Supportive Care Theory and Practice

Assignment: The Role of the Support Worker in Preventative Care Assignment Part 3
Weighting: 10% of final grade

Course Outcomes:
1. Identify evidence informed practice procedures and the rationale the support worker
can implement to promote optimal functioning using person centered care.
2. Identify how care may need to be altered to accommodate age related changes in the
older adult population.
3. Recognize principles of safety for the individual and the support worker applied in the
delivery of person-centered care.
4. Describe the support worker ’s responsibilities in assisting the individual with routine
activities of daily living and instrumental activities of daily living according to the
principles of person-centered care.
5. Recognize the roles of the interprofessional team related to supportive care practices.
6. Identify the role in observing, reporting, and documenting routine activities of daily
living and instrumental activities of daily living.
8. Recognize use of problem solving and critical thinking skills both as an individual care
provider and as a member of the interprofessional care/service team.

Instructions for Assignment:

1. Using your textbook, Sorrentino’s Canadian Textbook for the Support Worker,
lecture slides and resources provided in your shell respond to the “Questions” on
the following pages.
2. All work is expected to be your original work in your own words. All items copied
from other sources must be quoted or paraphrased or summarized with
appropriate citations or references. Academic honesty is expected and
required of all Conestoga students. It is critical that you familiarize yourself
with the Academic Offences Policy found in the Conestoga Student Guide. 
3. Follow the marks for each question.
4. The assignment is divided into 3 sections, worth 10% each. Each section will
be submitted separately on the specific due date for that section.
5. Submit to the Assignment Submission Folder on eConestoga.

Instructions for Submission:

1. To be marked, this assignment must be submitted one section at a time to the
Assignment Submission Folder entitled “The Role of the Support Worker in Preventative
Care” on eConestoga
a. Click on “Supportive Care Theory and Practice.”
b. Click on “Course Tools” tab
c. Click on “Assignment”
d. Click on the Assignment Submission Folder called “The Role of the Support
Worker in Preventative Care”
e. Upload your file
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f. Click “Submit”
2. Receive verification of a “Dropbox submission receipt” in your eConestoga inbox
a. Only the most recent submission to the Dropbox is kept to be marked

Submitting Assignments (from the PSW Program Handbook):

1. Students are expected to submit all assignments on or before the date and time specified.
2. Students should anticipate problems that will necessitate an extension of time.
3. If an extension of time is required, students will make this request to the appropriate
instructor before the due date. Extensions will not be given if the request is made on the
date it is due. Any student requiring more than two extensions will be required to meet
with the coordinator.
4. Assignments that are late and do not meet the above criteria will lose 10% of the value of
the assignment each day that it is late.
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The Role of Support Worker in Preventative Care

Mr. and Mrs. Evan’s are a married couple who live in a small home in the city. Mr. Evan’s
(John) is 84 years old and his wife (Eva) is 78 years old. Mr. Evan’s met his wife in Scotland
and she came to Canada with him and they settled in Kitchener. They have been married for
56 years. They both worked outside the home most of their lives and have 3 grown children
and 5 grandchildren. Two of their children live in Kitchener. They visit often and bring their
grandchildren along, which delights Mr. and Mrs. Evan’s immensely. Their 40-year-old daughter
Jennifer who has severe cerebral palsy lives down the street at Conestoga Group Home. Mr.
and Mrs. Evan’s are essentially home bound. They are adamant they want to age in place and
would rather pay for help to stay in their home than consider moving to an assisted living
setting. Their support worker has been instrumental in supporting Mr. and Mrs. Evan’s remain
in their home.

Both Mr. and Mrs. Evan’s were in excellent health until their 70’s when Mrs. Evan’s had a
massive heart attack (MI). She recovered well initially but has been suffering with congestive
heart failure the last 2-3 years which has made her increasingly short of breath causing her to
fatigue easily. This has impacted her ability to preform her ADL’s and mobilize more than 10-15
feet at a time with a rollator walker. The decline in mobility has contributed to functional
incontinence. Unfortunately, Mrs. Evan’s has developed a stage 1 pressure injury on her
coccyx since she started sleeping in her lazy boy recliner. She sleeps in the recliner because
she finds that it helps with her breathing at night. Mrs. Evan’s states “I have a hard time getting
comfortable, and my bottom is very painful”. Mrs. Evan’s reports, ”I wish I could get more
sleep, I sleep 3-4 hours at best”. She also finds it very stressful caring for her husband. She
says, “he sleeps all day and is often awake most of the night.”

Mrs. Evan’s has been the primary caregiver for Mr. Evan’s who was diagnosed with
Alzheimer’s disease 5 years ago. He had a stroke 2 years ago, has left sided weakness and
walks with the assistance of a quad cane. He is in the moderate stages requiring cueing for
ADL’s. He is particularly reluctant to accept help with bathing. He has been experiencing
urinary incontinence for the last 18 months. Mrs. Evan’s describes her husband as
mischievous. He has always worked hard and enjoys puttering around the home trying to
perform activities he was previously able to do. Mrs. Evan’s is having to keep an eye on him as
he tends to leave the home “to run errands forgetting he can no longer drive”. She has noticed
his clothes are big on him and “he has not been eating or drinking very well over the last 4
months. Sometimes he has difficulty with swallowing. He seems to cough a lot while he is
eating.”

As the support worker you have been caring for Mr. and Mrs. Evan’s for the last 18 months.
Your role is to assist both with ADL’s, mobility and to prepare a light meal for lunch. You have
3 hours to provide care 5x per week. As you arrive at 10 am today you notice Mr. Evan’s is
sitting outside on the front porch in his undershirt and light pants, without anything covering his
bare feet. You hear Mrs. Evan’s calling her husband to “come inside, it’s freezing out there”.
You can see Mrs. Evan’s breathe a sigh of relief when she see’s you have arrived.
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You arrive the next day to find Mrs. Evan’s still laying in her bed, she asks you for assistance
getting up out of bed. You assist her with her transfer and walk with her to the kitchen. As she
is walking, she is out of breath and tells you, "I need to rest, my feet are swollen". She also
states, "My feet are so sore."

You prepare a light lunch for Mr. and Mrs. Evan’s. As you are preparing lunch the Evan’s tell
you that their neighbor, Mrs. Freeman, had brought over a nutritious casserole for supper last
night. She said it was her husbands favorite, one his mother use to make him when he was a
child and it reminds him of being a small boy in Ireland. She says it always brings a smile to his
face to remember his cultural background. Once you have prepared lunch the Evan’s sit and
eat as you clean up. You ask Mr. Evan’s how he is enjoying his lunch. You notice he has tears
in his eyes. He then coughs and you notice he is drooling and there is food pocketed in his
cheeks.

Questions:

Part 3: Sleep, Personal Hygiene, Oxygenation, Skin Care and

Alterations and Global Safety Risks

1. Assisting clients with ADLs such as bathing is one of many responsibilities of a support
worker. Describe 3-person centered care strategies the support worker can use with Mr.
Evans to promote independence and prevent him from feeling threatened as you, the
support worker helps him with his partial bath. (3 marks)

Offer choices: Giving Mr. Evans a sense of control by offering choices can help
him feel more comfortable and independent. For example, asking him if he would
1 like to start with his face or his feet, or if he would prefer to use a washcloth or a
sponge, can help him feel more in control of the bathing process.

Use positive reinforcement: Praising Mr. Evans for his efforts and acknowledging
his strengths can help boost his confidence and sense of independence. For
2 example, saying "Great job washing your arms, Mr. Evans! You're doing a great
job!" can help him feel valued and capable.

3 Respect his privacy: It is important to respect Mr. Evans' privacy and dignity
during the bathing process. This can be done by providing him with a towel or
blanket to cover up as needed, closing the bathroom door or curtains, and
allowing him to do as much of the bathing process as he feels comfortable with.
Being respectful and supportive can help him feel more comfortable and in control
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of the situation.

2. Mrs. Evans has developed a pressure injury on her buttock area. Describe the
subjective and objective observations you have noticed about Mrs. Evan’s buttock. Refer
to the case study and provide two risk factors for the development of a pressure injury
and two strategies you would use to prevent Mrs. Evan’s pressure injury from worsening.
(6 marks)

(Swezey, 2015)

Objective observation you
have noticed about Mrs.
Evan’s buttock.
Subjective observation
you have noticed about
Mrs. Evan’s buttock.
Risk factor 1
Risk factor 2
Strategy 1
Pressure Injury
objective observations that can be noticed include skin
changes, such as discoloration, redness, or darkening
of the skin. The affected area may feel warm to the
touch and be painful. Additionally, there may be
swelling, blisters, or open wounds with drainage.
Based on the case study, some subjective observations
that may be reported by Mrs. Evans include pain or
discomfort in the buttock area, tenderness, warmth or
redness, and possibly an itching or burning sensation.
She may also report feeling unwell or having a fever,
depending on the severity of the pressure injury.
Mrs. Evans is immobile due to her age and frailty,
she is also incontinent, which can lead to prolonged
moisture exposure and irritation of the skin
Frequent repositioning: To alleviate pressure on the
affected area, Mrs. Evans should be repositioned
frequently. This can be done every 2-3 hours, and
positioning should be changed from side-to-side to
relieve pressure on the buttocks.

Strategy 2 Skin care management: To prevent further skin

breakdown, Mrs. Evans' skin should be kept clean and
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dry. Moisture barriers such as creams or ointments

should be used to protect the skin from prolonged
moisture exposure. Additionally, her incontinence
should be managed promptly, and her skin should be
cleansed with a gentle cleanser to avoid further
irritation.

3. Mrs. Evans experiences shortness of breath when she exerts herself. Provide 2
strategies to promote oxygenation during her partial bath. (2 marks)

Encourage Mrs. Evans to take slow and deep breaths during the partial bath to
1
promote oxygen exchange in the lungs.
Provide Mrs. Evans with supplemental oxygen during the partial bath to improve
2 oxygenation and alleviate shortness of breath.

4. Describe 2 things the support worker can do to promote rest and sleep for Mrs. Evans.
Provide rationale. (2 marks)

Create a comfortable sleeping environment: The support worker can create a

comfortable sleeping environment for Mrs. Evans by adjusting the room
1
temperature, ensuring that the bed is comfortable and the bedding is clean and
fresh, and minimizing noise and disruptions.
Encourage relaxation techniques: The support worker can encourage Mrs. Evans
2 to practice relaxation techniques such as deep breathing exercises, progressive
muscle relaxation, or guided imagery before going to bed.

5. Mrs. Evans has stated that Mr. Evans is awake in the night and sleeps in the day. She
finds this stressful. What is this sleep disorder called? Describe one strategy Mrs. Evans
can try to help Mr. Evans readjust his routine? (2 marks)

Name of sleep Mr. Evans is likely experiencing a sleep disorder called circadian
disorder rhythm disorder
One strategy Mrs. Evans can try to help Mr. Evans readjust his
routine is by gradually adjusting his sleep schedule. This can be
Strategy to adjust
done by gradually advancing his bedtime by 15-30 minutes each
night until he reaches the desired bedtime.
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6. Identify 2 client safety risks evident in the case study that you would report to your
supervisor. (2 marks)

Risk of falls: Mrs. Evans is at risk of falls due to her mobility issues and her recent
pressure injury on her buttock. She also has a history of falls, and her recent
1 hospitalization may have weakened her further. Therefore, there is a high risk of
falls, which needs to be addressed to ensure her safety.

Risk of infection: Mrs. Evans has developed a pressure injury on her buttock,
2 which is prone to infection. She is also on medications, which may suppress her
immune system, further increasing the risk of infection.

7. List two risk factors that predispose Mr. and Mrs. Evans to falling? (2 marks)

1. History of falls: According to the case study, both Mr. and Mrs.
Evans have a history of falls. This puts them at an increased risk of
falling again in the future.
2. Medication use: Mr. and Mrs. Evans are taking multiple medications,
which can increase the risk of falls due to side effects such as
dizziness, confusion, and balance problems.

Total Marks /19

References

Swezey, L. (2015). Stage 1 Pressure Ulcer. https://woundeducators.com/stage-1-pressure-

ulcer/
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Grading Rubric

Criteria Level 0 Level 1 Level 2 Level 3 Level 4 Criterion

Score
1. Describe 3-person 0 points 1 point 2 points 3 points N/A /3
centered care strategies Incorrect 1 Correct 2 Correct 3 Correct
the support worker can Response Responses Response
use with Mr. Evans to s
promote independence
and prevent him from
feeling threatened as
you, the support worker
helps him with his partial
bath.
2. a. Objective 0 points 1 point N/A N/A N/A /1
observation you have Incorrect Correct
noticed about Mrs. Response
Evan’s buttock.
2. b. Subjective 0 points 1 point N/A N/A N/A /1
observation you have Incorrect Correct
noticed about Mrs. Response
Evan’s buttock.
2 c. Two risk factors for 0 points 1 point 2 points N/A N/A /2
the development of a Incorrect 1 Correct 2 Correct
pressure injury Response Responses
2. d. Two strategies you 0 points 1 point 2 points N/A N/A /2
would use to prevent Incorrect 1 Correct 2 Correct
Mrs. Evan’s pressure Response Responses
injury from worsening.
3. Mrs. Evans 0 points 1 point 2 points N/A N/A /2
experiences shortness of Incorrect 1 Correct 2 Correct
breath when she exerts Response Responses
herself. Provide 2
strategies to promote
oxygenation during her
partial bath.
4. Describe 2 things the 0 points 1 point 2 points N/A N/A /2
support worker can do to Incorrect 1 Correct 2 Correct
promote rest and sleep Response Responses
for Mrs. Evans. Provide
rationale.
5.A. Mrs. Evans has 0 points 1 point N/A N/A N/A /1
stated that Mr. Evans s Incorrect Correct
is awake in the night and Response
sleeps in the day. She
finds this stressful. What
is this sleep disorder
called?
5.B. Describe one 0 points 1 point N/A N/A N/A /1
strategy Mrs. Evans can Incorrect Correct
try to help Mr. Evans Response
readjust his routine?
6. Identify 2 client safety 0 points 1 point 2 points N/A N/A /2
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risks evident in the case Incorrect 1 Correct 2 Correct

study that you would Response Responses
report to your supervisor.
7. List two risk factors 0 points 1 point 2 points N/A N/A /2
that predispose Mr. and Incorrect Correct 2 Correct
Mrs. Evans to falling? Response Responses