Support older people to maintain their independence August 2009
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- Slide 1
- Support older people to maintain their independence August
2009
- Slide 2
- This Unit involves: Supporting older people with their daily
activities Checking an older persons ability to do daily activities
Making sure an older persons environment is suitable, safe and
secure. Supporting a person experiencing loss & grief
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- Older People Everyone's needs are different, they can be
complex and include physical, emotional, educational, safety,
social, cultural, religious and sexual. In meeting the individual
needs of each client in our care, it is important to acknowledge
that all these needs have to be met -if one of these needs is not
met it can impact on other needs. Meeting these needs is a team
approach, we are part of a multidisciplinary team and we need to be
aware of the roles and responsibilities of all team members.
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- Care plans Outline the needs of the client, it is a written
document that clearly explains the following about the client: o
Health status o Problems/ issues o Goals and outcomes o
Interventions o Responsibly of team members It is essential to
abide by the organisations p & p.
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- Maintaining independence One of our aims in aged care is to
promote the maintenance of independence. So that clients can engage
as independently as possible within the community. Our role may be
to assist with ADLs such as assisting in the home- meals &
cleaning; garden- yard maintenance; community- involvement in
activities such as hobbies, sport, education... Activities assist
clients to meet social, emotional & recreational needs, without
which may lead to isolation/increased
dependence/depression....
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- Supporting ADLs Independence is linked to control, choices and
confidence. As people get older they may need to rely on others to
undertake ADLs Ageing in place may mean older people need support
with ADLs & information. When an older person can no longer
independently complete daily tasks (ADLs) we need to establish
cause as well as offer the support needed.
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- Doris can no longer see clearly, her eye sight has deteriorated
to the point she cannot see the cooking knobs on the stove &
cannot read cooking recipes and instructions. It is not safe for
her to cook. Therefore she may need support with cooking &
reading, provision of magnifying page so she can read the recipes,
provision of equipment to make cooking easier for her. There are a
number of ways a person can get support- family/ friends/ community
or local council support. The amount & type of support is
different depending upon wether a client lives at home, community
or residential care.
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- Support Home and garden maintenance can be supported with
family/ friends, govt. Funded organisations, private businesses
such VP lawn mowing/housekeeping; staff at aged care facility or
retirement village. Older people ideally will live their lives as
they wish, catch up with friends, keep appointments, shopping
dates, playing sport etc.... Support with transport may be needed,
this could be in the form courtesy buses, shopping transport via
local council, private services such as taxi, volunteer services,
subsidised transport passes via the govt.
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- Some older people need someone to go out with them due to poor
memory, vision/ hearing, gait and mobility problems.... They may
need assistance to push a shopping trolley or to get around from
one place to the next and keep appointments. This may be part of a
carer or volunteers role within the community. Helping with
household tasks may be putting the laundry on the line, preparing
meals- a client is encouraged to do as much as possible and the
assistance provided is only for the gaps. Assistance may be
provided via HACC program or privately such as meals on
wheels.
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- Personal or financial matters Older persons may need assistance
with reading or writing due to memory or vision impairment for
example. Assistance may be provided from family/ friends; HACC
services for reading/writing, guardian or power of attorney may be
appointed to assist with financial decisions.
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- Caring for pets As an older persons condition changes they may
no longer be able to walk, wash, brush or take their pet to the
vet. Support services may be via friends/ family, volunteers,
HACCs, private services such as mobile vet.
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- Helping older people to find support First the level of help
needs to be established by asking the client and significant others
what help is needed, observe the client to identify areas needed
support, the client can be assessed via ACAS. Once the level of
support needed is established the client can then be matched to
services. As an aged care worker you need to know the level of
services you and your organisation can provide. A communication
book and care plan needs to be established. Not all older people
are happy to get support for reasons such as loss of
independence...
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- Support provision You must practice within your scope of
practice and according to your p & p of your employer for
example you may be employed to assist a client with household
duties but not allowed to climb a ladder to change a light bulb or
clean away cob webs.... The provision of support is individual to
the client and dependent upon their care plan and level of need.
The care plan will describe the level of support and where the
support will be provided. The older person needs to know where,
when, by whom the support will be provided and what the service
will not do.
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- Care Plans Explain the care requirements of the client The
client should where possible be involved in the development of a
care plan. Within the community the plan should include the support
provided by family/ friends/ volunteers and other services; such a
plan may also be referred to as service plans, support plans or
service delivery plans. Plans need to be updated regularly and
changed as the clients needs change. It is important to read your
clients care plans and understand the information in them always
ask if not sure.
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- Amaroo Aged Care Facility SURNAMEGIVEN NAME BED NUMBERWING
DIAGNOSISDOB ALLERGIES OBSERVATIONGOALINTERVENTIONEVALUATON/
OUTCOME Impaired mobility due to arthritis Optimise mobility as
independently as possible. Have client assessed by physio.
Provision of walker as per physio Slippers on when mobilising
Removal of clutter Non slip mats in the bathroom Passive ROM
exercises Implement falls prevention program. Client mobilising
with walker without assistance- no falls this week. KP
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- Home & community Care See example of service provision plan
You should always refer to your supervisor to gain clarification,
more information or if a clients needs have changed. Your
supervisor is there to help you. It is important that a clients
routine, beliefs and customs are respected in the delivery of
services and care. Remember that at all times a clients
independence needs to promoted at all times, all older people
deserve to feel in control of their ADLs and the help you are
giving them.
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- Respect Always ask for permission before entering a clients
home, using a clients belongings or before you undertake any care
or service delivery. Always ask the client when, where and how they
would like to receive their support.
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- As a worker you may be required to use a variety of equipment-
you need to ensure you always abide by the p & p of your
organisation. Make sure the equipment is good working order before
use- this may be a microwave or washer in the home to a mechanical
lifter in a residential care facility. Always undertake a
risk/hazard assessment prior to undertaking the task. If not sure
always ask your supervisor. With transport- ensure you have
undertaken the required training in moving clients in & out of
vehicles/ their equipment or hoists in transporting people in wheel
chairs for example. Ensure you have all OH & S training to
ensure safety of your client and yourself.
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- Assessing an older persons ability to undertake ADLs An
important part of our role to assess and observe the clients
ability to undertake ADLs Remember the importance of modifying the
task or environment to promote independence of the client A clients
condition may be progressive- dementia A clients condition may be
temporary- fracture It is essential part of our role to notice
changes, report & document these changes according to p&p.
Activity: diagram- Id needs.
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- Ask & observe When you notice changes or a client voices
complaints of changes such as pain/ increased stiffness for
example..be sure to question further to gain more information. Be
careful how you ask the question- they may feel embarrassed that
can no longer do a task... Do you need some help with the washing?
Instead of why haven't you done your washing? Another way to
establish changes is to review the care plan and progress
notes.
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- Reporting changes Reporting changes is essential part of
communication for the provision of care- as you are one part of the
multidisciplinary team. Reporting may be in the form of f:f,
telephone, care notes/ progress report and hazard/incident reports.
Activity- complete hazard/ incident & progress notes.
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- Supporting the older person to modify activities to adapt
behaviour Once a change has been identified and reported then a
modification in service delivery may be required. An activity may
be adapted with the help of an OT or PT to optimise the clients
independence. Finding out about aids and equipment can be via
information centres such as Independent Living Centre website-
www.ilcaustralia.org.auwww.ilcaustralia.org.au Equipment may be
such as tap turner, long handed broom, non slip bench mats, grips,
large print, trolleys, walking sticks, alarms..... A client may
need an increase in services to support their ageing in place or
they may require placement into an aged care facility.
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- Safe & Secure environments Supporting the older person to
maintain their environment may involve the client to assess for
safety risks and identify strategies to assist them undertake ADLs
easier. Helping the older person keeping their environment secure;
prevention of falls, clients have control over ADLs- i.e.. A client
with dementia may feel more secure with notes to jolt memory; and
clients are fully informed. Talk with your client to ensure they
feel safe & secure and discuss ways which may be adopted to
assist a sense of security.
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- Adapting environs for safety & security Safety refers to
being free from risk of harm, injury and danger. Adapting an
environ for safety may mean- checking locks, removing hazards,
checking equipment, assisting clients to pay bills on time, keep
apts, temperature comfortable, shop regularly for healthy food.
Ensure clients are aware of external potential dangers such as
curbs/ footpaths. It is essential not to upset a client in the
process of adapting the environment & to involve them in the
decision making process, even if they do not want to adapt a
necessary change such as clutter or purchasing a new chair.
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- Loss To cease to have something that has been a normal or
desirable part of life.
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- Grief An intense emotional response to any significant loss,
especially the death of a loved one. Grieving is part of adapting
to loss.
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- Experiencing loss & grief Chaotic and disordered thinking
Super-drive efficiency to deal with emergency Dreams and nightmares
Loss of interest, aimlessness Loss of concentration or inability to
remember detail Loss of faith, hopelessness Suicidal ideas Pleasure
in remembering Changing values and beliefs.
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- Physical Reactions Headaches Sweating, shaking Nausea Shortness
of breath Over sensitivity to noise Loss of energy Aching muscles
Dizziness and disorientation Loss of appetite Insomnia Increased
incidence of infections and common ailments Pain that imitates
illness or pain experienced by a loved one Stress related
disorders.
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- The Stages of Grief The five Stages of Grief were originally
defined by Elizabeth Kubler-Ross. These five stages have come to be
identified with the general experience of grief.
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- This cant be happening its not true Denial people may seek
second opinions, or refuse to discuss the situation. Denial allows
the person time before they have to start dealing with the
loss.
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- Why me, why is this happening? Anger when the person begins to
realize the severity of their loss and becomes angry. The person
may feel isolated or cheated.
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- If I eat healthy foodgive up smoking? By bargaining with
medical staff, God or their own concept of fate the person may try
to regain control of the situation.
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- Theres no point Depression occurs as the person realizes the
severity of the loss. They may feel completely powerless and unable
to take any action on their own behalf. There is a feeling that
life is over.
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- OK, this thing has happened what do I do now? Acceptance occurs
after having worked through these emotional responses the person is
ready to start the often long and slow process of adapting to the
loss. The negative emotions from the early stages of grief are
likely to recur from time to time.
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- Tips for Supporting the grieving person Being There Listening
Reminiscence Relaxation Ritual Structure Opportunity
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- Ground Rules for Interviewing People who are Grieving Their
experience will be significantly different from your own. Create a
safe emotional environment Listen more talk less! Listen to the
clients tone of voice Look at their body language Accept the person
the way he or she is at this moment. Encourage the safe expression
of feelings. Reinforce personal responsibility and choice
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- What to say Tell me Tell me what its like for you Hearing that
makes me feel I feel I want to know Id like to hear about I
feel
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- What not to say Be brave Lets not talk about this, what did you
do the other day? Just remember the good times Youre going through
the angry stage, it will pass If I were you Id Youll be stronger
for this Why dont you try Time heals all wounds When I I know just
how you feel
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- Grief and loss will be discussed further in the palliative care
and emotional and psychosocial wellbeing units.. References: Aged
Care text & Aspire learning resources.