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RESIDENTIAL, HOME AND

COMMUNITY AGED CARE

Workbook

Carla Unicomb RN, Bachelor of Health Science (Nursing), Graduate Certificate in VET,

Graduate Certificate in OHS, Certificate IV in Training and Assessment

Director, Training Beyond 2000

Wendy Bell RN, Bachelor of Health Science (Nursing),

Certificate IV in Training and Assessment

Principal Trainer, Training Beyond 2000

Disclaimer:

These materials have been written to the latest version of the qualifi cations and units of competence. However, it is up to each individual registered training organisation to ensure that it is meeting the requirements of the latest version of the training package/units of competence.

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Table of Contents

Preface vi

How to use this workbook vii

About the Authors viii

Contributor & Reviewers ix

Chapter 1 CHCCCS015 Provide individualised support 1

Chapter 2 CHCLEG001 Work legally and ethically 15

Chapter 3 HLTWHS002 Follow safe work practices for direct

client care 30

Chapter 4 CHCDIV001 Work with diverse people 54

Chapter 5 CHCCCS023 Support independence and wellbeing 66

Chapter 6 CHCCOM005 Communicate and work in health or

community services 77

Chapter 7 CHCHCS001 Provide home and community support

services 94

Chapter 8 HLTAAP001 Recognise healthy body systems 110

Chapter 9 HLTAAP001 Recognise healthy body systems:

health assessment 140

Chapter 10 CHCCCS025 Support relationships with carers and families 152

Chapter 11 CHCCCS011 Meet personal support needs 161

Chapter 12 CHCAGE005 Provide support to people living with

dementia 186

Chapter 13 CHCAGE001 Facilitate the empowerment of older people 201

Chapter 14 CHCPAL001 Deliver care services using a palliative

approach 210

Chapter 15 HLTHPS006 Assist clients with medication 222

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Preface

This workbook has been written to address the most current aged care training package requirements and is a resource to support the third edition of Scott, Webb and Sorrentino ’ s Long-Term Caring: Residential, Home and Community Aged Care textbook.

The workbook has been prepared after extensive consultation with aged care providers and feedback from past training participants, and is aimed at learners undertaking aged care qualifi cations. We especially acknowledge the contribution of Penny Kraemer, a registered pharmacist, who was the author of the chapter entitled ‘Assist Clients with Medication’.

We would like to express our sincere thanks to Melinda McEvoy, Liz Coady, Natalie Hamad, Robyn Flemming and Karthikeyan Murthy for their valuable support and suggestions in preparing the workbook.

Carla Unicomb Wendy Bell

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How to use this workbook

This workbook is to be used in conjunction with Long-Term Caring: Residential, Home and Community Aged Care , 3rd edition, published by Elsevier.

The workbook is closely aligned to the textbook and has activities throughout which are to be completed by the participant.

The activities and fi nal assessment have been designed to support the training and assessment strategies of the registered training organisation.

The workbook should be used in conjunction with a registered training organisation ’ s training and assessment plans, and can be customised and contextualised to satisfy the industry and the training organisation ’ s requirements.

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viii

About the Authors

Carla Unicomb and Wendy Bell are registered nurses, both with over 40 years of nursing and vocational education and training experience.

Carla Unicomb is the managing director of Training Beyond 2000 Pty Limited, a registered training organisation that is recognised as a leader in the delivery of training and assessment services to the com-munity services and health sector.

Wendy Bell is the principal trainer with Training Beyond 2000 Pty Limited, responsible for the delivery of Certifi cate III and Certifi cate IV nationally recognised qualifi cations in the aged care sector.

In preparing these learning materials, Carla and Wendy have drawn upon the resources they have developed in consultation with aged care providers over the past 15 years. The learning and assessment activities refl ect real work-based contexts and provide the learner with the opportunity to demonstrate that they have the requisite knowledge and skills to competently perform their role in the community services and health industry.

Carla and Wendy are passionate about delivering high-quality training and assessment that allows learners to transfer knowledge and skills to their work environment. Their newly acquired knowledge and skills will assist the learner to deliver person-centred care that enhances the quality of life of the care recipient.

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Chapter 12

UNIT CHCAGE005: Provide support to people living with dementia

Figure 12.1: Brain deterioration and its effect on the elderly (www.neterimages.com.)

Unicomb_Chapter 12_main.indd 186 1/18/2016 7:03:19 PM

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1. The Brain 189

2. Acute Confusion 190

3. Depression 190

4. Dementia 191

5. Alzheimer’s Disease 191

6. Care of the Person with Alzheimer’s Disease 195

Table of Contents


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INTRODUCTION

This workbook relates to the unit CHCAGE005: Provide support to people living with dementia.

The workbook activities and final assessment tasks will enable you to:

• prepare to provide support to those affected by dementia

• use appropriate communication strategies

• provide activities for maintenance of dignity, skills and health

• implement strategies that minimise the impact of behaviours of concern

• complete documentation

• implement self-care strategies.

To prepare for this unit and the assessment activities, we recommend that you first read Scott, Webb and Sorrentino, 3rd edition, Chapter 14 (Working with older clients with dementia).


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Chapter 12 • UNIT CHCAGE005: Provide support to people living with dementia

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1. THE BRAIN(page 360 of Scott, Webb and Sorrentino, 3rd edition)

Figure 12.2: The four lobes of the brain (Scott, Webb and Sorrentino, 3rd edition, Figure 14.1.)

FRONTALLOBE

TEMPORALLOBE

OCCIPITALLOBE

PARIETALLOBEVision

Wordunderstanding

MemoryEmotion (not visible)

Behavioural controlEmotion

Problem solvingPlanning

Wordproduction

Backof head

Frontof head

Activity 1The brain has four main lobes. Describe the changes to each lobe when damaged.

1. Frontal lobe:

2. Parietal lobe:

3. Temporal lobe:

4. Occipital lobe:


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RESIDENTIAL, HOME AND COMMUNITY AGED CARE WORKBOOK

190

Cognitive function(pages 360–2 of Scott, Webb and Sorrentino, 3rd edition)

2. ACUTE CONFUSION(pages 360–2 of Scott, Webb and Sorrentino, 3rd edition)

Acute confusion (delirium) occurs suddenly and is usually temporary. List the main causes of delirium.

3. DEPRESSION(page 362 of Scott, Webb and Sorrentino, 3rd edition)

Depression is the most common mental health problem in older people and is often confused with dementia. A correct diagnosis is needed for proper treatment. List the signs and symptoms of depression.


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4. DEMENTIA(pages 362–3 of Scott, Webb and Sorrentino, 3rd edition)

Dementia is not a normal part of ageing. If you had to describe dementia to a relative, what would you say?

Identify three early warning signs of dementia.

There are over 100 diseases that can cause dementia. List some of the more common conditions.

5. ALZHEIMER’S DISEASE(pages 363–4 of Scott, Webb and Sorrentino, 3rd edition)

Alzheimer’s disease is the most common form of dementia. It causes a gradual decline in cognitive abilities, with family first noticing short-term memory loss. Alzheimer’s disease is characterised by two abnormalities in the brain – amyloid plaques and neuro-fibrillary tangles. These plaques and tangles stop communication between nerve cells and cause the cell to die.


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Activity 2List signs and symptoms of Alzheimer’s disease. Classify them as either a care issue or a safety issue.

Care issues Safety issues

Stages of Alzheimer’s disease(page 364 of Scott, Webb and Sorrentino, 3rd edition)

Each person goes through the journey of dementia at an individual pace, but symptoms do become more severe as each stage progresses. Alzheimer’s disease is progressive and irreversible.

Read Box 14.5. As a group, discuss the needs of a person with Alzheimer’s disease as they move through each stage. Use the headings below as a discussion guide.

Personal care needs Safety and security needs

Nutrition needs Social/leisure needs

Communication needs Mobility needs

Need for a stable and familiar environment

Behavioural and psychological symptoms of dementia (BPSD)(pages 364–8 of Scott, Webb and Sorrentino, 3rd edition)

People with dementia may exhibit many challenging behaviours as a result of their condition.

Activity 3For each of these behaviours, provide a definition and a strategy for managing the behaviour.

1. Wandering:


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2. Hallucinations:

3. Delusions:

4. Aggression and combativeness:

5. Screaming:

6. Inappropriate sexual behaviours:

7. Repetitive behaviour:

8. Sundowning:


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9. Catastrophic reaction:

Challenging behaviours(page 370 of Scott, Webb and Sorrentino, 3rd edition)

People with dementia cannot control what is happening to them. If you try to determine what is triggering the behaviour, you may be able to prevent it from recurring. Think ABC.

A

B

C

Activity 4: Case studyIt is dinnertime in your facility and Kev, a new resident, has finished his meal. He reaches across the table and takes Matt’s dessert. Matt hits out at Kev. There is shouting and commotion. An inexperienced care worker rushes over, grabs Kev’s arm and pulls him away from the table. She shouts at Matt, who then pushes his teacup to the floor.

Using the ABC tool for Kev and the carer, complete the table.

1.

For Kev For the carer

A

B

C

2. How should the carer have handled the situation?

3. What systems could be put in place to prevent this from happening again?


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6. CARE OF THE PERSON WITH ALZHEIMER’S DISEASE(pages 366–9 of Scott, Webb and Sorrentino, 3rd edition)

Activity 5People with dementia do not choose the behaviours of the condition. Currently, dementia has no cure, and the symptoms worsen over time.

Look at the following list of care needs, and identify ways that you would meet these needs.

Safety:

Hygiene:

Nutrition:

Fluids:

Elimination:


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Comfort:

Sleep:

Dignity and respect:

Elder abuseElder abuse is a pattern of behaviour that causes physical, psychological, financial or social harm to an older person. Carers owe a duty of care to clients to keep them safe. People with dementia are more likely to be abused, as they cannot always speak up about the abuse and so it may go undetected.

Abuse may be physical, psychological, financial, sexual or as a result of neglect. Abuse may be carried out by partners, friends, family members, carers or health professionals. Abuse can occur at home or in a residential aged care setting.

Activity 6For each type of abuse, list some indications for that abuse.

Type of abuse Indications of abuse

Physical

Psychological

Financial

Sexual

Neglect


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Communication(pages 369–70 of Scott, Webb and Sorrentino, 3rd edition)

‘Communication is made up of three parts:

• 55% body language, facial expression posture and gestures• 38% tone and pitch of our voice• 7% the words we use.’

(www.alzheimers.org.au)

The person who is having difficulty communicating may pick up on negative body language such as crossed arms and eye rolling. When communicating with the resident, always maintain their dignity and self-esteem. Allow time for a response from the person. Use touch to keep the person’s attention and to communicate feelings of warmth.

When talking:

Activity 7In 1995, Christine Bryden (Boden) was diagnosed with dementia at age 46. She has written a book called Who Will I Be When I Die? Imagine you are a person with dementia. What suggestions could you give to people on how to communicate with you effectively?

Other communication strategies(pages 369–70 of Scott, Webb and Sorrentino, 3rd edition)


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Activity 8From your experience of dealing with people with dementia, give some examples of each of the following strategies.

Reminiscence: Remembering and reflecting on previous life events and experiences.

Redirection: Redirection of thoughts to something that is more pleasant.

Validation: Entering the person’s reality; recognising the person’s thoughts and emotions.

Reality orientation: Orientating the person to time and place.

Music therapy: An enjoyable experience which can unlock memories and feelings.

Using sense of smell: Smell can trigger powerful memories.


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Complete documentationDocumentation is a term used for any written information that an organisation collects. Aged care organisations use documentation for the following purposes:

Reporting gives an oral account of care and observations. Recording means writing an account of care and observations.

Activity 9What are some types of reporting and documentation required from you as a carer in your organisation?

Caregivers(page 370 of Scott, Webb and Sorrentino, 3rd edition)

The person with dementia may live at home with family members or in a residential aged care facility. As a family member giving care, there can be positive and negative aspects of being a caregiver.

Positive aspects of being a caregiver:

Negative aspects of being a caregiver:


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Carer stress and self-careWorking with people with dementia can be stressful. You take on the dual role of caring for the person with dementia as well as their relatives. It is important that you monitor your own stress level in relation to your work.

Activity 10

1. Signs and symptoms that your body is under stress:

2. Healthy strategies to help you cope with stress:

REFERENCEScott, K., Webb, M., & Sorrentino, S. (2015). Long-Term Caring: Residential, Home and Community Aged Care (3rd ed.). Sydney:

Elsevier.


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