9. CHCAGE005

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9.CHCAGE005.pdf

CHCAGE005

PROVIDE SUPPORT TO PEOPLE LIVING WITH DEMENTIA

LEARNER RESOURCE

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T A B L E O F C O N T E N T S

TABLE OF CONTENTS ........................................................................................................................................ 2

UNIT INTRODUCTION ....................................................................................................................................... 6

ABOUT THIS RESOURCE ...................................................................................................................................... 6 ABOUT ASSESSMENT .......................................................................................................................................... 7

ELEMENTS AND PERFORMANCE CRITERIA ....................................................................................................... 9

PERFORMANCE EVIDENCE AND KNOWLEDGE EVIDENCE ............................................................................... 11

PERFORMANCE EVIDENCE ....................................................................................................................................... 11 KNOWLEDGE EVIDENCE .......................................................................................................................................... 11

ASSESSMENT CONDITIONS ............................................................................................................................ 13

PRE-REQUISITES ............................................................................................................................................. 13

TOPIC 1 – PREPARE TO PROVIDE SUPPORT TO THOSE AFFECTED BY DEMENTIA ............................................ 14

WHAT IS DEMENTIA? ............................................................................................................................................ 14 WHAT IS THE DIFFERENCE BETWEEN DEMENTIA AND ALZHEIMER’S DISEASE? .................................................................... 15 EARLY SIGNS OF DEMENTIA ..................................................................................................................................... 17 SYMPTOMS AND STAGES OF DEMENTIA ..................................................................................................................... 19 FIRST-STAGE ........................................................................................................................................................ 19 SECOND-STAGE .................................................................................................................................................... 21 THIRD-STAGE ....................................................................................................................................................... 23 FOURTH-STAGE .................................................................................................................................................... 24

APPLY PERSON-CENTRED CARE APPROACHES TO ALL INTERACTIONS WITH THE PERSON LIVING WITH

DEMENTIA ..................................................................................................................................................... 25

WHAT IS PERSON-CENTRED PRACTICE? ...................................................................................................................... 25 Why is person-centred practice important? ................................................................................................ 25

LANGUAGE AND PERSON CENTRED CARE ................................................................................................................... 26

INTERPRET INDIVIDUALISED PLAN AND FAMILIARISE SELF WITH THE SPECIFIC NEEDS AND WANTS OF THE

PERSON LIVING WITH DEMENTIA AND IDENTIFY AND ADDRESS PERSON’S NEEDS FOR A STABLE AND

FAMILIAR ENVIRONMENT .............................................................................................................................. 27

TREATMENT AND CARE ........................................................................................................................................... 27 RISK FACTORS AND PREVENTION............................................................................................................................... 28 SOCIAL AND ECONOMIC IMPACTS ............................................................................................................................. 28 LIVING WITH DEMENTIA ......................................................................................................................................... 28 WHAT IS THE EXPERIENCE OF DEMENTIA? .................................................................................................................. 28

RECOGNISE SIGNS CONSISTENT WITH FINANCIAL, PHYSICAL OR EMOTIONAL ABUSE OR NEGLECT OF THE

PERSON AND REPORT TO AN APPROPRIATE PERSON .................................................................................... 31

DOMESTIC VIOLENCE ............................................................................................................................................. 32 NEGLECT ............................................................................................................................................................. 32 PHYSICAL ABUSE ................................................................................................................................................... 33 RESTRAINTS AND RESTRICTED PRACTICES .................................................................................................................... 33 SEXUAL ASSAULT ................................................................................................................................................... 34 EMOTIONAL ABUSE ............................................................................................................................................... 35 FINANCIAL ABUSE .................................................................................................................................................. 35 SYSTEMIC ABUSE ................................................................................................................................................... 36 RECOGNISING SIGNS THAT MAY BE INDICATORS OF ABUSE ............................................................................ 36

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TOPIC 2 – USE APPROPRIATE COMMUNICATION STRATEGIES ....................................................................... 39

USE VERBAL AND NON-VERBAL COMMUNICATION STRATEGIES TO MAXIMISE ENGAGEMENT OF THE PERSON

WITH DEMENTIA ............................................................................................................................................ 39

THE GOOD NEWS .................................................................................................................................................. 39 BE A GOOD LISTENER ............................................................................................................................................. 40 INTUITION ........................................................................................................................................................... 40 THE EFFECTS OF DEMENTIA ON COMMUNICATION ........................................................................................................ 41 THE COMMUNICATIVE NEEDS OF PEOPLE LIVING WITH DEMENTIA ................................................................................... 41

GAIN COOPERATION AND PROVIDE REASSURANCE AS APPROPRIATE BY USING REALITY ORIENTATION ...... 43

UNREALISTIC BELIEF IN DEMENTIA CLIENTS ................................................................................................................. 43 WHAT ARE THEY? ................................................................................................................................................. 43 VALIDATE THE PERSONS ‘S BELIEF ............................................................................................................................. 44 TREATMENT ......................................................................................................................................................... 45 SUPPORT FOR FAMILIES AND CARERS ......................................................................................................................... 46

USE A RANGE OF VALIDATION STRATEGIES TO RELIEVE DISTRESS AND AGITATION IN THE PERSON ............. 47

WHAT IS AGITATED BEHAVIOUR? ............................................................................................................................. 47 WHAT CAUSES THESE BEHAVIOURS? ......................................................................................................................... 47 UNDERSTANDING THE BEHAVIOURS .......................................................................................................................... 47 FREQUENT CAUSES OF AGITATED BEHAVIOURS ............................................................................................................. 48

TOPIC 3 – PROVIDE ACTIVITIES FOR MAINTENANCE OF DIGNITY, SKILLS AND HEALTH .................................. 51

ORGANISE ACTIVITIES WHICH AIM TO MAINTAIN INDEPENDENCE, USING FAMILIAR ROUTINES AND EXISTING

SKILLS ............................................................................................................................................................ 51

CREATING OPPORTUNITIES FOR PERSONAL ENJOYMENT ................................................................................................. 51

ORGANISE ACTIVITIES THAT ARE APPROPRIATE TO THE INDIVIDUAL, REFLECTING THEIR CULTURAL LIKES AND

DISLIKES, IN ORDER TO BRING BACK PLEASURABLE MEMORIES .................................................................... 53

DAILY LIVING AND PAST SOCIAL ROLES ....................................................................................................................... 53 CREATING A LIFE STORY .......................................................................................................................................... 53 MEANINGFUL AND PURPOSEFUL DAILY LIVING ............................................................................................................. 54 INTIMACY AND SEXUAL ISSUES ................................................................................................................................. 55 INTIMACY AND SEXUALITY ....................................................................................................................................... 55 HOW ARE INTIMACY AND SEXUALITY AFFECTED BY DEMENTIA? ....................................................................................... 55 CHANGED SEXUAL BEHAVIOURS ............................................................................................................................... 55 INCREASED SEXUAL DEMANDS .................................................................................................................................. 56 DIMINISHING SEXUAL INTEREST ................................................................................................................................ 56 LOSS OF INHIBITIONS ............................................................................................................................................. 56 MANAGING INAPPROPRIATE SEXUAL BEHAVIOURS ....................................................................................................... 56 INCONTINENCE ..................................................................................................................................................... 57 WHERE TO BEGIN .................................................................................................................................................. 57 CHANGES IN A PERSON’S ABILITY .............................................................................................................................. 57 DRESSING ............................................................................................................................................................ 58 PHYSICAL OR MEDICAL CAUSES ................................................................................................................................. 58 FORGETTING HOW TO DRESS ................................................................................................................................... 58 PROBLEMS WITH THE ENVIRONMENT ........................................................................................................................ 59 LACK OF PRIVACY .................................................................................................................................................. 59 PROBLEMS MAKING DECISIONS ABOUT WHAT TO WEAR ................................................................................................ 60

ENSURE THE SAFETY AND COMFORT OF THE PERSON BALANCED WITH AUTONOMY AND RISK TAKING ....... 61

SAFETY ............................................................................................................................................................... 61 WALKING AND WANDERING .................................................................................................................................... 62

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PARTICIPATING IN MEANINGFUL ACTIVITIES ................................................................................................................ 63 ACTIVITIES CAN BE AN IMPORTANT WAY OF HELPING A PERSON WITH DEMENTIA TO RETAIN THEIR

INDEPENDENCE. ............................................................................................................................................... 64 ACTIVITY SELECTION ............................................................................................................................................... 66

ACCESS INFORMATION ABOUT THE PERSON’S REMINISCENCES AND ROUTINES WITH FAMILY AND CARERS 69

HOW DO I MANAGE OUR COMMUNICATION NEEDS? .................................................................................................... 69 HOW DO I MANAGE THEIR EATING AND NUTRITION NEEDS? ........................................................................................... 70 HOW DO I MANAGE THEIR HYGIENE NEEDS? ............................................................................................................... 71 HOW DO I MANAGE THEIR CONTINENCE NEEDS? ......................................................................................................... 71 HOW DO I MANAGE THEIR SLEEPING HABITS? ............................................................................................................. 72 HOW DO I MANAGE MEMORY LOSS? ......................................................................................................................... 73 HOW DO I MANAGE IF THEY ARE CONFUSED? .............................................................................................................. 74 HOW DO I MANAGE IF THEY ARE AGGRESSIVE? ............................................................................................................ 74

PROVIDE SUPPORT AND GUIDANCE TO FAMILY, CARERS AND/OR SIGNIFICANT OTHERS WHERE

APPROPRIATE ................................................................................................................................................ 76

CARERS OF PEOPLE WITH DEMENTIA ARE NOT ALONE .................................................................................................... 76 MANAGING STRESS AS CARERS ................................................................................................................................. 76 ASKING FOR HELP .................................................................................................................................................. 77 COMMUNICATING WITH FRIENDS AND RELATIVES ........................................................................................................ 77

TOPIC 4 – IMPLEMENT STRATEGIES WHICH MINIMISE THE IMPACT OF BEHAVIOURS OF CONCERN .............. 79

IDENTIFY BEHAVIOURS OF CONCERN AND POTENTIAL TRIGGERS .................................................................. 79

SLEEPING PROBLEMS ............................................................................................................................................. 79 HOARDING .......................................................................................................................................................... 80 REPETITIVE BEHAVIOUR .......................................................................................................................................... 80 WANDERING ........................................................................................................................................................ 80 SUNDOWNING ..................................................................................................................................................... 81 IDENTIFY POTENTIAL TRIGGERS ................................................................................................................................. 81 MEDICAL CAUSES OF SLEEPING PROBLEMS IN DEMENTIA ............................................................................................... 81 ENVIRONMENTAL CAUSES OF SLEEPING PROBLEMS IN DEMENTIA .................................................................................... 82 OTHER CAUSES OF SLEEPING PROBLEMS IN DEMENTIA .................................................................................................. 82 CAUSES OF WANDERING ......................................................................................................................................... 82

CONTRIBUTE TO TEAM DISCUSSIONS ON SUPPORT PLANNING AND REVIEW AND TAKE ACTION TO MINIMISE

THE LIKELIHOOD OF AND REDUCE THE IMPACT OF BEHAVIOURS ON THE PERSON AND OTHERS .................. 84

SAFETY INSIDE THE HOME FOR PEOPLE WITH DEMENTIA ................................................................................................ 84 SAFETY OUTSIDE THE HOME FOR PEOPLE WITH DEMENTIA ............................................................................................. 86 INDEPENDENCE AIDS FOR THE PERSON WITH DEMENTIA ................................................................................................ 86 CHANGES TO THE ENVIRONMENT FOR PEOPLE WITH DEMENTIA ...................................................................................... 87

EVALUATE IMPLEMENTED STRATEGIES WITH SUPPORT PLANNING TEAM TO ENSURE EFFECTIVENESS IN

MINIMISING BEHAVIOURS ............................................................................................................................. 89

TOPIC 5 – COMPLETE DOCUMENTATION ....................................................................................................... 90

COMPLY WITH THE ORGANISATION’S REPORTING REQUIREMENTS, INCLUDING REPORTING OBSERVATIONS

TO SUPERVISOR ............................................................................................................................................. 90

COMPLETE, MAINTAIN AND STORE DOCUMENTATION ACCORDING TO ORGANISATION POLICY AND

PROTOCOLS ................................................................................................................................................... 91

COMPLETE DOCUMENTATION ......................................................................................................................... 91 MAINTAIN DOCUMENTATION ......................................................................................................................... 92 STORE INFORMATION ............................................................................................................................................. 92

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TOPIC 6 – IMPLEMENT SELF CARE STRATEGIES .............................................................................................. 93

MONITOR OWN STRESS LEVEL IN RELATION TO WORKING WITH PEOPLE WITH DEMENTIA .......................... 93

USE APPROPRIATE SELF CARE STRATEGIES AND SEEK SUPPORT IF REQUIRED ............................................... 95

SUMMARY ..................................................................................................................................................... 96

REFERENCES ................................................................................................................................................... 97

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U N I T I N T R O D U C T I O N

This resource covers the unit CHCAGE005 Provide support to people living with dementia.

This unit describes the skills and knowledge required to provide person-centred care and support to people living with dementia. It involves following and contributing to an established individual plan.

This unit applies to workers in a residential or community context, including family homes. Work performed requires some discretion and judgement and may be carried out under regular direct or indirect supervision.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

ABOUT THIS RESOURCE

This resource brings together information to develop your knowledge about this unit. The information is designed to reflect the requirements of the unit and uses headings to makes it easier to follow.

Read through this resource to develop your knowledge in preparation for your assessment. You will be required to complete the assessment tools that are included in your program. At the back of the resource are a list of references you may find useful to review.

As a student it is important to extend your learning and to search out text books, internet sites, talk to people at work and read newspaper articles and journals which can provide additional learning material.

Your trainer may include additional information and provide activities. Slide presentations and assessments in class to support your learning.

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ABOUT ASSESSMENT

Throughout your training we are committed to your learning by providing a training and assessment framework that ensures the knowledge gained through training is translated into practical on the job improvements.

You are going to be assessed for:

 Your skills and knowledge using written and observation activities that apply

to your workplace.

 Your ability to apply your learning.

 Your ability to recognise common principles and actively use these on the job.

You will receive an overall result of Competent or Not Yet Competent for the assessment of this unit. The assessment is a competency based assessment, which has no pass or fail. You are either competent or not yet competent. Not Yet Competent means that you still are in the process of understanding and acquiring the skills and knowledge required to be marked competent. The assessment process is made up of a number of assessment methods. You are required to achieve a satisfactory result in each of these to be deemed competent overall.

All of your assessment and training is provided as a positive learning tool. Your assessor will guide your learning and provide feedback on your responses to the assessment. For valid and reliable assessment of this unit, a range of assessment methods will be used to assess practical skills and knowledge.

Your assessment may be conducted through a combination of the following methods:

 Written Activity

 Case Study

 Observation

 Questions

 Third Party Report

The assessment tool for this unit should be completed within the specified time period following the delivery of the unit. If you feel you are not yet ready for assessment, discuss this with your trainer and assessor.

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To be successful in this unit you will need to relate your learning to your workplace. You may be required to demonstrate your skills and be observed by your assessor in your workplace environment. Some units provide for a simulated work environment and your trainer and assessor will outline the requirements in these instances.

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E L E M E N T S A N D P E R F O R M A NC E C R I T E R I A

1. Prepare to provide support to those affected by dementia

1.1 Apply person-centred care approaches to all interactions with the person living with dementia

1.2 Interpret individualised plan and familiarise self with the specific needs and wants of the person living with dementia

1.3 Identify and address person’s needs for a stable and familiar environment

1.4 Recognise signs consistent with financial, physical or emotional abuse or neglect of the person and report to an appropriate person

2. Use appropriate communication strategies

2.1 Use verbal and non-verbal communication strategies to maximise engagement of the person with dementia

2.2 Gain cooperation and provide reassurance as appropriate by using reality orientation

2.3 Use a range of validation strategies to relieve distress and agitation in the person

3. Provide activities for maintenance of dignity, skills and health

3.1 Organise activities which aim to maintain independence, using familiar routines and existing skills

3.2 Organise activities that are appropriate to the individual, reflecting their cultural likes and dislikes, in order to bring back pleasurable memories

3.3 Ensure the safety and comfort of the person balanced with autonomy and risk taking

3.4 Access information about the person’s reminiscences and routines with family and carers

3.5 Provide support and guidance to family, carers and/or significant others where appropriate

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4. Implement strategies which minimise the impact of behaviours of concern

4.1 Identify behaviours of concern and potential triggers

4.2 Contribute to team discussions on support planning and review

4.3 Take action to minimise the likelihood of and reduce the impact of behaviours on the person and others

4.4 Evaluate implemented strategies with support planning team to ensure effectiveness in minimising behaviours

5. Complete documentation 5.1 Comply with the organisation’s reporting requirements, including reporting observations to supervisor

5.2 Complete, maintain and store documentation according to organisation policy and protocols

6. Implement self-care strategies

6.1 Monitor own stress level in relation to working with people with dementia

6.2 Use appropriate self-care strategies and seek support if required

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P E R F O R M A N C E E V I D E N C E A N D K N O W L E D G E E V I D E N C E

This describes the essential knowledge and skills and their level required for this unit.

PERFORMANCE EVIDENCE

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

 Provided support to 2 different people living with dementia:

 Using a person-centred approach to support

 Using appropriate communication strategies

 Assisting in implementing a range of suitable activities that meet the person’s

needs

KNOWLEDGE EVIDENCE

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the …