CHCCCS023 Support independence and wellbeing

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CHCCCS023 Support independence and

wellbeing Learner Guide

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Table of Contents

Unit of Competency ..................................................................................................................... 5

Application ...................................................................................................................................... 5

Unit Sector ...................................................................................................................................... 5

Performance Criteria ....................................................................................................................... 6

Foundation Skills ............................................................................................................................. 8

Assessment Requirements .............................................................................................................. 9

1. Recognise and support individual differences.......................................................................... 12

1.1 – Recognise and respect the person’s social, cultural and spiritual differences ........................ 13

Individual differences .................................................................................................................... 13

Social differences .......................................................................................................................... 13

Cultural differences ....................................................................................................................... 13

Spiritual differences ...................................................................................................................... 14

1.2 – Avoid imposing own values and attitudes on others and support the person to express their

own identity and preferences ........................................................................................................... 15

Your own values and attitudes ..................................................................................................... 15

Supporting clients to express their own identity and preferences ............................................... 16

1.3 – Consider the person’s individual needs, stage of life, development and strengths when

engaging in support activities ........................................................................................................... 17

Individual needs ............................................................................................................................ 17

Maslow’s hierarchy of needs ........................................................................................................ 17

Stages of life and development .................................................................................................... 21

1.4 – Recognise, respect and accommodate the person’s expressions of identity and sexuality as

appropriate in the context of their age or stage of life .................................................................... 22

Expressions of identity .................................................................................................................. 22

Expressions of sexuality ................................................................................................................ 22

1.5 – Promote and facilitate opportunities for participation in activities that reflect the person’s

individual physical, social, cultural and spiritual needs .................................................................... 24

Activities that reflect clients’ individual needs ............................................................................. 24

2. Promote independence .......................................................................................................... 26

2.1 – Support the person to identify and acknowledge their own strengths and self-care capacity

.......................................................................................................................................................... 27

Promoting independence ............................................................................................................. 27

Clients’ strengths .......................................................................................................................... 27

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Self-care capacity .......................................................................................................................... 28

2.2 – Assist the person to identify opportunities to utilise their strengths, while communicating

the importance of using available support when required .............................................................. 29

Utilising strengths ......................................................................................................................... 29

2.3 – Provide information and assistance to the person in order to facilitate access to support

services and resources when needed ............................................................................................... 31

Support services and resources .................................................................................................... 31

2.4 – Provide support that allows the person to self manage their own service delivery as

appropriate ....................................................................................................................................... 32

Supporting clients to self-manage own service delivery .............................................................. 32

2.5 – Encourage the person to build, strengthen and maintain independence ............................... 33

Encouraging independence .......................................................................................................... 33

3. Support physical wellbeing ..................................................................................................... 34

3.1 – Promote and encourage daily living habits that contribute to healthy lifestyle ..................... 35

What is a healthy lifestyle? ........................................................................................................... 35

3.2 – Support and assist the person to maintain a safe and healthy environment .......................... 38

Maintaining a safe and healthy environment ............................................................................... 38

Clean environment ........................................................................................................................ 38

Comfortable environment ............................................................................................................ 39

3.3 – Identify hazards and report according to organisation procedures ........................................ 41

Identifying hazards ........................................................................................................................ 41

3.4 – Identify variations in a person’s physical condition and report according to organisation

procedures ........................................................................................................................................ 43

3.5 – Recognise indications that the person’s physical situation is affecting their wellbeing and

report according to organisation procedures ................................................................................... 43

Clients’ physical condition ............................................................................................................ 43

3.6 – Identify physical health situations beyond scope of own role and report to relevant person 44

Identifying situations beyond your role ........................................................................................ 44

4. Support social, emotional and psychological wellbeing ........................................................... 45

4.1 – Promote self-esteem and confidence through use of positive and supportive communication

.......................................................................................................................................................... 46

Promoting self-esteem and confidence ........................................................................................ 46

Positive and supportive communication ...................................................................................... 46

4.2 – Contribute to the person’s sense of security through use of safe and predictable routines .. 47

Using safe and predictable routines ............................................................................................. 47

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4.3 – Encourage and facilitate participation in social, cultural, spiritual activities, using existing and

potential new networks and as per the person’s preferences ......................................................... 48

Social activities .............................................................................................................................. 48

Cultural and spiritual activities ..................................................................................................... 48

Spiritual support............................................................................................................................ 49

4.4 – Identify aspects of supporting a person’s wellbeing outside scope of knowledge, skills and/or

job role and seek appropriate support ............................................................................................. 50

Things outside of your own scope of knowledge, skills and/or job role ...................................... 50

4.5 – Identify variations to a person’s wellbeing and report according to organisation procedures

.......................................................................................................................................................... 51

Variations to a client’s wellbeing .................................................................................................. 51

4.6 – Identify any cultural or financial issues impacting on the person’s wellbeing ........................ 52

Cultural issues ............................................................................................................................... 52

Financial issues .............................................................................................................................. 52

4.7 – Identify the person’s risk and protective factors in relation to mental health ........................ 53

Risk and protective factors ........................................................................................................... 53

4.8 – Recognise and report possible indicators of abuse or neglect and report according to

organisation procedures ................................................................................................................... 55

4. 9 – Identify situations beyond scope of own role and report to relevant person ........................ 55

Abuse and neglect ......................................................................................................................... 55

Signs of abuse and neglect ............................................................................................................ 56

Acting on abuse and neglect ......................................................................................................... 58

References ........................................................................................................................................ 59

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Unit of Competency

Application This unit describes the skills and knowledge required to provide individualised services in ways that support independence, as well as, physical and emotional wellbeing. This unit applies to workers in a range of community services contexts who provide frontline support services within the context of an established individualised plan. 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.

Unit Sector

Not applicable

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Performance Criteria

Element Elements describe the essential outcomes.

Performance Criteria

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Recognise and support individual differences

2. Promote independence

3. Support physical

wellbeing

1.1 Recognise and respect the person’s social, cultural and spiritual differences

1.2 Avoid imposing own values and attitudes on others and support the person to express their own identity and preferences

1.3 Consider the person’s individual needs, stage of life, development and strengths when engaging in support activities

1.4 Recognise, respect and accommodate the person’s expressions of identity and sexuality as appropriate in the context of their age or stage of life

1.5 Promote and facilitate opportunities for participation in activities that reflect the person’s individual physical, social, cultural and spiritual needs

2.1 Support the person to identify and acknowledge their own

strengths and self-care capacity 2.2 Assist the person to identify opportunities to utilise their

strengths, while communicating the importance of using available support when required

2.3 Provide information and assistance to the person in order to facilitate access to support services and resources when needed

2.4 Provide support that allows the person to self-manage their own service delivery as appropriate

2.5 Encourage the person to build, strengthen and maintain independence

3.1 Promote and encourage daily living habits that contribute to

healthy lifestyle 3.2 Support and assist the person to maintain a safe and healthy

environment 3.3 Identify hazards and report according to organisation

procedures 3.4 Identify variations in a person’s physical condition and

report according to organisation procedures 3.5 Recognise indications that the person’s physical situation is

affecting their wellbeing and report according to organisation procedures

3.6 Identify physical health situations beyond scope of own role and report to relevant person

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Element Elements describe the essential outcomes.

Performance Criteria

Performance criteria describe the performance needed to demonstrate achievement of the element.

4. Support social,

emotional and

psychological

wellbeing

4.1 Promote self-esteem and confidence through use of positive and supportive communication

4.2 Contribute to the person’s sense of security through use of safe and predictable routines

4.3 Encourage and facilitate participation in social, cultural, spiritual activities, using existing and potential new networks and as per the person’s preferences

4.4 Identify aspects of supporting a person’s wellbeing outside scope of knowledge, skills and/or job role and seek appropriate support

4.5 Identify variations to a person’s wellbeing and report according to organisation procedures

4.6 Identify any cultural or financial issues impacting on the person’s wellbeing

4.7 Identify the person’s risk and protective factors in relation to mental health

4.8 Recognise and report possible indicators of abuse or neglect and report according to organisation procedures

4.9 Identify situations beyond scope of own role and report to relevant person

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Foundation Skills

This section describes language, literacy, numeracy and employment skills incorporated in the performance criteria that are required for competent performance.

Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.

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Assessment Requirements

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 demonstrated evidence that the candidate has:

➢ Safely supported at least 3 people to enhance independence and wellbeing

➢ Performed the activities outlined in the performance criteria of this unit during a

period of at least 120 hours of direct support work in at least one aged care, home

and community, disability or community service organisation

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 context of the work role. This includes knowledge of:

➢ Basic human needs:

o physical

o psychological

o spiritual

o cultural

o sexual

➢ Concept of self-actualisation

➢ Human development across the lifespan

➢ Wellbeing, including:

o physical

o psychological

o social

o spiritual

o cultural

o financial

o career/occupation

➢ Individual differences, how these may be interrelated and impact on support provided

➢ Basic requirements for good health for the person, including:

o mental health

o nutrition and hydration

o exercise

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o hygiene

o lifestyle

o oral health

➢ Mental health uses and risk and protective factors

➢ Indications of neglect or abuse:

o physical

o sexual

o psychological

o financial

➢ Reporting requirements for suspected abuse situations

➢ Service delivery models and standards

➢ Relevant funding models

➢ Issues that impact health and well being

➢ Impacts of community values and attitudes, including myths and stereotypes

➢ Issues surrounding sexuality and sexual expression

➢ Indicators of emotional concerns and issues

➢ Support strategies, resources and networks

➢ Legal and ethical requirements and how these are applied in an organisation and individual practice, including:

o duty of care

o dignity of risk

o human rights

o discrimination

o mandatory reporting

o privacy, confidentiality and disclosure

o work role boundaries – responsibilities and limitations.

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Assessment Conditions Skills must have been demonstrated in a relevant workplace with the addition of simulations and scenarios where the full range of contexts and situations have not been provided in the workplace. Where simulation is used it must reflect real working conditions and contingencies by modelling industry operating conditions and contingencies, as well as using suitable facilities, equipment and resources, including:

➢ Individualised plans and any relevant equipment outlined in the plan

➢ Modelling of industry operating conditions including real interactions with the

person and their carers

Overall, assessment must involve some real interactions with the person and their families/carers. Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors. Links Companion volumes from the CS&HISC website - http://companion_volumes.vetnet.education.gov.au/Pages/TrainingPackage.aspx?pid=7

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1. Recognise and support individual differences

1.1. Recognise and respect the person’s social, cultural and spiritual differences

1.2. Avoid imposing own values and attitudes on others and support the person to

express their own identity and preferences

1.3. Consider the person’s individual needs, stage of life, development and strengths

when engaging in support activities 1.4. Recognise, respect and accommodate the person’s expressions of identity and

sexuality as appropriate in the context of their age or stage of life 1.5. Promote and facilitate opportunities for participation in activities that reflect the

person’s individual physical, social, cultural and spiritual needs

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1.1 – Recognise and respect the person’s social, cultural and spiritual differences

Individual differences

Individual differences are the variations that occur from one person to another. How do people differ from each other? You will come into contact with a variety of different clients from all walks of life that require support. Your role is to recognise the differences between your clients, respect them and provide them with the appropriate support. Think about two of your regular clients; how are they different? One may be female; the other may be male. One may be an introvert; the other may be an extrovert. One may be physically able; the other may have a disability. One may be Christian; the other may be Muslim. Think about how these differences can impact the kind of support and care that they require. Part of recognising and supporting individual differences within your role is to recognise and respect your clients’ social, cultural and spiritual differences. This chapter will explore what these differences are and look into ways to demonstrate respect for them.

Social differences

Social differences are the complex differences between people based on their social characteristics. These social characteristics can include:

➢ Race

➢ Class

➢ Age

➢ Power

➢ Gender.

Cultural differences

Cultural differences are the differences between people based on the country, society or community that they come from. They can be differences associated with a person’s:

➢ Country of origin

➢ Religion

➢ Nationality

➢ Ethnicity

➢ Family background

➢ Individual experiences.

A person’s culture can have a great impact on all aspects of our life, for example:

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➢ The way they dress

➢ The food they eat

➢ The ceremonies and festivals they take part in

➢ Their traditions

➢ Their beliefs and attitudes

➢ The language they speak

➢ The way they express their personality

➢ Their perceptions.

Ultimately, a person’s culture will influence their behaviour and expectations; including their expectations surrounding their care and support.

Spiritual differences

Spirituality has different meanings for different people. Take a moment to think about what you think spirituality is. Some people will think that spirituality is about religion; spiritual differences are therefore associated with peoples’ religion. Other people will think that spirituality is about getting in touch with their soul, spirit or mind (e.g. through meditation and yoga). You may come across many different spiritual beliefs within your role; some may adopt an alternative belief system relating to spirits – this is something that you would need to recognise and respect whilst providing them with support and care. A client that is spiritual may participate in ceremonies and activities that they require privacy and an appropriate environment to do. This chapter has explored what social, cultural and spiritual differences are. As you can see, they can sometimes overlap and be interrelated. It is your job to recognise, respect and accept these differences when providing individualised support for your clients. In what ways can you respect these differences? Ultimately, it’s about ensuring you treat your clients, regardless of their particular characteristics, in a way you would expect to be treated. You should learn to embrace the variety of differences amongst your clients. You should never make assumptions or judgements about someone’s individual differences. Listen to your clients, acknowledge their views and opinions and develop an understanding of them as an individual so that you can better support and care for them.

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1.2 – Avoid imposing own values and attitudes on others and support the person to express their own identity and preferences

Your own values and attitudes

Your values are principles, qualities or standards that you attach worth or importance to or hold in high regard. These values will guide the way that you live your life, affect the decisions that you make and influence the judgements that you make. Your attitudes can be related to your beliefs, feelings and behaviour tendencies. An attitude often describes what you think is the ‘proper’ way of doing something. The terms values and attitudes can often be used interchangeably – the attitudes that you feel strongly about can be considered to be your values. Just because you have to accept and respect your clients’ differences it doesn’t mean that you cannot have your own. You have the right to your own values and beliefs and shouldn’t have someone else’s forced onto you – your clients have the same right. When you are providing support and care for them, it is important not to impose your own values and attitudes onto them. Remember that there is no right or wrong value, belief or attitude – they’re personal to the individual and nobody should ever be discriminated against because of these. This also means that your own values and attitudes should never impact the care, support and treatment of any of your clients. The care and support that you provide for your clients should always be based on their values – not yours. Your care and support should never be based on what you feel is right; it should be based on what is right for that particular client. You should never try to influence their beliefs, feelings, behaviours, values or attitudes. This can sometimes occur unintentionally if you don’t understand your own values and attitudes. Self-awareness is one of the best tools you can use to avoid imposing your values and attitudes onto others. It is extremely important to develop an awareness and understanding of your own values and attitudes as they are essential in forming your relationships with others. Knowing what your own values and attitudes are can help you to push them aside and work effectively and appropriately with your clients. Take a moment to think about your own values and attitudes. What do you hold in high regard? What do you think is important? For example, you may value:

➢ Good manners

➢ Family

➢ Human life

➢ The environment

➢ The chance to learn.

Another way that you can avoid imposing your values or attitudes on others is to adopt a neutral position. Although this will be quite difficult, a neutral attitude can allow you to keep your values in check. In order to adopt a neutral attitude, you will need to listen to and acknowledge what your clients have to say without applying your own bias or judgement. It comes down to accepting that everyone is different and understanding that your own

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values and attitudes are not relevant to the care and support you are providing for your clients.

Supporting clients to express their own identity and preferences

Everyone has the right to express their own identity. You’re allowed to wear what you want, eat what you want and listen to the music that you want to (along with many, many other things). Your clients have this right too, even if they rely on someone else’s care and support to do so. Within your role, you may find that you need to help your clients express their own identity and preferences. Who are they as a person? Your clients should feel as though they can be themselves without being mocked or judged – they have the freedom to be themselves. Think about the different ways that you can support a client to express their own identity and preferences. You should encourage them to share what makes them unique so that you can support them in expressing their identity and preferences. What do they love? What are they good at? What are their likes and dislikes? Examples of ways to support a client in expressing their identity and preferences include:

➢ Encouraging them to choose their own clothes and allowing them to wear exactly

what they want – even if you think yellow pants and a blue jumper don’t look right

together

➢ Giving them the chance to decorate their personal space in the way that reflects

them as a person – even if you think black wallpaper isn’t a good choice

➢ Allowing them to listen to the music that they like – even if it’s not to anyone else’s

liking (you can always get them a personal music player if it’s really that bad)

➢ Allowing them to watch the television programmes that they like – even if you and

the other clients detest that programme

➢ Giving them privacy to practice their religion – even if it is completely different to

everyone else’s

➢ Subscribing to their favourite magazine so that they get it delivered every week –

even if you’re not really a fan of fishing, for example

➢ Supporting their choice to have their hair dyed pink – even if you think that they’re

probably too old to be doing so

➢ Encouraging them to go see their favourite band in concert – even if that band is

not to your taste.

At the end of the day, your clients should be encouraged and allowed to be honest, say exactly how they feel and tell you exactly what they want. Your job is to encourage them to share their identity and preferences with you so that you can support them in expressing them.

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1.3 – Consider the person’s individual needs, stage of life, development and strengths when engaging in support activities

Individual needs

It is important to consider the person’s individual needs when engaging in support activities. We know that no two clients are the same, but what are their specific needs? Clients will have many needs and these needs will differ from one client to another. A good place to start with individual needs is to assess the different basic human needs and how these can differ between clients.

Maslow’s hierarchy of needs

A popular way to look at basic human needs is to refer to Maslow’s hierarchy of needs. It suggests that people are motivated to achieve certain needs, starting with basic physiological needs and eventually reaching self-actualisation. It’s worth noting that these different needs are necessarily separated; they are closely related. Although this hierarchy of needs is related to motivation, it is useful to consider it when striving to meet your clients’ needs. The different needs outlined in Maslow’s hierarchy include physiological (physical) needs and psychological needs. These psychological needs include safety needs, social needs, esteem needs and the need for self-actualisation.

Physiological needs

Physiological needs are the physical requirements that are necessary for human survival. They are considered as the most important needs and should be a priority. If these needs are not met, then the human body will not be able to function properly and will be at risk of failing. Also known as biological needs, they include air, water, food, sleep, incontinence, shelter and warmth. Think about the support you give your clients – how does it meet these needs? You provide them with adequate bathroom facilities, three healthy meals a day, a warm and dry bed to

Self- actualisation

Esteem

Social

Safety

Physiological

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rest and sleep in and clean water. What could you do if one of these needs wasn’t being met? For example, what could you do for a client that was struggling to sleep? This may involve rearranging their room, getting them a new bed, putting on a relaxing CD, getting them a black-out blind or giving them a night-light. Safety needs

Safety needs are associated with feeling safe, protected and secure. Safety needs often refer to order, stability, personal safety, financial safety and health and wellbeing. Whilst providing your clients with the necessary support it is essential that these safety needs are met. Think about how you can ensure your clients’ safety in different ways. If you’ve noticed their carpet is coming up at one of the corners and it is slowly becoming a trip hazard, you should do something about it in order to avoid an accident occurring. If you’ve noticed their stairway lightbulb has popped, make sure that is replaced in order to prevent any falls due to bad lighting. Think about a client that feels unsafe in their home; by installing a new alarm system, you can ensure that they do feel safe. Social needs

Social needs are related to relationships and peoples’ needs for love and affection. This can include companionship and the relationships with friends and family. It is associated with a sense of belonging and a need for affection and intimacy. Social needs are also related to interactions and can be met through pleasing and fulfilling relationships with others. Think about the different ways that you can ensure your support can meet these needs for your clients and avoid them becoming lonely. For example, taking the time to have a meaningful conversation with them when you see them can be enough to meet their needs. You may find that, for other clients, they need more interaction. So, in order to meet their social needs, you may need to get them involved in activities in which they can interact with others. Perhaps there’s a weekly choir group, a book club or an evening dance class that they could go to in order to satisfy their social needs. Esteem needs

Esteem needs are needs that are associated with respecting yourself and feeling respected by others. It’s about developing positive feelings of self-worth and self-esteem and having pride and confidence in you as an individual. People need to feel accepted and valued by others; they need attention and recognition from others and need to feel a sense of contribution. It is also related to freedom, independence and strength, all of which will be discussed in detail later in the unit. For now, think about how you can meet a client’s esteem needs. This can involve recognising and accepting their values and beliefs and encouraging them to set small, achievable goals. Need for self-actualisation

Self-actualisation is about personal growth and is related to realising and fulfilling your potential. It’s about finding a meaning to life that is important to you and accomplishing everything that you can. It’s about becoming the most you possibly can be. In order to ensure your clients’ needs for self-actualisation are met, you should focus on their strengths and possibilities, rather than problems. It’s about providing them with a sense of direction and supporting them achieve what they can. Even if this is as simple as getting out of bed themselves; this can be a real achievement for someone relying on your care and support.

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Your support activities should be based around your clients’ strengths and should work towards encouraging them to be as independent as possible.

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As you can see, Maslow’s hierarchy of needs is a good place to start when you are considering the ways in which you can meet your clients’ needs. There are other needs that Maslow doesn’t touch on that you should also take into consideration. For example, you will also need to consider your clients’ spiritual, cultural and sexual needs. Spiritual needs can be associated with the need to feel that there is a greater power or being in order to find a meaning or purpose in life. These needs are complex, abstract, intangible and more difficult to measure. It is essential that you acknowledge and support these spiritual needs whilst providing your clients with the relevant care and support. This will involve listening to their concerns and empathising with them and can often lead to you giving them hope. Spiritual needs can be important in end-of-life care and can help a client prepare for death and dying. Cultural needs are associated with a client’s need to have their culture acknowledged, accepted and respected in all aspects of their care and support. It can involve encouraging them to express their culture in the clothes that they wear, the food that they eat and the ceremonies that they participate in. It could also involve taking the time to learn about their culture and the different ways you can respect it. For example, is there a specific way you should address them? Is there a specific time that they need to pray? Should you remove your shoes if visiting their home? Sexual needs stem from Maslow’s social needs and relate to the need for love, affection and intimacy. They can be difficult to address within a care and support setting. In order to help your clients meet these needs, you could give sexual health advice, encourage them to express their sexuality and offer the necessary support. Remember that each client should be allowed to make their own choices and have these choices supported. It essential that you understand your clients’ needs to ensure they receive the appropriate support. As well as their individual needs, you should consider your clients’ stage of life and development too.

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Stages of life and development

As well as considering a client’s individual needs when engaging in support activities, you will need to consider the particular stage that they are in their life and development. Throughout our lives, we go through various stages of development. It is essential to understand how people grow, develop and adapt at different life stages. This can then be applied within the support activities that you engage in to ensure that they are suitable for that particular client. There are 10 life stages:

1. Infant (0-2 years) – dependent

2. Child (3-9 years) – growing, mastering skills, learning to play and socialise

3. Adolescent (10-19 years) – growing, puberty, hormones and emotions

4. Young adult (20-29 years) – finishing education, starting career and family

5. Adult (30-39 years) – managing family and career

6. Middle age (40-60 years) – first signs of ageing

7. Independent elder (60+ years) – more signs of ageing, retirement and health

problems

8. Vulnerable elder – elders requiring some assistance due to cognitive/health

problems

9. Dependent elder – unable to perform personal functions and requires daily care

10. End of life – preparing for death/dying and may require full-on care.

Before engaging in support activities with your clients, you should ensure that you understand what stage they are at in their life. This will help you to ensure that your support is appropriate and compliments their current stage of life and development. For example, a client at the last stage of their life (death and dying) will require different support activities than a client at an earlier stage of their life. The last stage of a client’s life can be stressful and it is essential that you support your client in a way that can make the concept of dying as stress-free as possible. A client that is in the last stage of their life may lose their interest in food and drink. So, rather than forcing them to eat and drink, you would need to support them in another way to ensure that they don’t experience pain or discomfort. This may involve refraining from giving them food or drink (unless they request it), wetting their lips and mouth every now and then with a small amount of water or a small sponge dipped in water or applying a lip balm to protect their lips from dryness.

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1.4 – Recognise, respect and accommodate the person’s expressions of identity and sexuality as appropriate in the context of their age or stage of life

Expressions of identity

It is important to allow clients to express their identity; you need to recognise, respect and accommodate these expressions. Refer back to chapter 1.2 to recap on the different ways that you can support your clients in expressing their identity. A client should be allowed to be themselves; you should respect this and accommodate it, if necessary. For example:

➢ If a client is out-going, loud and friendly, they should be free to do so and now be

told to ‘shush’ or ‘be quiet’

➢ If a client is quiet, shy and reserved, this should be respected and they should not

be forced to talk to someone or about something if they don’t feel comfortable

doing so

➢ If a client is an extrovert and likes being around others, they should be encouraged

to do so by joining groups and meeting new people

➢ If a client likes to be alone, they shouldn’t be forced to participate in group activities

if they don’t want to – they would be happier in their own space doing their own

thing.

Expressions of sexuality

Along with expressing their identity, your clients should feel as though they can express their sexuality too. Expressions of sexuality may include:

➢ Access to assistive/protective devices

➢ Love and affection

➢ Need for privacy and discretion

➢ Physical appearance

➢ Touch.

You should ensure that your clients have the freedom to express their sexuality without the fear of prejudice or discrimination. To suppress a client’s need to express their sexuality could lead to further health issues, isolation and depression. The effects of suppression may include:

➢ Depression

➢ Frustration

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➢ Anger or violence

➢ Social withdrawal.

Allow the client to open up and talk to you, especially if they have been forced to suppress or hide

their feelings in the past. Your client may have grown up in a very suppressive household where they

were not allowed to express that they were in fact homosexual. You may find that a lot of elderly

clients grew up whilst homosexuality was either frowned upon or even illegal. Some homosexuals

would marry a person of the opposite sex to try and change their feelings or hide how they truly felt.

The client might now be at a time when they can be open and express their feelings without any

fear. By giving your clients the chance to express their sexuality, you may be able to make them

calmer and increase their happiness and comfort.

Different clients will express their sexuality in

different ways, so do not be surprised if some

are more open than others because of their

personality, culture and/or upbringing. Some

cultures are much more open than others,

whereas some will prefer not to discuss the

matter, especially if they are religious and

their beliefs actually frown upon certain

behaviours. It’s about letting them know that

you are willing to listen to and support them

regardless of their sexuality. Making sexuality

a taboo subject may discourage and

dishearten your clients. The previous chapter

highlighted the sexual needs of clients,

demonstrating the importance to facilitate in

the discussion and expression of it.

Whether you are respecting or accommodating a client’s expression of their identity or their

sexuality, you should do so in a way that is appropriate to them as an individual, their age and the

stage that they are at within their life.

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1.5 – Promote and facilitate opportunities for participation in activities that reflect the person’s individual physical, social, cultural and spiritual needs

Activities that reflect clients’ individual needs

Part of your role includes promoting and facilitating opportunities for your clients to participate in activities. It is important that these activities reflect your clients’ individual physical, social, cultural and spiritual needs. Physical needs

Activities that would reflect clients’ physical needs may include:

➢ Educational workshops about nutrition and a healthy lifestyle

➢ Cooking workshops and shopping trips to promote good, healthy eating

➢ Walks in the countryside get your client moving (also increases natural light

exposure)

➢ Swimming is a good way to ensure clients exercise (exercise can increase sleep

quality)

➢ Yoga lessons (or deep breathing techniques) can help clients sleep better

➢ A client that is recovering from an operation could do gentle stretches daily.

The key to encouraging your clients to participate in activities that reflect their physical needs is to consider them as an individual. What works for one client may not work for another. In order to ensure they get enough exercise, you may need to find something that the enjoy doing. One client may like walks in the countryside; another may enjoy swimming, and another may enjoy weekly dance lessons. Social needs

In order to meet clients’ social needs, you may need to encourage them to participate in group activities in which they can interact with others, for example:

➢ Book club

➢ Choir

➢ Chess club

➢ Weekends away

➢ Bingo nights

➢ Dance lessons

➢ Arts and crafts groups

➢ Coffee mornings

➢ Luncheons

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➢ Day trips.

As with any other activities, activities that reflect a client’s social needs should depend on them as an individual. One client will have different social needs compared to another client. One client will need to participate in activities like the ones discussed above. What about the clients that don’t really like group activities? How could you ensure their social needs were met? You could ensure that someone pops in for a conversation daily, you could encourage them to make phone calls to friends and family, or you could arrange for them to get a ‘pen pal’. A ‘pen pal’ would give them an opportunity to get to know someone new, develop a friendship and satisfy their social needs, without having to feel uncomfortable in a group setting. Cultural and spiritual needs

Activities that would reflect clients’ cultural and spiritual needs may include:

➢ Visiting their place of worship

➢ Attending relevant celebrations

➢ Visits from spiritual leaders

➢ Praying

➢ Relaxation sessions

➢ Putting up a Christmas tree up or making Christmas cards

➢ Participating in Ramadan

➢ Visiting museums

➢ Maintaining existing religious networks (e.g. meeting up or talking over the phone)

➢ Reading books/watching television in their preferred language.

What should you do if there aren’t relevant or appropriate activities for your clients to participate in? If your client wishes to participate in a dance class and there isn’t one currently running, you could look into putting one together. This would involve doing a bit of research and ensuring that there are others that would want to take part. If there isn’t a healthy eating workshop currently running, think of how you could teach your clients about nutrition and a healthy lifestyle in order to meet their needs.

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2. Promote independence

2.1. Support the person to identify and acknowledge their own strengths and self-care

capacity

2.2. Assist the person to identify opportunities to utilise their strengths, while

communicating the importance of using available support when required 2.3. Provide information and assistance to the person in order to facilitate access to

support services and resources when needed

2.4. Provide support that allows the person to self-manage their own service delivery as

appropriate

2.5. Encourage the person to build, strengthen and maintain independence

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2.1 – Support the person to identify and acknowledge their own strengths and self-care capacity

Promoting independence

Independence is often considered one of the most important attributes that a person can possess. Following the principles of person-centred and strengths-based support and care, it is essential that you promote the independence of your clients. Your clients should be encouraged to do as much as possible for themselves. Your role is to promote this independence; get your clients to do what they feel comfortable with doing. You should strive to help your clients improve their quality of life whilst maintaining their pride and keeping their dignity. Just because an individual needs care and support, it doesn’t mean their life should stop. You should do what you can, and what they feel comfortable with, to promote their independence. The level of independence a client has will obviously depend on the individual client and their particular situation; everyone is different and likes their own things. For example, for one client, making their own cup of tea in the morning is something that they may not be ready to lose. How can you ensure they keep this little bit of independence? The next few chapters will look at the different ways that you can promote, encourage and support your clients’ independence.

Clients’ strengths

The first step to promoting your clients’ independence is to support them in identifying and acknowledging their own strengths. Taking a strengths-based approach to care and support involves you working in collaboration with your clients to find a level of care and support that draws on their particular strengths. You should value the skills, knowledge and abilities of your clients and you should help them in finding out what they are good at. By identifying and acknowledging their strengths, your clients can be in control of their care and support. Also, it gives you the opportunity to provide them with care and support in a way that allows them to lead. So how can you support your clients in identifying their needs? It’s about figuring out what they are capable of doing and what they are particularly good at doing. What different elements can help or enable your client to deal with the challenges of day-to-day life? What different elements can help or enable your client to meet their needs and achieve their outcomes? These different elements are their strengths and can include:

➢ Their personal resources, abilities, skills, knowledge and

potential

➢ Their social network and its resources, abilities, skills,

knowledge and potential.

Source: What is a strengths-based approach to care? (n.d.). Retrieved from https://www.scie.org.uk/care-act-2014/assessment-and-eligibility/strengths-

based

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Examples of the strengths that your client may have include:

➢ Interpersonal relationships and supports (e.g. friends and family)

➢ Ability to set and pursue goals

➢ They are optimistic and motivated.

Once you and your client are aware of their strengths, you will need to utilise them to empower your clients and get them to focus on their health and wellbeing. How can they use their particular strengths to aid the care and support that you are providing them with?

Self-care capacity

As well as supporting clients to identify and acknowledge their strengths, you should also support them in identifying and acknowledging their self-care capacity. A client’s self-care capacity is related to their ability to:

➢ Manage own health

➢ Take care of themselves

➢ Identify what they need and want

➢ Take the necessary steps to get what they need and want

➢ Ask for what they need and want.

In order to assess a client’s ability to manage their own health, answer the following questions:

➢ How are they able to maintain their health, life and general wellbeing?

➢ Do they eat a healthy, balanced diet?

➢ Do they exercise regularly?

➢ Do they get enough sleep?

➢ Do they take their medication as

prescribed?

➢ Do they avoid high-risk behaviours (e.g.

drinking and smoking excessively)?

It could also be more specific to their particular condition or situation. For example, if they have a dressing that will need changing daily, are they able and willing to do this themselves? You will find that a client’s self-care capacity will depend on many things, including their age, family system, health status, developmental state and resource availability. Combined with a client’s strengths, their capacity for self-care can determine how to offer them the best possible care and support.

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2.2 – Assist the person to identify opportunities to utilise their strengths, while communicating the importance of using available support when required

Utilising strengths

The previous chapter explored what client strengths may include; this chapter will look at the ways that you can assist your client to identify opportunities to utilise their strengths. Opportunities are the tasks and activities that can give your client the chance to be independent, to grow and to assist in their own care. We know that client strengths refer to the capabilities, interests, knowledge, resources, goals and objectives of the individual and their social network (e.g. friends and family). But in what ways can these strengths be utilised and enhanced? How can your clients use their strengths to contribute to their care and support? How can they use these strengths to improve their particular situation? It’s all about matching tasks to your clients’ abilities and skills; what kind of tasks can they manage or excel at? It can range from simple things like:

➢ Washing their own face

➢ Making their own cup of tea

➢ Opening their own post

➢ Watering their plants

➢ Setting the table.

It may also involve more complicated tasks, for example:

➢ Preparing and cooking their own meals

➢ Cleaning tasks

➢ Doing the gardening or DIY

➢ Being in charge of their medication

➢ Changing their dressings.

Think about how the strengths of a client’s friends and family can also be utilised, for example:

➢ They may be able to provide basic health and personal care (e.g. assisting client in

washing and dressing)

➢ They may be able to provide domestic assistance (e.g. assisting with

preparing/cooking meals and cleaning duties)

➢ They may be able to accompany the client when leaving the house (e.g. to go

shopping or to the post office)

➢ They may be able to help monitor the health and wellbeing of the client

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➢ They may be able to provide client with emotional, financial and social support.

You should remember that even though clients should use any opportunities to utilise their strengths that arise, they should also use any available support when required. It is your job to communicate the importance of using this support should your clients need it. Just because they have the capability of doing some tasks and can use their strengths in a variety of ways, it doesn’t mean that they should refuse or ignore any level of support altogether. For example, if a client is able to make their own cup of tea but still struggles to make their own hot meals, you should encourage them to use meal preparation and/or delivery services. If they are able to walk to the shop down the road every morning to get their papers but cannot manage the longer walk to supermarket for their groceries, you could encourage them to use transport services.

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2.3 – Provide information and assistance to the person in order to facilitate access to support services and resources when needed

Support services and resources

There are many support services and resources available for clients in both residential environments and the community. These services will be run by the government, charities and just general good Samaritans who want to help others. It is your job to provide clients with the relevant information and assistance in order to facilitate access to these support services and resources. Support services and resources may include:

➢ Pensions

➢ Rental assistance

➢ Disability payments and services

➢ Veteran facilities

➢ Medical and pharmaceutical funding

➢ Acute care

➢ Coffee mornings

➢ Trips/excursions

➢ Counselling

➢ Support programs

➢ Information services

➢ Cards that allow discounts of range of products and services (particularly for elderly

clients)

➢ Travel passes.

Some clients may already be aware, or in receipt of, support services and resources. However, they may not be aware of other services and resources that they could benefit from. It is part of your responsibility to monitor your clients and decide if they could benefit from any of these services or resources. You should try and keep up to date with local and government support services at all times. Something as simple as local coffee mornings can benefit your clients; these may help a client to socialise and maintain their independence. If you believe a client can benefit from a service, you should discuss it with them and the relevant personnel. You can determine if the client wants to utilise the service and if their relatives/advocates feel as though it is appropriate. You will also need to determine if the individual is entitled to the support, needs funding or is entitled to funding. You may then need to provide your client with any relevant information (e.g. how much it will cost and if

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there is any need for transport) and in some cases you may have to make arrangements for them.

2.4 – Provide support that allows the person to self manage their own service delivery as appropriate

Supporting clients to self-manage own service delivery

As we have established, it is important that clients are independent and have control over their own service delivery. They should have a central role in managing their condition and should make their own decisions. Your job is to provide support that allows your clients to do this. Although health professionals are experts in diseases and treatment, your clients are experts in how they want to live their life. How can your support allow clients to take care of their own health? How can your support allow clients to manage their illness/condition? This may involve supporting your clients in learning about their condition and developing the skills that they need to manage their health. You could locate a support group that they can attend, get them books, leaflets or brochures that they can read or conduct research with them. Think about the different ways that you can provide support in a way that allows your clients to self-manage their own service delivery. For example:

➢ Encouraging clients to brush their teeth, wash their face and comb their hair

➢ Assisting clients to take control of their diet, do their own shopping and prepare

their own meals

➢ Allowing clients to choose their own clothes and get themselves dressed

➢ Giving clients the chance to monitor their own blood pressure

➢ Taking clients for walks if they are capable of gentle exercise

➢ Allowing clients to be in control of their own medication (if appropriate).

You should never just do something because it is quicker and easier for you; if your client is capable of doing something, then you should let them.

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2.5 – Encourage the person to build, strengthen and maintain independence

Encouraging independence

We know how important client independence is. The past few chapters have looked into different ways that you can promote clients’ independence. You should encourage and allow your clients to be independent. They should be fully involved in the design, development and delivery of their care and support. This will ensure that the care and support they receive is a reflection of their particular needs and preferences. By building, strengthening and maintaining their independence, clients are able to improve their quality of life. You should give clients ‘just enough’ support, promoting their ability to do as much for themselves as possible. The care and support that you deliver should maximise their skills and abilities. To summarise the previous chapters, promoting independence involves:

➢ Assisting clients to identify, acknowledge and utilise their strengths

➢ Assisting clients accessing support services and resources

➢ Providing support in a manner that encourages clients to self-manage their own

service delivery.

In what other ways can you encourage your clients to build, strengthen and maintain their independence? It may involve:

➢ Acknowledging that each client will have their individual pathway

➢ Working with clients to create a care and support plan

➢ Working with clients to identify their needs,

goals and aspirations

➢ Delivering care and support in a way that

supports clients’ plans

➢ Teaching clients/encouraging them to learn

new skills (e.g. using the internet or cooking

skills)

➢ Encouraging clients to make their own

decisions (e.g. what to wear and eat)

➢ Respecting their privacy (e.g. knocking before

you enter their room and asking before you go

through any of their belongings).

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3. Support physical wellbeing

3.1. Promote and encourage daily living habits that contribute to healthy lifestyle 3.2. Support and assist the person to maintain a safe and healthy environment

3.3. Identify hazards and report according to organisation procedures 3.4. Identify variations in a person’s physical condition and report according to

organisation procedures

3.5. Recognise indications that the person’s physical situation is affecting their wellbeing

and report according to organisation procedures

3.6. Identify physical health situations beyond scope of own role and report to relevant

person

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3.1 – Promote and encourage daily living habits that contribute to healthy lifestyle

What is a healthy lifestyle?

Being healthy is so important for clients receiving care and support. Although it is your clients’ responsibility to ensure their lifestyle is a healthy one, it is your responsibility to help them to find different ways that they can achieve a healthy lifestyle. In order to support the physical well-being of your clients, you will need to promote and encourage daily living habits that will contribute to their overall healthy lifestyle. Ultimately a healthy lifestyle is a particular way of living that can help to maintain and improve your clients’ health and wellbeing. It’s not just about eating right and exercising properly; it is about balancing all the demands of their life in order to achieve good health. After adopting a healthy, balanced lifestyle your clients will be fitter, they will have more energy, their risk of disease will be reduced and they are more likely to recover. Unfortunately, for many people a healthy lifestyle is not at the top of their ‘to-do’ list as it’s not always convenient. For clients receiving care and support, a healthy lifestyle is essential in recovering and developing. Good health and a healthy lifestyle are associated with:

➢ Making wise choices

➢ Good mental health

➢ High self-esteem

➢ An education about health

➢ Regular physical fitness

➢ Good personal hygiene and oral health

➢ Adequate sleep and relaxation

➢ Proper nutrition and hydration

➢ Managing stress effectively

➢ A safe environment

➢ Job satisfaction

➢ Absence of bad habits/addictions

➢ Feeling valued and appreciated

➢ Positive social communication.

So, what daily living habits can you promote and encourage your client to do in order to contribute to a healthy lifestyle? Think about the different ways you have helped clients achieve a healthy lifestyle in the past. For example, by booking (and taking them to) dentist

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and doctor appointments you will be encouraging them to develop habits that can contribute to a healthy lifestyle. Other ways to promote and encourage clients to achieve a healthy lifestyle include:

➢ Nutrition – encouraging clients to eat a nutritious, balanced diet will ensure they

receive the adequate vitamins, nutrients and minerals needed to maintain a healthy

body. Think about the ways you can encourage clients to drink enough water, eat

enough fruit and vegetables and reduce their salt and sugar intake. This could

involve taking them shopping to pick food they want to eat, bringing them new,

exotic foods that they can try or teaching them new recipes using fresh, healthy

ingredients. In order to encourage clients to drink enough water, you could get

them a filtering system (if they don’t like drinking from the tap) or you could add

fruit (e.g. a slice of lemon) to give it some flavour.

➢ Exercising – encouraging clients to have an active lifestyle (that is appropriate for

their particular condition) will ensure they keep their weight in check and prevent

health problems; exercising has so many benefits. You could do this by suggesting

walking places rather than driving the car or getting clients involved in a hobby that

will keep them active. For clients that aren’t capable of exercises, you can teach

them small exercises that they can do sat in their chair or bed (e.g. simple stretches

and rotations of the joints).

➢ Sleeping – by making sure your clients get enough sleep (around 8 hours a night)

you can ensure that they are getting enough rest and giving their body chance to

recuperate. This will avoid your client getting tired, stressed or demotivated and

will ensure that they are happy and full of energy, ready to take on the day ahead.

You could do this by getting them into a routine in the evenings, encouraging small

naps in the daytime (rather than long naps) and making their sleeping environment

more effective (e.g. putting up a black-out blind to stop the light disrupting their

sleep, playing relaxing music to help them get to sleep or getting them a new

mattress to ensure they are comfortable).

➢ Reducing stress – encouraging clients to

manage their stress effectively can be

essential in ensuring they maintain a

healthy lifestyle as stress is associated

with many illnesses. You can promote and

encourage effective stress management

by introducing clients to stretching,

massage, yoga, and meditation and

relaxation techniques. It can also be as

simple as ensuring that clients participate

in an activity that makes them feel good.

For example, a particular hobby (e.g.

reading or knitting) or connecting and

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socialising with family and friends can often reduce stress in clients.

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3.2 – Support and assist the person to maintain a safe and healthy environment

Maintaining a safe and healthy environment

In order to ensure that their independence is maximised, your clients will need to maintain a safe and healthy environment. Maintaining their home or surroundings, is a part of remaining independent for most people receiving care and support. It helps to keep them busy, take pride in their surroundings and remain in a safe environment. If the individual is struggling to complete everyday household tasks, they should be monitored to determine if they either require support or if there are any cleaning apparatus that could be adapted to make it easier for them. Environment may include:

➢ Community centres

➢ Employment services

➢ Independent living accommodation

➢ Person’s own dwelling

➢ Residential aged care facilities.

A safe and healthy environment refers to an environment that is safe, secure, clean and comfortable. A safe and healthy environment can have psychological benefits for your clients so it is important that they are encouraged to maintain their environment at all times. Sometimes, when this isn’t possible, you may be required to support and assist them in doing so.

Clean environment

A clean environment is critical in a care and support setting; it is essential to the health of both the workers and the clients. A clean environment can reduce the risks to health and improve client safety too. Your clients have a right to a clean environment and you should encourage, support and assist them in maintaining their environment. A clean environment should include:

➢ Physical cleanliness of surfaces and tools used

➢ Low risks to health from microorganisms

➢ Access to safe, clean water

➢ Access to basic sanitation

➢ Low risks of cross-contamination

➢ Low risks of infection

➢ Safe disposal of waste (particularly high-risk wastes such as needles).

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Think about the ways in which your client can maintain a clean environment. How would you need to support and assist them in doing so?

Comfortable environment

A comfortable environment is about ensuring your clients have physical comfort, ease and relaxation. Although this will involve an environment being clean, a comfortable environment is more focused on being free from stress or anxiety. As well as providing clients with physical comfort, ease and relaxation a comfortable environment should:

➢ Be free from stress or anxiety

➢ Be homely

➢ Create a welcoming atmosphere

➢ Be clean and safe

➢ Allow clients to feel secure

➢ Be pleasant and enjoyable.

The important thing to remember when supporting your clients to maintain a comfortable environment is that ‘comfort’ will be considered differently by the variety of clients you work with. You can help maintain a comfortable environment for your clients by listening to and understanding their specific needs in relation to ‘comfort’ and providing them with the relevant support and assistance. For example:

➢ One of your clients feels comfortable in a warm environment; another feels

comfortable in a cooler environment

➢ One client may feel comfortable in a smaller, cosy living environment; another may

feel comfortable in a larger, open living environment

➢ One client may feel comfortable in structured environment with routine and order;

another client may feel comfortable in an unstructured environment with more

freedom and spontaneity

➢ One client may feel comfortable in a brightly-lit environment; another may feel

comfortable in a dimly-lit environment.

As you can see, it’s about addressing the individual client and their definition of a comfortable environment. You are caring for a client with Dementia. How can you ensure that their environment is comfortable for them? This may involve using signs and labels to help them remember where and what things are. This would put them at ease with their environment and reduce the level of stress and anxiety when they can’t get their bearings or find what they are looking for. What about clients that can’t see very well? How can you ensure that they feel comfortable within their environment? This could involve making simple, minor adjustments to ensure

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they don’t get stressed and anxious when needing to read things. For example, how can you make the process of ordering their lunch easier? It can be as simple as providing them will a visual menu that includes pictures of the different options available. This way, they can order their meals stress-free. A major part of a comfortable environment is ensuring that it is safe. Keeping the environment safe can involve:

➢ Checking electrical appliances for faults

➢ Keeping the environment tidy

➢ Removing trip hazards

➢ Ensuring exits are clear in case of a fire

➢ Regularly checking smoke/carbon monoxide detectors.

The above may need to be supported by yourself or a professional. If you are to

carry out any of the above, you should inform the individual of what you are doing and why.

Encouraging the individual to keep their environment safe, clean and tidy will not only help them to maintain their independence but will also help them to remain psychologically healthy. Living in a dirty or messy environment can lead to low self-esteem and depression. Looking after your environment and yourself can help to keep you healthy and give your life purpose and meaning.

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3.3 – Identify hazards and report according to organisation procedures

Identifying hazards

A ‘hazard’ is something with the potential to cause injury or disease to people, damage to property or disruption to productivity. Hazards can arise from the workplace environment:

➢ Use of equipment and appliances

➢ Poor environment layout

➢ Inappropriate systems and/or procedures

➢ Human behaviour.

Hazards may include:

➢ Poor or inappropriate lighting

➢ Slippery or uneven floor surfaces

➢ Physical obstructions (e.g. furniture and equipment)

➢ Poor home and domestic appliance maintenance

➢ Inadequate heating and cooling devices

➢ Inappropriate footwear and clothing.

Using these definitions, there are many hazards present in any environment. Identifying hazards is required in order to:

➢ Minimise accident or injury

➢ Eradicate accident or injury

➢ Protect staff

➢ Protect clients

➢ Protect the public

➢ Ensure smooth operation of the business and care provision.

If you are aware of a hazard, such as a particularly steep staircase, you can take measures to avoid it or be more careful around it. For example, you could use a different staircase or make sure you are very careful using the steep one.

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You may identify hazards through your daily working life, such as:

➢ That staircase is really steep

➢ There’s a leak coming through the kitchen ceiling

➢ This chair is wobbly.

You will need to take steps to rectify the problem or manage it more effectively, for example:

➢ I won’t use that staircase anymore and I will warn the others that is it steep. Maybe

if we ask the management, it will be replaced.

➢ I should report this leak immediately and mop up the water, leaving a ‘caution wet

floor’ sign there for others to see.

➢ This chair is broken; I will throw it away. I will have the maintenance man tighten

this. I should put it away and inform a manager.

Hazards can pose a risk to anyone that comes into contact with them. Failing to take action or ignoring the problem will leave it for the next person along, who may not realise that the stairs are very steep, that there is water on the floor or that the chair could collapse at any moment. Many things in the workplace can cause a hazard, especially if they become compromised in some way. For example, if they are:

➢ Broken

➢ Faulty

➢ Worn out

➢ Dirty

➢ Sharp

➢ Hot

➢ Wet

➢ Used improperly.

You have a duty of care and a moral obligation to protect colleagues and clients from hazards; this is why we identify them in our daily lives and have procedures and policies in place to deal with them. Your organisation will have their own policies and procedures for identifying and reporting hazards, so make sure you have the update to date training required and are aware of these procedures.

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3.4 – Identify variations in a person’s physical condition and report according to organisation procedures

3.5 – Recognise indications that the person’s physical situation is affecting their wellbeing and report according to organisation procedures

Clients’ physical condition

Whilst spending time with the client, you should be on the lookout for changes in both their mental and physical state. If you notice that the client’s physical condition has changed in any way, you should keep an eye on it, possibly discuss it with the client and/or their advocate and then report it where necessary. Variations in a client’s physical condition may include:

➢ Aches

➢ Client reporting feeling unwell

➢ Nail status

➢ Oral health anomalies

➢ Pain

➢ Skin tone and colour

➢ Weight gain

➢ Weight loss.

You should not ignore any changes that you see, even if you think the client might get better. It is vital that you understand and know how to complete your organisational report forms regarding incidents, illnesses, etc. Initially, you should contact your supervisor, either by email or telephone and inform them of the matter, before deciding the best course of action to take. You may find that the client physical condition is causing them pain, at which point you will need to recognise whether this is affecting their wellbeing. Signs to look out for could include:

➢ Not being able to look after themselves

➢ Confused, upset, sad or depressed

➢ Extreme fatigue

➢ Character, humour, etc. has changed

➢ Not partaking in usual social activities

➢ Loss of appetite

➢ Agitated or irritated easily.

Once again, these are things you would need to report and your organisation will have their own policies and procedures that you will need to strictly follow to ensure this is done correctly and dealt with efficiently.

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3.6 – Identify physical health situations beyond scope of own role and report to relevant person

Identifying situations beyond your role

You may find that there are instances in which some of your clients’ physical health situations will be beyond the scope of your own role. These are instances where you are faced with a situation that is outside the scope of your own knowledge, skills or job role. Your clients’ particular physical health situation may reach a level that you simply cannot cope with appropriately. If it’s not in your job description, you shouldn’t attempt it. Instead, it’s essential to identify these particular instances so that you can report them to the relevant person and ensure the client receives the care and support that they need. If you do find yourself faced with a situation that is beyond the scope of your particular role, you will need to report it immediately to the relevant person. This particular person may depend on the situation itself, but you should ensure that you find someone who can deal with it appropriately – it should be within the scope of their particular role. For example, this person may be:

➢ Your supervisor

➢ Your manager

➢ A doctor

➢ A health professional

➢ A fellow colleague.

You noticed one of your clients had lost quite a lot of weight and was looking worryingly thin. After investigating this further, you found out that they stopped bothering to cook hot meals since their partner passed away – they just didn’t see the point. You spoke to your client about the importance of eating hot meals and arranged for a meal-delivery service to deliver them hot meals throughout the week and a family member to come and cook for them at the weekend. They seemed to take everything on board and started enjoying eating new things. It has now been a month and they still seem to be losing weight. You think that there is more to it – what should you do? You would need to report to someone who may be able to help. For example, one of your clients may have recently experienced this with one of their own clients and may be able to offer assistance or advice. Otherwise, you may need to report to your supervisor, manager or even a doctor.

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4. Support social, emotional and psychological wellbeing

4.1. Promote self-esteem and confidence through use of positive and supportive

communication

4.2. Contribute to the person’s sense of security through use of safe and predictable

routines 4.3. Encourage and facilitate participation in social, cultural, spiritual activities, using

existing and potential new networks and as per the person’s preferences 4.4. Identify aspects of supporting a person’s wellbeing outside scope of knowledge,

skills and/or job role and seek appropriate support

4.5. Identify variations to a person’s wellbeing and report according to organisation

procedures 4.6. Identify variations to a person’s wellbeing and report according to organisation

procedures 4.7. Identify the person’s risk and protective factors in relation to mental health 4.8. Recognise and report possible indicators of abuse or neglect and report according to

organisation procedures 4.9. Identify situations beyond scope of own role and report to relevant person

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4.1 – Promote self-esteem and confidence through use of positive and supportive communication

Promoting self-esteem and confidence

In order to support a client’s emotional and psychological wellbeing, you will need to promote their self-esteem and confidence. As an individual receiving care and support, you can feel a lack of self-worth and powerlessness, especially if you cannot look after yourself as well as you once could. Part of building a person’s self-esteem is giving them the confidence to achieve their goals and show them that they can accomplish anything they set their mind to. This can be as simple as being able to cook a meal, tend to their garden or walk their dog without any aids. If your client lives in a residential home, it can be harder to give them a sense of freedom and free will, especially if they have carers cooking for them.

Positive and supportive communication

One way of promoting self-esteem and confidence in your clients is through the use of positive and supportive communication. You should communicate in a way that makes them feel as though they can do things, like their opinions matter and like their choices are being heard. You need to demonstrate that you have respect for them and you have confidence in their thoughts and ideas regarding their own care. You should never judge; communicate in a way that will empower your clients. Positive and supportive communication is effective when clients are leading their care and support as they feel able to solve their own problems and make their own decisions, whilst having your support too. Examples of communicating in a positive and supportive way include:

➢ Giving clients time and space to talk

➢ Listening to clients effectively

➢ Showing interest in what your clients have to say

➢ Valuing clients’ opinions and thoughts

➢ Summarising what’s been said to check your

understanding

➢ Never judging

➢ Reassuring clients when they need it

➢ Being helpful

➢ Being kind and compassionate

➢ Being optimistic

➢ Showing encouragement

➢ Being constructive with your advice.

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4.2 – Contribute to the person’s sense of security through use of safe and predictable routines

Using safe and predictable routines

Safe and predictable routines can be essential in care and support settings – they provide clients with continuity and structure. This routine, continuity and structure will contribute to their sense of security, as well as providing them with comfort and control. Receiving care and support can be a stressful situation; routine can help clients cope with change and can put them at ease. Clients will strive on familiarity, particularly clients that are suffering with memory loss. Many clients will rely on these routines. It is important to remember that the safe and predictable routines that you use should be relevant to the client as an individual. You shouldn’t fit the routine around your own schedule – it should be suited to your client. For example, if your client wants to eat their breakfast at 9am, you shouldn’t give it to them at 8am just because it fits better with your plans. Perhaps they already had their own routine before they needed your care and support. How can you continue with their established routine in order to contribute to their sense of security? Did they have any habits that should continue? Examples of aspects of a safe and predictable routine may include:

➢ Having a cup of coffee every morning before getting dressed

➢ Visiting the market every Friday morning to get fresh fruit and vegetables

➢ Getting into bed at 10pm every night and reading a chapter of their book

➢ Phoning their daughter every Wednesday evening at 6pm

➢ Having their shower in an evening rather than a morning

➢ Doing their ironing on a Tuesday afternoon

➢ Weekly Bingo trips with friends

➢ Having their hair cut on the last Friday of the

month

➢ Having fish for dinner on a Saturday

➢ Reading the local newspaper every morning

➢ Watching their favourite show on a Monday

evening.

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4.3 – Encourage and facilitate participation in social, cultural, spiritual activities, using existing and potential new networks and as per the person’s preferences

Social activities

You should encourage and facilitate the client’s participation in social activities. Social interaction can have many benefits, for example:

➢ Clients will feel happy

➢ Clients will feel motivated

➢ It is rewarding

➢ It is enjoyable

➢ It can improve clients’ self-esteem

➢ It ensures clients don’t become isolated

➢ It reduces loneliness.

As well as remaining in touch with friends and family and making new friends, clients should be encouraged to participate in social activities. For example:

➢ Book club

➢ Choir

➢ Chess club

➢ Weekends away

➢ Bingo nights

➢ Dance lessons

➢ Arts and crafts groups

➢ Coffee mornings

➢ Luncheons

➢ Day trips.

Cultural and spiritual activities

It is important to facilitate the client’s participation in cultural and spiritual practices and celebrations. If the client is new to the area or perhaps hasn’t had an opportunity to find their nearest cultural or spiritual network, you should ensure you provide them with relevant information regarding such networks in the community.

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You should ensure that the client has the correct information regarding the practice or celebration and that they have the correct resources and transport to be able to attend. Cultural and spiritual practices and celebrations could include:

➢ Attending place of worship

➢ Festivals

➢ Attending weddings, christenings and funerals

➢ Access to cultural dietary requirements.

You should always support the client’s spiritual and cultural practices as this will help them to

maintain their independence and all aspects of their wellbeing.

Spiritual support

Culturally appropriate spiritual support helps people maintain the practices, beliefs and networks that are important to them. First, you must identify the current practices and beliefs of someone in order to help meet their needs. This is not simply asking someone which religion someone follows; this will not give you an in-depth look at their spiritual beliefs. Some religious beliefs require strict compliance with rituals and influence the choices and activities of their everyday life. Consider also the changing needs of people. Just because someone wasn't interested in spiritual matters in the past does not mean that they won't change their mind – particularly for terminal patients, they take an interest in spirituality near the end of their life, perhaps for comfort. Therefore, a review of spiritual needs is important on a regular basis. Be aware that not all followers of the same religion or speakers of the same language have the same spiritual beliefs or practise the same rituals – treat each person as an individual regarding this. Whichever activities you are facilitating clients’ participation in; you should do so using existing and potential new networks. To provide effective spiritual and cultural support, you must:

➢ Identify, review and support the spiritual needs of clients, carers, their family

and/or significant others (including current beliefs and practices)

➢ Assess and review spiritual needs in the preferred language of the recipient

➢ Provide facilities to meet the needs of various religious and spiritual preferences

➢ Assist in maintaining the current religious networks

➢ Provide appropriate religious representation

➢ Allow outings to places of worship

➢ Observe days of religious significance and acknowledge them appropriately

➢ Have spiritual support staff trained in cultural awareness and communication.

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4.4 – Identify aspects of supporting a person’s wellbeing outside scope of knowledge, skills and/or job role and seek appropriate support

Things outside of your own scope of knowledge, skills and/or job role

You may find that there are aspects of supporting a client’s wellbeing that are outside the scope of your knowledge, skills and/or job role. This means you are faced with an aspect of their support that you don’t feel able to provide. This may be because it is not in your job description, you are not adequately qualified, or you don’t have the necessary skills, knowledge or experience. If something is outside the scope of your job role, knowledge or skills, you should not attempt it. This could leave your client unsatisfied or you or the client hurt (physically or mentally). It is important to be able to identify these aspects so you can seek the appropriate support and ensure that the client receives the care and support that they need. You should never ignore something – if you are unable to provide an aspect of support, you should find someone who is. Feeling able to seek support when you need it is a good quality to have and it can lead to all-around better care for your clients. For example, if they have a certain cultural or spiritual need that you are unfamiliar with it may be a good idea to seek the support of someone that is knowledgeable. This will ensure that the client still receives the necessary support for their wellbeing. What about a client needing emotional support? They may need to talk about their memories or may be experiencing grief or depression. If you are not able to provide the necessary support, you should seek the appropriate support. For example, a counsellor will be able to support your client better than you could. If you do find yourself with aspects that are beyond the scope of your knowledge, skills or particular role, you will need to act on it immediately. This may involve reporting it or seeking the relevant support – find someone who can deal with it appropriately. For example, this person may be:

➢ Your supervisor

➢ Your manager

➢ A doctor

➢ A health professional

➢ A fellow colleague.

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4.5 – Identify variations to a person’s wellbeing and report according to organisation procedures

Variations to a client’s wellbeing

Whilst providing clients with care and support you will have the chance to get to know them as an individual. You will get to know about their character, their behaviour and their mood. This also means that you will be able to notice any changes that occur and identify any variations in their wellbeing. Variations to a client’s wellbeing may include:

➢ Loss of appetite

➢ Change in character

➢ Depressed

➢ Sad, upset, always crying

➢ Confused

➢ Extreme fatigue

➢ Agitated or irritated easily.

Whenever you notice a variation in a client’s wellbeing, you should report it according to your organisation’s procedures. You should ensure that you are aware of the way that you should report these variations. This may mean you have to report it to your supervisor or manager.

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4.6 – Identify any cultural or financial issues impacting on the person’s wellbeing

Cultural issues

You may find that a client’s wellbeing will be impacted by cultural issues. For example:

➢ Their physical condition may be hindering them visiting their place of worship

➢ They may not be able to participate in the relevant ceremonies

➢ They may not be allowed to wear the clothes that express their culture

➢ They may not be being given the correct food

➢ They may be being judged or discriminated against based on their culture

➢ They may feel unable to express their cultural identity.

All of the above issues could affect a client’s wellbeing, making them feel sad, upset or depressed. It is your job to identify if and when these issues arise.

Financial issues

You will also need to identify any financial issues that may be impacting the client’s wellbeing. Financial issues may include:

➢ The inability to pay their rent or bills

➢ The inability to pay for their care and support

➢ The inability to pay for food

➢ Complicated benefits

➢ Victim of financial abuse or fraud

➢ The inability to provide for their family

➢ Job loss

➢ Non-existent savings.

A financial issue can have a detrimental effect on a client – it can be very stressful and they may become worried. By identifying any cultural or financial issues that are impacting on the client’s wellbeing, you will be able to ensure that they addressed correctly and they receive the correct support.

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4.7 – Identify the person’s risk and protective factors in relation to mental health

Risk and protective factors

Good mental health is essential for clients that are receiving care and support – particularly those striving to be independent and take control of their care and support. Good mental health can help your clients cope with change, solve problems that arise and achieve their goals and potential. Poor mental health can have a major impact on your clients and their care and support. It can disrupt their life and hinder their ability to function. It can change your clients’ mood, cause chronic anxiety and lead to impulsive actions. It is important to identify clients’ risk and protective factors in relation to mental health. Although no single factor can be guaranteed to be related to mental health, they are often correlated with mental health and should be identified. Although it won’t be an extensive list, this chapter will provide you with examples of risk and protective factors that may relate to mental health. Factors will vary depending on clients; keep your own clients in mind. By identifying these risk and protective factors, you will be able to predict clients’ chances of developing mental health issues and may be able to prevent them occurring and provide the appropriate interventions. Risk factors are internal or external conditions that increase a client’s likelihood of developing a mental health problem. Risk factors can include:

➢ Low intelligence

➢ Chronic illness

➢ Experiencing trauma

➢ Low self-esteem

➢ Poor social skills

➢ Difficult temperament

➢ Death of a family member

➢ Poor physical health

➢ Abuse and/or neglect

➢ Discrimination based on community values and attitudes, including myths and

stereotypes

➢ Socio-economic disadvantage.

Protective factors are internal or external conditions that decrease a client’s likelihood of developing a mental health problem whilst promoting resiliencies. Protective factors may include:

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➢ Strong cultural identity and ethnic pride

➢ Attachment to community networks

➢ Participation in church or other community group

➢ Supportive, caring friends and family

➢ Economic security

➢ Good physical health

➢ Moral beliefs

➢ Good coping style

➢ Social skills

➢ Optimism

➢ Above average intelligence.

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4.8 – Recognise and report possible indicators of abuse or neglect and report according to organisation procedures

4. 9 – Identify situations beyond scope of own role and report to relevant person

Abuse and neglect

Abuse is any instance where someone takes advantage of a client and neglect is any instance where someone fails to care for a client properly. It can include:

➢ Financial exploitation – this is the unauthorised use of a client’s money or their

property by either a caregiver or an external party.

The types of practices include:

o Stealing money

o Forging cheques/credit cards/accounts

o Forging their signature

o Identity theft

o Requesting them to pay money to claim a 'prize'

o Charity scams

o Investment fraud.

➢ Physical abuse – this is the deliberate use of force on a

client, causing them pain, injury or disability. It includes

violent assaults, using drugs (inappropriately), restraining

them or keeping them captive.

➢ Emotional abuse – also known as psychological abuse, this involves treating clients

in any way that causes them distress or emotional pain.

This can include:

o Verbal abuse – threats, intimidation, yelling, humiliation, placing blame

o Non-verbal abuse – ignoring, social isolation, terrorising behaviour.

➢ Sexual abuse – this includes contact with a client without their consent; this can

mean physical sex acts but also includes making them watch sex acts, pornography,

or forcing them to undress.

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➢ Neglect/abandonment – this includes failure to fulfil carer duties and is responsible

for over half of client abuse cases. It can be intentional or unintentional, based on

ignorance or denial of the care requirements for the client.

➢ Healthcare fraud – this can be committed by care providers or medical personnel; it

includes:

o Charging for healthcare they don't provide

o Overcharging for services

o Taking 'kickbacks' (bonuses) for referring clients to providers of certain drugs

o Over/under-medicating

o Recommending incorrect/fraudulent remedies for medical

conditions/illnesses

o Medicare fraud.

Signs of abuse and neglect

Symptoms can be difficult to recognise, particularly in older clients as they may mirror those of dementia or frailty. It can be easy for people to explain the signs and many people may dismiss them as a minor issue. However, you should not believe a caregiver at face value and investigate if you are at all concerned. The following are things you should be on the lookout for:

General abuse

➢ Arguments (frequent) between client and caregiver

➢ Changes in personality of the client

➢ Odd behaviour.

Physical abuse

➢ Unexplained injuries

➢ Broken bones/sprains/dislocations

➢ Medication irregularities

➢ Broken glasses

➢ Signs of restraint

➢ Caregiver refuses to let client be seen alone.

Emotional abuse

➢ Experience of threatening, bullying or controlling behaviour from caregiver

➢ Dementia-like behaviour from client – rocking, mumbling, sucking thumb.

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Sexual abuse

➢ Bruises around genitals

➢ Unexplained genital infections or STDs

➢ Unexplained vaginal/anal bleeding

➢ Torn/stained clothing.

Neglect

➢ Weight loss, malnutrition, dehydration

➢ Being left unclean

➢ Untreated physical problems

➢ Unsuitable clothing for the conditions

➢ Unsanitary living conditions

➢ Unsafe living conditions

➢ Desertion in a public place.

Financial exploitation

➢ Unexplained withdrawals from client’s accounts

➢ Sudden changes in financial situation

➢ Missing items/cash from the client’s house

➢ Suspicious will/policy/power of attorney changes

➢ Addition of names of documents

➢ Unpaid bills/lack of medical care (despite a healthy financial situation)

➢ Financial activity taking place when the client is incapacitated

➢ Unnecessary services being provided.

Healthcare fraud

➢ Duplicate medical bills

➢ Evidence of over/under-medication

➢ Evidence of inadequate care pertaining to the amount paid

➢ Problems in the care facility.

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Acting on abuse and neglect

There are three things you must do to prevent client abuse and neglect:

➢ Listen to clients and caregivers

➢ Intervene when you suspect abuse

➢ Educate others on how to identify and report abuse.

As a caregiver, you can do the following if you are overwhelmed by the demands:

➢ Request help from colleagues, friends and

family (of the client)

➢ Maintain your own health

➢ Practice stress reduction exercises

➢ Seek counselling if you are depressed

➢ Finds support groups (if necessary)

➢ Seek help for any substance abuse

➢ Contact client abuse helplines.

If you suspect any kind of client abuse or neglect, the main thing you need to do is report it to the appropriate person – this can include any of the following:

➢ Supervisor

➢ Member of senior management

➢ Colleagues

➢ Carers

➢ Health professionals

➢ External agencies (complaints and advocacy services and professional registering

authorities)

➢ Law enforcement officer.

If a situation arises that is beyond the scope of your own role, you should ensure that you deal with it effectively. It is essential that it is reported to the relevant person in order to ensure your client receives the care and support that they need.

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References

These suggested references are for further reading and do not necessarily represent the contents of this unit.

Websites

12 stages of life: http://www.personalfutures.net/id65.html Maslow’s hierarchy of needs: https://books.google.co.uk/books?id=whziBAAAQBAJ&pg=PA356&lpg=PA356&dq=maslow+ hierarchy+of+needs+australia&source=bl&ots=n- o5KPzcL0&sig=GCaOeOIT_4qMY2U8hnAn9kdi0Nw&hl=en&sa=X&ved=0CFkQ6AEwCmoVCh MI7I6QifmRyAIVAyzbCh2CNg4W#v=onepage&q=maslow%20hierarchy%20of%20needs%20 australia&f=false What is a strengths-based approach to care? (n.d.). Retrieved from https://www.scie.org.uk/care-act-2014/assessment-and-eligibility/strengths-based

All references accessed on and correct as of 28/09/15, unless other otherwise stated.