carer Allowance is a fortnightly supplementary payment for people who
care for an adult with a disability or a severe medical condition or
someone who is frail, aged and living at home. It is not income tested.
Carer Payment provides income support (similar to a pension) to carers
who, because of their extensive caring role, are unable to support
themselves through participation in the workforce. Unlike the Carer
Allowance, the Carer Payment is income tested.

Respite
The National Respite for Carers Program (NRCP) is one of several
Australian Government initiatives designed to support and assist carers
through the provision of information and support for carers and respite
services.
The National Respite for Carers Program funds:
 respite services
 Commonwealth Carer Respite Centres
 Commonwealth Carer Resource Centres
 the National Carer Counselling Program
 Respite care is provided by community care services, such as
those provided by the Home and Community Care Program (HACC)
and by residential care facilities.

Carer Resource Centres
Each State and territory has a Commonwealth Carer Resource Centre,
This includes information on:
 services in the local area
 financial entitlements
 support services
 respite options
 advice on legal issues
 carer support groups and networks
 home help.



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The National Carer Counselling Program (NCCP) provides short term
counselling through professionally qualified counsellors and is delivered
through the Commonwealth Carer Resources Centre. The focus on
issues such as:
 stress management
 coping skills
 grief and loss issues
 practical problem solving techniques
 emotional support
 health and wellbeing.

Formal Care
Formal care is the term used to describe any home and community care
services provided by organisations or paid individuals. Formal home and
community care services may be provided by a range of local, state or
territory government bodies, community providers, charitable
organisations and private service providers, or a combination of all of
these providers.
Recently, services to assist older people to remain in their home for as
long as possible to include:
Community care services including Home and Community Care
(HACC), Community Aged Care Packages (CACP), Therapy Centres
and Carers programs to assist an older person to stay independent and
living at home and to maintain a life with dignity in the community; and
Residential Aged Care (RAC), particularly when they develop chronic
problems that prevent them from functioning at normal capacity or
independently in the community.
The primary aim of all home and community care is to maintain or
enhance the personal independence and quality of life of frail older
people, people with disabilities and their carers. Home and community
care services enable people to remain living at home rather than using
hospitals, residential or institutional-based care. Without access to home
and community care services many frail older people and people
disabilities would require placement in a residential facility much sooner.
Home and Community Care (HACC) funds community agencies to
provide services to help older people with:
 Provide a comprehensive, coordinated and integrated range of basic
maintenance and support services for frail older people, people with
a disability and their carers;
 Support people to be more dependent at home hence, enhancing
their quality of life;
 Provide flexible, timely service to respond to the needs of the older
person;
 Work around the home such as cleaning, cooking, washing, ironing
and home maintenance;



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 Personal care such as bathing and dressing, and social support
such as banking and transport;
 Food services such as home nursing, podiatry and physiotherapy.
The range of assistance provided will vary depending on the needs of
the client. Some clients need assistance with tasks such as household
cleaning and transport. Other people have more complex and personal
care needs such as assistance with mobilising, showering or bathing,
continence management, technical nursing care, specialist mental
health care and allied health or palliative care services.
Although the specific services provided will differ from client to client, the
most commonly used services include:
 assessment, case planning and review
 domestic assistance
 home nursing and personal care
 transport services
 home maintenance and modification
 meal services
 allied health care
 social support
 centre-based day care.
Some clients receive only a single service, but many frail older people
and people with complex care needs access multiple services which are
often provided by a number of different agencies.
Residential Aged Care (RAC):- offer two options for frail older people
who cannot live at home and who have been assessed as needing such
care. These are:
 Hostels - Hostels generally provide accommodation and personal
care, such as help with dressing and showering, together with
occasional nursing care.
 Nursing homes - Nursing homes tend to care for people with a
greater degree of frailty, often in need of continuous nursing care.
This can be low and high nursing care.

High level care
High-level care is for people who need 24-hour nursing care. This may
be because they are physically unable to move around and care for
themselves, or because they have a severe dementia-type illness or
other behavioural problems. Clients in high care must receive additional
care and services at no additional cost.
All aged care homes must provide a specified range of care and
services at no additional cost to clients. These requirements vary
according to whether the client has ‘low-care’ or ‘high-care’ needs.
There is some specified care and services that all clients receive and
additional ones that are provided for high-level care clients.



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If you are unsure of whether you are receiving high-level care or low-
level care, ask the manager of the aged care home.
The specified care and services that must be provided by the aged care
home at no additional cost are listed below. If a home provides the
required range of specified care and services but the client would like
certain other brands, or has individual specific needs, then the home
does not have to cover the cost of those products.
Hostel/accommodation services
All clients receive specified care and services relating to:
 maintenance of buildings and grounds
 accommodation
 furnishings
 bedding
 cleaning services
 general laundry
 toiletries - bath towels, face washers, soap and toilet paper
 meals and refreshments
 social activities
 provision of staff on call to provide emergency help.

Additional requirements for high-level care
High care clients must be provided with additional items, care and
services such as:
 goods to help them move themselves e.g. crutches, walkers
 goods to assist with toilet and incontinence management
 more basic toiletries – such as tissues, toothpaste, denture cleaning
preparations, shampoo, conditioner and talcum powder.
Personal care and services
All clients receive specified care and services including:
 assistance with the activities of daily living, such as:
 bathing and grooming
 using the toilet
 eating
 dressing
 mobility
 maintaining continence or managing incontinence
 communicating with other people
 emotional support



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 treatments and procedures (such as assistance with taking
medication)
 recreational activities
 rehabilitation support
 assistance in obtaining health practitioner services and access to
specific therapy services, and
 support for people with memory loss or confusion.

Additional requirements for high-level care
High care clients must be provided with additional items, care and
services such as:
Nursing services and equipment, such as equipment to assist with:-
mobility, continence aids, basic medical and pharmaceutical
supplies and equipment, helping with medications, provision of
therapy services and short term oxygen.

Low level Care
Low-level care places are for people who need some help. Mostly,
people in low-level care can walk or move about on their own.
Low-level care focuses on personal care services (help with dressing,
eating, bathing etc.), accommodation, support services (cleaning,
laundry and meals) and some allied health services such as
physiotherapy. Nursing care can be given when required.
Most low-level aged care homes have nurses on staff, or at least have
easy access to them.
Low-level care is for people who need some help, but do not have very
complex ongoing care needs.
Low care includes:
 accommodation-related services — furnishings, bedding, general
laundry, some toiletries, cleaning services, all meals, maintenance of
buildings and grounds, and the provision of staff on call to provide
emergency assistance, and
 personal care services — assistance with the activities of daily living,
such as bathing, going to the toilet, eating, dressing, moving around,
maintaining continence or managing incontinence, rehabilitation
support, and assistance in obtaining health and therapy services.
Ageing in Place
As stated before Ageing in place refers to aged care homes that offer
both high- and low-level care, and to situations where it is possible to
stay in the same home if your care needs increase.



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There are also short-term care options called respite care which can
include:
 Care in a day centre
 Support in a person’s own home for a number of hours a week
 A short stay in a residential care facility.

Activity 2: Case Study
Paul is a 68-year-old man who had a stroke 10 years ago. The stroke
left him unable to move his right arm. His right leg is weak. He has some
memory loss. Paul lives in a small unit on his own. There is no garden.
These are the things Paul does:
 Paul gets onto the community bus each week to go to the local
shopping centre. He has a friend that goes with him to the shops, as
Paul sometimes forgets the way back to the entrance and where to
catch the bus home.
 Paul reads all his mail and sorts out the bills. To remind himself to
pay the bills, he writes the dates they are due on the calendar.
However, Paul doesn't remember to check the calendar regularly to
read his notes.
 Paul uses a walking frame with wheels to get around, as the stroke
has left him very weak on one side.
 Paul cannot take a shower or get dressed without help, and he
needs to sit down to do these things and can only use one hand
properly.
 Paul can no longer cook meals but he can make a sandwich.
 Paul cannot do his laundry or hang it out and he is unable to look
after the building maintenance. His unit is cleaned for him twice a
week.
 Paul has two cats that are very independent. Paul is able to feed the
cats if the cans of cat food have been opened.

What help with the ADLs would Paul need to maintain his independence?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
What services are available to Paul to help him stay at home?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________




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How does Paul get access to the help he needs?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

Should Paul be put into an aged care facility? Why/why not?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________



1.3 Identify the needs of the older person from the service delivery plan
and from consultation with a supervisor.
Every client or client in your care will have a number of documents and
records about their care requirements. The most important document
you will work with is the care plan or service delivery plan. A care plan
gives all staff, including yourself, detailed information about the person
in your care and their specific care needs. This ensures everybody
works together in a consistent way, to provide the best quality care.
When assessing an older persons’ needs, a care plan or a service
delivery plan is developed. The purpose of the care plan is to establish
goals with the person/client and to determine ways of delivering services
that suit their individual needs and preferences. The care plan is re-
evaluated regularly to check that all care is implemented and to
reassess the needs of the client. For instance, if the older person has a
fall and fractures a leg and usually the person only needs a walking stick
to mobilise and now requires a wheelchair as cannot manage crutches
then the care plan would be changed immediately to meet the new
needs of the person and when the leg is healed then the care plan may
need to be modified again. It is a crucial document for ensuring
delivered care is responsive to the needs of the client.
Care plans are legal documents. You must consult the care plan before
completing any task with a client. This ensures the client or your team
members and you remain safe.
The role of the aged care worker in documenting what they do
throughout the care planning process is very important. The care plan is
an essential tool for providing evidence that the facility is meeting its
contractual obligations to the government via the accreditation process,
as well as ensuring appropriate care for clients.
The care planning process is designed to ensure that the care provided
meets the identified needs of the older person in the most effective way.
There are many names given to this process, including continuous



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improvement, risk management, case management and individual
service plans.
The care planning process involves four steps:-
1. Assessment — identifying the problems through comprehensive
assessment. (Collect information)
2. Planning — planning actions/strategies/solutions and identifying
goals to be achieved. (Care plan developed by the team and the
client)
3. Implementation — putting the action/strategy/solution into
practice.(Carry out the plan of care)
4. Evaluation — reflecting/evaluating on how effectively the goals were
achieved, and revising the plan in line with any revised care
needs(Review the plan and revise as necessary)
If you work in aged care, you will be involved in the care planning
process, and your level of involvement will depend on your role in the
team. You may be collecting information for the assessment phase, or
suggesting actions/strategies/solutions to support your client. You may
be involved in documentation of the plan, or reporting or recording
details of care you provided and the older person's responses to that
care. The care planning process is an example of a continuous
improvement process — care is evaluated on an ongoing basis, and the
care plan is updated in response to this evaluation to ensure the most
appropriate care is always provided.
A care plan is a 'dynamic' document. This means it is reviewed and
updated regularly, to meet changing needs. All staff, including yourself,
will be responsible for maintaining the care plans for people in your care.
Therefore, it is part of your role to report changes to your supervisor and
seek guidance on how to update the care plans in your workplace.
Different workplaces will have different ways of presenting information in
a care plan. You need to know how to access and read the care plans in
your workplace. They will help you plan your daily work with each client
or client.




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Summary of Care Planning Process:-













Stages of Care Planning
The care planning process directs client care, provides a framework for
teamwork and ensures adequate documentation. In residential care, this
process is closely linked to the funding mechanisms. By following this
process, all staff will know exactly what care is required for each
client/client and what issues exist for each client/client.
1. Assessment
Assessment is the process of gathering information to identify care
needs. Assessment of older people tends to focus on function and
include assessment through observation physical, cognitive/mental,
social and emotional aspects of their life. Information can be collected
by talking to or interviewing the client, their family or friends, past carers
or health workers. Each new client will be interviewed, and
comprehensive assessments are carried out to ensure that their abilities
and care needs are identified.
A range of forms and tools are used for assessment, and each health
professional will undertake an assessment according to their area of
professional expertise. As an aged care worker, your role in assessment
will include documenting the client's abilities — for example
communication, mobility, eating and drinking, personal hygiene,
toileting, social and emotional needs. You will need to observe your
client, assess their level of independence or ability, and then document
your observations. This contributes to a comprehensive assessment of
their personal care needs. Assessment provides the opportunity to
report and record your observations.
2. Planning
During the planning stage, the information collected during the
assessment stage is reviewed, and a plan of care is developed to meet
the needs of the older person. Aged care workers will be involved in
case conference discussions and client interviews, which contribute to
1. Assessment
2. Planning
3. Implementation
4. Evaluation



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the development of the care plan. The care plan should reflect the
client's goals and the type of care and support they require. It will be
documented in a way that provides clear directions on how to care for
the older person, and assists the team to regularly review the plan to
assess whether those needs/goals are being met.
3. Implementation
This is the action stage. Once the care plan has been agreed upon and
documented, the interdisciplinary team will implement the strategies
(also called actions or interventions/solutions) outlined in the care plan
to ensure the older person's needs are met. You will follow this plan of
care and document what you did for the client and how they responded.
4. Evaluation
Evaluation involves reflecting on the process and reviewing the care
plan. Aged care workers look at how the older person has responded to
the care given and make changes to the care plan as required.
Evaluation asks the question 'is the plan achieving the needs/goals that
were identified?' For example, if the care plan identifies that assistance
with toileting is required, evaluation would include reviewing whether the
older person has received assistance as required, do they still need the
level of assistance provided, are they comfortable and dry at all times
and if not, why the plan did not work and what should be done to
achieve the desired outcome.
The care planning process involves assessment, planning, interventions
or actions, and evaluation of these actions. It allows workers to
communicate effectively, leads to coordinated and client-focused care,
and provides ongoing documentation to ensure care is consistent and
holistic.
When care plans are written, they should encompass all of the factors
contributing to holistic care, empowerment to the older person, meet
individual needs and in turn, inform future decisions about care delivery.
Supervision
Remember, your supervisor is there to help you provide the best
possible support to older people. Always discuss any questions, queries
or concerns with your supervisor prior to the event if possible rather
than, doing something wrong because you are unsure of what to do then
making mistakes and then having to either fix them or someone else
fixes them. The person who has to fix the mistakes will be agitated or
angry for fixing something up that shouldn’t have to be done in the first
place as it takes away time for their duties that need to be carried out. It
may also highlight to your supervisor that the care plan or service
delivery plan needs more details written on it so it is very clear about
what needs to be done to meet this particular clients needs.




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Respite/Summary Resident Care Plan
Respite: This form to be completed for all respite clients as 'Respite Care Plan
Summary: This form to be completed using admission history.
This form is to be included in EACH 'Resident Care Plan' as a summary of care need assessments.

Preferred name DOB Allergies (Red)
Diagnosis Date
Resident/relative input
Brief social history Likes/dislikes Special risk area Communication & sensory
Vision Hearing
Speech/comprehension
Mobility
Day EvenNight
Continence Physical Aggression

Toilet







Washing/Dressing



Verbal disruption








Therapy


Skin integrity



Dentures

Special Assessment
Eating Special nursing Behaviour

Surname Given Names Doctor

Another example of Resident Care Plan: (Front of Sheet)





Resident Name:____________________________________________
Care Need Relating To:_____________________________________
Date What is the Problems/Diagnosis? Signature





Date
What Goal/s do we want to
Achieve?
Signature






Date
Which Interventions will achieve
these Goals
Signature





FITZROY FALLS AGED CARE FACILITY
RESIDENT CARE PLAN



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RECORD EVALUATIONS OF INTERVENTIONS & GOALS ACHIEVED
ON ATTACHED EVALUATION SHEET.
Resident Care Plan: (Back of Sheet)


It is important to watch older people as you visit them EACH time to
ascertain if their needs have changed or if they require extra help.

Resident Name:____________________________________________
Care Need Relating To:_____________________________________

Date Evaluation Signature




















FITZROY FALLS AGED CARE FACILITY
CARE PLAN EVALUATION FORM



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Activity 3
Use the Respite/Summary Resident Care Plan form to fill out the
following scenario.
Bill Perkins is 90 years old. He lives in a nursing home in the dementia
unit. He has high support needs. He speaks, but is often hard to
understand. Bill has a hearing aid but doesn’t wear it as he thinks he
can hear okay.
Bill fought in World War II. He likes to be up early, enjoys a daily
morning shower, shave and dentures cleaned twice a day. He enjoys
participating in ANZAC festivities. Bill enjoys the radio and television put
on very loud. At times Bill is incontinent of urine and faeces if not taken
to the toilet as per routine.
He needs help to stand and transfer into a chair. He uses a wheelchair
to move from one place to another. His wheelchair is old and one foot
plate is broken. He uses a shower chair and needs someone to wash,
dry and change him. He cannot stand without support.
He has problems with migraine headaches. He also gets pain from an
old ankle injury. At times, when Bill has migraines or pain in the ankle he
can be verbally and physically aggressive if pain not subsided quickly. It
has been six months since his family has visited him. On the last visit,
he became angry. He told his daughter not to visit again. Next week is
Bill's 91st birthday.

Activity 4
What are the four stages of care planning process?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

In your own words, summarise the four stages of the care planning
process.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Why does the care plan need to be up-to-date?
_________________________________________________________
_________________________________________________________
_________________________________________________________



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What happens if you do not comply with or follow care plans of
individual clients?
_________________________________________________________
_________________________________________________________
_________________________________________________________

If you have a client that has a hearing impairment, what would or could
you do to assist in the communication process?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________



Ensure visits and service delivery accommodate the older person’s
established routines and customs where possible.
Most people have a daily routine. Routine is the usual way a person
arranges tasks and activities. It may involve a certain time, place and
method used to complete EACH task. They might get up at a certain
time in the morning. They may have the same food for breakfast every
day. They might meet a friend for coffee on a certain day of the week.
They might observe a religious custom at a certain time of the day, week
or year.
Generally, when a person gets older they like to keep to the routines
they have always followed. Some older people feel very strongly about
sticking to them. They might get upset if a routine is changed.
It is important that services that support older people fit in around the
older person's routine where possible. Aged care workers should be
aware of the routines of older people who they work with so that they
can work in a way that meets their needs. It is important that services
are flexible so they can be changed to fit around the person's routine
when necessary.
We all feel more independent and in control of our own lives when we
are able to decide what we want to do and how we want to do it. Our
routines are important to us because they give us a sense of control
over our lives. We know what is happening next, what to expect. An
older person's sense of control over their lives lessens when they
require more support to do their day-to-day activities.
Our regular social appointments are important to keep us connected
to our friends and family. Our customs are important as they help us
to maintain our connection with religion or culture.
As an aged care worker, it is your responsibility to help older people
maintain their independence as much as possible. It could be a simple
as allowing the person to wash their own face to holding the water
nozzle in the shower right through to just washing their backs and toes



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in the shower, this is the be assessed individually simply, by ask the
person what they can door what they need help with. This ensures the
person feels in control of their ADLs and a sense of empowerment with
what you are offering to them.
It is important to make sure the older person is as independent as
possible for their situation/condition. This is because if you, the aged
care worker, just do all the older persons’ ADLs (everything) for them
they could lose the level of independence they have regardless if the
amount of independence the older person has is a little or a lot.
Routine in an Aged Care Facility
Aged care facilities plan their daily routines around staffing and making
sure that there is time for staff to meet the needs of all of those living in
the facility. The routine for each shift are also put into the policies and
procedures of the organisation so that, if new staff or casuals are on
they can more effectively utilise their time and the clients/clients
maintain the routines they are used to. Remembering, that the routine is
also used in conjunction with the individual care plans, as it has what
ADLs need to be met based on the older persons’ needs and
preferences. The daily routine in an aged care facility is planned to meet
the individual needs of the older people living there as much as possible.
Sometimes it is not possible for the older person to maintain the routine
they may have had in their own home when they move into an aged care
facility. Older people in aged care facilities must sometimes follow the
routines set by the facility for meals, personal care and some social and
recreational activities.
Aged care facilities make sure that older people maintain control over
their lives through individualised care planning. When an older person
first moves into the aged care facility, the staff find out what their routine
was like at home. They ask about their customs. The staff at the facility
will then try to match the daily routine at the facility as closely as
possible to the older persons’ routine followed at their home. For
example, if an older person always has a glass of sherry at night before
their dinner, the staff may try to make sure that this still happens. If the
older person goes out to lunch with relatives and friends once a
fortnight, the staff will try to ensure that the older person is still able to
do this. If the older person enjoys having a shower before they go to
bed rather than in the morning this will be adhered to.

Activity 5: Case Study
Melinda is an aged care worker in an aged care facility. She goes to Mr
Smyth's room to help him get dressed and ready for the day. Mr Smyth’s
care plan says that he likes to get up at 0800hrs. It says he likes a cup
of tea in bed before he gets up. It says that he is able to dress himself.
He needs help only with doing buttons up and putting his socks on.
Melinda arrives at Mr Smyth's room at 0730hrs. She wakes him and
helps him out of bed. She puts his trousers over his feet for him, and
pulls them up when he stands up. She helps him to put his arms in his
shirt before doing up the buttons, then Melinda pulls his jumper over his
head. She asks him to put his shoes and socks on while she tidies up



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the bed, and then ties his shoelaces for him. Once he is dressed,
Melinda makes sure he is comfortable in his armchair and serves him a
cup of tea.
1. What tasks did Melinda do that were not part of Mr Smyth’s care
plan/routine?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

2. As a aged care worker, how do you think this may have made Mr
Smyth feel?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

3. What would you have done at 0730hrs? What would you have done
to maintain Mr Smyth’s routine?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Customs/Cultural needs
Aged care services in Australia are provided in a diverse multi-cultural
setting. On any given work day, you may be working with clients who do
not share the same cultural background or speak the same language.
Working holistically in this context requires awareness of cultural
differences and an understanding of your own attitudes towards cultural
differences.
Culture may be thought of as a collection of behaviours and beliefs that
distinguishes one group of people from another. Culture is developed
and passed on to others through formal and informal stories
(fairytales, folk stories, poetry, literature, movies), education, family life,
religion, government, media, social activity, work and law.
Culture touches every area of a person's life. We usually identify that a
person is from a different culture by their obvious behavioural
differences, but we are less aware of the underlying cultural differences
around belief systems.



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The Iceberg Model


The portion of an iceberg which is visible above water is only a small
piece of a much larger whole. Similarly, people often think of culture as
the observable characteristics of a group, be it their food, dances,
music, arts, or even greeting rituals. The reality is that these are broad
components of culture -- the complex ideas and deeply-held preferences
known as attitudes and values.
Deep below the "water line" are a culture's core values. These are
primarily learned ideas of what is good, right, desirable, and acceptable,
as well as what is bad, wrong, undesirable, and unacceptable. In many
cases, different cultural groups share the similar core values (such as
"honesty", or "respect", or "family"), but these are often interpreted
differently in different situations and incorporated in unique ways into
specific attitudes we apply in daily situations. Ultimately, these internal



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forces become visible to the casual observer in the form of observable
behaviours, such as the words we use, the way we act, the laws we
enact, and the ways we communicate with each other.
It is also important to note that the core values of a culture do not
change quickly or easily. They are passed on from generation to
generation by numerous institutions which surround us. These
institutions of influence are powerful forces which guide us and teach
us.
So, like an iceberg, there are things that we can see and describe
easily, but there are also many deeply rooted ideas that can only be
understood by analysing values, studying institutions, and in many
cases, reflecting on our own core values.
Be aware that the Australian governments and territories have also
passed laws to protect against discrimination, including
discrimination based on cultural background. it is extremely
important to keep in mind that all cultures share a common
humanity.
Human beings share many basic needs regardless of cultural
differences, but we also seek out a cultural identity with specific groups
and develop personalised ways of 'belonging' in the world. It is
common to belong to many different cultural groups — groups based
on race, nationality, gender, religion, age and interests. Multiple
combinations are possible — for example, Australian Lebanese
Christian, or Australian-born Chinese.
Cultural competence means being able to interact effectively in many
different cultural situations, where you enable the other person to
feel respected and confident to express their cultural needs.
Cultural competence recognises and accepts differences between
people, and acknowledges that there is a shared humanity
between all cultural groups. Workers demonstrate cultural
competence when they provide services to meet the unique
needs of each person, and when they are able to identify and
reflect on their own attitudes about cultural differences.
Cultural communication
Many people are born and live in a variety of countries during the course
of their life. To give the best care possible we need to gather detailed
information about our client or client. We need to know about their
language skills and their culture. One word written on a document, such
as Vietnamese, does not give very true and accurate information about
how that person lives, speaks, thinks and what they believe.
The following may give you some ideas on things we need to know
about our client or client:
 Family may be extremely important. It may be a specific requirement
that family are involved with all decisions about treatment and care.
 The structure of the family may be very different from what you are
familiar with.



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 The care recipient may suffer extra stresses related to a change
in their role and financial dependency because of their cultural
beliefs.
 Different cultures have different values. Some client/clients may be
proud. Independence and self-control are important to them.
Another culture may value co-operation. Yet another may be brave.
We need to be careful not to be judgemental about a client/client's
outward
personality. It takes a lifetime to get to truly know a person.
 The care recipient may use other types of healing. They may use
folk medicine methods with or without Western treatments.
 Other cultures may look more at the whole person for healing.
Their thoughts, feelings, spirituality, family, environment, diet and
physical self are a key to their health.
 There may be issues related to the client or client being male or
female. Some cultures have rules about what gender may treat and
care for them.
 The care recipient may have lived through incredible suffering for
example if they have been a refugee or prisoner of war.
 Some cultures feel shame to express their feelings about a trauma
or loss.
 Some cultures use terms like "hot", "cold", "wind", "nerves" to
describe symptoms.
A discussion with your client/client can find out a lot of information that will
be useful for all care workers and most of all for benefit of that person.
Another group of people we need to consider in our workplace are our
working partners and colleagues. Many of our co-workers also have a
diverse cultural background. To promote a better workplace, take time to
find out about your co-workers without being too nosy! The more we know
about people the easier it is to understand them and work with them.
As many of our care recipients are born in another country or speak
more than one language, we need to know information about them to
ensure their care needs are met. As people age, it is common for language
use to go back to their first learnt language. It is very important that we
recognise this is happening and follow clear steps to support the person.
The following are some tips to help you communicate effectively across
cultures;
1. Speak slowly and clearly
The care recipient or client needs time to understand your words.
Pronounce your words clearly not loudly. We all have an accent check
to see if your client or client understands yours. Take care not to talk
down to the person. Clarify by writing down words. Don't use slang
words or jargon (like medical terms and initials).




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2. Explain your role to the care recipient
It is important to explain your role in words that is understood by your
client or client.

3. Listen and observe
Words are only one part of communication. The majority of our
communication involves many other cues. The way someone is
dressed, their stance, the tone of voice, the pitch, body gestures, the
use of silence. Be aware of your body language and learn about the
body language of your care recipient's culture.
In some cultures it is respectful to maintain eye contact yet in another it
is respectful NOT to have eye contact. Lack of understanding and
awareness can lead to misinterpretation and lack of respect.

4. Take time to listen
Extra time taken to listen can enable you to clarify what is needed. This
will save a lot of time for all staff later and prevent the care recipient
becoming frustrated or withdrawn. Take care not to approach the client
or client when you know you really haven't got the time to talk it through
thoroughly. Rather, make sure you have the time to discuss any issue
with patience and respect.

5. People express feelings in many different ways
Emotions and feelings are open to a lot of misunderstanding when
translating from one language to another. Remain respectful of people's
different ways. One person may cry and sob to express their grief and
another may not show any signs of emotion at all. Care workers need to
remain non-judgemental. Everyone has their right to express their
feelings their own way. What may be proper behaviour for one group of
people may be disrespectful for another.

6. Rules of communication
All cultures have unspoken rules of communication. These rules include
things like - what is the right thing to talk about and in what setting. What
tone of voice we use, the speed we speak and the emphasis we place
on words, are all factors to be considered when we speak with people of
another culture.

7. Differences in word meanings
Some words have different meanings in different cultures. "Yes"
does not always mean the person understands, it may be their
custom to say "yes" to be polite. It is better to have the person let you
know that they "understand" what you have said rather than accept a
simple "yes" for an answer.




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8. Beliefs and attitudes must be respected
Care recipients have developed certain beliefs about illness and ageing
over their lifetime. We need to ask for more information about what they
believe rather than discount them. It is more respectful to ask them to
tell you more about what they believe and how they would be cared
for in their former country. Let the client or client know you are
interested to know more about them.

9. Do not assume that a care recipient's level of English will always be
correct
As a care recipient translates from one language to another, the
structure of their sentences can become confused. This can occur if a
person is distressed or excited.
Co-workers
Another group of people we need to consider in our workplace are our
working partners and colleagues. Many of our co-workers also have a
diverse cultural background. To promote a better workplace, take time to
find out about your co-workers without being too nosy! The more we know
about people the easier it is to understand them and work with them.
If the aged care worker is still having difficulties with the older person
culture and the workers own beliefs and attitudes you may need to
speak to the supervisor or manager to get guidance and possibly need
further training in this area.

Activity 6
Write down five things that are part of your routine. This could be every
day or week.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Why are routines important to the older person and the aged care workers?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

Why is the cultural and religious background of an older person important
to meeting their needs?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________



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How do aged care workers communicate with an older person that has
reverted back to their primary language which is not english?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________


1.5 Perform work in a manner that acknowledges that the services are
being provided in the client’s own home.
Home care workers provide an important service in assisting people
with a disability and frail older people, to maintain their independence
in their home. Home care workers also provide significant support for, and
work in partnership with carers.
Home care workers may perform a large range of tasks which can
include, but is not limited to:
 domestic duties such as vacuuming, cleaning, washing, cooking
and shopping
 assisting with arranging social activities and accompanying people
on community outings
 providing companionship, friendship and emotional support
 basic personal care such as assisting the person to bathe, dress,
shave and perform other personal hygiene tasks
 providing assistance with meals
 monitoring health issues such as taking blood pressure readings
and performing blood glucose level testing
 assisting with medications
 basic wound care
 implementing appropriate strategies for managing complex
problems related to dementia, continence, pain management
and challenging behaviours
 providing respite care services
 palliative care services
Home care workers may be employed to visit and work within both
private homes and/or community establishments (such as group homes for



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people with a disability) or day centres. They may be required to work
evenings, weekends and public holidays and in rare circumstances they
may be required to sleep-over in the person's residence or to live-in on a
permanent basis.
Working in people's homes and in the community setting requires a
slightly different skill set than when working in residential aged care. In
the community the worker must have effective time management skills
and be able to prioritise their work EACH day. It is also important to be
able to work closely with family members and carers as well as liaise
with staff from other agencies. Home care workers can also exercise
more control of their work routine and work flexible hours that may
better suit their needs and the needs of the older person.
Carer attributes
In addition to particular skills that are important when working in home
and community care there are also desirable personal attributes
important for the home care worker. These include:
 excellent verbal and written communication skills
 the ability to communicate effectively with frail older people,
people with a disability, carers and families
 the ability to provide professional and non-judgemental
assistance to clients from diverse backgrounds
 the ability to work as part of a team, but also be able to work
independently and without direct supervision
 the ability to maintain confidentiality and privacy
 the ability to be flexible and respond to the changing needs of
the client
 ability to provide safe, competent and ethical care
 a commitment to best practice and continuous improvement
principles
Working with Carers
The needs of carers are as important as the needs of the client. Working
in partnership with carers and providing appropriate support,
information and respite for carers is central to providing quality home
and community care services.
Carers play such a critical role in enabling frail older people and people
with a disability to remain living at home. Home care workers need to
be mindful of meeting the needs of carers. Working in partnership with
the carer may include:
 building a relationship of trust with the carer based on mutual
respect and consideration
 identifying the carer's preferred way of doing things and working
within these standards wherever possible
 consulting the carer and client before making any changes in
their environment or usual care routine.



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Home and community care agencies go to great lengths to ensure that
workers and clients are appropriately matched. Assigning an appropriate
and suitable home care worker to the client is a critical aspect of the care
planning process.
When selecting the most suitable home care worker for the client, the
agency will need to take into account the nature of the work, personal
attributes of the worker, client needs and preferences, knowledge and
skills required to perform the job, staff training and qualifications of the
worker. Assigning the most appropriate worker is an important part of
creating a positive and therapeutic relationship between the client,
carer and the home care worker.

Roles and Responsibilities
Every employer will have a state of roles and responsibilities to guide
their employees and are found in the policies and procedures of the
organisations. While many personal care activities are provided by
home care workers, some clients with personal care needs may require
the services of a registered or enrolled nurse or an allied health
professional. For example, complex wound care is to be performed by
the district or community nurse.
The appropriate person to provide such a service must be decided on
an individual basis. During the assessment of the client, the client's
characteristics, level of ability, complexity or technical skill of the service
and the activity to be performed must be considered.
Some agencies will also provide a list of duties that cannot be
performed by the home care worker. For example, the home care
worker must not give insulin injections or undertake any tasks related to
the care and maintenance of renal dialysis equipment.
It is essential that all home care workers have a clear understanding
of their role and role boundaries and do not engage in duties or
tasks that exceed their role and/or their training and qualifications
allow.
Most home and community care agencies will provide workers with a
clear list of tasks or service descriptors. These may come in many
forms, such as a service record, service sheet or task sheet and the
individualised care plans.
Limited Supervision
Home care workers usually work alone in the client's home, unless
two workers are required for specific duties. Make sure you get consent
to enter the persons’ home and to do the tasks that are required. Even
though the older person understands that you are from an organisation
to do you job, you may be new and as yet have not build a positive,
trusting relationship with that client. Support is available from a
supervisor who is on call to assist home care workers if necessary,
working in the client's home means that it is not always possible to
provide home care workers with direct supervision.
The home care worker must be able to work independently. This may
involve making decisions about the order in which they complete their



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scheduled work to best meet the needs of the client. It may also
involve being able to respond to an unexpected event or emergency
situation.
Reporting to your supervisor
Workers may be required to use their judgement about what to report
to their supervisor and when to report it.
It is critical that the home care worker uses whatever communication
means are most appropriate to receive direction from others and to
report events such as:
 absences from work or changes to routines
 any observed changes in a client's emotional and/or physical
health
 all situations of risk to the worker, client and others
 all situations of abuse or possible abuse, both elder abuse and
child abuse
 any difficulties or conflicts related to providing the client with
services
 instances where services have been refused or where they no
longer meet the needs of the client
 all instances of threatening, aggressive or violent behaviour from
the client, their family or others
 incidents and deaths immediately according to the policies of
the organisation.
It is also essential to report any instances where the client's or worker's
rights and responsibilities have been ignored or are not being upheld.

Documentation
Documentation strategies used in the community must therefore
ensure effective transfer of information between workers. EACH
client will have a care record; however, many community
organisations also use a diary, daybook or communication book to
record information such as significant incidents, special instructions,
or information about future activities/client appointments.
As with all forms of documentation, you must record the date, time of
entry, your signature and designation. Include relevant information
only, maintain confidentiality and ensure the communication book is
stored in a safe and secure place. Your employer will have
guidelines, policies and procedures for the use of communication
diaries and the type of information that is recorded in them.
Health team members rely on documentation to provide
individualised care which is responsive to the needs of the older
person. Continuity of care depends on effective communication and
accurate recording of care needs, the support that is provided, and
the older person's response to interventions.



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Progress notes for a client or client are the most appropriate place to
note that the plan of care has been evaluated. The progress notes
provide evidence that regular evaluation is taking place. Progress
notes help in maintaining a record of the continuity of care and quality of
care to the standards that are required by the organisation and by
legislation. They reflect client/client care in a legal document which can
be used to protect the organisation if there is a claim made against them
by the client or their family.
When writing in documentation such as progress notes, you will need to
ensure that they are of the highest quality to meet legal and
organisational standards. It is important to keep the following points in
mind:
 Always use black ink. These documents are permanent records
and may be required for legal purposes
 Avoid 'white out'. Draw a line through an error, date and sign
 Your writing should be neat, clear and legible
 Only use abbreviations approved by your organisation
 Use correct spelling, punctuation and grammar
 Don't leave spaces between entries
 Be objective, accurate, concise and factual and present the
information in a logical order
 Use quotation marks when recording a resident's statement
 Consider who is going to read the document, why it is being
written and what effect it is intended to have
 Write events in the order that they happened and as soon as
practical after they happened
 Be certain the resident's/client's name is written on EACH page of
your notes
 Sign your name then print name and status (i.e. Care Worker) on
any written information
 No entry concerning a resident's care or treatment given
should be made on behalf of another care worker

Activity 7
Mrs Stallone's care plan states that the community care worker should
help her with all or part of the following tasks:
 Preparing lunch
 Opening and reading mail
 Folding clean laundry
 Getting out of bed in the morning (Mrs Stallone likes to get up
at 0730hrs)
 Preparing breakfast



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 Cleaning teeth
 Getting dressed
 Walking the dog
How would prioritise the tasks that need to be completed for Mrs
Stallone?
_________________________________________________________

List the tasks in order of priority for Mrs Stallone
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Is there any flexiblitiy between the older persons’ care plan and the
community workers’ tasks that need to be completed? How?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

List the important points to remember when documenting in any clients’
progress/clinical notes.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________





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1.6 Provide services in a manner that enables the older person to direct
the processes where appropriate.
The aged care worker needs to look at an older person as a whole, a
holistic approach, this entails looking at the person in a physical,
mental/emotional, social and cultural approach, and not as a specific
illness or disease. This is so that positive contributions for health
outcomes can be met for EACH older person.
Remember, the key areas that underpin quality care services and
promote successful ageing outcomes:
 an understanding of the key issues affecting older people
 social justice approaches
 culturally inclusive approaches
 positive ageing
 client-centredness or person-centred approach to
individualised care
The client/person-centred approach to care encourages and values
older people to maintain their independence and control over important
and routine aspects of their daily lives. For instance, choosing the
clothes they wear; when the person wants a shower, have lunch, or
when they want to go to sleep; which sock goes on which foot first; what
activities the person wants to do; and the list keeps going on and on. It
is normal for most older people to fear losing a sense of control and self-
worth especially if they do not have any choices or do not participate in
meeting their own needs.
It is vital that the older person retains and continues to practise skills
required for daily living. As the saying goes, if you don't use it, you lose
it. In some care situations it may appear to be more practical and
usually quicker to take over doing something for the person, rather than
encouraging and supporting their efforts, but it is critical that all care is
tailored to maximise the abilities of the older person and to help them
to regain or retain their optimal level of independence.
How do you know what services are appropriate to the older person?
Firstly, assessment is the process of gathering information to identify
care needs. Assessment of the older person tends to focus on function
and include assessment of the physical, cognitive/mental, social and
emotional aspects of their life. The assessment will include an
evaluation of risk factors for instance, whether the older person is at risk
of falling, and this will also consider the needs of carers if appropriate.
Assessment of the older person's needs should begin with their
perspective of their needs, their abilities, concerns, views, fears and
what support they feel they need to maximise their independence.
Encourage the older person to ask questions and take an active part in
the assessment.
Assessments may be undertaken to gather comprehensive information
about the older person's health condition, abilities and social



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situation, or they may be targeted to collect specific information, for
example to monitor their blood pressure.
It is important for the aged care worker to approach the assessment with
sensitivity. You need to inform the older person what issues will be
covered and what information you are seeking.
Remember that some of the questions you may need to ask during
the assessment could cause embarrassment. The person has a right
to privacy and should be able to share information about their
problems, needs and circumstances without others being able to hear.
Meeting Care Needs
When the assessment of the older person is complete and necessary
information has been collected, a care plan can be developed.
Again, the older person should be actively involved in the
development of the care plan and help to make decisions about the
care they need. Family members, carers and those close to the older
person should also have the opportunity to be part of making
decisions about how best to meet the needs of the older person. The
aim of any intervention will be to maximise the independence, abilities
and quality of life of the older person, while considering resources
available and the needs of carers.
The care plan identifies appropriate support services, as well as
adaptations or assistive devices that would help the older person to
regain their independence and maximise their abilities. This may not
be sufficient as the older person may require the assistance of another
person to manage their ADLs, in particular to meet their personal care
needs.
People who require assistance with personal care have many differing
personal characteristics, abilities and needs. Therefore, it is essential
that all assistance with personal care reflects the highly specific needs
and preferences of the individual, and that care services are provided
in a manner that is free from discrimination, stereotyping and
judgement.
Home and Community Care (HACC) Services
As a service provider working in a HACC program it is imperative that
you understand the aims of the HACC program.
The aims of the HACC program:-
 To provide a comprehensive and integrated range of basic
support services for frail, aged and other people with a
disability, and their carers.
 To help these people be more independent at home and in the
community, thereby preventing their inappropriate admission to
long term residential care and enhancing their quality of life.
 To provide a greater range of services and more flexible
service provision to ensure that services respond to the needs
of users (Health& community services Victoria: aims of the HACC
program)



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Social support
This program is aimed at re-establishing people's community links.
Because of illness or disability, the HACC consumer may experience
loneliness, isolation and loss of social interaction. The social support
program includes friendly visits, transport, telelinks, telephone-
monitoring and participation in senior citizens' clubs/groups where
appropriate/
Home help/Home care
This program assists individuals and families with everyday and
personal tasks. These include:- cleaning; laundering, cooking, shopping
and helping people get appointments. Home care services also
provide assistance in personal tasks such as dressing and showering,
bill-paying and other appropriate services.
Food services
There is a variety of ways that this service can be delivered. EACH
locality has adapted this service to suit local needs. The supply of meals
into the home for the consumer is one important support to enable them
to continue to reside in their own home
Meals can be provided so the consumer can reheat them at a time
appropriate for them, or they can be delivered hot as 'meals on wheels'.
Some meals can also be arranged at senior citizen centres and
community centres. Also a range of flexible options can be explored
such as excursions or vouchers in restaurants and hotels.
In many areas this service delivery is being tendered out to private
industry.
Consideration in the provision of food services must be given to food
preferences, special dietary needs and to religious and cultural factors.
Specific home help
This service helps families who are caring for HACC consumer and who
meet the criteria for specific home help. This service helps the usual
care to take a break. Specific home help can also assist with everyday
household task and can be available at night and weekends.
Home maintenance
This service provides essential repairs and maintenance tasks to the
person's home. It can include cleaning spouts, repairing broken windows
and occasional garden maintenance. Minor modifications to a home can
also be carried for ‘at-risk' situations.
Community nursing
This program provides nursing to improve and maintain the consumer’s
health and well-being. Nurses visit consumer's home on a regular or on-
off basis. The program also coordinates care with other areas of the
home care organisations such as doctors, hospitals and other agencies.
There are some localities where home care is being integrated to assist
this service.



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Senior citizens centres
There are centre that provide a regular meeting-place for senior citizens
and provide opportunities for older people to meet socially.
Adult Day Activity Support Services (ADASS)
Planned activity groups are designed to provide out-of-home group
activities that will enhance their physical, intellectual, psychological and
social well-being for older people, people with disabilities and their
carers.
Various localities organise these programs to suit local needs. For most
consumers, transport and meals are provided.
Allied health
This program assists the consumers to maintain independence, mobility
and the ability to lead as normal a life as possible. The services include
physiotherapy, podiatry, speech therapy and dietary advice. These
services are provided either at home, or at community centres such as
Adult Day Centres, Community Health Centres or Senior Citizen
Centres.
Interchange
This program provides respite care for carers through the short term
placement of children with disabilities (zero to eighteen years old) with
host carers.
Linkages, Co- Care, Community Care Options These programs aim to
improve service delivery in the HACC system and be responsible for :

 the coordination of services
 the case management of consumers promoting service flexibility
 providing effective care
 offering consumers greater choice of services
 purchase or brokerage of services to meet special needs.
There are several different funding sources for the care services and
this affects the manner of the service delivery. Co-care, for instance,
uses case management and assesses consumers for 'on-going complex
care needs.'
Some services are subsidised and some are not. Money to deliver these
services can come from Federal funds directly, or Via State
administration or state funds directly.
Personal care
Personal care is the service provided by a HACC worker to assist the
consumer in tasks or personal care. For example:
 assistance with dressing
 assistance with bathing



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 assistance with personal hygiene( e.g. cleaning teeth, washing
hair)
 assistance with access to transport (e.g. transfer to/from
wheelchairs).
EACH program has a common objective, which is to provide services to
the HACC target group.
Once it is decided by the older person, carer, family and health
professional about the persons’ needs, the services needed then an
individualised care plan devised with the older person being to put
some input into it. The care planning process entails:-




















Activity 8
For EACH step of the care planning process, in your own words
describe in more detail what happens in EACH step
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
1. ASSESSMENT
Collect Information
2. PLANNING
Care plan developed by the
team & the client
3. IMPLEMENTATION
Carry out the plan of care to
meet the needs of the older
person
4. EVALUATION
Review the plan & revise as
needed or 6 monthly



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Activity 9: Case Study
Norma is a widow and lives alone in her own home. She has two sons:
Kane, who lives overseas with his wife, and Daniel, who is a courier.
Daniel does not see a lot of his mother, calling in occasionally when his
work takes him into that area or when he needs money from his mother
to help cover the costs of running his truck.
Over the last year, Norma has become quite confused. She often
forgets appointments, does not go out much and has stopped catching
up with friends. Her doctor contacted Daniel, who agreed to visit more
regularly and help out with shopping and managing things in the house.
Kane recently came from overseas to stay with his mother for a week.
Kane was concerned not only about his mother's health, but also about
her financial situation. Many bills had not been paid and all the money in
her bank account had been gradually withdrawn over the previous six
months. Norma now has no savings and it has become apparent to
Kane that Daniel has been taking financial advantage of his mother
without her knowledge.
You have been assigned Norma’s case, what steps and/or actions
would you follow and complete so that you can put an individualised
care plan together for Norma and what services are available for Norma
so she can stay at home.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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_________________________________________________________
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1.7 Provide support/assistance in accordance with organisation policy,
protocols and procedures.
Policies and procedures manuals exist within organisations to ensure
there is consistency in the delivery of care. This is an important
document because it tells you what should be implemented in a
particular situation and how it should be carried out. The policy and
procedures manual will reflect all the relevant legislation, common law
responsibilities and standards of care that you must follow.
These manuals include a contents page to help you find information
quickly. Usually the information will be organised under general section
headings, with further information under sub-section headings. Before
you start looking for information, think about where it might be — in
which general section, and in which sub-section.
Policies are formal statements that guide the decisions of staff. They
combine the values of the organisation within the broader professional
and legislative framework to which the organisation belongs. Policies
reflect the individual organisation's values and should be consistent with
relevant Australian and state legislations, for example the Occupational
Health and Safety Act, the Aged Care Act 1997 and the Aged Care
Standards and Principles.
Remember, policies have been written to make your job easier. They
guide you in how to do your work and help you make decisions about
the right thing to do. They are there to give you protection in difficult
situations. They mean you do not have to guess about what is expected.
There are policies for every aspect of workplace activities, for example
working safely, lifting and handling heavy items, providing transport and
handling money. An example of a policy is a rule that no aged care
worker is to lift heavy items until they have successfully completed a
manual handling certificate.
An organisation's occupational health and safety policy specifies the
course of action to be followed in relation to workplace health and safety
issues. The policy will ensure that the organisation is complying with the
occupational health and safety legislation and regulations of that state or
territory.
Procedures reflect the policies of the organisation. Procedures are step-
by-step instructions on how to perform certain tasks, and they provide
clear direction for all workers. This may be simple lists of instructions
that are used every day. They may tell you how to act in a situation.
Having procedures in place ensures that everyone knows exactly what
to do and how to do it. For example, an organisation's Procedure for
Handwashing or Disposal of Sharps or ways to support older people to
complete their daily living activities, explains in detail how to carry out
these procedures.
You should familiarise yourself with your organisation's policies and
procedures, as a reference book to consult when you are unfamiliar with
a particular procedure or the accepted practice within your organisation.



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Also you should know where and how to access the policy and
procedures manual at your workplace.
Ask your supervisor to explain any terms you do not understand, or to
clarify any procedures that seem unclear. This is due to policy and
procedures manuals sometimes use very complex language because
they relate to legal frameworks. If you find yourself faced with a situation
that does not seem to be covered by any particular policy, check with
your supervisor.
As a worker please be aware that policies and procedures are regularly
being reviewed and updated so, you need to be updated with theses in
the way of memos on staff notice boards or signing new policies that
you have read or they may be on the computer in the organisations
intranet of policies and procedures. The most important thing to
remember about policies and procedures is that if you work within these
guidelines you are protecting yourself as policies and procedures come
from legislation which is law. As soon as a worker deviates from these
policies and procedures you may be in trouble with the organisation and
law enforcers.

Activity 10
If an older person asks you, an aged care worker, to buy cannabis, roll it
into a joint and then light it for them would you do it? Why/why not?
_________________________________________________________
_________________________________________________________
_________________________________________________________

Why do organisations have a no lift policy?
_________________________________________________________
_________________________________________________________

Where in the policies and procedure manual would I find the
handwashing procedures? Why is it in this part of the manual?
_________________________________________________________
_________________________________________________________
_________________________________________________________
You are a new employee in the organisation, during staff induction you
need to locate where all the policy and procedures manuals are kept.
Where are policy and procedure manuals located?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________



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Give 5 examples of policy and procedure documents an organisation
would have in their manual.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

1.8 Demonstrate appropriate use of equipment to support/assist the
older person with activities of living within work role and responsibility.

An aged care worker may heed to use different types of equipment to
help older people do their daily living activities. Mostly this equipment
will be the same as what you use every day at home to do your own
tasks. Sometimes the equipment may be different. It may be a special
type of equipment that is used only by workers helping older people, or
only by older people who can no longer use the normal household
equipment for a common task. If you don't know what the piece of
equipment is, or how to use it, make sure you tell your supervisor.
Someone who knows how to use it will be able to show you how. You
may need to be trained to use it by the manufacturer or a qualified per
son. There may be a procedure to read about the equipment. There may
be policies about how and when the equipment is to be used, and how
to use it safely. Make sure you read these. Make sure you are confident
in the safe use of equipment before you use it to help an older person.
Where possible it is appropriate to have training in the use of all items or
equipment which you may be using during the care of your client. For
example, when using hoists/lifters; new shower bed; use of wheelchairs
and so on.

Manual Wheelchair Electric Wheelchair






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Lifter/Hoist 1 Lifter/Hoist 2



Stand Up Lifter 1 Stand Up Lifter 2



Shower Trolley Walking Aids 1



Walking Aids 2 Walking Aids 3







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If there is a particular item of equipment which you are not familiar with,
ensure that you ask your supervisor for instruction and training of it. It
might also be possible to obtain the original training manual. If the
instruction manual is no longer available access the Internet and obtain
operating instructions for the equipment. Under no circumstances
should you be using equipment for which you have no knowledge or
training in the use of same.
When utilising any equipment ensure that you follow organisational
policy and protocol, and if the equipment requires the assistance of 2
persons to operate it, ensure that you bring this to the attention of your
supervisor so as to ensure that there are appropriate and sufficient staff
available to assist you in providing the care.
There are many aids available to assist older people meet their needs. It
is important that staff know and understand how to use aids safely. This
is also important as you may need to train or educate the older person
how to use the aid/equipment so that they do not get an injury.
Remember, when using any aid/equipment never put yourself or
colleagues and the client at risk of injury. Other aids available include:-

Shower Chair 1 Shower Chair 2



Shower Chair 3 Adjustable Toilet Chair



Modified Utensils 1 Modified Utensils 2





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Commode Chair 1 Continence Pads 1


Continence Pads 2 Continence Pads 3


Button Hook Aid 1







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Activity 11
You are an aged care worker, Mrs Jackson is your client and has had
her mobility status revised as now needs 2 staff to help her as she has
needs to use a hoist/lifter to transfer her at all times.
If neither staff have used a hoist/lifter before, what do they need to do to
be able to use the lifter?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________


Should the staff use Mrs Jackson to practice on? Why/Why not?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

If both staff know how to use the lifter/hoist safely, what instructions/
explanations do you give Mrs Jackson as she is anxious and it is her
first time using the equipment?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________



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Activity 12

How would you as a carer encourage older people to utilise support
services where appropriate?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

In what way as a carer can you clearly explain the scope of the service
to be provided to the older person and/or their advocate?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

As a carer how do you identify the needs of the older person from the
service delivery plan and from consultation with a supervisor?

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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In what ways as a carer do you need to ensure visits and service
delivery accommodates the older person’s established routines and
customs where possible?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

How, as a carer would you perform work in a manner that acknowledges
that the services are being provided in the client’s own home?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

How, as a carer could you assist in providing services in a manner that
enables the older person to direct the processes where appropriate?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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As a carer you need to provide support/assistance in accordance with
organisation policy, protocols and procedures. How would you go about
doing this? Give examples.
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How is your role carer involved in Demonstrating the appropriate use of
equipment to support/assist the older person with activities of living
within work role and responsibility?
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2. Recognise and report changes in
an older person’s ability to undertake
activities of living.
2.1
Monitor the older person’s activities and environment to
identify increased need for support/assistance with activities
of living.
2.2
Report to a supervisor the older person’s inability to
undertake activities of living independently.
2.3
Support/assist the older person to modify or adapt the
environment or activity to facilitate independence.
2.4
Seek aids and/or equipment to support/assist the older
person undertake activities of living independently.

2.1 Monitor the older person’s activities and environment to identify
increased need for support/assistance with activities of living.
Information is gathered through the initial assessment process, this
information is then used to develop the client/client care and service
needs. Care and service needs are recorded on relevant documents
including care and service plans. Care needs are reviewed on a regular
basis through the process of regular care plan evaluations and
through case conference between the care provider and
client/client/representative. Resident/client care and service needs can
be subject to change. The changes are most commonly monitored
through a regular process of evaluation of care and service plans.
Changes in care and service needs can occur at any time though for
many varied reasons.
It is important as a care worker to report these changes either in written
or verbal form to assist in the process of providing accurate care and
service to client/client's. Clients/client's may request a change in their
care and service delivery themselves or alternatively you may identify
that a change is required through your own observation. As a care
worker it is important to remember that client/client's are able to
make individual choices and their choices must be respected. These
choices may impact on a change to their care or service need. It is a
requirement to provide information to your supervisor regarding changes
to your client/client as this information may impact on a change to their
care plan or service and impact on their overall wellbeing.
An aged care worker who provides support with an older person's ADLs
may be in regular contact with them. They may visit the older person
every day or every week in their home, or several times EACH day in
their room in an aged care facility.



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As someone who is regularly assisting an older person with their ADLs, it
is important to notice changes in the older person's condition this is
achieved through observation (watching, listening), asking questions
and listening to clients and family or significant others. It is important to
know when the older person may need more help with their ADLs.
Example

Warren is a community aged care worker. He visits Mr Rolland twice a
week to help him with his shopping and laundry. Warren knows that this
is the only regular help that Mr Rolland receives and that he has always
seemed very capable of keeping his house and garden tidy and clean,
doing his cooking and caring for his little dog, Fido.
Over the past few weeks, Warren notices that the same dirty dishes are
in the sink two visits in a row. He sees that some of the meat Mr
Rolland’s buys on their shopping trips hasn't been cooked. He notices
that Fido hasn't been washed or brushed for a while.

Who and where would Warren report his observations to?
_________________________________________________________
_________________________________________________________
_________________________________________________________
It is important to notice these changes in an older person's environment.
Changes such as those in Mr Rolland's home may show that his
condition has worsened and he is less able to do all his ADLs.
Possible changes in condition of the client that must be immediately
reported to a supervisor or health professional may include, but are not
limited to:
 Changes to airway (eg choking), breathing (including slowed, fast
or absent bathing, colour changes) or circulation (including
unexpected drowsiness, colour change and absence of pulse)
 Rash
 Inflammation, redness or swelling
 Headache
 Skin tone
 Feelings of dizziness
 Slurring of speech
 Nausea and vomiting
 Blurred vision
 Confusion
 Changes in behaviour
 Anything that appears abnormal about the client/client




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Watch for signs of physical or memory impairment that strongly inhibit or
prevent one from performing tasks of daily living without assistance.
Basic Activities of Daily Living (ADLs) are the self-care tasks of bathing,
dressing and undressing, eating, transferring from bed to chair and
back, maintaining bladder and bowel control, being able to use the toilet,
and walking (not bedridden).
Listen to family members who may be in regular contact with their family
member. They may be aware that your client has experienced difficulty
with bathing and dressing or needing to be reminded to bathe, inability
to prepare nutritious meals and taking medications incorrectly.
Should you notice a change in your client’s abilities to attend to the
activities of daily living regardless of how subtle or small it may be, then
it is important that aged care workers document these changes in the
client’s clinical/progress notes and verbally report the changes to your
supervisor.

Activity 13
The following is a case study and a sample of the daily progress notes.
Belinda, an community care worker, has supported and attended to Mrs.
Hughes for the past eight months. She writes daily notes in Mrs. Hughes
communication / progress notes book. The first note was written three
months ago and the next one was written after her latest visit.
Case notes / progress
Date
and
time
Name .. Mrs. Hughes
D.O.B
31/08/1929
14/1/08
1100hrs


1200hrs



1400hrs
Attended to Mrs. Hughes today for three hours
activity including shopping. Assisted her in
carrying in the shopping bags from the car. Mrs.
Hughes put groceries away.
Vacuumed and dusted living room and dining
room, attended to make bed but it had already
been done. Mrs. Hughes attended to some
gardening whilst I did living room.
Had afternoon tea with Mrs. Hughes when jobs
finished. Mrs. Hughes had baked some
homemade biscuits for us to have.





Belinda Smith
ACW

Belinda Smith
ACW




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Care Notes / Progress
Date
and
time
Name. Mrs. Hughes
D.O.B
31/08/1929
21/4/08
1100hrs

1130hrs

1200hrs

1330hrs


1430hrs
Attended to Mrs. Hughes today for three hours.
Carried delivered shopping to kitchen and put
heavy items away such as the canned goods
and cleaning products.

Picked up newspapers and items from the
floors prior to vacuuming the house. Cleaned
bathroom and kitchen. Made bed. Vacuuming
taking longer to do because carpet is becoming
frayed.
Mrs. Hughes stayed dozing in lounge recliner
whilst I worked.
Prepared lunch, for Mrs. Hughes but minimal
amount eaten. She said she wasn’t hungry.
She says her knees and hands are very sore
these days.
Put Mrs. Hughes to bed before leaving.






Belinda Smith
ACW


1. Make a list of the changes which are in Mrs. Hughes care between
the two sets of progress notes.
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2. What changes might help and improve the care which you provide to
Mrs. Hughes.?
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________

3. Give reasons for the changes in Mrs. Hughes ability to perform
everyday tasks.
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________

4. Who would Belinda report these changes to?
______________________________________________________
______________________________________________________
______________________________________________________

5. Look at the progress notes entries. As Belinda’s supervisor, what
suggestions do you offer to improve the way the documentation is
completed.
______________________________________________________
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______________________________________________________
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Activity 14
List other changes, such as physical, emotional, social and cultural
changes that may occur to an older person
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2.2 Report to a supervisor the older person’s inability to undertake
activities of living independently.

Any change which you notice in your client’s ability to undertake
activities of independent daily living need to be reported to your
supervisor as a matter of priority. This constitutes a risk assessment
profile and will lead to a change in the care plan for your client. It might
also necessitate an increase in care hours or increase in items or
instruments necessary for your client to maintain living independently. It
will also show a paper trail and provide appropriately and timely
admission to a residential complex when the independent living situation
deteriorates beyond suitability.
When aged care workers identify changes in an older person's ability to
do their ADLs, it is important that this is reported to a supervisor.
Sometimes, aged care workers change the support they provide to the
older person without telling anyone that the older person needs extra
help. They start to do a little more to help the person. Doing this means
that they are the only ones who know that the older person's condition is
getting worse. This means:
 they are the only person who knows what support the older person is
getting
 other aged care workers who support the older person may not be
aware of their additional needs
 the care plan is not up to date
 the older person may not be getting extra services that they may be
eligible for.
It is important that you follow the procedures for reporting that are set by
your workplace. These procedures are there to make sure that there is
clear and accurate information about the support needs of older people.
They make sure that this information is communicated in a way that
gives all workers supporting the older person access to current
information about their support needs. When everyone has access to
current information, older people can be reassessed as soon as their
support needs change, so that they can get the support they need.
This helps older people maintain their independence.
How you report the change depends on the situation and the procedures
for your workplace. You must make sure you know how your workplace
expects you to report changes to an older person's abilities and their
support needs. Ask your supervisor for help on reporting if you need to.
Changes to the older person's ability to complete their ADLs are usually
reported in the following ways.
Telephone
Generally you should call your supervisor if the change is sudden or
puts the older person or others around them in danger. You might also
phone your supervisor if you think they are not likely to read your written
notes in a reasonable time.



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Face to face/Verbally
If an urgent response is needed, you should contact your supervisor
immediately to explain the changes, what you (aged care worker) have
done and arrange to see them as soon as possible. If the change to the
person's support needs does not require an urgent response, you might
wait until you see your supervisor to report the change to them.
Do not forget to hand over the changes to the supervisor but also to
your colleagues in the next shift.
Clinical notes/Progress notes/Care Plan
You should write information about changes to the older person's
support needs into the clinical notes or communication book for the
older person. This makes sure that all the workers providing support to
the older person have access to this information.
Also the supervisor can change the care plan so that it reflects the new
needs of the client, as necessary.
Remember, if there are no changes reported or documented then your
duty of care is not upheld. The consequences could be injury or harm to
the client, yourself and other colleagues. Which may have been
prevented if the aged care worker had reported any changes in an older
persons’ needs, condition and level of independence.

For example
In the example about Mrs Zimmerman, the aged care worker wrote
about the extra help that they now had to give. However, they only
described the tasks that they did for her. They did not mention that they
had to do extra tasks because Mrs Zimmerman's condition was
worsening.
The following example shows how the notes can be written so they help
everyone who looks after Mrs Zimmerman.



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Care Notes
Date/Time NAME: Mrs Zimmerman DOB: 25/7/31
3/12/07
1530hrs
Attended Mrs Zimmerman today for two
hours. Carried shopping delivery to
kitchen and put away the heavy items
such as juice, cans and cleaning
products. Picked up newspapers in
lounge room and dirty clothes in
bedroom before vacuuming. Dusted
surfaces. Mopped bathroom and
kitchen and wiped down surfaces. Mrs
Z stayed in the lounge reading a
magazine while I worked . I made us a
cup of tea when jobs were finished and
took it to Mrs Z. Note: Mrs Zimmerman
says her hands and legs are very sore
these days. She now needs assistance
with her shopping bags and putting
heavy items away. She doesn't pick up
things from the floor. She finds it more
difficult to clean. I also noticed that she
does not go outdoors to work in the
garden or do any baking herself. Safety
note: The joins in the carpet in the
lounge room have started to come
apart. They are a tripping hazard.







Bella Jacob
(AIN)

Activity 15
In your own words, rewrite the content so that it shows Mrs
Zimmerman’s condition is getting worse.
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How would you tell your supervisor that Mrs Zimmerman’s condition is
worsening?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

How would you report the following in an older persons’ condition or
abilities? (in any setting)
Put a tick in the box that describes the option you would choose. You
can put a tick in more than one box.

Change in Older Person Phone
Face
to face
Care
Notes
Care
Plan
Unable to work out how to put
a shirt on

Forgetting if the person has
had lunch

Placing electric kettle on a
stove

Person has become
incontinent of urine

Person has gone for a walk
and cannot find their way back
home

Person is having trouble
weight bearing with their
walking frame


Any change which you notice in your client’s ability to undertake
activities of independent daily living need to be reported to your
supervisor as a matter of priority. This constitutes a risk assessment
profile and will lead to a change in the care plan for your client. It might
also necessitate an increase in care hours or increase in items or
instruments necessary for your client to maintain living independently. It
will also show a paper trail and provide appropriately and timely
admission to a residential complex when the independent living situation
deteriorates beyond suitability



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2.3 Support/assist the older person to modify or adapt the environment
or activity to facilitate independence.

Your assistance in identifying and overcoming difficulties may often be
necessary to maintain an older person’s independence and confidence.
However, you may need to be creative in you approach. Offer
assistance where you feel it may be necessary, but remember you will
need to treat you client with respect. This includes being aware of their
rights an adult to refuse assistance or choose not to continue with
activity.
The right to participate in situations that may involve some personal risk
must also be respected. Some of the factors you will need to consider
when planning assistance are:
 Decline in skills and abilities does not always happen with old age.
Training or practice will make a big difference to a older person’s
ability to complete tasks independently.
 Assistance should be kept to a minimum. The older person also
wants the opportunity to set goals and be successful.
 Problem solving skills and ability to stay with task until completed
often parts of a person’s personality. You may not be able to change
that attitude.
 Computer driven technology and electronic aids may be available.
These will give the older person a new skill and help them overcome
environmental or physical problems.
Break activities down into small steps or tasks. Look at problems that
might arise. Equipment and aids that may assist include:
 Wheelchairs and other transport devices
 Mobility aids
 Lifting and transferring equipment
 Beds
 Continence aids
 Toileting aids
 Personal audio-visual aids
You will need to consider the risk and rewards involved in completing
tasks successfully. Talk to your supervisor as other family members or
medical personnel may also need to be consulted if the difficulties are
caused by age-related illness.
Older people do not change a great deal in their ideas, like and dislikes.
The ageing process, however, can limit opportunities through age
related illness. This may affect a person’s ability to complete tasks.
You will need to think of the steps involve in the activity that may require
assistance without removing the sense of enjoyment and participation.



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This can sometimes be difficult. For example, Mrs Fong has enjoyed
china painting for many years. But now the arthritis in her fingers makes
this activity painful and frustrating.
You will need to have a good understanding of older person’s likes and
dislikes. Knowledge of the person’s character and personality will also
give you clues about their ability and desire to complete tasks.
Involvement in as many normal activities as possible allows an older
person to exercise control over their lives. The activities should involve a
number of the senses: sight, hearing, touch, smell and taste. Difficulties
in one area can be compensated for by ability in another. For example,
a keen gardener may not be able to bend or lift as they have in the past.
You may consider overcoming some of their difficulties by asking if they
are interested in
 Raised garden beds so they do not have to bend
 Indoor pots or flower arranging
 Gardening programs on radio and television
 Gardening books and magazines

Unresolved feelings or situations from stressful past events in an older
person’s life can give them a feeling of helplessness or reduced
motivation to participate.
Activities may need to be adjusted to allow for success in stages.
Often, anticipating the difficulties an older person may face will help you
in planning when and where you could assist. Sometimes, it is
necessary to adapt the way in which the person performs the ADL, to
help to maintain their independence.
In the following example, you will see how Mr Rogers is given
assistance to maintain personal independence.
Mr Rogers is becoming increasingly confused. The carers in the
residential care facility have noticed he often forgets item of clothing or
dresses inappropriately. The Care Plan is altered and the night staff now
hang out clothing for the next day on the wardrobe door. Mr Rogers
continues to dress himself at his own pace in the morning without
assistance, in the privacy of his own room.
Other examples include:
 If your client has trouble bending down to pick up things from the
floor then you could recommend they invest in a pick-up-device
which can be purchased from a number of places including
hardware stores and independent living specialist’s stores.
 If the older person likes to play bingo but the numbers are too small.
This could be modified by having larger print, bigger numbers or
even have a volunteer to help if there are other problems so the
person can still participate in an activity they enjoy.
 If playing indoor carpet bowls and they cannot bend down then
instead of standing up they could sit down and still play.



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 If an older person cannot read novels possibly get bigger font books,
use magnifying glass, get books that have CD’s so that it is read to
them.
 When eating meals using plate guards so the food doesn’t fall off the
plate and appropriate utensils especially if fingers and hands have
changed anatomically.
 If you client really likes to continue to attend to the local RSL to play
lawn bowls but can no longer drive their own car and it is too far to
walk or too difficult for them to take public transport, then you could
make arrangements with the club for their courtesy bus to collect
them and return them at the conclusion of the activity.
 If they love to do the weekly shopping but can no longer manage to
bring all the bags home, then home delivery service would be the
way to go, and possibly community transport bus or even applying
for subsidised taxi vouchers for your clients use.

Activity 16
Gladys enjoys participating in the morning exercise in her aged care
facility. This morning she is complaining of not being to stand for long
periods. How could you modify this activity for Gladys so that she can
still participate and not feel worthless?
_________________________________________________________
_________________________________________________________
_________________________________________________________

Mrs Tran is a new resident in the aged care facility. You have noticed
that she does not participate in any activities. In her care plan you notice
she enjoys bingo, knitting and socialising in general. How can you
encourage Mrs Tran to participate in the activities she enjoys?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

It is well known that nearly/if not all situations within the environment
and / or activities can benefit from some form of modification, and your
client’s environment is not an exception to this rule.
Sometimes it is more a matter of common sense which can make
observation of the change or modification which is needed, rather than a
professional university degree education.
If your client has trouble bending down to pick up things from the floor
then you could recommend they invest in a pick-up-devise which can be
purchased from a number of places including hardware stores and
independent living specialist’s stores.



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If you client really likes to continue to attend to the local RSL to play
lawn bowls but can no longer drive their own car and it is too far to walk
or too difficult for them to take public transport, then you could make
arrangements with the club for their courtesy bus to collect them and
return them at the conclusion of the activity. If they love to do the weekly
shopping but can no longer manage to bring all the bags home, then
home delivery service would be the way to go, and possibly community
transport bus or even applying for subsidised taxi vouchers for your
clients use.
Home handyman repairs and gardening could be attended to by firms
such as Hire-A-Hubby, or VIP lawn mowing services.

Activity 17

Research your local papers and/or the internet and make a list of at
least 10 local organisations which you could refer your client over to for
assisted services.



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2.4 Seek aids and/or equipment to support/assist the older person
undertake activities of living independently.

The following figure lists some major areas to consider when planning
assistance for older person. Aged care workers are often called upon to
play an important part in helping and older person overcome difficulties
with activities of daily living. Maintaining independence and pride in
accomplishments must be balanced with safety and other factors, see
below:

Figure 1: Safety

















As an aged care worker, you will need to consider the risk and rewards
involved in completing tasks successfully. Talk to your supervisor, other
family members or medical personnel may also need to be consulted if
the difficulties are caused by age-related illness. Older people do not
change a great deal in their ideas, like and dislikes. The ageing process,
however, can limit opportunities through age related illness. This may
affect a person’s ability to complete tasks.
There are many many aids and pieces of equipment to support an older
persons’ ADLs regardless if they live in their own home or in a aged
Recognise the continual
need for people of all
ages to take risks & learn
Self-care, where possible,
encourages physical &
emotional health
Environmental designs
may need improvement
Safety in daily routines is
always a major concern
Maintaining ADLs
provides valuable
exercise



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care facility. Remember that training is important for the colder person
and their support so that aids and equipment are used safely and
correctly to reduce the risk of injuries and harm.
There are many different types of equipment that have been designed to
assist older people and people with disabilities to perform everyday
tasks that would otherwise be difficult or impossible for them. The type
of equipment they need depends on what tasks they are having difficulty
with, and why.
Here are some examples of aids that are available:
 Tap turner
 long-handled dustpan and broom
 non-slip bench mats for mixing bowls
 jar grips to help open jars
 foam handle covers for knives, scissors and other utensils to assist
with gripping
 large-print measuring jugs, labels for washing machine and oven
knobs
 wash basket trolley to take washing to the line and prevent the need
to bend
 call bells
 personal alarms
 mobility equipment-walking stick, walking frame, wheelchair,
motorized scooter
 Braille Printer for Visually Impaired

Works with aid of a microphone and a voice recognition recorder on one
end and a printer on the other that puts out 25mm x 50mm labels that
can be stuck on any item.




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Big Button Phone Talking Microwave


Glasses Button Hook


Pick Up Reacher Sock & Stocking Aid


Toe Washer Long Handle Comb


Long Handled Brush Hearing Aid





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Inner Ear Hearing Aid Stocking Aid


Long Handled Shoehorn




Any of the pieces of equipment described above may assist an older
person to continue to do a daily living task independently. Without the
equipment, the person may not be able to continue to live in their own
home, or may need another person to do the task for them. Equipment
can be a great solution in helping an older person to maintain their
independence.



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Activity 18
An older person you work with can no longer bend down to pick things
off the floor. What piece of equipment could be used for this?
_________________________________________________________
_________________________________________________________

Mrs Samuels has difficulty using normal eating utensils because of her
arthritic fingers, what suggestions could you offer her , to maintain
independence?
_________________________________________________________
_________________________________________________________

Mr Blake lives at home by himself in a two-storey house and is finding it
more and more difficult to climb the stairs. What suggestions could you
offer so Mr Blake can stay at home?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Activity 19: Research
From the following website Independent Living Centre on
www.ilcaustralia.org.au list 5 other products that can be used by older
people to maintain their independence.
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Activity 20

How as a carer would you monitor the older person’s activities and
environment to identify increased need for support/assistance with
activities of living?
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In what way as carer is it your responsibility to report to a supervisor the
older person’s inability to undertake activities of living independently?
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As a carer you need to support/assist the older person to modify or
adapt the environment or activity to facilitate independence. Give
examples and reasons for this
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In what way as a carer are you able to assist in seeking aids and/or
equipment to support/assist the older person undertaking activities of
living independently? Give examples.
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3. Support the older person to
maintain an environment that
maximises independence, safety and
security.

3.1
Encourage and support/assist the older person to maintain their
environment.
3.2
Provide support to promote security of the older person’s
environment.
3.3
Adapt or modify the environment, in consultation with the older
person, to maximise safety and comfort.
3.4
Recognise hazards and address in accordance with organisation
policy and protocols.

3.1 Encourage and support/assist the older person to maintain their
environment.
Health assessment data allow health care providers to implement
primary and where needed secondary and tertiary regimens. Primary
care addresses disease prevention and health promotion and
maintenance. The individual can usually receive the care at home.
Appropriate care requires professionals with specialized knowledge and
skill to assist the client in remaining in their home.
Aged persons often do not seek assistance from care organisations, and
often the first approach to an organisation is made from a family
member or friend or following hospitalization due to physical or
emotional difficulties. The elderly are often reluctant to seek help due to
previous adverse experiences with the health system or because they
put their problems down to being just age related and don’t realise that
assistance is available.
The initial interview with your client requires a skill in establishing your
clients trust and confidence and in avoiding offending your client or their
family.
You may need to spend a considerable amount of time in completing a
health assessment of your aged client. This is often due to a number of
reasons, not the least being because of a lack of schooling of your
client; English is a second language, impaired communication skills as a
result of a previous illness – dysphasic.
Sometimes the initial health assessment can be completed by the client
before a visit, if they have vision and intellectual ability.



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Upon doing a house visit, you are able to assess the home environment
and become aware of any modifications or improvements which might
assist your client in being able to remain in their home and stay in their
environment.
With a home assessment you may be able to assist your client in
maintaining their home environment.
With your assessment, you would have a check list which could first be
filled in by your client in relation to their home environment and then by
yourself or your organisation.
A key part of helping older people maintain their independence is to help
them keep their environment safe, secure and comfortable. They will be
able to go about their daily living tasks independently and happily if they
feel confident that their environment is free from anything that could
cause them to have an accident or put them in danger.
It is important that older people are encouraged to make sure that their
environment is kept in a way that makes their lives as easy as possible.
All those responsible for supporting older people should make sure that
their home (in the community or aged care facility), room, garden and
other areas they use are safe, secure and comfortable. This helps the
older person maintain their independence for as long as possible.
It is important that aged care workers encourage older people to be
aware of their environment so they can see the things that are making
some tasks difficult for them.
Encourage older people to think through the tasks that they do. Help
them to plan how they can manage their home, room, equipment and
other features of their environment so that tasks can be done safely and
with as little effort as possible. This will help the older person maintain
their independence. Older people must have the best possible space,
tools and support in place to do the tasks they need to do to maintain
their independence.
It is more helpful to encourage the older person to look around their
environment and spot things they can do to improve it, rather than tell
the person the things they should do. This will help them think about the
daily tasks they do. This helps the older person identify strategies for
making sure that their environment is maintained in such a way that
tasks are made as easy as possible.
As an aged care worker, you may also need to refer to the individualised
care plan to see the persons’ likes and dislikes, preferences and aids
that they utilize.
For example, you could say, ‘It is important that you make sure that
there is nothing for you to trip over. Look around to see if there is
anything on the floor’. This is better than saying, 'There are electrical
cords here that you could trip on. You should move them.'
It is also important that you get permission off the older person to move
things. For instance, you work in community care and decide when
visiting a client who is visually impaired that you move all their furniture
because you don’t like the way it is arranged without permission. The
older person is likely to be injured because of this.



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Also encourage the older person to put rubbish in bins rather than
throwing it on the floor. If the bin is far away from the person then place
a plastic bag or bin closer to them so the rubbish is there rather than in
the floor which is a hazard itself.
As a worker if you are supporting or assisting them in their environment
ask the person questions to see if anything can be done to reduce risks
and hazards. For example, Horace a client who lives in his home,
slipped in the bathroom after going to the toilet because he didn’t want
to turn the light on to save money at money. When Horace, was telling
the community worker the worker suggested to get a night light for the
bathroom so the light is always on or to get a urinal or commode put
beside the bed at night so Horace doesn’t have to go the bathroom.
Before recommending any adaptation, modification or assistive device,
an assessment of the older person will be undertaken to ensure that the
most appropriate intervention is recommended. The assessment will
look at the older person's:
 ability to perform ADLs and lADLs
 vision and hearing
 transportation
 recreation
 home and work environment
 current equipment use.
Often, adaptations to their home environment will make it possible for
the older person to regain their independence — for example, a simple
modification to make the environment safer and allow the person to
mobilise more easily may be sufficient. The type of modification
necessary will depend on the needs of the individual and the part of the
home that is being modified. Modifications can include ramps, grab rails,
wider doorways, hand-held showers, better lighting and lowered bench
tops.
Assistive devices include any aids that help older people to perform
ADLs more independently and more easily. There are many assistive
devices available that can increase the older person's independence in
all ADLs — for example, aids that enhance safety with walking (such as
a walking frame), plate guards and cup holders that make eating and
drinking easier, and commodes that can increase an individual's
independence in toileting.
Any modification, adaptation or aid that is recommended and utilised
should increase the older person’s sense of security, safety and
independence.




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Activity 21: Case Study
Geraldine has had arthritis in her hands for 15 years. Her husband died
eight years ago and since then, Geraldine has lived alone. She is
determined to remain independent, and to stay in her own home for as
long as possible. Over the years she has developed innovative ways of
doing things and with support, manages to live a full and independent
life.
Geraldine enjoys and can still do the gardening, reading, cooking and
swimming.
The activities Geraldine has difficulty with, but still manages to do, are
dressing and grooming, simple household chores and hanging and
removing washing from a clothes line.
What aids/equipment could Geraldine use to maintain her
independence?
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_________________________________________________________

How would you make sure Geraldine understands and knows how to
use the aids in a safe manner?
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_________________________________________________________

Why is it important to maintain Geraldine’s independence in her home?
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Activity 22
An aged care worker notices the following things when they visit Mrs
Lyon's home:
 The brick path to the washing line has a couple of bricks sticking up.
 A jar grip has fallen into the laundry basket.
 The telephone ring is very quiet.
Write down some things you could say to Mrs Lyon that would help her
look after her environment so that tasks are as easy as possible to
reduce the risk of injury.
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3.2 Provide support to promote security of the older person’s
environment.
The older individuals in our society will share the same sentiment, the
same fears about violence and crime as is held by the rest of the
population, but there fears may-well be intensified as they feel more
vulnerable due to their frailness or disability.
Everyone needs to feel secure in their own homes and in their daily
lives. Feeling secure means being free from anxiety and worry. It means
feeling that you are protected from harm.
Feeling secure is very important for older people, especially if the
person is living alone. An older person may feel less independent if they
don't feel secure. They may feel that they cannot or do not want to do
things for themselves in case they get hurt or something else bad
happens.
Part of the role of an aged care worker is to help older people feel
secure in their own environment. Whether you work in the community, in
older people's homes or in aged care facilities it is important to help
older people feel secure.
A significant contribution and aspect to the fear of crime amongst the
elderly is the socioeconomic deterioration of the neighbourhood and the
loss of ‘true’ neighbours.
It would be pertinent as part of your assessment of your client‘s
condition to do an assessment of their environmental surrounding.
For most people, feeling and being secure in their own home can mean
feeling safe from intruders, fire and other serious events that would
cause them harm or distress. For an older person it may also mean
more than this. It may mean:
 being sure that floors, steps and pathways are clear and even so
they don't feel that they may accidentally trip and fall
 not being abused, harassed, pushed or bullied from anyone
 having windows and doors locked
 making sure that they are able to shop, clean, wash, care for pets,
visit friends and pay bills so that they remain in control of their own
lives
 knowing that the older person can get help at anytime especially if in
a facility
 knowing that someone is coming to visit at a particular time and will
know if the older person is unwell, hurt or in danger.




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For example

Julia is the aged care worker who visits Sheila in her home. She does
not visit at a regular time, but only as requested by her employer, when
Sheila needs support. When Julia is leaving, Sheila always asks her
when she will see her next. Julia says she doesn't know which day, but
she is sure it will be soon. Sheila always seems upset when she leaves.
Julia talks to her supervisor about this. Her supervisor suggests she talk
to Sheila about the things Sheila does during the week and who else
she sees.
The next time Julia visits Sheila, she talks to her and discovers that she
is the only person who visits Sheila at home on a regular basis. She
discovers that Sheila is very worried that if she is sick or has a fall in her
house, it could be days before someone finds her.
Julia talks to her supervisor again, and they arrange for Julia to visit
Sheila at a set time and day to provide support. They also arrange for
Sheila to get a personal alarm, so she can get help quickly if she needs
it.
The next time Julia visits Sheila she seems much calmer and says she
feels very safe with her personal alarm around her neck all the time.
When Julia is leaving, Sheila doesn't ask when she will be back, but
says, 'See you next Thursday.'
Sheila feels more secure due to her personal alarm and that someone
will come if she presses it. Also that Julia will be checking on her on a
particular day.


Make a list of the external environment of the home, is there
 Adequate tamper proof external lighting, possibly on a motion sensor
switch?
 Does the house have lockable screen doors in good – excellent
condition?
 Do the windows have key locks installed?
 Is there an alarm system installed?
 Does the client have an independent personal alarm?
 Are there instruments or items outside the home which could
possibly be used as a weapon in the event of a break and enter?
You may also:
 Take time out to talk to the neighbours, and maybe exchange phone
numbers with the neighbour in case of emergency situations. If your
client gets on well with a close neighbour it might be beneficial and
cost effective to install between them a cordless doorbell alarm
system, purchased cheaply from most hardware shops. Your client



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holds the buzzer portion, and the neighbor houses the ring
component. (Average cost is ($10-45). A cost effective alternative to
a duress alarm which can cost upwards of $300 - $400 a year to
maintain.
 Introduce them to community–centered neighbourhood crime
prevention networks, public education.
 Suggest they carry only a small amount of money and personal
items in a wallet or purse.
 Encourage your client to keep house keys and larger amounts of
money and credit cards in an inside clothing pocket or in a body
band. People who snatch purses and wallets are usually not
interested in injuring anyone, so it is best to hand over their bag or
wallet when being accosted. If there are no keys or identification in
the bag then the risk of having their house invaded is almost nil.
 Encourage your client to believe in safety in numbers. If going for a
walk always try to walk with a friend or neighbour.
 Encourage the wearing of a small sports whistle.
 Suggest when the client is going for a walk carry a cane or umbrella
as it can act as a deceptive weapon of defense.
 Encourage your client to be alert to stories and news items of fraud,
and bogus schemes.
 Encourage your client not to be overly trusting and not to let anyone
that they do not know into their home uninvited. If someone attends
and wants to gain entrance by showing identification, encourage
them to always phone the agency involved before allowing the
person to enter, to verify the authenticity of the identification.
 Encourage your client to engage in a self-defense course.
 Encourage an increase in police surveillance of the area or areas
that you or your client attends.
 If you notice that your client is purchasing a lot of unnecessary items
over the internet or from phone or door to door salesman, advise
them that’s its inappropriate. A lot of unscrupulous sales people will
try and sell anything to the elderly as they are a very vulnerable part
of our society and often the elderly don’t know how to say NO.
Contact the companies concerned and return the items for a full
refund.
For an older person living in an aged care facility, feeling secure may
also mean feeling that they have their own private space, maintaining
dignity and have privacy. Most areas, such as lounge rooms, dining
rooms and sometimes bathrooms and toilets, are shared with other
people. Often the only space the older person has that is their own is
their bedroom. It is important that the older person can feel secure when
they are in their own space, knowing that their belongings are safe,
knowing they have aged care workers to call upon and that no one will
go into their room without permission.



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For example

Timothy lives in an aged care facility. He has his own bedroom but
shares a bathroom with Basil in the next room. Basil has dementia and
spends most of the day and part of the night walking up and down the
hallways. He often comes into Timothy's room. Timothy locks the door
when he is in the bathroom. This puts an 'engaged' sign up outside the
door. However, Basil will often still rattle the door handle or call out
through the door, 'Anyone there?'
Timothy likes to spend the afternoon sitting in a chair in his room,
reading the paper and writing letters. The cleaner comes a couple of
days a week to mop the floor and empty the bin. She doesn't knock on
the door, or ask if it is OK to come in.
The young man who brings the afternoon tea also just walks in and puts
the afternoon tea on his tray.

Even though Timothy lives in an aged care facility, his home, what
should staff be doing for Timothy?
_________________________________________________________
_________________________________________________________
_________________________________________________________

How would you feel if you were Timothy and this is happening to you?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

For example
Elaine is a resident in an aged care facility, when particular aged care
workers are looking after her at night, she feels safer as the workers
always check the windows are locked and that her bed rails are up.
Other workers put her bed rails up but Elaine does not see the workers
look at the windows to see if they are locked so she doesn’t feel as safe.

For example, leaving a small night light on at night may make older
people feel more safe and secure than if there is no light on.
Sometimes feeling secure may depend on the older person's condition.
An older person who has a physical condition, such as arthritis or a
weak hip, wants to know that they can get around safely and get the
support they need to do physical tasks such as cleaning, laundry,
gardening and cooking. An older person with a condition that affects
them mentally, such as dementia, wants to know where they are, when



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their appointments are, and what to expect will happen next. It can be
very difficult to provide appropriate support for this.
For people with memory problems, security can also mean making sure
that they do not go out on their own. People with memory problems can
get lost if they go out on their own. They can forget to cross roads
safely. They may wander into bushland. Security of these people can
mean providing areas in aged care homes where they are able to walk
around and go out to a garden that is locked to make sure they cannot
leave the facility without someone knowing.
It is important that security measures in these facilities are followed so
that these people are safe. Sometimes the older person may not be
aware that the security measures are making them safer. Other times
they may not feel secure. The older person might be worried that they
could go for a walk and get lost. At these times the aged care worker
can explain the security measures to them so they will know that they
are safe.

Activity 23
What could be done by the aged care worker or community care worker
in the following situations to assist the older person to feel and be more
secure?
Mr Parker has Parkinson’s disease. He enjoys coffee but has stopped
having it as his hands shake, he is also worried he will burn himself.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

Carol has dementia and has lived in the same house for 30 years. Carol
enjoys going for a walk but lately has forgotten how to come home and
the police have brought her home.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

Ken lives by himself in the same family home he was born in. Ken has
mild dementia but tries to remain independent. Ken took the care for a
drive, parked the car, locked it and went for a walk. Ken was found
wandering the streets and taken back home. His family was notified and
it took 3 weeks to locate the car.

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___________________________________________________________
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___________________________________________________________

Dorothy lives in an aged care facility, she has dementia and when her
family comes to visit which is quiet regularly, Dorothy cannot recognise
who they are.
___________________________________________________________
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3.3 Adapt or modify the environment, in consultation with the older
person, to maximise safety and comfort.
It is impossible to completely separate the environment from the person
observing it. (Bowers 1973)
Individuals by their overt behaviour create, select and maintain
environments with properties congenial to their own cognitive,
motivational and behavioural states. (Altman 1975)
The individual’s environment will be installed with qualities that are
consistent in some respects to the individuals purpose and intention.
By their residential behaviours, individuals select, modify or maintain
their everyday environment by moving into and out of a place and by
remaining in a place for shorter or longer periods. By their activity
behaviours, individuals select, modify, or maintain their everyday
environment by the extent to which they differently occupy (temporarily)
and utilise its varied contents.
In other words, people are reluctant or are complacent to change their
environment or to repair it even though they realize it is in disrepair.
Your client may well stay in only 2 or 3 rooms of their house, due to the
balance of the house being too cold, and they are unable to or have no
idea on how to heat it.
They may have an increasing difficulty in managing to walk up and down
stairs, and as such they no longer access the back yard and sunshine
because it is too difficult and painful to walk up and down the 2-3 steps.
There are ways and means of assisting your client to make
modifications along a simplistic scale without rebuilding the whole
environment.
Before recommending any adaptation, modification or assistive device,
an assessment of the older person will be undertaken to ensure that the
most appropriate intervention is recommended. The assessment will
look at the older person's:
 ability to perform ADLs
 vision and hearing
 transportation
 recreation
 home and work environment
 current equipment use.
Assessment of the older person's needs should begin with their
perspective of their needs, their abilities, concerns, views, fears and
what support they feel they need to maximise their independence.
Encourage the older person to ask questions and take an active part in
the assessment.
An assessment will be carried out on initial contact with the older
person, and then regularly to monitor their wellbeing and to detect any
changes. In residential aged care facilities, an admission assessment
will be conducted when the person moves into the facility. In home care,



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physical assessment may not be the primary focus, as the assessment
may be directed towards the type of support offered by that service and
the assistance that the older person needs. For example, assessment of
an older person attending a day care centre may focus more on their
social, emotional, behavioural and leisure needs.
Often, adaptations to their home environment will make it possible for
the older person to regain their independence — for example, a simple
modification to make the environment safer and allow the person to
mobilise more easily may be sufficient. The type of modification
necessary will depend on the needs of the individual and the part of the
home that is being modified. Modifications can include ramps, grab rails,
wider doorways, hand-held showers, better lighting and lowered bench
tops.

Ramp to a house Wheelchair Elevator




Assistive devices include any aids that help older people to perform
ADLs more independently and more easily. There are many assistive
devices available that can increase the older person's independence in
all ADLs — for example, aids that enhance safety with walking (such as
a walking frame), ramps (to make wheelchairs or walking frames easier
access than steps), plate guards and cup holders that make eating and
drinking easier, and commodes that can increase an individual's
independence in toileting.
Any modification, adaptation or aid that is recommended should
increase the older person's sense of security, safety and independence.
Being safe means being free from harm, injury, danger or risk. It is
similar to feeling secure. Being comfortable means being free from pain
and anxiety and feeling that all our needs are satisfied.
It is still important that the older person is aware of their environment
and how to keep it safe and well arranged. This helps them to be
independent and in control. For example, an older person may be
encouraged to think about where they keep things in their room, so that
the things they use frequently are easily accessible, and that walkways
are clear.



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Making the environment safe and comfortable
There are many ways that an older person's environment can be
adapted to make sure that it is safe and comfortable for the that person.
Some examples might be:
 Make sure that the older person has locks on doors and windows,
which the older person can operate
 Make sure there are no tripping hazards around their home such as
uneven footpaths, rugs, frayed carpet
 Check electrical appliances and cords for faults or breaks
 Make sure that the older person can pay their bills, so that they
always have electricity, gas, telephone etc.
 Provide support for the older person to visit doctors and other
appointments when necessary.
 Make sure furniture is comfortable and that the older person can get
in and out of it independently.
 Make sure the temperature is at a comfortable level not too hot or
cold.
 Support an older person to shop regularly so they always have fresh,
healthy food and drink available.
Environments that are outside the older person's home, such as
footpaths and shops, are not controllable by the older person. The older
person should be encouraged to maintain an awareness of any dangers
in these places, for example uneven patches on footpaths. The older
person can then plan to avoid or manage these things. The older person
should also be encouraged to carefully plan how they will do the tasks
that involve the environment they cannot control.
What are 5 activities that we do everyday that we cannot control? (For
instance, uneven footpaths, drivers, etc)
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

Helping older people to have a safe and comfortable environment can
be different depending on where the older person lives.
As an aged care or a community worker, you may find that it is difficult
to adapt the environment in the person's own home. The home belongs
to the older person and they may not want, or they may not be able to
afford, to have big changes made to make their environment safe and
comfortable.



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For instance, if an older person is having difficulty getting in and out of a
lounge chair, the best solution would be to buy a new electric chair that
gets the person to a standing position, however this is costly to the older
person. The older person may not want to do this. They may like their
armchair. It may suit their house. The older person may not be able to
afford to buy an expensive new chair. The aged care worker can help
the older person to think of another way to adapt the environment. An
occupational therapist can help with this too. A suggestion may be to
have cushions on the chair to make the seat higher, or to attach blocks
to the legs to make the chair taller, or teach the older person to get out
of the chair by wriggling closer to the front edge then pushing up to
stand up.
In an aged care facility, the organisation running the facility has control
over the environment and how it can be adapted to make older people
safer or more comfortable.
Discussing with an older person about safety
It is very important to discuss with the older person about the ways in
which their environment could be adapted to make it safer and more
comfortable. You should never change something in the person's home
or room without first talking to them about it, making sure that they
understand why it needs to be modified or changed, and getting their
consent to do it.
It may be difficult to talk to an older person about making changes in
their environment as they don't like change. It may make them feel
disempowered over their own home and/or their life. It may make them
feel that they are becoming less independent and therefore have less
motivation, less self worth and confidence. It is important to approach
the older person with respect, courtesy, sensitivity to their needs in the
way you speak to an older person. Make sure that they understand that
they have choices and with the choices there may be consequences
that need to be considered. Allow the older person time to make
decisions as if they feel rushed or overwhelmed they lose that sense of
control. Emphasise that by making changes in the older persons’
environment will help them to maintain or increase their independence
and control, as long as the older person has made the decision
themselves and not the worker coercing them into a decision.

Activity 24
Winifred lived at home and enjoys having a bath 2-3 times a week. Last
time she was in the bath she found it difficult to get out of the bath. What
can be done so Winifred can continue to have bathes?
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Max lives in an aged care facility. He has very limited movement to the
left side of his body. Today, instead of having a bath he wants a shower.
He needs to 2 aged care workers do to his ADLs. Do you accommodate
Max’s wishes? Why/Why not?
_________________________________________________________
_________________________________________________________
_________________________________________________________
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3.4 Recognise hazards and address in accordance with organisation
policy and protocols.

Having a good understanding of your organisations policy and
procedures and protocols, will be instrumental in addressing the issue
with regards to recognizing the hazards of your client’s residence.
In recognizing the hazards it is important to document them in line with
your organisations policy.
Hazards can be in any form, they can include those in-house and
external.
In-house hazards could be:
 clients failing eye sight and unable to see whether the gas stove is lit
or not
 old carpet which is fraying at the seams
One of the most important parts of helping older people have a safe,
secure and comfortable environment is to recognise things that are likely
to be dangerous or cause injury or harm. These things are called
hazards. Hazards in an older person's environment means anything
that might cause harm or injury and affect the older person's
independence. For instance, an older person has magazines and
newspapers piled up in the hallway this is a hazard in the home.
As an aged care worker or community worker it is your responsibility to
recognise hazards, remove the hazards, report them verbally to the
supervisor and written by completing the paperwork as per the
organisations policies and procedures.
The purpose of following the policies and procedures of the organisation
means that you, as a worker, are complying with the appropriate federal
and state legislation such as Occupational Health and Safety Act,
Confidentiality Act and Privacy act to name a few. Remembering that
legislation is law so when organisations are writing policies and
procedures they comply with the law and so will you when you follow
them. For instance, if an older person in a facility smokes inside and you
as a worker do nothing to stop him, as the facility has a no smoking
policy on-site. Could you as a worker be in trouble? What happens if the
cigarette starts a fire?
Below are some examples of different hazards in the environment.




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Table 2: Hazards in the Environment

HAZARD WHAT HAZARD WHAT DANGER CONTROL
MEASURES
Environmental Wet floor Slipping Mop floor
Lighting No light on stairs Fall up or down Install light
Electrical Cords across the
floor
Tripping Hide, tape cord
Equipment Faulty machine Back injury,
electrocution
Out of order
Storage Heavy boxes high Back Shoulder Store at low and
central height
Entry/exit Blocking exits No exit in
emergency
Clear way
Human Lack of sleep Exhaustion Adequate
sleep/rest

Basically, risk management is the overall process of identifying hazards,
assessing the risk of those hazards, eliminating or controlling those
hazards and monitoring and reviewing risk assessments and control
measures. The steps of risk management is
 Step 1-Identify hazards (find a problem)
 Step 2-Assess risk (check it out)
 Step 3-Eliminate or control risks (fix it)
 Step 4-Monitor and review
When identifying risks from as simple as boxes obstructing the fire exit
to equipment not working properly and water on the floor there is a
policy and procedure in place to do with occupational health and safety.
The reason for this is that there is an Occupational health and Safety
Act at a federal and at a state level. This legislation is past through
parliament and therefore are law. As these are legal documents that
outline the requirements for that particular legislation and is law that is,
why they form the basis for all organizational policies and procedures.



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Hence, the risk management process is essential to have steps in place
for all workers to follow as it will provide a safe working environment.
The process to do this will vary from organisation to organisation but
generally it involves reporting to your supervisor, complete a hazard
report form, complete maintenance forms, if it entails equipment put “out
of service” tags and remove equipment and handover verbally to
colleagues and/or put in communication book what has been done.
By complying with the policies and procedures in place you have also
complied with your duty of care responsibilities.

Activity 25
Where would you locate the policy and procedures manuals in any
organisation?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

As an aged care worker, if you do not understand the policy and
procedures who do ask for help?
_________________________________________________________
_________________________________________________________

List 5 possible hazards in your home
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Pick one hazard in your home from the list above, and do the risk
management steps. (Identify hazards, Identify hazards, eliminate or
control risks and monitor and review).
_________________________________________________________
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_________________________________________________________
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Activity 26

How as a carer would you encourage and support/assist the older
person to maintain their environment? Give Examples
___________________________________________________________
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___________________________________________________________

How would you as a carer provide support to promote security of the
older person’s environment? Give examples
___________________________________________________________
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If an environment needs to be adapted or modified how would you as a
carer, in consultation with the older person, go about maximising safety
and comfort? Give examples
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

As a carer there are many hazards in your day to day activities. How do
you recognise hazards and address in accordance with organisation
policy and protocols? Give examples and how to go about rectifying
them.
___________________________________________________________
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___________________________________________________________
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4. Support the older person who is
experiencing loss and grief.
4.1
Recognise signs that older person is experiencing grief and
report to appropriate person.
4.2
Use appropriate communication strategies when older person is
expressing their fears and other emotions associated with loss
and grief.
4.3
Provide older person and/or their support network with
information regarding relevant support services as required.

4.1 Recognize signs that older person is experiencing grief and report
to appropriate person.
Change is a natural part of life and a significant part of the experience of
ageing. The changes that come with ageing are often associated with
loss, and this loss can be physical, emotional, psychological and social.
Grief is a natural response to loss and is experienced in many different
ways. There is no right or wrong way to grieve; it is the central part of
the healing and recovery process after a loss.
Reactions to loss and grief are very individual, and each of us will
experience unique responses to change, loss and grief. The process of
grief can be experienced emotionally, physically, psychologically and
behaviourally.
Not everyone will experience loss and grief the same way, some
common feelings of grief include:
 assumption of the lost loved one's mannerisms or speech patterns
 denial or disbelief that the loss occurred
 feeling of emptiness in the stomach or abdomen
 feelings of restlessness
 heaviness in the chest
 inability to complete tasks, even simple ones
 inability to concentrate
 intense anger at the departed loved one
 loss of appetite
 mood swings from anger to guilt
 need to take care of others, to protect them
 need to tell and retell stories about their loved one and the death
experience
 sensing or feeling the loved one's presence



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 sleep disruptions such as insomnia or extreme wakefulness
 tightness in the throat
 unexpected and unpredictable bouts of crying
 wandering aimlessly through the house or neighbourhood
 social withdrawal
 anxiety
 fear
 sadness
 guilt
 inadequacy
 loneliness
 lethargy
Recognizing the signs of a loss is the start of recognizing the signs of
grief
Loss may include the loss of:
 Independence
 Control
 Status
 Possessions
 Relationships
 Health and Significant others – loved ones both human and animals.
Reaction to the loss can take the form of:
 Shock
 Physical Distress
 Panic
 Guilt
 Hostility / destructive behaviours
 Lack of interest and apathy
 Emotional Release
The signs of depression and grief can be similar. Many people who have
experienced both talk about the ‘sadness’ of grief compared with the
‘numbness’ or almost non-feeling state of major depression.
Grief is defined as the normal, internal feeling one experiences in
reaction to a loss, while bereavement is the state of having experienced
that loss. Although people often suffer emotional pain in response to
loss of anything that is very important to them (for example, a job, a
friendship, one's sense of safety, a home), grief usually refers to the loss
of a loved one through death.



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The potential negative effects of a grief reaction can be significant. For
example, research shows that about 40% of bereaved people will suffer
from some form of anxiety disorder in the first year after the death of a
loved one, and there can be an up to 70% increase in death of the
surviving spouse within the first six months after the death of his or her
partner.
In addition to grief as an initial reaction to loss, the process can be
aggravated by events that remind the bereaved individual of their loved
one or the circumstances surrounding their loss. This can be in the form
of a particular date or anniversary, a location, a sound / song / smell /
flower or even food. It would help to have an insight into the
circumstances of the loss so that you can be prepared for the triggers
and can suitably assist your client.
Elisabeth Kubler-Ross (1969) is credited with awakening society's
sensitivity to the psychological needs of dying people. She devised a
theory of five typical responses—initially proposed as stages—to the
prospect of death and the ordeal of dying. According to Kubler-Ross,
when family members and health professionals understand these
responses, they are in a better position to provide compassionate
support.
 Denial - On learning of the terminal illness, the person denies its
seriousness to escape from the prospect of death. While the person
still feels reasonably well, denial is self-protective. Denial is
resistance and avoidance.
 Anger - Recognition that time is short promotes anger at having to
die without being given a chance to do all one wants to do. Family
members and health professionals are often targets of the client's
rage, resentment, and envy of those who will go on living. Still, they
must tolerate rather than lash out at the client's behaviour,
recognising that the underlying cause is the unfairness of death.
 Bargaining - Recognition inevitability of death, the terminally ill
person attempts to forestall it by bargaining for extra time—a deal he
or she may try to strike with family members, friends, doctors,
nurses, or God. Listening sympathetically is the best response to
these efforts to sustain hope.
 Depression - When denial, anger, and bargaining fail to postpone
the course of illness. Kubler-Ross regards depression as necessary
preparation for the last stage, acceptance.
 Acceptance - This is seen as achieving peace, accepting the
present and not fighting or protesting the future.
Be aware people do not move through the stages outlined by Kubler-
Ross in any fixed order. They may miss a stage, revisit a stage or
experience several stages at the same time.
Kubler-Ross stressed the importance of hope at all stages, of not crushing or
denying people’s hope. She felt that even at the stage of acceptance, people
hold some hope that their fate can be altered.



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Reporting Grief
The aged care worker or community worker need to be aware that there
are policies and procedures in place on what to do if a person is
experiencing grief and loss. Generally, the supervisor is notified verbally
and the worker will document in the progress or clinical notes what signs
of grief the older person is displaying. It will also be verbally handed
over to colleagues at handover. This is so staff are informed and to
make sure that if the feelings of grief intensify then further steps may
need to be taken such as, involving pastoral care, counsellors, family
members and other professional as needed.
Bereaved individuals who may have felt that the death of their loved one
was either unexpected or violent may well be at greater risk for suffering
from major depression, post-traumatic stress disorder (PTSD) or
complicated grief.
Major depression is described as a psychiatric disorder which can be
characterized by depression and/or irritability that lasts at least two
weeks in a row and is often accompanied by a number of other
symptoms, such as:
 Problems with sleep,
 Loss of appetite,
 Loss of weight,
 Loss or lack of concentration,
 Decrease in energy level
It is very important that should you notice your client experiencing any of
the above signs and symptoms that you document it accurately and
appropriately and notify your supervisor.
Major depression may also lead to the sufferer experiencing unjustified
guilt, losing interest in activities he or she used to enjoy, or thoughts of
wanting to kill them or someone else.
PTSD refers to a condition that involves the sufferer enduring an
experience that significantly threatened their sense of safety or well
being (for example, the suicide or homicide of a loved one),
They then re-experience the event through nightmares when they are
asleep or flashbacks (feeling as if the trauma is happening again at
times when the sufferer is awake),
They also develop a hypersensitivity to events that are normal and they
are very jittery and often tearful (for example, being quite irritable,
getting startled very easily, having trouble sleeping, or difficulty trusting
others),
And they start avoiding things that remind the person of the traumatic
event (for example, people, places, or things that the sufferer may
associate with the death of their loved one).



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Activity 27
Is there a right or wrong way to grieve? Why/why not?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Grief is experienced emotionally, psychologically, physically and
behaviourally. Give 5 examples of each:
Emotional - _______________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Psychological - ____________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Physical - ________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Behavioural - _____________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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Kubler-Ross created the “Stages of Dying”, what are they and outline
the main characteristics of each stage

Stage Main Characteristics






























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4.2 Use appropriate communication strategies when older person is
expressing their fears and other emotions associated with loss and grief.

Grief counseling helps mourners with normal grief reactions work
through the tasks of grieving. Grief counseling can be provided by
professionally trained people or in self-help groups where bereaved
people help other bereaved people. All of these services may be
available in individual or group settings.
Personal assistance you can provide to your client includes:
 Grief is a very private and individual process. Everyone grieves in
their own way and at their own time – but you do not have to do it
alone
 Grief can be physically exhausting: one hour of grieving can be
comparable to several hours of hard physical labor.
 Talk to them. A grieving person needs the opportunity to talk about
the loss.
 Recognize that loss can involve much more than death: divorce,
mental health diagnoses, etc all involve loss.
 If the loss is a death, do not be afraid to mention the loved one’s
name and to ask about the death (e.g., how the death occurred,
when it occurred).
 Give the bereaved person permission to grieve. Offer the person
support, but also give them the time to think and grieve.
 Do not assume that someone is over their grief because they do not
show outward signs. Check in with how they are feeling about the
loss.
 When supporting someone grieving a death, recognize that
anniversaries associated with the loss are common triggers.
 Ask how they coped or how they are coping now.
 The goals of grief counseling include:
 Helping the bereaved to accept the loss by helping him or her to talk
about the loss.
 Helping the bereaved to identify and express feelings related to the
loss (for example, anger, guilt, anxiety, helplessness, and sadness).
 Helping the bereaved to live without the person / pet who died and to
make decisions alone.
 Helping the bereaved to separate emotionally from the person / pet
who died and to begin new relationships.
 Providing support and time to focus on grieving at important times
such as birthdays and anniversaries.
 Describing normal grieving and the differences in grieving among
individuals.



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 Providing continuous support.
 Helping the bereaved to understand his or her methods of coping.
 Identifying coping problems the bereaved may have and making
recommendations for professional grief therapy.
It can be tough to know what to say or do when someone you care
about is grieving. It’s common to feel helpless, awkward, or unsure. You
may be afraid of intruding, saying the wrong thing, or making the person
feel even worse. Or maybe you feel there’s little you can do to make
things better.
While you can’t take away the pain of the loss, you can provide much-
needed comfort and support. There are many ways to help a grieving
friend or family member, starting with letting the person know you care.
The death of a loved one is one of life’s most difficult experiences. The
bereaved struggle with many intense and frightening emotions, including
depression, anger, and guilt. Often, they feel isolated and alone in their
grief. Having someone to lean on can help them through the grieving
process.
Don’t let discomfort prevent you from reaching out to someone who is
grieving. Now, more than ever, your support is needed. You might not
know exactly what to say or what to do, but that’s okay. You don’t need
to have answers or give advice. The most important thing you can do for
a grieving person is to simply be there. Your support and caring
presence will help them cope with the pain and begin to heal.
Listen with Compassion
Almost everyone worries about what to say to people who are grieving.
But knowing how to listen is much more important. At times, well-
meaning people avoid talking about the death or mentioning the
deceased person. However, the bereaved need to feel that their loss is
acknowledged, it’s not too terrible to talk about, and their loved one
won’t be forgotten.
While you should never try to force someone to open up, it’s important
to let the bereaved know they have permission to talk about the loss.
Talk candidly about the person who died and don’t steer away from the
subject if the deceased’s name comes up. This may include crying, fits
of anger, screaming, laughing, expressions of guilt or regret, or
engaging in activities that reduce their stress such as walking or
gardening. When it seems appropriate, ask sensitive questions – without
being nosy – that invite the grieving person to openly express his or her
feelings. Try simply asking, “Do you feel like talking?”
Accept and acknowledge all feelings. Let the grieving person know that
it’s okay to cry in front of you, to get angry, or to break down. Don’t try to
reason with them over how they should or shouldn’t feel. The bereaved
should feel free to express their feelings, without fear of judgment,
argument, or criticism.
Be willing to sit in silence. Don’t press if the grieving person doesn’t feel
like talking. You can offer comfort and support with your silent presence.
If you can’t think of something to say, just offer eye contact, a squeeze
of the hand, or a reassuring hug.



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Let the bereaved talk about how their loved one died. People who are
grieving may need to tell the story over and over again, sometimes in
minute detail. Be patient. Repeating the story is a way of processing and
accepting the death. With each retelling, the pain lessens.
Offer comfort and reassurance without minimising the loss. Tell the
bereaved that what they’re feeling is okay. If you’ve gone through a
similar loss, share your own experience if you think it would help.
However, don’t give unsolicited advice, claim to “know” what the person
is feeling, or compare your grief to theirs.
Concentrate your efforts on listening carefully and with compassion.
Everyone’s experience of grief is unique, so let them grieve their own
way. Don’t judge or dispute their responses. Criticising the way they
express their grief is hurtful and will make them less likely to share their
feelings with you.
If they don’t feel like talking, don’t press. Remember that you are
comforting them just by being there. Sitting together in silence is helpful
too.
Don’t forget the power of human touch. Holding the person’s hand or
giving them a hug offers emotional support.

Comments to avoid when comforting the bereaved
 "I know how you feel." One can never know how another may feel.
You could, instead, ask your friend to tell you how he or she feels.
 "It's part of God's plan." This phrase can make people angry and
they often respond with, "What plan? Nobody told me about any
plan."
 "Look at what you have to be thankful for." They know they have
things to be thankful for, but right now they are not important.
 "He's in a better place now." The bereaved may or may not believe
this. Keep your beliefs to yourself unless asked.
 "This is behind you now; it's time to get on with your life." Sometimes
the bereaved are resistant to getting on with because they feel this
means "forgetting" their loved one. In addition, moving on is easier
said than done. Grief has a mind of its own and works at its own
pace.
 Statements that begin with "You should" or "You will." These
statements are too directive. Instead you could begin your
comments with: "Have you thought about. . ." or "You might. . ."
 ‘She’s lucky she lived to such a ripe old age.’
 ‘It was God’s will.’
 ‘You can always try for another baby.’
 ‘He’s happy in heaven.’
 ‘Be thankful they’re not in pain anymore.’
 ‘Try to remember the good times.’



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 ‘You’ll feel better soon.’
 ‘Time heals all wounds.’
 ‘Count your blessings, you still have a lot to be grateful for.’
 ‘You’ve got to pull yourself together and be strong.’

Offer practical assistance
 Grief is a process and not an event. Coming to terms with the death
of a loved one can take months and years, rather than days and
weeks. Suggestions include:
 Don’t shy away from your friend after the funeral. Keep in contact.
 Never suggest that it’s time they ‘got over it’ and moved on with life.
Appreciate that your friend may continue to grieve in subtle ways for
the rest of their days.
 Don’t change the subject if the deceased naturally comes up in
conversation. Your friend needs to know that their loved one hasn’t
been forgotten. Use the name of the deceased in conversation.
 Remember there will be days in the year that will be particularly hard
for your friend to bear, such as anniversaries, Christmas and the
deceased’s birthday. Be sensitive to these times and offer your
support.

Provide ongoing support
Grieving continues long after the funeral is over and the cards and
flowers have stopped. The length of the grieving process varies from
person to person. But in general, grief lasts much longer than most
people expect. Your bereaved friend or family member may need your
support for months or even years.
Continue your support over the long haul. Stay in touch with the grieving
person, periodically checking in, dropping by, or sending letters or cards.
Your support is more valuable than ever once the funeral is over, the
other mourners are gone, and the initial shock of the loss has worn off.
Don’t make assumptions based on outward appearances. The bereaved
person may look fine on the outside, while inside he or she is suffering.
Avoid saying things like “You are so strong” or “You look so well.” This
puts pressure on the person to keep up appearances and to hide his or
her true feelings.
The pain of bereavement may never fully heal. Be sensitive to the fact
that life may never feel the same. You don’t “get over” the death of a
loved one. The bereaved person may learn to accept the loss. The pain
may lessen in intensity over time. But the sadness may never
completely go away.
Offer extra support on special days. Certain times and days of the year
will be particularly hard for your grieving friend or family member.
Holidays, family milestones, birthdays, and anniversaries often



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reawaken grief. Be sensitive on these occasions. Let the bereaved
person know that you’re there for whatever he or she needs.
Watch for warning signs
It’s common for a grieving person to feel depressed, confused,
disconnected from others, or like they’re going crazy. But if the bereaved
person’s symptoms don’t gradually start to fade – or they get worse with
time – this may be a sign that normal grief has evolved into a more
serious problem, such as clinical depression.
Encourage the grieving person to seek professional help if you observe
any of the following warning signs after the initial grieving period –
especially if it’s been over two months since the death.
 Difficulty functioning in daily life
 Extreme focus on the death
 Excessive bitterness, anger, or guilt
 Neglecting personal hygiene
 Alcohol or drug abuse
 Inability to enjoy life
 Hallucinations
 Withdrawing from others
 Constant feelings of hopelessness
 Talking about dying or suicide
 Anger
 Anxiety
 Change in worldview
 Confusion
 Sadness and depression
 Sleeping difficulties
 Drop in self-esteem
 Difficulties in concentration
 Feeling unable to cope
 Guilt and remorse
 Helplessness
 Hopelessness
 Loneliness
 Questioning of values and beliefs
 Relief
 Shock and disbelief.




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It can be tricky to bring up your concerns to the bereaved person. You
don’t want to perceive as invasive. Instead of telling the person what to
do, try stating your own feelings: “I am troubled by the fact that you
aren’t sleeping – perhaps you should look into getting help.”
Grief therapy is used with people who have more serious grief reactions.
The goal of grief therapy is to identify and solve problems the mourner
may have in separating from the person who died. When separation
difficulties occur, they may appear as physical or behavior problems,
delayed or extreme mourning, conflicted or extended grief, or
unexpected mourning (this is seldom present with cancer deaths).
Reporting your clients circumstances can be verbal / telephone / face –
to- face and in writing.
Communication with the grieving needs to be in a variety of forms:
 Non – judgmental - Non-judgmental is about being open-minded
enough to understand that other people have different points of view,
and that in their world-view, they may be correct
 Observing and listening - (facial expressions, gestures, raised
eyebrows, eye contact, vocal utterances, and posture). (questions
and answers, arguments and counterarguments, agreements and
disagreements, challenged and compliances)
 Respect for individual differences
 Courtesy - excellence of manners or social conduct; polite behavior;
a courteous, respectful, or considerate act or expression
 Empathy - is the capability to share your feelings and understand
another's emotion and feelings. It is often characterized as the ability
to "put oneself into another's shoes," or in some way experience
what the other person is feeling
 Sympathy - is a social affinity in which one person stands with
another person, closely understanding his or her feelings. It also can
mean being affected by feelings or emotions. Thus the essence of
sympathy is that one has a strong concern for the other person.
Sympathy exists when the feelings or emotions of one person are
deeply understood and appreciated by another person.

Activity 28: Case Study
Sara has just returned to work having had some days off. Before long
she notices the difference in the mood of the aged care facility. Jonas
has contracted pneumonia and is likely to die over the next couple of
days. Although Jonas has had emphysema for many years, this
deterioration has happened very suddenly.
All the staff members are extremely fond of Jonas, who has been a
resident of the facility for eight years. He has a generous and friendly
nature and a wonderful sense of humour. At times he has challenged
the policies of the facility, but always with goodwill and in a constructive
manner.



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Sara experiences a variety of strong emotions in response to Jonas's
dying. She feels sadness at the prospect of losing him, and it also brings
up memories of her own father's death.
How should the staff act towards Jonas?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

What can be done to help Sara with her previous memories of grief and
loss?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Are the feelings of staff towards Jonas normal? Why/why not?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

How can workers care for themselves in this type of situation?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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4.3 Provide older person and/or their support network with information
regarding relevant support services as required.
Most of the support that people receive after a loss comes from friends
and family. Doctors and nurses may and can also be a source of
support. For people who experience difficulty in coping with their loss,
grief counseling or grief therapy may be necessary.
It is important for there to be a good support network available to help
your clients through the stages of grief should the experience occur. The
support network can include personnel such as:
 Advocates
 Family members
 Carers
 Friends
 Clergy or local church members
 Veterans / war widows associations
 Lions clubs and Community welfare organisations
 Health professionals (registered nurse, doctor, social worker,
diversional therapists, and psychologists.
 National associations for loss and grief
 Palliative care associations

Support from family and friends is important

People who have support from family and friends are less likely to suffer
poor health as a consequence of bereavement and loss. However,
some people may also benefit from support in the form of counselling.

Bereavement counselling

Grief support services provide counselling, support and education to
bereaved individuals and families. The opportunity to talk things over
with a trained counsellor can help you make sense of your feelings.

Counsellors can offer you encouragement, support and advice through
the grieving process. They will not tell you what to do or how you should
be feeling, but they may put forward ideas and strategies to help you
cope.

Volunteer counsellors have often been through a similar experience.
They can share their experiences and give practical advice and
suggestions gained from their own bereavement journey.




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Support can help you cope with grief

Grief support services aim to:
 Help and guide people through the grieving process
 Help with complicated grief issues to prevent physical and mental
health problems occurring.
 Support is available in most communities
Community organisations, agencies and groups are often involved in
grief support services. These organisations may include:
 Hospitals and community health centres
 Palliative care agencies
 Volunteer groups
 Church and religious organisations.
 Specialist services

There are a range of specialist grief support services available. For
example, if you have experienced the death of a child or baby,
assistance is available from SIDS and Kids or SANDS (Stillbirth and
Neonatal Death Support). There are also grief support groups for
families of people involved in industrial or workplace accidents, victims
of homicide and people experiencing trauma as a result of road
accidents. Sometime specialist services are established in response to a
particular traumatic event or disaster such as a bushfire or flood.


Where to get help
 Your doctor
 Your local community health centre
 A trained counsellor
 Australian Centre for Grief and Bereavement – Bereavement
Counselling and Support Service 1800 642 066
 Australian Centre for Grief and Bereavement – Kids Grieve
 Kids Help Line Tel. 1800 551 800 – 24 hours a day, seven days a
week.
 Victims of Crime Helpline Tel. 1800 819 817

Things to remember
 Everyone experiences the pain associated with grief at some time in
their life.
 Support from family and friends is important.



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 Contact grief support volunteer groups, community or religious
organisations, hospitals and palliative care agencies to access
services
 Losing a loved one can be a shattering event that affects you
emotionally, physically and spiritually.
 There is no one correct way to grieve. Misconceptions about the
grieving process can cause difficulties for the bereaved person.
 The experience of grief depends on individual factors such as
personality and age, the relationship with the deceased and spiritual
beliefs.

It is important for there to be a good support network available to help
your clients through the stages of grief should the experience occur. The
support network can include personnel such as:
 Advocates
 Family members
 Carers
 Friends
 Clergy or local church members
 Veterans / war widows associations
 Lions clubs and Community welfare organisations
 Health professionals (registered nurse, doctor, social worker,
diversional therapists, and psychologists).
 National associations for loss and grief
 Palliative care associations

Being able to care for a dying loved one tends to promote the healing
process for those who are left behind. That care can either be provided
at home, in the hospital, or in hospice care.
A hospice is a program or facility that provides special care for people
whose health has declined to the point that they are near the end of their
life. Such programs or facilities also provide special care for their
families.
Moving on with life
There is an expectation that accepting the death of a loved one means
letting go of them and their memory. The reality is that many bereaved
people continue to have a relationship with their loved ones for the rest
of their lives through remembering them. Death ends a life, not a
relationship.

You may like to talk about your loved one in general conversation or
commemorate special events like the deceased’s birthday. Keeping your
relationship with the deceased ‘alive’ is a healthy, normal response. On



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the other hand, you may prefer to keep your memories to yourself and
grieve more privately – and that’s healthy and normal too.

Activity 29

As a care worker, you will care for residents/clients’/older people who
will die. List some strategies that could be utilised by workers, when
preparing a dead body to be viewed by the family.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

When working, you find an older person who has died, who do you
notify? Do you need to document anything? Why/why not?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

Who notifies the next of kin that an older person has died?
_________________________________________________________
_________________________________________________________

If you have never prepared a dead person before, how do you find out
what to do?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________




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Activity 30

How would you as a carer recognise signs that older person is
experiencing grief and report to appropriate person?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

What appropriate communication strategies could you use as a carer
when an older person is expressing their fears and other emotions
associated with loss and grief? Give details
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

How do you as a carer provide older person and/or their support
network with information regarding relevant support services as
required?
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________



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