Age Care certIV

STUDENT ASSESSMENT BOOKLET

CHCPAL001 Deliver Care Services Using a Palliative Approach

Suite 203, 11-15 Deane Street Burwood, NSW, 2134

Email: [email protected]

RTO Code: 45342

Student Name: ___________________________

© 2020 Advance College

Advance College is a trading name of Australian Newtown College, RTO 45342.

Cover image © Bigstock www.bigstock.com (Images 1 &2) and © Shutterstock www.shutterstock.com (Image 3)

RECORD OF ASSESSMENT OUTCOMES: CHCPAL001

This section records the outcome of each task/assessment requirement so that the final assessment outcome can be determined for the unit CHCPAL001 Deliver care services using a palliative approach.

The table below shows all the assessment requirements for this unit. Once a student has satisfactorily completed all requirements related to the unit, they can be given a Final Assessment Result of ‘Competent’. A number of spaces have been provided to record multiple attempts. Final Assessment Results should only be recorded once all tasks have been attempted.

Assessment requirements/tasks	Task Outcome
	Satisfactory (S) Not satisfactory (NS)	Date	Assessor initials
1. Written questions
2. Role play
3. Workplace observatons
4. Supervisor repor
Final Assessment Results	Result (C/NYC)	Date
CHCPAL001 Deliver care services using a palliative approach
Student name:
Assessor name:
Assessor signature:	Date: / /

ASSESSMENT OVERVIEW

This Student Assessment Booklet includes all your tasks for assessment of CHCPAL001 Deliver care services using a palliative approach.

ABOUT YOUR ASSESSMENTS

This unit requires that you complete 3 assessment tasks. You are required to complete all tasks to demonstrate competency in this unit.

Assessment Task	About this task
Assessment Task 1: Written questions	You must correctly answer all questions to show that you understand the knowledge required of this unit.
Assessment Task 3: Role play	Students are undertake a two role plays. One relating to pain management for a client in late stages of stomach cancer. Students will also need to answer a set of verbal questions. The second role play relates to the development of an advance care plan.
Assessment Task 3: Workplace Observation	Students are to support, report and document the issues and needs of 2 people in palliative care

Supporting resources

You may like to look at the following websites, books and documents for more information about the topics related to this unit:

· Croft, H 2013, The Australian Carer 3rd edn, Pearson Australia, Frenchs Forest, NSW.

How to submit your assessments

When you have completed each assessment task you will need to submit it to your assessor.

Instructions about submission can be found at the beginning of each assessment task.

Assessment Task Cover Sheet

At the beginning of each task in this booklet, you will find an Assessment Task Cover Sheet. Please fill it in for each task, making sure you sign the student declaration.

Your assessor will give you feedback about how well you went in each task, and will write this on the back of the Task Cover Sheet.

Prerequisite

The prerequisite for this unit is NIL.

PERFORMANCE EVIDENCE

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

supported, reported and documented issues and needs of 3 people in palliative care

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:

philosophy, principles, benefits and scope of palliative care

the needs of people dealing with a life-threatening or life-limiting illness and the emotional impact of diagnosis

cultural, religious and spiritual differences in relation to death and dying

the stages of grief and personal strategies for managing reactions to grief

advance care directives and end-of-life care strategies

pain relief and comfort promotion

nutritional and hydration requirements during a palliative approach

legal and ethical considerations for working in palliative care, including:

· dignity of risk

· duty of care

· human rights

· privacy, confidentiality and disclosure

· work role boundaries – responsibilities and limitations

relevant policies, protocols and practices of the organisation in relation to the provision of both a palliative approach and palliative care

responsibilities to self and colleagues

various signs of imminent death and/or deterioration

communication strategies to build trust, show empathy, demonstrate support and empowers the person, family, carers and/or significant others

For all documentation on the performance criteria and assessment requirements of the unit CHCPAL001 - Deliver care services using a palliative approach, please refer to the training.gov.au website with this link: https://training.gov.au/Training/Details/chcpal001.

ASSESSMENT TASK COVER SHEET

Students: Please fill out this cover sheet clearly and accurately for this task.

Student Name
Assessor Name
Unit: CHCPAL001 Deliver care services using a palliative approach
Assessment Details
Assessment Type	Written/Oral questions Role play Workplace observations
Agreement by the student
Read through the assessments in this booklet before you fill out and sign the agreement below. Make sure you sign this before you start any of your assessments.
Have you read and understood what is required of you in terms of assessment?	Yes	No
Do you understand the requirements of this assessment?	Yes	No
Do you agree to the way in which you are being assessed?	Yes	No
Do you have any special needs or considerations to be made for this assessment? If yes, what are they? …………………………… ………………………… ………………… ……… … … .………………………………………….	Yes	No
Do you understand your rights to appeal the decisions made in an assessment?	Yes	No
None of this work has been completed by any other person.	Yes	No
I have not cheated or plagiarised the work or colluded with any other student/s.	Yes	No
I have correctly referenced all resources and reference texts to complete these assessment tasks.	Yes	No
I understand that if I am found to be in breach of policy, disciplinary action may be taken against me.	Yes	No

STUDENT DECLARATION

I, , certify that the statements I have attested above have been made in a good faith, are true and correct. To the best of my knowledge and belief, these tasks are my own work.

Student Signature: …………………………… Date: ............... /................./...................................

ASSESSMENT TASK COVER SHEET – Attempt 1

Result

Satisfactory (S)

Not Yet Satisfactory (NYS)

ASSESSOR FEEDBACK (Assessment Task 1 to Task 2)

Assessors: Please return this cover sheet to the student with assessment results and feedback.

Assessor s

ignature: Date:

ASSESSOR FEEDBACK (Assessment Task 3)

Assessor signature: Date:

ASSESSMENT TASK COVER SHEET – Attempt 2

Re-assessment Result

Satisfactory (S)

Not Yet Satisfactory (NYS)

ASSESSOR FEEDBACK (Assessment Task 1 to Task 2)

Assessors: Please return this cover sheet to the student with assessment results and feedback.

Assessor signature: Date:

ASSESSOR FEEDBACK (Assessment Task 3)

Assessor signature: Date:

ASSESSMENT TASK COVER SHEET – Attempt 3
Re-assessment Result	Satisfactory (S)	Not Yet Satisfactory (NYS)

ASSESSOR FEEDBACK (Assessment Task 1 to Task 2)

Assessors: Please return this cover sheet to the student with assessment results and feedback.

Assessor signature: Date:

ASSESSOR FEEDBACK (Assessment Task 3)

Assessor signature: Date:

ASSESSOR DECLARATION

I declare that I have conducted a fair, valid, reliable and flexible assessment with this student, and I have observed the student demonstrate unit outcomes through consistent and repeated application of skills and knowledge over a period of time and provided appropriate feedback. Signature: ________________________ Date: ______/_______/______________

STUDENT FEEDBACK AND ASSESSMENT APPEALS

You can make an appeal about an assessment decision by putting it in writing and sending it to us. Refer to your Student Handbook for more information about our appeals process.

I have received my assessment result and I am satisfied with the given feedback for this assessment.

I am not satisfied about my result and I would like to appeal regarding my result.

Student Signature: …………………………… Date: ......... /.........../..................

ASSESSMENT TASK 1: WRITTEN QUESTIONS

Task summary: · This is an open book test – you can use the Internet, textbooks and other documents to help you with your answers if required. · You must answer all questions correctly. · Write your answers in the space provided. · If you need more space, you can use extra paper. All extra pieces of paper must include your name and the question number/s you are answering. · You may like to use a computer to type your answers. Your assessor will tell you if you can email them the file or if you need to print a hard copy and submit it.

What do I need in order to complete this assessment?

· Access to textbooks and other learning materials.

· Access to a computer and the Internet (if you prefer to type your answers).

When do I do this task?

· You will do this task in your own time.

what do I need to do if I get something wrong?

If your assessor marks any of your answers as incorrect, they will talk to you about resubmission. You will need to do one of the following:

Answer the questions that were incorrect in writing.

Answer the questions that were incorrect verbally.

Question 1

What is palliative care?

What are the aims of palliative care?

What are three of the principles of palliative care?

Principle 1:
Principle 2:
Principle 3:

What is the difference between a ‘curative’ and a ‘palliative’ approach?

Question 2

1. Working in palliative care can be very stressful. List three emotions that workers would feel while caring for terminally ill clients.

1:
2:
3:

What are four things that you can do to help your colleagues deal with their emotions?

1:
2:
3:
4:

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What are three things that you could do to help yourself deal with your emotions

Question 3

1. List three types of nutrition and hydration advice you would give to a client and their family during the early stages of palliative care.

1:
2:
3:

In the final stages of life, appetite and thirst may decrease significantly. Family members may feel that they should try to feed the person. What would you advise the family members?

Question 4

1. List two common misconceptions about pain relief.

1:
2:

Choose one of the misconceptions from a) above. In one paragraph describe why it is a misconception and what the truth is around this statement.

Question 5

Shamus’s family come to talk to you about their his care. They want to speak to you because they trust you as someone who has worked very closely with Shamus as a palliative care worker for the last two months. They are very distressed about a report they have received from the doctor, who has told them that Shamus has only days to live. His family ask you to refer them to a different doctor – there must be something that can be done to preserve his life. They aren’t ready to lose him yet! Shamus has an advanced care directive. It states he does not want any further medical treatment to keep him alive. His family are aware of this directive.

1. You feel that people have the right to get a second opinion. Should you refer Shamus’s family to a good doctor that you know? Explain your answer.

What other action could you take to support Shamus’s family?

Question 6

Shamus has died. His wife, Katherine, comes to see you and thanks you for looking after him so well. She gives you a hug and you both feel a bit sad. Katherine tells you that she seems to be living in a daze. She can’t even remember what she did this morning. She is usually so well organised but just can’t seem to concentrate at the minute – what if something goes wrong at the funeral because she forgets to do something? ‘I haven’t even cried yet!’ she exclaims.

1. Why is Katherine experiencing this type of reaction so soon after her husband’s death?

What would you say to Katherine to reduce her fear of something going wrong at the funeral?

What are the five stages of grief according to the Kübler-Ross Grief Cycle?

Question 7

Constipation is a common problem in palliative care clients. Laxatives may be prescribed by the doctor to assist with this.

Apart from medication, what are two supports that a personal care worker can give to a client suffering from constipation?

1.
2.

Question 8

A client’s family is looking for some information on palliative care. They have received the information provided by the HACC team but they are looking for more.

Research the Internet and find a reputable source of information that they can access to find out more. Write down the source of this information (ie the website address).

Question 9

Describe each of the following terms – give an example of each.

Bessie has severe dementia. Before she got dementia, she had written out an advanced care directive that said that she wanted to be resuscitated by CPR if she collapsed under any circumstances. As far as Bessie was concerned, life was more important than anything else – even if she wouldn’t be able to make her own decisions as her dementia progressed. Bessie’s son has not been to visit her for months. One day he appears at Bessie’s side. ‘I’m the only next of kin,’ he says. ‘Mum isn’t here anymore, she’s just a vegetable now. I don’t want her to be resuscitated if she collapses again. Just let the old lady die.’ You are aware that Bessie is a very rich woman. From the look of her son, he could do with some money.

1. What are the ethical issues involved in this scenario and what action should the care worker take?

Describe three legal and three ethical issues that may arise with advanced care directives and suggest to deal with these.

Bessie’s son begins to ask a lot of questions about his mother: · ‘What is the matter with her?’ · ‘How sick is she?’ · ‘Does she know who anyone is anymore?’ · ‘Where is all her bank paperwork?’ Bessie’s son assures you that he has a power of attorney for Bessie – but he does not show you a copy.

Bessie’s last surviving relative is her son. Considering he says he has power of attorney, do you think you can give him any of the information he has asked for? Explain your answer.

Question 10

1. List five communication strategies for providing information to people about support services available to them

1. Outline the SOLER technique for ensuring you maintain positive body language

1. List five active listening strategies

Question 11

In the table below, provide a brief explanation of each of the legal and ethical considerations in palliative care (15 – 20 words)

Dignity of Risk
Duty of Care
Human Rights

Question 12

1. List five of the emotional impacts the diagnosis of a life-limiting illness may have on a client or their family members?

Give five examples of needs a person dealing with a life-limiting illness may have?

Question 13

Do some research about the different spiritual, religious or cultural beliefs/ preferences client’s may have when it comes to death and dying. Provide two specific examples for each category

Spiritual
Religious
Cultural

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ASSESSMENT TASK 2: ROLE PLAY
	Task summary: Students are to undertake two role plays. Part A of the role play is about pain management for a client in late stages of stomach cancer. After the role play the student will need to answer a set of verbal questions. Part B of the role play relates to the development of an advanced care plan.

What do I need in order to complete this assessment?

Part A

· Access to a suitable workplace environment (ie ensure the room has a bed or comfortable chair for the client)

· A blanket

· A jug of water and a glass

· Palliative Care Management plan (provided)

· Pain and Symptom Management form (provided).

Part B

· Advance Care Plan, NSW Health, Hunter New England Local Health District (provided as a separate document)

· An extra participant to play the role of Thelma (assessor to organise – may be a classmate or another trainer/assessor).

When do I do this assessment?

· You will do this task in during your assessor’s workplace visit.

what do I need to do if I get something wrong?

If your assessor sees that you have not shown appropriate skills or knowledge, they will give you some feedback and you will need to do the role play again or answer the verbal questions again.

Instructions:

Role play: Pain management

You are a care worker who is working with a client called John. He has terminal stomach cancer and is receiving palliative care. John’s care plan provides you with the following information: · He is in the late stages of stomach cancer. · Pain medication is morphine taken orally. It has been successful in reducing pain and discomfort. · John needs to be reminded to take regular sips of water to remain hydrated. Today John has received his morphine as usual – his last dose was one hour ago.

Your assessor will play the role of John. You will need to show that you can respond to his needs and support him appropriately. You will document your observations on the Pain and Symptom Management form provided

Following this part of the role play, your assessor will play the role of the supervisor of John’s care team. Discuss your observations with your supervisor.

The table below gives further information about what you need to show during the role play.

John’s Palliative Care Management Plan can be found over the page.

After the role play you will need to answer a set of verbal questions.

ASSESSOR TO COMPLETE

Your assessor will be looking to see that you can:	Comments	Attempt 1 Yes/No Date:	Attempt 2 Yes/No Date:	Attempt 3 Yes/No Date:
Follow John’s Palliative Care Plan
Observe John and identify his pain or any other symptoms
Document John’s pain and other symptoms using the Pain and Symptom Management Form
Communicate appropriately in relation to John’s quality of life, pain, comfort and wishes
Create an emotionally supportive environment in which John can share information about his condition and his current symptoms?
Use strategies to manage John’s pain and make him more comfortable
Show that you respect and support John’s end-of-life wishes
Review and document whether John’s pain management was effective?
Accurately report their observations to the supervisor of John’s care team?
Ask the student the following verbal questions:
Comparing John’s condition today against his care plan, what do you think is significant about your observations?
What action will you take?
What will you do about John’s request to talk to someone about his end-of-life wishes?
A family member approaches you and says, ‘Why is John having so much morphine? The morphine will kill him before the stomach cancer does!’ How would you respond to them?
What other resources could you use to make John comfortable, apart from those available in this role play? If you discovered any of these were successful, how would you document your findings?
Considering the role play – what was the limit of your responsibilities? What responsibilities must be referred?
How do you feel about John wanting to go home to die? He won’t be able to receive the professional help that he gets in the hospice. It will be a big strain on his family.
How do you feel about working with people who are ageing and dying? How will you look after your own emotional needs?
Working in palliative care is a team approach. How would you make sure you worked effectively in the team?
How do you think you went with your role play? Do you think you gave John the best care that you could? Is there anything you would do differently if you were to do the role play again?
What would you do if were unsure about the procedure for changing end-of-life wishes?
Please add any feedback to the student about this task on the Assessment Cover Sheet. Keep a copy of the completed Assessment Task Cover Sheet.

Verbal questions

At the completion of the role play, your assessor will ask you a set of verbal questions about John and his care.

Palliative Care Management Plan
Name: John Smith	Date: 12/05/2015
DOB: 01/07/1942	Address: 286 High Street, Kerrytown VIC 3878
Diagnosis of illness: Terminal stomach cancer
Current medical treatment: Morphine 10mg 4 hourly Laxative as required Liquid food only
Client’s prognosis John has advanced stage stomach cancer. He has had surgery and one round of both chemotherapy and radiotherapy. However, the cancer has spread to the bowel region. John has made the decision to refuse any further surgery or chemo/radio therapy and is now receiving palliative care. John’s condition is terminal – John’s doctor has indicated that he may have 3–5 months left.
Palliative care planning
Physical needs: · Needs assistance for all activities of daily living · Pain is severe but well controlled with medication · Requires assistance with feeding (liquid diet) and drinking · Can walk short distances with support · Requires laxatives for constipation	Emotional/psychological: · John has accepted his condition · John has a very supportive family who visit often · He may sometimes be teary, but is generally in good spirits
Family: · John’s wife, Catherine, is next of kin. Catherine is supportive and has accepted his condition; however, she feels helpless to care for him. · Catherine and John have agreed that he will remain at the hospice until he is in last stages, then he will return home to Catherine’s care. · John has two sons, Jeremy and Peter.	Spiritual/religious: · John is Catholic (non-practicing)
Future care needs: · Palliative care only – no further surgery, chemotherapy or radiation therapy at John’s request. · Maintain pain control. · Maintain hydration. · Feed liquids orally only – no feeding tubes at John’s request.	Communication · John is able to communicate himself with no trouble.

Client Care Plan
Symptoms	Objectives	Intervention
Pain	Reduce pain to a manageable level	Morphine orally 10mg every 4 hours
Nutrition	Prevent malnutrition; enjoy food Prevent choking, nausea	Liquid food only by mouth – no feeding tubes
Hydration	Maintain adequate level of hydration Prevent dry mouth and mouth conditions	Provide sips of water frequently
Temperature maintenance	Provide adequate body and ambient temperature	Monitor body temperature Provide blankets, warm drinks if cold Control ambient room temperature
Nausea	To prevent distressing symptoms	Maxolon as required

Pain and Symptom Management Form
Client’s name:	Student’s name:
Date:	Time:
Medication: · Morphine orally 10mg 4-hourly · Laxative twice daily
Pain level:
No Pain 0	1	2	3	4	5	6	7	8	9	Worst Pain 10
Pain location: Locate on the diagram the location of client’s pain. Source: http://www.wps.ac.nz
What makes the pain less?
What makes the pain worse?
What type of pain is it? (For example, stabbing, throbbing, dull ache.)
Is it constant or does it come and go?
Is the pain relief you are currently receiving enough to make a real difference to your life?
Adverse Events Is the client experiencing any of the following symptoms?
	None	Mild	Moderate	Severe
Nausea
Vomiting
Constipation (When were bowels last open?)
Itching
Mental cloudiness
Sweating
Fatigue
Drowsiness
Other (insert details):
Other (insert details):
Comments:
Action to be taken:

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Role play- Part B: Advance Care Plan

This role play carries on from Part A John has just been advised that his stomach cancer has progressed to Stage 4. John has had chemotherapy, which initially looked like it would be successful, but last week John was told by the oncologist that the chemo was no longer effective. John and his wife, Thelma, talked it over and they both decided that they would like John to remain at home for as long as possible – hopefully being able to die peacefully and with dignity in his home. John has been referred to the community palliative care team. You work with this team and you are meeting with John and Thelma today to put together an advance care plan.

Your assessor will play the role of John. You will need to show that you can support him in developing his advance care plan.

Your assessor will give you a copy of an advance care pan template before you start the role play.

Following your discussions with John and Thelma, the assessor will play the role of the the supervisor in John’s care team. Provide an accurate account of your observations during your discussions with John and Thelma.

The table below gives further information about what you need to show during the role play.

ASSESSOR TO COMPLETE

Your assessor will be looking to see that you can:	Comments	Attempt 1 Yes/No Date:	Attempt 2 Yes/No Date:	Attempt 3 Yes/No Date:
Identify that John’s needs will vary from now until his death.
Support John and Thelma to talk about their needs, including physical, cultural and spiritual needs.
Communicate with John and Thelma appropriately
Respect Thelma’s role as an integral part of John’s care team?
Identify any needs and issues that may be outside their boundaries and refer to appropriate person for advice
Respect John’s dignity of risk
Accurately record all information in the advance care plan template
Report their observations to the supervisor of John’s care team
Please add any feedback to the student about this task on the Assessment Cover Sheet. Keep a copy of the completed Assessment Task Cover Sheet.
Please note any reasonable adjustments for this task below.

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ASSESSMENT TASK 3: WORKPLACE OBSERVATION

Task summary: Students are to support, report and document the issues and needs of 2 people in palliative care

What do students need in order to complete this assessment?

· Workplace policies and procedures

· Access to two palliative care clients

When and where do students need to do this?

· Students will do this task during their assessor’s workplace visit.

· Provide students with the date of your workplace visit so they can write it in their Student Assessment Booklet.

What do students have to submit?

· Any completed documents as outlined in the workplace’s policies and procedures. This may include

· Palliative care management plan

· Pain management plan

· Advance Care plan

Instructions to students:

You will be required to provide support to two palliative care clients during your work placement. This includes reporting and documenting their needs according to your organisation’s policies and procedures. Ensure when you are providing client documentation that the privacy and confidentiality if the client is maintained. This may mean you will need to fill out additional copies with all identifying information removed to provide to your assessor.

Assessment Task 3: Workplace Observation – Client 1 (ASSESSOR TO COMPLETE)
Your assessor will be looking to see that you can:	Comments	Attempt 1 Yes/No Date:	Attempt 2 Yes/No Date:	Attempt 3 Yes/No Date:
Access the client’s documentation
Tailor their approach to the support provided and daily activities taking using a holistic approach to clients needs
Support the client and their family to talk about their needs and preferences
Communicate with the client and their family appropriately?
Report any differences in the care plan as well as information about quality of life and pain / comfort levels to the supervisor
Respect the family’s role as an integral part of client’s care team and provide them with any information that they need?
Identify that the client’s needs will vary from now until their death?
Create an emotionally supportive, safe, and open environment free from judgement in which the client and their carers can share information about their condition, symptoms and changing needs and preferences?
Identify ways that the clients needs can be met and document these in the care plan?
Only act in a way that was within the scope of their role and report anything outside role to supervisor or colleague.
Follow the requirements of the clients care including end of life decisions as was outlined in the advance care plan
Ensure that if the client indicates that they would like their end of life strategies to change that it is reported to a supervisor
Montiors and provides support to the family or carers relating to the end of life decision and refer to other services when it is within organisational policies and procedures
Show respect for the client’s right to decide the location of their end of life care
Correctly identifies when the client may be in pain and document this on the pain management plan / care plan and report to a supervisor when necessary.
Where the client is not showing visible signs of pain, did the student ensure to ask the client if they were feeling any pain and report changes to their supervisor
Correctly identify other changes in condition that may require intervention, document it and report to a supervisor
Implement sufficient strategies to improve the clients pain or comfort in line with the care plan
Monitor if the clients response to pain medication has changed and if implemented strategies were successful
identify any needs and issues that may be outside their boundaries and refer to appropriate person for advice?
Report misconceptions around pain management to appropriate profession to clarify this understanding
Check the clients care plan to ensure that end of life care strategies have been reviewed and updated.
Provide a supportive environment for the person involved in end of life care as well as their families and carers
Maintain the clients dignity at end of life and following death
Accurately recognise signs of imminent death and follow organisations policies and procedures
Provide relevant emotional support to loved ones in line with job role
Complete all relevant documentation
Manage potential ethical issues and personal responses to death in line with organisational policies and procedures
Identifies if any of their own personal responses to death may be an issue and raise with a supervisor
Report any ethical issues to a supervisor
Identify and implement self-care strategies to address impact of personal responses