Week 1

The Role of the Support Worker

● It improves a client's quality of life. ● Caring is provided in a kind,
● Supervising medications. sensitive, and understanding
● Provides services to people who manner.
need assistance with their daily ● Relieve the client’s loneliness.
lives. (Emotional or Social support)
● Legislation, employer policies, and ● Provide comfort, encourage
the client’s condition will all influence independence, and promote the
how you function and how much person’s self-respect.
supervision you will need. ● Making a difference in people’s lives
Responsibilities
1. Personal care
2. Support for nurses and other healthcare professionals
3. Family support
4. Social support
5. Housekeeping or home management.
● Personal Care
○ Includes assisting with Activities of Daily Living (ADL)
○ Self-care activities that people perform every day to remain independent and to
function effectively in society
○ When you are giving care, you must observe the client.
■ Skin condition
■ Movements
■ Body postures
■ Or anything essential to the ADL of the client
○ Report the client’s behaviour or health status
● Support for Nurse’s and other Healthcare Professionals
○ Assist health care professionals by following the established care plan for
each client.
○ Assists in providing nursing care or other healthcare professionals.
○ You are the nurse’s “the EYES and the EARS.”
■ Because you spend the most amount of time on the client.
■ You will likely observe or hear things that need to be reported to
the nurse.
■ This is a very important part of your role, as it could have a great
impact on your client’s care
● Family Support
○ You may assist with admissions and discharges.
○ You may also introduce the person and their family to the facility.
○ In a private home, you help families care for loved ones with health issues
or those who just need assistance with ADL’s.
○ PSW support family members by giving them respite.
○ Respite means relief. Keep the family together through respite care.

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 ● Social Support
○ You can help clients participate in social activities.
○ These activities provide the client with enjoyment, recreation, and the opportunity
to meet with friends.
○ You can also be hired privately to be a companion for a client.
○ Provide Maslow’s Hierarchy of Needs
● Housekeeping or Home Management
○ In a facility, you may do a variety of housekeeping tasks:
■ Making beds ■ Tidying up living areas
■ Delivering meals ■ Maintaining supplies
○ In a private home, housekeeping is called home management.
○ Services depend on the needs of the person and the resources available to
provide these services. It might include:
■ Light housekeeping
■ Doing laundry
■ Preparing and serving nutritious meals
○ Clean-up the area that you are working in.
The people you support:
● Always remember that the individual receiving care is first and foremost a person.
● Every person is unique and these people come from a variety of cultures
and backgrounds
● Accept this diversity among people
● Understand the importance of diversity and how people’s backgrounds influence
who they are and what they do
The people you support can be grouped according to their issues, needs, and ages:
● Older adults ● People requiring special care
● People with disabilities ● People needing rehabilitation
● People with medical issues ● Children
● People having surgery ● Mother’s and newborn
● People with mental health issues
*Acute = short-term (3 months)
*Chronic = long-term (4 months to forever)
Regulates & Unregulated Workers
● A regulated profession is self-governing. They belong to a professional
organization called a “college”, which sets education and license requirements.
● It also establishes the scope of practice, codes of ethics, and standards of conduct for
its member’s conduct.
● If necessary, the college disciplines members guilty of misconduct
● Each regulated health care profession has legislation that details the roles and
responsibilities of its members.
● Nursing is one of many regulated health care professions
● An unregulated profession does not have a professional college, and it does not have
legislation written specifically for it.
● There are no official requirements for educational programs, and there are no codes of

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 ethics.
● At this point, Support Workers in most provinces are considered Unregulated
Care Providers (UCP).
● As a support worker, you do not have an organization or college that governs your
role, so you are accountable to your supervisor, your employer, and your client.

Scope of Practice
● You must understand the legal limits of your role, what you can do, and what you
can’t do in order to protect your clients from harm.
● “Never act beyond the legal limits of your role. Also, never perform a function
or task that you have not been trained to do. If you perform a task that is
outside these limits, you could harm a client and create serious legal problems
for yourself and your employer.”
● 3 sources of information abo
● ut the scope of practice are as follows:
○ Your educational program
○ Your employer’s policies
○ Your supervisor
Being a professional
● Demonstrate respect for others
● Commitment
● Competence
● Appropriate behaviour
● Being cheerful and friendly
● Keeping work schedules
● Performing tasks competently
● Being helpful is all part of a professional approach
● To be a true professional
○ A positive attitude
○ A sense of responsibility
○ A professional appearance
○ Discretion about client information
○ Keeping your knowledge up to date
○ Discretion about personal matters
○ Using acceptable speech and language
The Priorities of Support Work: Compassionate Care and Support
● Compassion means caring about another person’s misfortune and suffering
● Caring means having concern for the dignity, independence, preference, privacy,
and safety of clients and their families at all times.
● You are dealing with a vulnerable client. Whenever you’re giving a bath on a client.
The body will be exposed. Only uncover the part of the body that needs a wash.
● When you are doing care, you must do the safest approach. Check the condition of the
equipment and environment.
● True compassionate care includes honesty, sensitivity, comforting, discretion and

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 respect.
● The principles of providing compassionate care: use the acronym DIPPS
○ Dignity - the quality of being honoured and respected
○ Independence - is to take care of your own independently
○ Preference - the inclination of a person for one thing over another
○ Privacy - state of being free from being observed or disturbed by others
○ Safety - the condition of being protected from danger
Decision Making and Problem Solving
● Throughout the day we make many decisions. Many of our decisions involve
problem-solving.
● When problem-solving consider the following:
○ The principles of support work (DIPPS)
○ The client’s viewpoint
○ Your scope of practice
○ You supervisor’s viewpoint
Workplace Settings
● Community-based services
○ Health care and support services which are provided outside of a facility and is in
a community setting (ex: schools, community health centre’s, and doctor’s
offices)
● Home care agencies and day programs are also community-based services that employ
support workers.
○ Home care - a vital part of Canada’s health care system, and support workers
have a central role within home care. Responsibilities include assisting with
personal care, ADL’s, childcare, transportation and home management
○ Home care services hire support workers on a full-time, part-time, and casual.
You must always follow your agency’s policies and procedures
● Community Day Programs
○ Also called Adult Day Centre or Adult Day Program which is a daytime
program for people with physical or mental health issues or for older adults
who need assistance.
○ The aim of this program is to meet the client’s needs and also to provide a break
for family caregivers. It offers recreational activities, arts and crafts, social
events, movies and board games.
○ Some programs offer rehabilitation for people with disabilities and counselling
for people with mental impairment.
● Working Directly for Clients
○ Clients may hire their own support workers if they need services that are not
provided by local agencies.
○ You may work directly for a client or the client’s family.
○ These clients will select and supervise their own support workers.
● Hospital & Medical Facilities
○ Support workers work in a variety of hospital departments and in most cases,
they report to and are supervised by a nurse.

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 ○ Depending on the hospital’s hiring policies you may work in the ICU and ER.
○ Your role may be to provide basic care, taking vital signs, and carry specimens
to the lab.
○ You do not provide care to unstable clients but you may assist the nurse
in turning and repositioning and bathing clients.
○ Hospitals and medical facilities offer a variety of services which include:
■ Acute care - care that is provided in a short time and its to treat and
diagnose immediate health issues.
■ Subacute care or (convalescent care) - care or rehabilitation for people
recovering from surgery, injury, or a serious illness. The client is stable
but requires complex equipment and procedures.
■ Respite care - temporary care of a person who requires a high level of
support, care, and supervision. Respite care gives the person’s
caregiver a break and is often provided by support workers.
● Long-term care (Chroniuc care)
○ Care that is provided over the course of months to years to people who cannot
care for themselves.
○ Those that require long-term care have persistent illnesses or (chronic illness)
which is an ongoing illness, slow or gradual onset that may or may not get worse
over time.
○ The goal is to help people cope with the challenges of living with a long-
term illness or disability.
● Rehabilitation services
○ Therapies or educational programs that are designed to restore and/or improve
the client’s independence and functional activities.
○ This is for clients who have been ill, injured, or disabled.
○ Services may include:
■ Life skills training
■ Occupational and rehabilitation services
■ Behavioural management
■ Speech therapy
■ Physiotherapy
● Palliative care
○ To provide end of life care
○ The care that emphasizes client goals
○ Relief of pain and suffering and quality of life
○ End of life care is provided through an interdisciplinary approach

● Hospice care
○ A portion of palliative care that provides home, residential or inpatient care to
a 7client who has a terminal diagnosis and is no longer seeking life-prolonging
care.
○ The philosophy of hospice is to provide support for the client's emotional, social

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 and spiritual needs as well as addressing medical symptoms as part of
treating the whole person.
● Mental health care services or (psychiatric care services)
○ For people with mental disorders
○ The entire facilities, health care centres and hospital units are devoted to
caring for people with mental disorders.
○ Programs offered to enable people to function independently as possible
within the community.
○ Clients are encouraged to return to the community which gives them access to
community-based care and support services.
● Residential facilities
○ Provides living accommodations, care and support services.
○ The facility is their temporary or permanent home and is in a comfortable
homelike atmosphere that meets the social and emotional needs of the client.
○ Clients need residential care when they require supervision and assistance
with some of their ADL’s but do not need acute medical care or high-level
nursing care.
● Assisted-Living facilities
○ Also known as supportive housing facilities
○ This is where people live in their own apartments and are provided with support
services.
○ Home for people who need help with ADL.
○
○ Considered as community-based services.
● Group homes
○ A residential facility in which a small number of people with physical and
mental disabilities live together.
○ They receive supervision, meals, housekeeping, and laundry services,
and assistance with personal care and ADL’s
● Retirement residence
○ A facility that provides accommodation and supervision for older adults.
○ This is expensive and not everybody can afford this.
○ Residents have their own bedroom and bathroom but share common living
room and dining area.
○ They may need assistance with housekeeping but little to no assistance
with personal care.
○ The goal is to allow older people to live as independently as possible while
providing security, support services, and varying degrees of care as needed.

● Long-term care facilities

○ Also called as nursing homes, home for the aged, long-term care homehs.
○ They provide higher levels of care than retirement residence and assisted living
facilities because it serves many clients with various physical or other disabilities.
○ To function properly, these facilities maintain highly structured work environments

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 ○ Nurses plan and coordinate resident care
○ As a support worker, you can provide personal care and assist clients with
ADL’s Issues and Challenges in the Workplace
● Working in a home care
○ Working on your own
○ Taking direction from different healthcare professionals
○ Maintaining professional boundaries
○ Providing client safety
○ Providing personal safety
● Working in a community day program
○ Working closely with a team and a supervisor
○ Working in a structured environment
○ Meeting multiple needs
● Working directly for clients
○ Clarifying the terms of employment
○ Establishing work limits
○ Knowing the scope of practice limits and your role and responsibilities
● Working in a facility
○ Working in a structured team environment
○ Meeting multiple needs and demands
○ Doing many tasks within a short period
○ Respecting your role and scope of practice
○ Working in shifts
○ Dealing with people in distress (hospital & medical facilities)
○ Making the facility feel like home (residential facility)
○ Respecting the client's privacy and dignity
○ Maintaining professional boundaries
Quality Workplaces
● Professional Practice Environments
○ Support Patient Practice
○ Shared responsibility between employer and employees to create work
environments that support safe and competent care to the patient
○ Requires an understanding and agreement of scopes of practice of care
providers
○ Scopes of Practice sources include PSW program, employer’s policies and
your supervisor
● Healthy Healthcare Leadership Charter
○ Developed by the Canadian Nurses Association (CNA)
○ Based on the principle that a fundamental way to better healthcare if
through healthier workplaces
○ Unacceptable to work in, receive care in, govern, manage and fund
unhealthy workplaces
○ Healthy workplaces maximize the health and well being of healthcare providers,
quality of patient outcomes and organization and system performance.

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The Health Care Team
● What is a team?
○ A team is a group of people working together towards a particular or
common goal
■ Which is to improve the client’s quality of life
○ Always consider the whole person - a holistic approach
○ Must promote health in all 5 areas of the client’s life: physical, emotional,
social, intellectual and spiritual
● How is the team determinedThe client’s needs will determine who will be on the team
○ A multidisciplinary team can be formed (Team members may come from
the other branches of healthcare)
○ Multidisciplinary and interdisciplinary - inter meaning work together -
like interdependence
● Benefits and challenges of Team Work
○ Benefits
■ Collaborations
■ Communication
■ Share knowledge of expertise
■ Better decision making and problem-solving
■ Positive trusting atmosphere
■ Support from one another during difficult situations
○ Challenges
■ Recognizing role boundaries
■ Need to be flexible
■ Handling conflict
■ Expressing your needs and views
Week 2
Supervision and Delegation
● PSWs are supervised healthcare provider
● Supervisors are most likely an RN, RPN, Social Worker, Occupational Therapist,
Client’s Family, depending on where you are working
● Delegation - A transfer of function
○ Usually performed by a nurse but which, under certain circumstances, can
be assigned to a PSW to carry out
○ Delegation is different depending on the place:
■ Facility - RN/RPN delegates and teaches the task, assess your
performance and monitors you over time
■ Community - RN/RPN or workshop teaching of a task, client, family
or supervisor monitors your performance
○ In order for a task can be delegated to a PSW, it must be a routine,
predictable, require little supervision, and can be delegated to a stable client
■ Teach or Instruct PSWs
■ Monitor PSWs
■ Evaluate PSWs

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 ○ Client-specific only
○ Whatever you can do in other provinces, you cannot do in Ontario
○ Support workers cannot delegate
○ A doctor cannot delegate task to PSWs, only RN/RPN because it’s a transfer of
a function from their profession
○ Nurses are accountable to whatever they delegate to PSWs.
○ PSWs cannot be delegated to give insulin by a nurse in a long-term
care/nursing home
● Accepting a Delegated Task
○ Can only be delegated by members of the College of Nurses
○ Only some nursing tasks can be delegated
○ Delegated tasks must be routine, require little supervision, client-specific, done
on a stable client, remain the responsibility of the person who delegated the task
● Delegation - 5 rights
○ Right Task - Something that your supervisor will assign to you. Something
that will fall into your scope of practice as a PSW.
■ Controlled acts - tasks that only nurses are legally able (authorized) to
perform.
○ Right Circumstance - do you have the right equipment?
○ Right Person - did you get a proper training or orientation?
○ Right Directions and Communications - do you get clear instructions, what
to report, when to report
○ Right Supervision and evaluation - are you getting the right supervision
or evaluation?
● Delegation - Your role
○ If you accept the task:
■ You are responsible (accountable) for your own actions
■ You must complete the task safely
■ Ask for help if you need it
■ Report what you did
○ If you refuse the task:
■ Need a good, valid reason to refuse
■ Follow the five rights before refusing
■ Tell the person who delegated the task to you why you are refusing
■ Never ignore the order or request
● Factors Affecting Delegation Decisions
○ Client’s condition - you should not be dealing with unstable clients
○ Your level of caregiving knowledge
○ Risks involved to client/you
○ Did you receive support for the task?
○ Is support available if a problem arises?
○ Amount of time required to perform the task and other duties
○ Legislation affecting you performing the task
○ Job description and delegated task

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 ● Boundaries of Delegation
○ Ask yourself these questions when determining your acceptance of a
delegated task
■ What types of jobs am I permitted to do?
■ Does the task fall within the types of jobs I am permitted to do?
■ What should I do if I am asked to perform a task that is outside of
my scope of practice?
The Canadian Health Care System
● Healthcare should be available to all Canadians regardless of inability to pay
Canada Health Act
● Medicare - national insurance plan. OHIP in Ontario.
● Tommy Douglas - first politician (Premier of Saskatchewan) to provide medicare
in Saskatchewan
● 1961 - all other provinces joined the plan
● 1972 - care receive to communities
● 5 Principles of Medicare (Page. 24 Box 2-3)
○ Comprehensive - pay for all medically necessary services
○ Universality - every permanent resident is entitled
○ Portability - people can keep their healthcare coverage even if they are
unemployed, change jobs, relocate between provinces and territories, and
travel within Canada or abroad
○ Accessibility - people can receive necessary services regardless of
their income, health status, gender or geographical location
○ Public administration - must be run by a public organization on a non-
profit basis
The Federal Role
○ The federal government is responsible for:
■ Administering the Canada Health Act and providing provincial funding
■ Providing direct delivery of health care services to specific groups (ex.
Inuit, Canadian Forces, RCMP)
■ Developing and carrying out government policy and programs that
promote health and prevent disease
■ Transferring tax money to the provinces to share the cost of
medically necessary health care services
■ Ensuring that the provinces provide the same quality and type of care
Primary, Secondary, and Tertiary Health Care Delivery
● Primary health care delivery - the first point of contact most people have with the
health care system. It usually takes place in the community but can also take place in
the hospital. It focuses on promoting health, early diagnosis of disease or disability,
and prevention of disease. (Family Doctor)
● Secondary health care delivery - the assessment, treatment, and preventative
services associated with more complex medical issues and are generally provided by
specialized health care professionals. (Referred to the Specialist)
● Tertiary health care delivery - it is the specialized, highly technical level of health care

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 that takes place in large research and teaching hospitals. It usually takes place within
specialized care units such as the ICU and requires advanced diagnostic and treatment
by highly specialized personnel. (ICU)
Health Care Challenges
● Many factors have challenged the country’s ability to provide universal, quality
health care. The factors that have stressed Canada’s health care system include:
○ Worker shortages
○ Ageing of the “baby boomer” generation (1945-1965) and many current
health care workers
○ Long waiting lists for surgeries, diagnostics, or medical procedures
○ The steadily rising cost of care
Health Promotion and Disease Prevention
● Traditionally, the purpose of a health care system has been to diagnose, treat, and
cure illnesses.
● A more recent approach to health care involves developing ways to promote health and
prevent diseases.
● Preventing illnesses and injury, while keeping people healthy is more effective
and cheaper than providing treatments in hospitals
● Health promotion refers to strategies that improve or maintain health and independence
● Disease prevention refers to strategies that prevent the occurrence of disease or injury.
● Health promotion and disease prevention are important functions to Canada’s
health care system
● Government policies promote health and prevent illness by improving the quality
of people’s lives
○ Examples of policies that promote health and prevent illnesses include:
■ Immunization programs
■ Prenatal and parenting classes
■ Information campaigns to reduce drinking during pregnancy, unsafe
sex, and to encourage a healthy lifestyle and physical activities
■ Efforts to improve housing, decrease poverty, monitor safe drinking
water, and protect the environment
Support workers contribute to health promotion and disease prevention and are more
needed now than ever before since they provide non-medical care and services that can
help prevent major health problems
Legal Rights of the PSW (Human Rights Legislation)
● Legislation - This is what you can and cannot do. A body of laws that governs
the behaviour of a country’s resident.
● Canadian Charter of Rights and Freedom - a piece of law enjoyed by every Canadian
regardless of where they live
○ Freedom of speech
○ Freedom of assembly
○ Freedom of religion
○ Freedom to vote
○ Freedom of security

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● Human Rights Legislation
○ To protect workers’ basic human rights
○ To be treated equally by all employers
○ Not to discriminate
○ To be free from harassment
● Occupational Health and Safety
○ Rights and responsibilities of Canadian workers, employers, and supervisors to
keep workplaces safe
○ The legislation does not apply to home care
○ Workers have the right to receive proper orientati8aon
○ Employers may be fined if no orientation
○ Employees have the right to refuse unsafe work
● Employment Standards
○ The legislation refers to rules regarding wages and hours of work
○ Discusses vacation time and fair pay for overtime hours of work
○ Refers to leave of absences and when a worker would qualify for such a
circumstance
● Labour Relations Legislation
○ The resolution of workplace issues between the employer and the employee
○ The employees have the right to join a union and participate in union activities
○ The union negotiates issues on behalf of its’ union members
○ Collective bargaining
○ It identifies reasons for the legal strike, unfair labour, and conduct of
the employee
● Worker’s Compensation
○ Canadian workers compensated financially if an accidental injury occurs while at
work
○ On the job: start and end of shift
○ Travelling on the job included
○ If injury occurs, the employee and the employer rights discussed within
this legislation
● LTC Facilities’ Legislation
○ Regulated by provincial and territorial legislation
○ Concerned with basic rights of residents
○ Requirements to be met for the functioning of tihe facility
○ Licensing, funding, accountability systems, policies
● Community Services Legislation
○ Rules/procedures for the manner in which community services are accessed
and provided
○ Variety of community services defined
○ Provision of how services dispersed to others
○ Support work provision also included
● Regulated health professions health act
● Access to information act - Right to see personal information

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Week 3
Professionalism
● An approach to work that demonstrates respect for others, commitment, competence
and appropriate behavior
Characteristics of a Professional
● A positive attitude - body language, facial expression, enthusiastic
● A sense of responsibility - get the task done, following the healthcare plan,
reporting, documentation, being able to receive constructive criticism
● A professional appearance - short-nail length, no dangling jewelries
● Discretion regarding client information - privacy, only can be shared with
other healthcare team members that are involved to the healthcare plan
● Lifelong learning - learning new technologies, attending seminars, keeping up
with healthcare-related trends, adaptability to environment
● Advocating for the client - standing up for the client
○ Advocating - sharing important information about the client to your
supervisor for their benefit - especially those who cannot stand for themselves
● Discretion about personal matters - professional boundaries, personal problems
should not be brought up in the workplace
● Acceptable speech and language - No swearing, no cursing, using appropriate words,
use the abbreviation in the healthcare setting, being respectful, no shouting to clients,
never fight with your clients/families/coworkers
● Good time management skills
● Controlling emotions in a professional manner
● Being detailed-oriented
● Being a good team player
● Flexible
Ethics
● Law is what you can do and what you cannot do that is enforced by the society
● Ethics is what you should and what you should not do. The rules of conduct that guides
us decide between right and wrong.
○ Moral is the behaviour which is what you believe is right or wrong without being
concerned with the law. It could be dictated by religion, community, family value.
○ Values are what we considered worthwhile qualities
○ Belief is a conviction that something is true
● What is a code of ethics?
○ Are ethical standards established by a profession to guide their workers in their
interaction with clients
○ The way that your employers expect you to behave
○ Ethics guide individuals when determining what is right or wrong
● What is the purpose of a code of ethics? ● What does a code of ethics
consist of?
Four Principles of Healthcare Ethics
● Autonomy - the right to chose. Self-determination. Assuming they are mentally
competent. Always respect their choices and preferences. Safety chomps everything

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 else.
● Justice - all people should be treated in a fair and equal manner regardless of their
mood or condition.
● Beneficence - doing good or promoting good.
● Non-maleficence - seeking to do no harm.
What is Ethical Dilemma?
● It is a situation in which there is an apparent conflict between opposing moral choices
Dealing with Dilemmas - when there are opposing belief, moral, ethics
● Ask yourself the following questions
○ What is the client’s preference?
○ Does the option honour this preference?
○ Does the option treat the client fairly and justly?
○ Does the option represent short or long term benefits
○ Could the option cause harm or increase the risk of harm?
PSW Code of Ethics (Mosby Textbook Page 119-120 Box 8-1)
● PSWs provide high-quality personal care and support services
● PSWs are aware of organizational policies and procedures
● PSWs provide compassionate care
● PSWs value the dignity and worth of all clients
● PSWs respect their clients’ choices about their care
● PSWs do not misuse their position of trust
● PSWs are reliable
● PSWs promote and maintain their client safety
PSW Associations
● PSNO - Personal Support Network of Ontario
○ PSNO is a division of OCSA which strives to help personal support service
professionals carry out their work more effectively by offering access to
information, resources and tools as well as providing opportunities to
connect with a network of professionals in the field.
○ PSNO’s vision is to build a strong, cooperative personal support service
sector where providers, managers, trainers and employees are equal
contributors to strengthening the profession.
○ Cooperation and Collaboration between all stakeholders is seen as key to the
ongoing success of the network
● PSNO’s Value Proposition
○ PSNO is striving to be the one voice of Personal Support in Ontario
■ Increase awareness of the value and importance of PSWs
■ Professional Development
■ Networking opportunities to share knowledge and experience
■ Share information and resources in one central location for
PSWs, Supervisions and Trainers
● Benefits of Membership
○ (Outline)
■ As a PSW member, you are entitled to benefits that are geared toward

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 your special needs:
● Professional and General Liability Insurance
● Long and Short Term Disability Coverage
● Home, Auto and Travel Insurance
● Discounts on conferences and events
● Access to other PSWs through the PSW Email Listserv
● Online Job board
● PSW Newsletter
● Members Only section
How the Network Can Help You
● PSNO’s dedicated team is constantly tracking the latest trends and developments
affecting personal support services
● PSNO members are able to tap into this vital information at their convenience, giving
them a competitive advantage over non-members
● Whether it’s legal, regulatory or questions related to practice, PSNO has the expertise
to answer members’ specific concerns
Information at Students Fingertips
● PSNO is constantly benchmarking the field to better track the latest trends and
developments affecting home care, community support services and long-term care
● PSNO members are able to tap into this vital information at their convenience, giving
them a competitive advantage over non-members
The latest information and In-depth Analysis
● To get its members the latest, most accurate news as soon as it happens-
sometime before the information is public
● PSNO staff is involved in shaping policy with government agencies overseeing home
care and long-term care, gathering news and background information on everything
that affects the sector
● PSNO keeps its members ahead of the curve on all issues through several sources
● PSNO’s quarterly newsletter - reviews the latest personal support trends,
technology, and issues all in an easy to read format.
● Networking
● PSNOs member ListServ (PSNO Members Only) - an online forum for CSWs monitored
by experts, gives you instant access to over 1,000 colleagues from across the province.
Giving PSNO members a quick and easy method to communicate with each other, just
ask a question and receive advice from others in the field.
● PSNO Resources - Include manuals, reports, fact sheets, public relations materials and
others are designed to assist you in your daily activities. All information and resources
are created by experts with the mission of providing you with the information you need in
an easy-to-use format.
Learning Opportunities
● Workshops and conferences
● Teleconferences and webinars
OPSWA - Ontario Personal Support Worker Association
● Mission Statement:

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 ○ To continuously strive to improve the professional status of the PSW of
Ontario through advocacy for excellence and consistency in training, services,
working conditions, and value to those we serve
● Vision Statement:
○ Standardization of the PSW will afford all Ontarians the quality of care which
they are entitled to
Benefits of Memberships
● Applicants receive a photo ID that identifies them as a competent professional who
is committed to providing outstanding patient care
● Members gain access to valuable training materials and receive regular updates on
new government regulations and changes that may affect their practice
● A yearly police check is provided free of charge
● Online job posting board
● Members may easily connect with other PSW in their area
● Unrestricted access to OPSWA staff whenever there is a question
● Members may also take advantage of various corporate discounts
● Resume and cover letter writing services
● New or renewing members have the choice of adding liability insurance to their
membership. InsurePSW is designed to protect the individual PSW and covers
personal accidents and disability
How the Network Can Help You
● 6Advocate for its members
● Corresponds with the Ontario Government
● Advocate for improvement of government and industry standards
● OPSWA has created its own Standards of Practice of
PSWs Learning Opportunities
● Resource Material & E-Learning opportunities & seminars and conference at a discount
price
● Seminars include:
○ Palliative Care from a PSW Perspective
○ CPR and First Aid “Level C” - PSW Focused
○ Dementia and Mental Health
○ PSW Professionalism and Anti-Bullying
○ Coming soon - The PPSW role and Autism
Week 4
Working with Clients and their Families
● Psychosocial Health is a state of well-being in the social, emotional, intellectual, and
spiritual dimensions of one’s life. A holistic approach to healthcare takes into account
the “whole” client. It considers the client's physical as well as psychosocial health. Some
factors that can influence psychosocial health are:
○ Personality: is a blend of thought patterns, feelings, characteristics, and
behaviors that make a person unique.
○ Family background: if a person grew up in a loving caring family, they are more
likely to have good psychosocial health than someone who didn’t. When there

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 are serious family problems like abuse, neglect, and anger, children may
be harmed psychosocially (this pattern is carried with them to adulthood).
○ Environment: experiences outside of the family strongly influence psychosocial
health. Some experiences include, school, media, interactions with friends and
colleagues, work, and access to social support systems like healthcare.
○ Life circumstances: some people experience devastating losses or tragedies in
their lives (death of a parent/child). For some people who experience such tragic
losses, they may never enjoy strong psychosocial health.
The two most common theories which are referred to most, to be able to meet your
clients needs are:
● Erikson’s Development Stages
○ It has 8 distinct stages, each with two possible outcomes. According to the
theory, successful completion of each stage results in a healthy personality
and successful interactions with others.
○ Failure to successfully complete a stage can result in a reduced ability to
complete further stages and therefore a more unhealthy personality and sense of
self. These stages, however, can be resolved successfully at a later time.
● Maslow’s Hierarchy of Needs
○ Humans have certain needs that must be fulfilled for healthy living. These needs
motivate us to act the way we do, and in particular, in ways that satisfy the
needs that are not yet fulfilled. In addition, Maslow suggested that these needs
are not all equally important, but exist in a hierarchy, with the most important,
basic needs at the bottom. It is only when these lower-level needs are met to
some degree that one can move up to fulfill other needs.

A Professional Helping Relationship

● Your relationship with your client is a professional helping relationship that is
established to benefit the client. It’s different from a friendship which is a personal
social relationship that benefits both people involved. Your professional relationship
with a client is not a friendship but you should still show your client that you care
about them. Recognizing that each client is a unique individual, who must be treated
with compassion and consideration

Professional Helping Relationship Versus Friendship

Professional Helping Relationship Friendships

One person takes the responsibility for The people involved are not responsible for
helping the other helping each other, it’s a choice they make
when one friend needs help

There is a specific goal to the relationship, The relationship is not goal directed, as
you are providing care according to your friends you choose to visit casually
supervisor

Behaviors are based on professional roles, as Behaviors are based on your relationship with

17
a support worker and client your friend

The people involved may not choose the The people involved choose to have the
relationship relationship

The helper seeks to fulfill the needs of the Both people in the relationship seek to have
person being helped their needs fulfilled

The helper is non-judgmental and must Both people may be judgmental and can
continue care to meet the needs of the client decide to end the friendship for any reason
Characteristics to Demonstrate
● Respect is showing acceptance and regard for another person, accepting their
values, feelings, lifestyle, and decisions.
● Compassion is characterized by a person’s awareness of the misfortune and
suffering of another and the desire to take action to reduce or ease the problem.
● Empathy is the ability to recognize and understand another’s emotions, by being
receptive to others and not being judgmental. Empathy means you have had a similar
experience. Putting yourself into that person’s situation to understand their feelings.
● Sympathy involves reacting, when you sympathize with your client you identify with
their feelings to the point where you feel their pain.
● Competence is performing your job well, safely and skillfully. You must be well
organized, punctual, and reliable. You must know your scope of practice and
your limitations.
● Self-awareness is understanding one’s own feelings, moods, attitudes,
preferences, biases, qualities, and limitations.
● Independence is the state of not depending on others for control or authority. People who
are independent control and direct their own lives and can do things for themselves.
● Dependence is the state of relying on others for support and being unable to manage
without help.
● Interdependence is the state of depending on each other.
The Client’s Family
● Family is a biological, legal, or social network of people who provide support for one
another.
● Families can take on many forms and may include people related by blood, marriage
or even unrelated people who have formed personal relationships.
● Primary Caregiver is someone who takes care of the elderly person or who is with the
elderly person most of the time.
● Family Conference is a team meeting that involves that healthcare team and the
family, often including the client.
***Always respect your client’s definition of a family, never try to impose your values on
that person
● When working with a family, be aware of family relationships and any
conflicts, communication difficulties, and stressful situations.
● Family conflicts could be hidden because most families do not want other people
to know that there’s a problem.

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 ○ It is not part of your role to help families deal with the interpersonal problems
○ There are some things you can do in a stressful situation:
■ Encourage communication without taking sides
■ You can calm a tense situation if family members are angry ask them
to go out for a coffee
○ Your agency/facility with have policies to guide you dealing with conflict
Client Centered Care
● The client is the main focus of the care
● Dependence is the state of relying on others for support, being unable to
manage without help
● Independence is the state of not depending on others for control or authority.
Doing things for themselves
○ Losing independence because of illness may cause a person to show
many different emotions
● Interdependence is the state of depending on each other
● How can you show compassion when caring for others?
○ Putting yourself in the person’s situation and thinking how you would like to be
treated
○ Providing the person dignity and respect
○ Learning about the person’s likes and dislikes - allowing choices
○ Listening to their troubles
○ Performing your tasks gently and carefully
○ Showing client has worth
● Self-esteem
○ Changeable and variable throughout life
○ Influenced by life experiences
○ Thinking well of yourself and being well-thought of by others
● How do we build children’s self-esteem?
○ Encouragement, compliments, support, constructive feedback
● Compassionate Care
○ Compassion - genuinely caring about the other person’s problems, challenges
○ Empathy - put yourself in the other person’s place (not sympathy)
○ Sympathy - feeling sorry for the person - not beneficial
○ Provide respect & dignity
○ Promote success - lead to a good feeling of self-esteem
○ Promote positive self-concept
○ Meeting Maslow’s needs
● The Power Balance
○ Power means being in control of a situation
○ Powerlessness is a perceived or actual lack of power
● Client-Directed Care
○ Everyone control of their lives
■ Advocacy
■ They may be dependent on some of their ADLs but they still have the

19
 right or capability to choose
○ Each person has their own desires when they want help and when they want
to do things independently
■ The client has the right to refuse on whatever it might be
○ Each person has goals and priorities which are important to them
■ For the client’s care plan
○ You must respect your client’s priorities and goals of their care
○ You need to allow your client independence and choices in their care (even if
you would not make the same choices)
● Client-Centered Care
○ In order to be effective caregivers, we must involve the client whenever possible
in their care
■ Keeping the client as the focus
○ Important Goal in Caregiving:
■ Achieve or maintain as much independence as possible in your client
● Client Rights
○ The right to:
■ Be treated with dignity and respect
■ Privacy and confidentiality
■ Give or withhold informed consent
■ Who, what, when, how, what if - alternatives
■ Autonomy
● Optimal Client Support
○ Don’t
■ Make assumptions
■ Judge behaviours
■ Compare clients
■ Display rejection (facial expressions, etc)
■ Use demeaning terms/names (sweetie, dearie)
***We must be really aware of what we say, how we say it, when and our actions - don’t mean
to be disrespectful but it may come across as that
○ Do
■ Dignity
■ Independence
■ Preferences
■ Privacy
■ Safety
■ Encouragement
■ Respect
***Basic things of how we would want to be treated - even as students - not
patients Week 5
Health, Wellness, Illness and Disability
● Job of a PSW is to assist the client to achieve optimal (for them) health
● Achieving optimal health means focusing on improving/maximizing a person’s health

20
 potential
● In order to do so, need to understand that definition of health has changed over the
years
● Health is more than the absence of disease
● Health is a state of complete physical, mental, and social wellbeing; and also
includes the ability to lead a socially and economically productive life (WHO)
Health is a Continuum
● On one end is optimal (complete) health or wellness, and on the other end is
extremely ill health (Mosby Text. Page 53. Figure 4-5)
○ Health is not just about the absence of disease or being severely ill but it could be
a healthy lifestyle, high self-esteem, positive social relationships, balance of mind,
body and spirit, effective handling of disability, severe emotional distress,
unhealthy lifestyle, social isolation, and imbalance of mind, body and spirit
Personal Factors that Influence Health
● Social Relationships/Family Dynamics
● Personal Beliefs/Culture
● Emotional/Physical Stress
● Personal lifestyle choices e.g. Drinking, Smoking, Diet
● Sense of Control/Powerlessness
Determinants of Health
● What is a determinant of health?
○ Those factors that determine health status in an individual or community
● How does it differ from the dimensions of health?
○ Dimensions of health are all of the aspects that make up a person’s health
■ Social ■ Physical
■ Emotional ■ Spiritual
■ Intellectual
● Of the twelve determinants of health, which does an individual have the most control
over?
The 12 Determinants of Health (Mosby Text. Page 55)
● Income and social statu s coping skills
● Social support networks ● Healthy child development
● Education and literacy ● Biology and genetic endowment
● Employment and working conditions ● Health services
● Social support ● Gender
● Physical environment ● Culture
● Personal health practices and
Illness and Disability
● Illness is the loss of physical or mental health
● A disability is the loss of physical or mental function
○ Common reactions ○ Depression
○ Anxiety ○ Loss
○ Fear ○ Stress
○ Angry

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*Some illnesses and disabilities are acute (e.g., broken arm, influenza) and some are chronic
(e.g., paraplegia); some can be progressive*; and some can be managed to prevent further
● *Progressive - gets worse over time
Attitudes
● Some people may be uncomfortable or fearful and may stare or avoid eye contact
with people who are ill or disabled
● Some people who are ill or disabled experience stigma (social disgrace because of their
circumstance) or discrimination (unfair treatment because of their group membership)
● The language that we use can also convey negative or demeaning images of
people, especially those who have disabilities
● **Our attitude will have an impact on the client. PSWs should be aware on how
they approach their clients. Think about the whole wellbeing of your client. DIPPS!

Managing Stress, Time and Problems

● Stress is the emotional, behavioral, or physical response to an event or situation.
The event or situation that causes the stress is a stressor.
● There are many different types of stress that we will encounter in our lifetime.
● Stress can be positive or negative.
● Eustress is a type of stress that is healthy and gives one a feeling of fulfillment or other
positive feelings.
○ Acute stress is short in duration, whereas
○ Chronic stress is ongoing and can lead to burnout - a state of
physical, emotional, and mental exhaustion.
Sources of Stress
● Change (positive/negative) ● Conflict
● Pressure (feeling pushed beyond ● School
limit) ● Daily frustrations (alarm didn’t go off)
● Lack of control
Emotional and Behavioral Signs & Symptoms of Stress
● Anxiety ● Dissatisfaction
● Depression ● Forgetfulness
● Anger ● Poor concentration
● Worry ● Difficulty focusing or following
● Fear directions
● Burnout ● Emotional outbursts (yell/cry)
● Irritability ● Smoking/drinking
● Loss of self-esteem ● Talking about stressor
● Fatigue
A defense mechanism or coping mechanism is an unconscious reaction to a threat to a
stressor or unwanted feelings. It helps a person to relieve stress by helping them avoid facing a
troubling reality.
Defense Mechanisms

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 Conversion Changing an emotion into a physical symptom

Denial Refusing to accept an unpleasant or threatening reality

Displacement Directing emotions towards something safe instead of real source

Projection Assigning one’s feelings to someone or something else

Rationalization Making excuses for one’s behavior while ignoring the real person

Reaction formation Acting in a way that is opposite of what one feels

Regression Reverting back to earlier behaviors’

Repression Keeping unpleasant thoughts from the conscious mind

● As a support worker it is important to recognize the common responses to stress in
yourself and in your clients.
● Always report to your supervisor when your client is showing signs of stress.
● Being able to recognize client’s defense mechanisms is useful. You will be able to help
your clients by being empathetic to their feelings and provide compassionate care
*Remember it is not within your scope of practice to use any of these terms when
reporting your client’s behaviour, but it is important to be familiar with the terms, as it will
help you when giving care.
How Can You Manage Your Stress?
● Avoiding stressful situations
● Avoid extremes
● Set realistic goals
● Manage how stress affects you
● Change how you see the situation
● Change how you react to stress
● Set priorities
● Take control of the situation
● Discover new relaxation techniques
● Figure out what’s most
important Managing Stress in Your Life
● Develop self-awareness (know what causes your stress)
● Take care of your needs (sleep/exercise/food)
● Think positively (what you can and cannot do)
● Assert yourself (never agree to take on more than you can handle)
● Ask others for help and support
● Practice calming exercises
● Learn to accept the things you cannot change
Burnout is common among health care workers, since these helping professions can be
very demanding physically, emotionally, mentally, and spiritually.
● Like stress, burnout can have a negative effect on your health, like insomnia, weight
gain/loss, depression, and anxiety.

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 ○ Some signs of burnout:
■ You find yourself more critical or sarcastic at work
■ Your sleep habits have changed
■ Your appetite has changed
■ You drag yourself to work, trouble starting your work
■ You have less patience with your client’s & coworkers
■ You are self medicating by using food, drugs/alcohol to feel better
Time Management
● Time management is essential in reducing stress.
● You can use time management strategies in all aspects of your life.
● When you reduce your overall stress levels, your stress at work will also decrease.
● To manage your time, you must identify your priorities.
● To determine your priorities outside of work ask yourself:
○ What do I value most in life?
○ What gives me satisfaction?
○ What principles do I want to live my life by?
**You may notice a large number of priorities, decide which ones are more
important and number them according to importance. Now your priorities can be
made into goals.
Goal Setting
● S - Specific ● R - Realistic
● M - Measurable ● T - Timed-framed
● A - Attainable
Decision Making
As healthcare providers, you make numerous decisions throughout the day, from
organizing your day to which client are you going to give care to first. Some skills needed to
help you improve your decision making:
● Focus: requires concentration, involvement and commitment, stay focused on the
client and task at hand.
● Flexibility: you need to be flexible and responsive, involve clients in decisions that
affect them, always remembering each client is an individual with unique needs.
● Decisiveness: stick to your decisions unless they are not working. Clients expect you to
be confident and competent.
Problem Solving is a process. You must first identify and analyze the problem, try to find
a solution, and then devise a plan and put it into action.
● Step 1: Identify the problem
○ Is the issue/situation affecting you, coworker or a client?
○ Should you be concerned about the issue/situation?
○ Can you influence or contribute to a positive outcome?
○ Does the issue/situation require immediate attention?
● (Analyze) Once you know you have a problem, think about what kind of problem it is, is it
one you can handle on your own or do you need assistance from your coworkers.
Gather information!
Always consult with your supervisor when:

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 ○ There is an emergency
○ Change in client status
○ Client safety is at risk
○ Client is in distress
○ If you have a conflict with a client and/or family member
● Solution
○ Try to think of as many solutions as you can. Then decide which is the most
practical and helpful, and always making sure that it is safe. Try the solution
to see if it works.

● Planning
○ The planning part of the problem solving process may require some
creativity. Don’t be afraid to try a plan, as long as it is safe to do so.
● Implement - Execution of the plan
● Evaluate - Assess the implementation. See what went wrong with the execution of the
solution or what’s missing in the solution. Check aspects or parts that can be improved.
Dealing with Conflict - Value the outcome and the relationship!
Some problems can be solved immediately, but others may take longer. Interpersonal
problems, which are a common cause of stress, may take several weeks to solve. People bring
their own attitudes, values, opinions, and experiences with them to the work setting. Differences
often lead to conflicts, arguments, disagreements, and misunderstandings. In dealing with any
conflict, it is important to remember that caring for the client’s needs is always your first priority.
● Conflict between you and a client can arise if a client is too tired, confused, over
stimulated, soiled, or just having difficulty communicating with you.
● You can prevent a conflict from escalating by remaining calm and respectful,
understanding the client’s needs and feelings, and recognize the reason for the
client’s behaviour.
● Conflict can also occur with family members. In most cases it is important to remember
they are only trying to ensure the best possible care for their sick loved one. Always
report back to your supervisor the family members concern even if you were able to
make the situation better.
● Conflict between coworkers can have a negative effect on the care of clients.
● Unresolved conflict causes stress and hinders communication and teamwork. To
some extent this is unavoidable since you are not always going to agree with
everyone you work with.
● If you can’t resolve a conflict, discuss it with your supervisor.
Communication and work ethics are essential in preventing and resolving conflicts. Identify and
solve problems before they become major issues. Goal Setting

● Begin the process of setting Professional Goals by:

○ Identifying goal setting processes
○ Reviewing Standards of Practice for PSWs
○ Identifying deficits in PSW knowledge, skill and values

25
 ● The process of setting goals helps you choose where you want to go in life.
● By knowing precisely what you want to achieve, you know where you have to
concentrate your efforts.
● You will also quickly identify the distractions that will take you away from achieving
your goals.
● Goals are set on a number of different levels:
○ Step 1 - set big picture goal of what you want to do with your life.
○ Step 2 - break the big picture goal down into smaller and smaller targets that you
must hit in order to reach your lifetime goal.
○ Step 3 - identify the things you can do today to move towards achieving your
goal.
Goal Setting Tips
● State each goal as a positive statement
● Be precise
● Set priorities
● Write goals down
● Keep operational goals small
● Set performance goals
Week 6
What is Interpersonal Communication?
● Is the exchange of information between two people - usually face to face
● The ability to understand the situation
● Adjust your behavior and how you communicate to meet the needs of the situation
● The ability to get along with others
● Knowledge of what is the best way to communicate in any given situation
● Involves a sender, receiver, message and feedback
○ The sender sends the message received by the receiver which
he/she understands and gives feedback to the message
The Cycle of Communication
● A message
● A sender
● A receiver
● Feedback from receiver to sender
● The meaning/content of the message
● Checking for clarity
● The cycle is ongoing
What Affects Communication?
● Perceptions - how a person sees events
● Experiences
● Physical and mental health
● Emotions
● Values
● Beliefs/Culture
● Age and Gender

26
 ● Electronic Communication
What Gets in the Way of Good Communication
● Relationships/Mixing Roles: personal vs. professional
● Gender: how do men & women communicate
● Age: older and younger people
● Expectations: what is the role at that point?
● Lack of Manners: be courteous/respectful

Therapeutic Communication
● Communication between the Health Care Professional and the client (as well as the
patient’s family) that takes place to advance the client’s wellbeing and care
Types of Communication
● Verbal - face to face/phone/voice messages/tape/video/DVD
● Written - progress notes, e-mail, letters, care plans, directions, signs
● Non-verbal - body language, touch, silence, sign language
Body language is the most important part of communication
Effective Verbal Communication
● Choose words carefully
● Use simple language
● Speak clearly, slowly & distinctly
● Control volume & tone of your voice
● Be brief, concise, & logical
● Ask one question at a time
● Do not pretend to understand & clarify meaning
Skills with Clients
● Acceptance, interest and concern
● Listening and observing
● Recognizing significant behavior
● Appropriate response and confidentiality
● Sensitivity to feelings
● Identify and understand client needs
● Being willing to serve
● Leaving personal needs at the door
Communication is
● 65% non-verbal
● 20-25% voice tone
● 10-15% content
Non-Verbal Communication
● Mixed message - verbal and non-verbal are contradictory, inconsistent, or unclear
● Body language - posture, eye contact, gestures, facial expression
● Appearance - first 10 to 30 sec this registers
○ For example: hygiene, dress, perfume, jewellry, cosmetics
● Silence - can mean many things
● Touch - very important, means many things

27
Purpose of Communication
● Think clearly about what we want to achieve and understand when we communicate
● What kind of response do we hope/expect to get from the other person/s?
Always remember that body language and voice tone are more
important than the content.

Communication Skills
● Active listening
○ Close attention to verbal/non-verbal
○ Listen to content/intent
○ Be interested/show that you care
○ Listen for feelings
○ Eliminate distractions
○ Be aware of your attending behaviors
■ How you sit
■ Personal space
■ Where you are
■ Eye contact
■ Time you give
■ Body language & gestures/expressions
● Paraphrasing
○ Restating the person’s message/words in your own words
○ Use fewer words than the person used
○ Three purposes:
■ It shows you are listening
■ It shows understanding on both parts
■ It promotes more communication
● Empathetic listening
○ Being aware of feelings & not judging
○ Being open & understanding the experiences & feelings of others
○ Staying focused on the person
○ This creates trust, reduces feelings of loneliness and sadness
○ Avoid cliches or quick thoughtless responses
● Open-ended and closed-ended questions
○ Closed questions are used to focus on specific information - usually illicit a ‘yes
or no’ response - do not really promote conversation.
○ Open-ended questions invite a person to share thoughts, feelings or ideas - The
person being questioned determines how much information to share.
● Clarifying
○ This helps to make sure you understand the message
○ YOU can say you do not understand
○ YOU can restate the information as a question
○ YOU can ask the person to restate/repeat the information

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 ● Focusing
○ Limiting the conversation to a certain topic
○ When the person goes off topic you can gently redirect them back to the original
topic
○ This may help the client to think more about what is going on at that moment

Laws of Better Listening

1. Gag yourself
2. Find interest in the other person
3. Stay out of the way
4. Listen between the lines
5. Make notes when appropriate
6. Your posture shows your interest or not
7. Be aware of your filters
Week 7
Assertive Behaviour
● You are confident, calm, composed
● Thoughts expressed positively & directly
● Helps you to respect each person
● Helps to consider your needs
● Help to consider the other person’s needs
● Helps in resolving problems
Aggressive Communication - Can be upset, cold, angry, threatening. May be an attempt
to put people down & is not respectful
Passive Communication - You may appear hesitant, apologetic, timid. This makes
others uncomfortable as the message is mixed. What is really going on? Using the “I”
Word
● Using “I” think, feel etc instead of “you” means you take responsibility for the words.
● This means that you are not blaming the other person.
● You state your position & this gives the other room to state theirs
This is a very effective way to deal with situations
Rights & Responsibilities
Your rights Your responsibilities

To speak up To listen

To take To give

To have problems To find solutions

To be respected To respect
Rights do not exist without responsibilities
Week 8
Problem Solving is a process:
Identify the Problem

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 ● Is there a problem?
● Who does it affect? - you, client, co-worker, supervisor?
● Is it your concern?
● Can you positively contribute to an outcome?
● Does the problem need immediate attention?
Analyzing the Problem?
● Once a problem is identified, think about what kind of problem is it.
● Decide if it is one you can solve on your own or not.
● CONSULT the assignment sheet & care plan to make sure you know what is expected
of you.
● CONSULT your supervisor.
Analyzing a problem involves communication
● Ask the person questions about the problem
● Listen attentively to the answers
● Pay attention to verbal & non-verbal messages
● DO NOT make assumptions about the cause of a
problem Understanding the Information
● First collect ALL the information from all parties concerned.
● Is this something I need assistance with or can I resolve it on my own?
● Am I aware of what is a resident problem?
● Am I aware of what is a work-related issue?
● What do I expect the outcome to be?
● Am I able to see the whole picture?
Find a Solution & Devise a plan
● Think of as many solutions as you can
● Decide which is the most practical and helpful solution
● Ensure the plan is safe
● Try it and see if it works
Six Helpful Steps
1. Information gathering and sharing 4. Negotiation
2. Clarifying views 5. Carrying out the plan
3. Identifying priorities 6. Evaluating the outcome
Conflict A Part of Life
● Conflict: What is it and where does it come from?
○ A natural part of interpersonal relations
○ Arises out of basic human differences
○ Usually represents a request to change something
○ How one deals with conflict is determined by past experiences, personal
preferences and abilities
● Circle of Conflict
○ Moods:
■ Factors unrelated to dispute
■ Psychological influences
■ Physiological influences

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 ○ Relationships:
■ Stereotypes ■ Poor History
■ Misperceptions
○ Values:
■ Religious beliefs ■ Good and evil
■ Right and wrong
○ Data:
■ Lack of information ■ Perceived hiding of
■ Relevance of information
information
○ Structure:
■ Availability of resources
■ Authority issues
■ Structure of decision-making
■ Time and space constraints
○ Interests:
■ Wants, needs
■ Diverging interests, perceived or real
How to Determine Source of Conflict?
● In every conflict, there are two things to consider:
○ Importance of the outcome and the relationship
Your Personal Conflict Style
● In every conflict, determine the balance between the relationship and the outcome,
then choose the strategy that best meets your needs.
● You will be more successful in the long term if you can identify your
colleague’s response strategy and respond accordingly.
● If the relationship is important, use as many approaches to maintain the
relationship without losing the desired outcome.
● You must first identify your own personal conflict style as this style may not always
be the best.
Personal Conflict Styles:
● Avoidance
○ Avoidance: “I will postpone my decision as I need more time to think”
○ No one gets anything for now (low relationship, low outcome)
○ Good choice when have no chance of succeeding or when timing/setting
isn’t conducive
○ Never get pushed into a dispute
○ Don’t avoid indefinitely - makes the other side anxious
● Competing
○ Competing: “I am usually good at getting what I want”
○ I get what I want for now (low relationship, high outcome)
○ Good strategy when the outcome is crucial but the price is high in terms of
relationship as other side can feel abused
○ Best seen as a final strategy and best used sparingly

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 ● Compromise
○ Compromise: “I think conflict resolution is a matter of give and take”
○ I give a bit and you do too (satisfactory relationship, satisfactory outcome)
○ Assumes that both sides are willing to give up something they would prefer
in order to achieve a goal
○ Be careful not to offer compromise if you are not sure the other side will do the
same
● Accomodation
○ Accomodation: “I will give in on my wishes if it makes the other person happy”
○ You get what you want (high relationship, low outcome)
○ Relationship is paramount
○ May lose important values in the negotiations
○ Usually part of a longer term strategy - give up something today to get something
tomorrow
○ Can feel like being taken advantage of depending on pay back time
● Collaboration
○ Collaboration: “I find working together with others we can solve problems”
○ I get what I want and you do too (high relationship, high outcome)
○ Best form of dispute resolution for the long term, relationship endures over
time, has the flexibility to change
○ Requires time and sufficient knowledge of the other party
○ Best used when you plan on maintaining the relationship and can clearly
identify the needs of all
Personal Accountability: Achieving What Matters to You
● Accountability means taking action that is consistent with our desired outcomes. It
means making a choice as to how we will respond to any given situation. The
opposite of accountability is choosing the “Victim Road.”
Accountability Loop vs. Victime Loop

-Recognize the Problem -Ignore the problem

-Take ownership for getting the problem resolved -Deny your involvement in the problem

-Forgive yourself and others who may have -Blame someone else for the problem
contributed to the problem

-Self-examine how you contributed to the -Rationalize and justify why someone else
problem should solve the problem

-Learn what you can do differently -Resist any attempt to get you involved

Take action Hide to avoid dealing with the problem

Why Chose the Accountability Loop?

● Gives you an opportunity to improve your relationships and clarify your direction

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 ● Promotes growth and development
● Help you stay focused
● Improves your team work
● Increases your self-confidence and self-esteem
● Expands your ability to love and be loved
● Helps to resolve conflicts and increase
trust The Rewards of Accountability
● The Reward of Trust
● The Reward of Achievement
● The Reward of Recognition
● The Reward of Freedom
Accountability Skills
● People who are accountable are skilled at:
○ Thinking critically
○ Setting goals
○ Resolving conflicts
Week 9
Communicating with Hearing and Visually Impaired Clients
Disorders of the Ear
● Ear - maintains balance and hearing. Receptacle from sound waves. It is the brain that
tells you what the sound means.
● Impairments from slight to total deafness, sudden or gradual, one or both ears affected
● Health promotion necessary re: ear protection
● Effects of Impaired Hearing
○ Impairment varies among people
○ May notice unable to hear others’ voices
○ Frustration when unable to hear others
○ Others may become frustrated when trying to communicate with the
hearing impaired
○ Denial - do not want to admit hearing loss as sign of aging
○ Refuse to wear hearing aid(s)
○ Signs in both children and adults:
■ Louder than usual speaking
■ Moving forward to hear
■ Turning and cupping non-affected ear to speaker
■ Inappropriately responding to speaker
■ Requesting to repeat words
■ Psychosocial health can be affected
■ Speech problems may occur
● Strategies
○ Communicate directly with and in front of client - to treat with dignity
○ Note and respect client’s preference of communication - may hear better in
one ear than other
○ Ensure client sees PSW approach before PSW speaks to client - to avoid

33
 startling client
○ Speak in clear, normal voice tone and a little more loudly (avoid shouting) at
a moderate pace - to avoid discomfort for client who wears a hearing aid(s)
○ Pause between short, simple sentences - to enable client to process information
○ PSW should avoid gum, candy, etc. in mouth - to enable speech reading
○ Accommodate for speech reading - room well lit
○ Decrease use of medical language
○ Maintain eye contact and use non-verbal communication
○ Observe client’s non-verbal behaviour
○ Decrease background noise if possible
○ Rephrase or write message
○ Involve professional interpreter
○ Determine a change in topic
○ Utilize visual aids
○ Ask client to repeat information back to PSW to ensure client’s understanding
● Aids to Assist with Hearing Loss
○ Hearing aids
○ Different types
○ Improve hearing
○ Background noise and speech become louder
○ Expensive, handle with care, client’s name
● Care of Hearing Aids
○ Check for damage - cracks, blocked openings, moisture - keep case in
dry storage area
○ Turn batter on to M (microphone) once placed in hearing aid
○ Listen for whistle to indicate hearing aid on
○ Avoid dropping to prevent damage
○ Report to supervisor if hearing aid is damaged or missing
● Technology for Hearing Assistance
○ TTY: Specialized telephone system
○ Signalling devices: Lighting system attached to smoke detector, doorbell
and phone, light flashes with sound
○ E-mails: Increase communication with others
○ Hearing dogs: Alert person to sounds
○ Closed captioning: 13 inch or larger TV screens-built in decoder system
○ Sign language: Hand symbols used for words
Disorders of the Eye
● Macular Degeneration: Age-related, over 50
● Breakdown of the centre of the retina which is the macula-senses light and colour
● Two types:
○ Wet - leakage of blood and fluid from growth of blood vessels under the macula
- more severe than dry
○ Dry - breakdown of light sensitive cells in the macula - more common than wet
● Effects of Impaired Vision

34
 ○ The eye simple picks up the image. The brain tells you what you are seeing
means.
○ Psychosocial health affected
○ Independence may be most impacted
○ Adapt over time to taking longer to complete ADLs and tasks
○ Adapt to different methods of reading
● Strategies
○ Other senses increase
○ PSW voice should be pleasant and respectful
○ Adjust lighting according to client’s wishes
○ Assist with ADLs as required - if client is independent in own way, leave
well enough alone, do not interfere
○ Use “look” and “see” as PSW normally would as same vocabulary for
both people of sight and no sight
○ Make the client aware of when PSW is leaving and returning to client’s room
or home, whether or not someone else is with client
○ Ask before physically guiding client - to take PSW’s arm above elbow or client
to place hand on PSW’s shoulder to guide control of movements
○ Speak in a normal tone of voice when identifying yourself on greeting your client
○ Shake hands when client offers to do so
○ Speak face to face and use client’s name
○ State when you are going to touch client ahead of time
○ Provide verbal descriptions
○ Do not interfere with service dog in-charge and responsible for his companion
○ Avoid touching dog
○ Dog is “working” while harness in place
○ When dog at rest-ask for permission to touch dog if desired
○ Client to walk in between PSW and service dog
● Aids to Assist with Vision
○ Eyeglasses, contact lenses
○ Reading with Braille
○ Communication devices such as cheque and envelope writing guides
○ Computer software
○ Entertainment devices
○ Medical devices - pill boxes, talking prescriptions
○ Artificial eyes - permanent prosthesis or removable
○ Audiotape of medical information
○ Audiotaped novels
○ Notes recorded in braille
○ clocks/watches that announce time
○ White cane when ambulating
○ Decrease vision - larger fonts, black print on white paper, one inch margins
all slides of paper, 1.5 spaces between typed lines
Speech and Language Disorders

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● Causes
○ Genetic
○ Brain injury related to infection, CVA, accident, use of street drugs
○ Tumours of the brain
○ Loss of hearing
○ Disease
○ Structures used for speech damaged/problems with
● Terminology
○ Aphasia - Injury to the brain. Part of the brain responsible for speaking
is damaged.
■ Loss (a) of the ability to speak and use language skills (phasia) related
to brain injury - head injury, CVA, brain tumour
■ Loss may be partial or complete, temporary or permanent
■ May also occur in people who have dementia
■ Three types of Aphasia
● Receptive Aphasia - difficulty understanding spoken and
written language
○ Cannot understand one's own words, muddled speech
and sounds mixed up within own words
○ Example: “posital” for hospital
● Expressive Aphasia - speaking and writing difficulties
○ Able to understand spoken and written words
○ jumbled , slurred speech, difficult to understand
○ May not state what actually thinking
○ Frustrating for client
● Expressive-Receptive Aphasia, global aphasia
○ Speaking is difficult
○ Difficulty with spoken and written language
○ May only be able to state “yes, no, da da”
○ All speech and language skills may be lost by some people
○ Apraxia - inability to move muscles required to speak
■ Uncontrollable movements of lip, tongue, jaw
■ Often a result of brain injury
■ Children may also be born with apraxia
■ Apraxia may also occur with aphasia
■ Speech is often slow
■ May state “me” instead of “tea”
■ Inconsistent speech
○ Dysarthria - inability to speak clearly
■ Muscles used for speech weakened or paralyzed
■ Common in people with CP, MS
■ May also be a result of head injury, infection and tumour
■ Speech is slurred, slow and soft and may speak in tones that are flat,
harsh or nasal

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 ■ Errors in speech-unable to form to form or space words, and
breathing when talking
■ Drooling
● Emotional Effects
○ May avoid social events
○ May be avoided by family and friends
○ Stressful in relationships
○ May be unable to work - financial issues
○ May become dependent on others to help
● Assistive Devices
○ Speech therapist - teaches communication methods to client and family
■ Client relearns how to speak, how to strengthen muscles and how to
breathe when speaking
○ Communication boards - client points to pictures/words to
show functions/tasks/ADLs
○ Eye-gaze boards - quadriplegic client
○ Mechanical/Electrical Devices:
■ Large computers, handheld talking aids
■ Touchable picture on screen, voice activated
■ Message may also print on screen
○ Computers:
■ Screen reading, magnification, symbols
■ Electrically generated male/female voice
■ Expensive, difficult to carry on person
● Therapeutic Communication Skills
○ Follow care plan and supervisor’s instructions
○ Be aware of own facial expressions while communicating with client -
avoid looking frustrated or impatient
○ Fatigue may result - effort to understand others and to feel understood
○ Avoid distractions to maintain concentration
○ Allow for extra time with client - interacting will increase self-esteem/recovery
○ Include client in conversation
Week 10
Team Work & Group Dynamics
● What is a Team/Group?
○ A team is a group of people working together toward a common goal.
○ The Healthcare team has various people & different ways of interacting
■ It is important to be aware of:
● Group standards & values
● The need for conformity to appropriate group practice
● Group Standards & Conformity
○ As a healthcare provider, you will be expected to conform to the standards
and practices of the healthcare field
■ Common policies & procedures across facilitates include:

37
 ● Appropriate dress
● Ethical behavior
● High standards of performance
● The Healthcare Team
○ The group of people that make up healthcare teams will be different according to
the situation & the needs of the client/resident
○ Much of what happens on the team depends on how you are able to adapt
to the changing needs of the situation
● Benefits of Team Work
○ Opportunities for collaboration
○ Opportunities for communication
○ A variety of abilities, skills & perspectives
○ Better decision making & problem solving
○ A positive trusting atmosphere
RAPPORT - trust, harmony, cooperation
● Challenges of Team Work
○ Recognizing role boundaries
○ Being flexible
○ Handling conflict
○ Expressing your needs and views
Before expressing your views, think about how what you say will affect others
● Working Under Supervision
○ Taking direction from a leader can be challenging
○ It is important to note that the group's goal is to provide compassionate care
to the client
○ You are one member of that group & the goal is important to remember
○ It is not personal, it is professional
● Team Building in a Healthcare Setting
○ Organizational research has demonstrated that team building can
increase efficiency and productivity
● A successful team has 4 essential qualities:
○ Open and effective communication
■ It involves active listening-using all senses to assess verbal as well as
nonverbal messages-and a movement toward conflict resolution
○ Member involvement
■ It means a sense of commitment to the team, a respect for team
members, and a growing desire to understand team dynamics
■ Involved members appreciate the diversity within the team and are
emotionally invested in the team
■ Willingness to collaborate with others
■ While recognizing their own contributions to the team, they see
themselves as part of the whole, striving to reach a common goal
○ Clearly defined goals
■ Clearly defined member roles and responsibilities

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 ■ Goals may focus on such varied activities as developing care plans,
allocating resources, or evaluating team progress
○ Trust
■ It evolves naturally in the presence of effective communication,
member involvement and clearly defined goals
■ Teams with all 4 qualities have energetic, enthusiastic members who
can work together, sharing resources, information, and skills
● How teams develop
○ 5 Developmental Stages:
■ Forming
● Team members gain self-awareness and seek acceptance
from other members
● Team members note similarities and differences
among themselves, and form alliances and bonds
● Members raise questions about the purpose of the team,
available resources, time constraints, their roles, and the roles,
strengths, and weaknesses of other members
■ Storming
● Characterized by turbulence and stress as members
become more task-oriented
● Team resilience is tested as tensions build; trust becomes weak
● Personality conflicts and hidden agendas
● Goals are blurred
● Resolution depends on effective leadership: providing clear
directions and encouraging members to adopt specific roles, the
team leader focuses the group
■ Norming
● It occurs after initial conflicts have been resolved, roles accepted,
and the strengths and limitations of team members acknowledged
● Members feel less threatened, tensions decrease, allowing the
team to focus on purposes and goals
● Productivity increases and morale improves as the team becomes
more confident in their common purpose

■ Performing
● Characterized by productivity, quality decision-making,
progression toward the stated goals, and personal growth on the
part of team members
● Internal conflicts are settled, and team performance is optimal
● A genuine commitment and loyalty to team goals is required
to reach this stage
■ Adjourning
● The project is coming to an end and the team members are
moving off into different directions.

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 ● This stage looks at the team from the perspective of the well-
being of the team rather than from the perspective of managing a
team through the original four stages of team growth.
● When they regroup together, they expect more on each of
the members.
Week 11
Learning
● It is the gaining of information that causes a change in behavior.
● This could be acquisition of new knowledge & skills.
● Once something is learned, it is never fully forgotten. We store it in our
subconscious mind and retrieve it when necessary.
To be effective - learning has to be MEANINGFUL
How Does Learning Occur?
● Person wants something eg. the drive, need, motivation is the stimulus (Maslow)
● Person notices something that will satisfy his/her need (Stimulus)
● Person acts on the stimulus (Response)
● Person gets a reward, satisfaction The
purpose can be: 1. Achievement
2. Social
3. Self-fulfillment
Identifying Learning Problems
● Slow development speaking & writing
● Idea expression/understanding directions
● Difficulty writing, spelling, forming letters
● Trouble memorizing, remembering
● Difficulty paying attention, completing tasks
● Poor organization, sloppy, poor handwriting
*These can cross the life span & may require extra support & appropriate teaching
Barriers To Learning
● Frustration - happens when progress to a goal is blocked
● Sources of frustrations may be:
○ The self
○ The environment
○ Other people
○ Illness
○ Prejudice
These can get in the way of effective learning

Other Barriers
● Experiences in infancy & childhood & then in school especially in the early grades
● Difficult school/learning experiences in adolescence and adulthood
● Literacy levels & availability of schooling
● Gender roles & cultural beliefs/values
● The importance of education

40
 ● The cost of education for some
people Coping Strategies
● WHAT METHODS DO YOU HAVE TO LEARN?
○ Using problem solving skills (The 6 steps)
○ What is the goal?
○ Is the goal realistic/achievable?
○ How do I organize priorities?
○ Who can you/I go to for help?
○ How to choose between solutions?
○ Being aware of what my abilities
are Some Reasons for Teaching
● To assist a person in regaining independence
● To assist a person in mastery of a new task
● To let a person know the reasons for the task & the correct order of steps
● To assist a person to care for a relative at home
● To prepare a person for a procedure/operation or for care after the
procedure What Affects Learning In Older Adults
● MCO for changes: 1. Motivation 2. Capacity 3.
Opportunity All 3 need to be present for change to happen.
● Medical problems & ongoing illness ●
Hearing problems/memory changes ●
Visual deficits cultural beliefs & values ●
Previous learning/literacy levels
● Changes in ability/motivation to learn/change
Clients Feel More Secure When They Know What is Going On
● What
● Why
● Who
● How
● What Sensations
● What they may do
● What will you do
Teaching Methods With Clients
● Put clients at ease - Anxiety is the fear of learning
● What are they interested in learning?
● Small steps & start with the easiest - because once they feel success, they get
motivated to learn more
● Let client set the pace
● Be positive, it’s almost right
● Provide support, encouragement
● Observe, listen, watch for tiredness
● Give time for practice
● Practice the “tell-show-do-review” model
● Questions with answers - handouts for review later

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 ● Written instructions, pictures
● Videos, films, actual examples
● One on one/special learning groups (eg. for diabetics, bowel disorders)
● Support groups that show the client they are not the only one with the concern
Make Sure your instructions are:
● Clear
● Precise
● Use simple everyday language
● Organized
● Review things the client did correctly - and things that need
improvement Learning Styles
● Visual Learners
○ Color coding
○ Watch videos
○ Mind Maps & diagrams
○ Use picture & sketches
● Audio Learners
○ Read out loud
○ Record yourself
○ Group discussions
○ Create songs & rhymes
○ Listen to podcast/instructions
● Kinaesthetic Learners
○ Participate in group activities
○ Build models
○ Create a game
○ Walk around as reading over notes
○ Field trips
USE MORE THAN ONE LEARNING STYLE!
Interprofessional Education
An Understanding
● Interprofessional Care - is the provision of comprehensive health services to patients
by multiple health caregivers who work collaboratively to deliver quality care within and
across settings. Interprofessional care is the goal.
● Interprofessional Collaboration - is the teamwork and discussion with other professions
that allows for interprofessional care
● Interprofessional Education - occasions when two or more professions learn about, with,
and from each other to improve collaboration and the quality of care. IPE is now a
competency for health sciences curriculum.
- IPE is one of the vital strategies that education programs can employ to prepare
healthcare providers to participate in a new more collaborative future healthcare
workforce. New federal and provincial policies indicate that IPE and collaborative care
are expectations for future practice.
- The way we achieve Interprofessional Care this is through Interprofessional

42
 Collaboration
- Collaboration is a learned process and requires an understanding of each other;
this is achieved through Interprofessional Education

● Currently professions tend to reside in “silos”, performing assessments, treating and

managing patients within a narrow field of vision, realising our roles and our roles
only (very little knowledge about other professional roles) – advance Slide to see
arrow graphic

● Currently professions work within “silos”, performing assessments.. etc that are
profession specific
○ Patient directed, not always centred

43
 ○ Much overlap in assessments
○ Patient pulled in many directions, frustrated with overlap
○ Causes health care delays, repetitive assessments, confusion… etc

● Currently, involvement of professions is driven by “profession specific” assessments

and then referrals to other professions.
● Net result is “we look like we are all over the place”; patient left in dark

● All professions/patient/individual and family left confused and wondering “if people talk
to each other”. Professions unaware of each others roles & responsibilities; while each
profession works toward a discipline directed goal vs. common goal

44
 ● In collaboration we all work together, understanding each others’ roles &
responsibilities, with a common goal in mind.
WHY Interprofessional Care?
● Ontario faces a significant reduction in its health human resources workforce
○ Trend data indicates that Ontario faces a significant reduction in its health
human resources workforce by 2010.
● Unless new ways of practicing healthcare are introduced, Ontario will face a significant
shortage of healthcare workers and Ontarians will risk receiving suboptimal care.
● Providers need to work in multi-disciplinary, collaborative, team-based models
○ The education system needs to prepare current and future providers
to work in multi-disciplinary, collaborative, team-based models.
● Improve patient/individual care while increasing provider satisfaction within a
respectful and collaborative environment
○ A growing understanding that interprofessional care can help improve patient
care while increasing provider satisfaction within a respectful and collaborative
environment.
Interprofessional Collaboration
● Work with other Health Science & Health Field related students
● Learn each other’s professional identity, roles and how to work together
● Discussions and opportunities to build professional relationships and networks
● YOU will be part of the primary Healthcare initiative in Ontario
● YOU will be knowledgeable of the benefits of interprofessional collaboration and care
● YOUR future employer will seek interprofessional collaborators
Leading Edge: All current/field Health Care Professions undergoing
workshops/education in IPC; as a student you will start your career as a
collaborator, entering the workforce ready for this change in health care delivery.
Employment: Costly for employers to educate and train employees; as a student and
future “employee”/Health Care Professional; you will be graduating with IPC education

45
and an ability to work with other professions, this will be very attractive to
potential employers.
Expert: part of “culture change”; they will have a background to build on, IPC is a young
and changing directive/initiative; They will be the future developers of IPC initiatives and
change. (leaders)
Week 12
Types of Care, Support Plans & Checklists
● Long-Term Care - some examples
○ LTC facility, retirement home, group home, supportive housing
● Short-Term Care - some examples
○ Hospital, client just home from hospital, adult day program
● Household & Social Care - may give housekeeping & child support while parent
recovers
Types of Care Plans
● Written - Individual to each facility home agency - sometimes called a
service agreement
● Verbal - May get care plan directions & information over the phone
● Client-directed may have to create your own with client
What is a Care Plan?
● A written communication tool used between members of the healthcare team
- enables team members to communicate details about client care
● Guide to individual client goals, needs & services
● Assists in providing consistent care across all shifts & gives
accurate information
● Gives direction for planning & reviewing care & changes according to the
needs of client
● Confidential
Who Creates Care Plans
RN & RPN Nursing Diagnosis

Doctors Orders

Physio/OT Mobility, daily living

PSW Observations, care

Client/Family Needs, history

Social Worker Financial/Social needs

Dietitian - prn Special diets prn

Speech Therapy - prn For special cases

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Care Planning in Facilities
1. Assessment
2. Nursing Diagnosis
3. Planning
4. Implementation
5. Evaluation
Remember effective planning requires:
● Identifying the needs
● Do you have the resources
● Do you have the manpower to carry it
out #1. Assessment Step
● Assessment - involves collecting information about the client
○ What information?
■ RN gets from client
● Health HX: Describes past & present health problems
● Physical assessment: Vital signs & observations
about client’s physical health
● Emotional, social intellectual & spiritual health assessment
■ Other sources:
● Info. collected by: physician, social worker & other
health care providers
● Past medical records & test results
● Family members/primary caregivers
Nursing VS Medical Diagnosis
● Nursing Diagnosis: is a statement describing a health problem that is treated
by nursing measures
○ eg. low self-esteem, social isolation or spiritual distress.
● A medical diagnosis: is the identification of a disease or condition by
a physician. Medications, therapies & surgery are ordered to treat
disease/condition
○ Eg. cancer, pneumonia, bipolar disorder, stroke, heart attack, AIDS
or diabetes
#2. Nursing Diagnosis Step
● The RN uses information from the assessment to make a nursing diagnosis
● Holistic approach; meaning the nurse diagnosis takes into consideration
the WHOLE person (psychosocial & physical health)
● Client may have one OR several nursing diagnosis based on a specific
existing health problem or a potential health problem (at risk for…)
Planning & its parts
● Setting priorities (see Maslow)
● Goals are practical, achievable, measurable results of the care

47
 ● Goals promote health, rehabilitation, independence
● Goals can focus on physical, emotional, spiritual & intellectual well-being
● Deciding how to do it & then carrying out the plan
#3. Planning Step
● Planning involves establishing priorities & goals and developing measures
or actions to help the client meet these goals.
○ Establishing priorities (Usually the needs for LIFE & SURVIVAL
have priority)
○ Setting goals (Goals are: practical, achievable, and have
measurable outcomes)
○ Determining interventions (an action/measure done to help the client meet
the goal)
○ Establishing the care plan
Establishing the Care Plan
● Care Plan: is a document that details the care & services the client
should receive
● Contains: diagnosis, goals & interventions
● Functions: lists care & services client receives, ensures consistent client
care, enables healthcare team to communicate details about client care.
● LIVING DOCUMENT = continually reviewed & revised depending on
client needs, condition & progress
● RN in charge of client’s care is the only one who makes changes to
document #4. Implementation Step
● Actions in the care plan are implemented
○ RN in charge of the client’s care assigns or delegates tasks to members
of the team
○ RN communicates tasks by use of assignment sheets to PSW
● 4 main functions of the implementation process:
○ Providing the care
○ Observing the person during the care
○ Reporting & recording that the care has been completed
○ Reporting & recording observations made during the care
(PSWs: practice within the legal limits of your role/job
description) #5. Evaluation Step
● Evaluation means assessing & measuring
○ Involves: determining if the goals in the care plan have been met
○ Goals may be met totally, partly or not at all
○ RN assesses why client has made no or partial progress towards
reaching a goal
○ Evaluations are ONGOING - as client’s condition or needs
change revisions are made to the diagnosis, goals & interventions

48
Care Planning in Community Settings
● The process is the same. Four step care planning process: assessment,
planning, implementation & evaluation
● There may be differences in carrying it out
● Case managers coordinate & manage client care
● Differences eg. the home of the client needs to be assessed for safety, determine if
the services needed are locally available, and determine service funding, etc
● The case manager may have to work with several agencies in coordinating
care PSWs Role in the Care Planning Process
● Make observations & provide feedback
● Others use your information when reassessing client’s progress, revising goals
& changing care plan
Review
● Observation is the act of noticing a truth or fact
● Observation requires you to use your senses
● Objective data (signs) = information observed about client eg. pulse, urine, etc.
● Subjective data (symptoms) = information reported by client that is not
directly observed eg. pain, fear, nausea, etc.
Check Lists
● The PSW may work with the following:
○ Progress notes
○ ADL checklists & flow sheets
○ Task sheets
○ Graphic sheets
○ Summary reports
○ Incident reports
 PSW1 Test 2 Review

Delegated task- is a specific duty or responsibility within a professional context, typically in healthcare,
that is authorized by one individual (such as a nurse) to be performed by another individual (such as a
PSW) under certain circumstances.

An assigned task is a responsibility or duty appointed to an individual within their scope of practice and
within the agency's job description and scope of employment.
A family conference (also called a care conference) is a meeting attended by the health care team, the
client (if possible), and family members to discuss the client’s care.
accountability The willingness to accept responsibility and to explain one’s actions, inactions or omissions,
intentions, and decisions

assault Intentionally attempting to or threatening to touch a person’s body without consent, causing the person to
fear bodily harm

battery The touching of a person’s body without the person’s consent

False imprisonment is the unlawful restraint of or restrictions on a person’s freedom of movement. For example,
preventing a client from leaving a facility is false imprisonment.

invasion of privacy Violation of a person’s right not to have their name, photograph, private affairs, health
information, or any personal information made public without consent.

substitute decision maker for health care A person authorized to make health care decisions on behalf of a living
person who is unable to do so. Also called power of attorney for health care or proxy, depending on the province

legislation A body of laws that govern the behaviour of a country’s residents

restraint Any device, garment, barrier, furniture, or medication that limits or restricts freedom of movement or
access to one’s own body

negligence Failure to act in a careful or competent manner, resulting in harm to a person or damage to property

OH&S legislation is the body of laws and regulations enacted by provincial and territorial
governments in Canada to ensure the health, safety, and welfare of employees in the workplace.

advance directive A legal document in which a person states wishes about future health care, treatment, and
personal care.

1) Client rights:
a. Identify the client rights

Client Rights
b. The right to:
i. Be treated with dignity and respect
ii. Privacy and confidentiality
iii. Give or withhold informed consent
iv. Autonomy

c. Identify 5 ways to maintain a client’s privacy

1. Keep information safe: Store client records and documents in secure places, like locked cabinets or
password-protected computer systems.
2. Limit access: Only allow authorized personnel to access client information, and regularly review who has
permission to see it.
3. Talk privately: Have discussions with clients in private areas where others can't hear.
4. Ask permission: Always get a client's permission before sharing their information with anyone else.
5. Respect their choices: Let clients decide what information they want to share and with whom.

d. Give 5 examples of negligence

1.For example, you are taught to keep a urinary drainage bag below the client’s bladder
level. If you keep it above the bladder level, urine will not drain, and the client could
develop a urinary tract infection.
2. You may be asked to do something beyond your scope of practice—for example, giving
medications.
3. For example, if you do not mop up a spill, you could cause a client to slip and fall, and
your carelessness could be considered negligence.
4. For example, a client confined to bed develops serious pressure sores. The family thinks
she was left lying in the same position too long. Your charting shows that you repositioned
her every hour, as stated in her care plan. This proves that you gave the required care and
did not cause the pressure sores. If you had not recorded that you repositioned her every
hour, it could have been presumed that you did not do it
5. Let's say you're responsible for assisting a client with mobility issues in transferring from
their bed to a wheelchair. However, you neglect to properly secure the wheelchair before
helping the client transfer. As a result, the wheelchair moves unexpectedly, causing the
client to fall and sustain an injury.
2) Ethics
a. Identify and define the 4 principles of Ethics

Four Principles of Healthcare Ethics

● Autonomy - the right to chose. Self-determination. Assuming they are mentally
competent. Always respect their choices and preferences. Safety chomps everything

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else.
● Justice - all people should be treated in a fair and equal manner regardless of their
mood or condition.
● Beneficence - doing good or promoting good.
● Non-maleficence - seeking to do no harm.

b. Define ethics

Ethics is what you should and what you should not do. The rules of conduct that guides
us decide between right and wrong.

c. How are ethics different than morals

The term ethics refers to the rules of conduct that guide us when deciding what is right
and what is wrong (immoral). These rules come from society’s expectation of how
people should conduct themselves. Morals are the fundamental principles of behaviour
each person believes to be right or wrong for themselves without concern for legalities
or customs
d. Identify the principles of ethical decision making
 e. When faced with an ethical dilemma what do you need to consider

3) Dealing with Dilemmas - when there are opposing belief, moral, ethics
4) Ask yourself the following questions
a. What is the client’s preference?
b. Does the option honour this preference?
c. Does the option treat the client fairly and justly?
d. Does the option represent short or long term benefits
e. Could the option cause harm or increase the risk of harm?

When problem-solving consider the following:

f. The principles of support work (DIPPS)
g. The client’s viewpoint
h. Your scope of practice
i. You supervisor’s viewpoint

5) Home care
a. When working independently for a client what should a PSW do prior to taking the job
1. Asses Client Needs: Make sure you know what the client requires in terms of care and support.
2. Discuss Expectations: Talk with the client about what they expect from you, including tasks, schedule, and
payment.
3. Check Agreement: If there's a contract, read it carefully to understand terms like pay rate and cancellation
policies.
4. Confirm Credentials: Ensure you have the right qualifications and certifications for the job.
5. Get References: Ask for feedback from past clients or employers to show your experience.
6. Set Boundaries: Discuss boundaries with the client, like privacy and professionalism.
7. Plan for Emergencies: Have a plan for dealing with unexpected situations or emergencies.
8. Think About Safety: Make sure the work environment is safe for you, and discuss any concerns with the
client.

6) Multidisciplinary team
a. Define
An interdisciplinary team (also called an interprofessional health care team) includes
health care providers from a variety of backgrounds and specialties, as needed, who
work together to meet the client’s needs.
b. List the advantages of working in a multidisciplinary team

Benefits and challenges of Team Work

c. Benefits
i. Collaborations
ii. Communication
iii. Share knowledge of expertise
iv. Better decision making and problem-solving
v. Positive trusting atmosphere
vi. Support from one another during difficult situations
d. Challenges
i. Recognizing role boundaries
ii. Need to be flexible
iii. Handling conflict
iv. Expressing your needs and views
 7) Delegation
a. Define
b. Identify the 5 rights of delegation
c. Identify in order the steps of the delegation process
Assessment of Needs
Communication
Guidance and Assistance
Follow Up and Feedback
d. Under what circumstances can a PSW refuse to perform a delegated task
8) Communication
a. How is communication (ie giving report) different in homecare settings
1. Location: Instead of a hospital or clinic, communication happens at the client's home.
2. Personalized Approach: Communication is adjusted to fit the client's personality and needs.
3. Flexibility: Caregivers need to be adaptable because home environments can be unpredictable.
4. Privacy Concerns: Caregivers must be careful when discussing private matters due to family members or
visitors being present.
5. Limited Resources: Homecare workers may not have access to the same tools as in a healthcare facility.
6. Independence of Clients: Clients may have more say in their care, affecting communication.
7. Collaboration with Family: Communication often involves working with family members who are also
present at home.

9) Competency
a. Define
competence The ability to do a job well
b. How can a PSW remain competent
Maintaining competence requires that you keep your knowledge up to date and continue
to be able to perform your skills. To do so, you will need to seek and participate in
lifelong learning opportunities. To keep your knowledge up to date, attend workshops
and in-services that are offered by your employer, get clarifications from your supervisor,
and read up about new equipment or practices that you are uncertain about
10) Informed consent
a. Define
informed consent Consent obtained under the legal condition whereby a person is first
given complete, accurate, and relevant information so as to fully understand the action
or procedure and its potential implications.
b. Identify the principles of informed consent
Consent is informed when the client clearly understands the following:8 l The reason for
the treatment or service l What will be done l How it will be done l Who will be doing it l
The expected outcomes l Potential risks and side effects of the treatment l Other
treatment options l The likely consequences of not having the treatment