HOLLOWAY PAYNE Best Practice for Working with Caregivers ...? Imagine how you would like a caregiver to treat a close relative ... • Ask open‐ended ... HOLLOWAY PAYNE Best Practice

  • View
    217

  • Download
    4

Embed Size (px)

Text of HOLLOWAY PAYNE Best Practice for Working with Caregivers ...? Imagine how you would like a caregiver...

  • Working with Informal Caregivers for FrontCaregivers for Front

    Line Workers: Guidelines for Best

    PracticesPractices

    June9,2011Lori Holloway Payne Director PSNOLoriHollowayPayne.DirectorPSNO

    lori.payne@ocsa.on.ca

    1

  • AboutPSNO

    ThePersonalSupportNetworkofOntarioisadivisionofppOCSAwhichstrivestohelppersonalsupportserviceprofessionalscarryouttheirworkmoreeffectivelyby

    offering access to information resources and tools as wellofferingaccesstoinformation,resourcesandtoolsaswellasprovidingopportunitiestoconnectwithanetworkof

    professionalsinthefield.

    PSNOsvisionistobuildastrong,cooperativepersonalsupport service sector where providers managerssupportservicesectorwhereproviders,managers,trainers andemployees areequalcontributorsto

    strengtheningtheprofession.

    2

  • Agenda

    UnderstandingtheRoleandscopeofpracticeofg p pPersonalSupportWorkers

    UnderstandingthePrinciplesofTherapeuticR l ti hiRelationships

    UnderstandingtheRoleofPersonalSupportWorkersinTherapeuticRelationshipsp p

    PhasesofTherapeuticRelationships StrategiesforImprovingCommunicationinTherapeutic

    Relationships Discussion,Scenarios,VideoTestimonials

    3

  • WhatandWhoDeterminesWhatAPSWMay DoMayDo

    Legislationg Employer Training CurrentExperience

    4

  • Regulation&PSWs

    ManyhealthprofessionalsinOntarioareregulatedy p gunder RegulatedHealthProfessionsAct Defineswhichprofessionsareregulated

    26professionsinOntario

    Establishescontrolledacts

    Criteriaforexemption

    Setsoutrequirementsforeachprofession'sregulatorycollege

    5

  • Regulation&PSWs

    Professionalregulatorycollegesareresponsibletog y g pset Practicestandards

    Educationalrequirements

    Publicinformation

    Complaintanddisciplinaryprocedures

    PersonalSupportWorkersarenotregulated

    PSW Registry is coming..6

  • PSWRole&Accountability

    TheRegulatedHealthProfessionsAct onlyidentifiestheactsthatanonregulatedhealthprofessional(suchasaPSW)cannot do orcanonlydoinspecificcircumstances

    Under Common Law all PSWs must act responsibly and UnderCommonLaw,allPSWsmustactresponsiblyandexercisedutyofcare inallacts

    Therearealsotheethicalobligationstoavoidharmandpromotegood

    7

  • ScopeofPractise

    PSWsdowhatapersonwoulddoforhimorherselfifpphysicallyand/orcognitivelyablethatareusuallynotcontrolledacts

    PSWsmayperformcontrolledacts,onlyifroutineforthepersonh l dtheemployerpermits,andaspecifictrainingprocedureis

    followed

    8

    followed

  • WhatDoPSWsDo?

    According to the Provincial Role StatementAccordingtotheProvincialRoleStatement Dependsupontheindividualneedsofeachpersonyou

    support Caninclude

    Homemanagement Personal care Personalcare Familyresponsibilities(routinecaregivingtochildren) Work,socialandrecreationalactivities

    9

  • Work,Social&Recreational

    The PSWs role includes assisting the person toThePSW sroleincludesassistingthepersontoparticipateinsocialandrecreationalevents,including accompanyingtheperson assistingwhilethere

    APSWmayalsosupportapersonatthepersonsworkplace

    10

  • Therapeutic Relationships

    TherapeuticRelationshipPhilosophyp p p y ReviewPhasesoftheTherapeuticRelationship ReviewPhasesoftheNonTherapeuticrelationship

  • Philosophy

    TheCaregiver/clientrelationshipisestablishedandd b h h h h f k l dmaintainedbythePSWthroughtheuseofknowledge,

    skill,caringattitudesandbehaviors.

    TheCaregiver/Clientrelationshipisbasedontrust,respect,andunderstandingoftheclient.Thetherapeuticrelationshiprequirestheappropriateuseofpower.

    TheCaregiverengagesinreflectivepractice/selfawareness.

  • Philosophy

    Establishmentofatherapeuticrelationshiprequiresreflectionofcare.Thisconceptincludesthecapacitiesof: selfknowledge,g awarenessofboundaries, limitsoftheprofessional/clientrelationship, empathyempathy, selfdisclosure, selfawareness

    13

  • UnderstandingtheRoleofPersonalSupport Workers in TherapeuticSupportWorkersinTherapeutic

    Relationships

    14

  • 15

  • Barriers

    PSWs struggle to understand their rolegg

    Little common understanding of where the role is going

    Lack of appreciation for personal support services as Lack of appreciation for personal support services as essential to improving the quality of life for clients residents, and especially informal caregivers

    Lack of interdisciplinary collaborations, d t di f th t ti t tunderstanding of the expectations, trust

    16

  • Therapeutic Relationships

    Highly intimate care

    Delicate balance between professional boundaries pand fostering the therapeutic relationship between staff, client and caregivers

    Strong personal connection makes for better care, quality experience for clients

    17

  • Therapeutic Relationships

    Negative side:

    Strong relationships fosters dependencyg p p y

    Lack of flexibility

    Frustration for client

    l k i d l i h b d PSWs lack ongoing support to deal with boundary issues, grief and loss

    18

  • Phases of the Therapeutic RelationshipRelationship

    5 Phases 5Phases

    MutualWithdrawal Grappling Orientation WorkingPhase ResolutionPhase

  • Mutual Withdrawal

    Mutualwithdrawal: Bothclientandcaregiversavoidcontactand

    appointments Therelationshipissuperficialconversationandlack

    ofcommitment

  • Grappling

    Grappling:pp g Bothclientandcaregiversarefrustratedtrydifferent

    approachesbutdontgetanywhere Clientandcaregiverdreadmeetings

  • Orientation

    Orientation: Bothclientandcaregiverareengagedinlearning

    abouttheirroles Therelationshipischaracterizedbyexplorationof

    possiblecareplansandactivities

  • Working Phase

    Workingphase:(Identification Exploitation)g p ( p ) Clientworkingonbeingindependentcompetentand

    developingnewskills Thecaregiverassistswithdecreasinganxiety,

    meetingtheclientsneedsastheyariseandmovingtheclientforward

  • Resolution

    ResolutionPhase: Clientnolongerneedssupportfromthecaregiver Client'smovestowardnewgoals Thehelperconnectstheclient'swithcommunity

    servicesandterminatesrelationship

  • Communication Strategies for PSWs that Strengthen Therapeutic Relationships

    25

  • Communication Strategies for PSWs that Strengthen Therapeutic Relationships with CaregiversCaregivers

    Imaginehowyouwouldlikeacaregivertotreatacloseg y grelativeandthenmodelyourbehavioraccordingly

    Introduceyourselfbyname(firstname)andyourrole Usetheclientspreferredname Makeeyecontact,whenculturallyappropriateandbe

    aware of your body languageawareofyourbodylanguage Recognizeyouarenottheretoreplacethefamily Askabouttherolethefamilywantsyoutoplayy y p y Understandtheymayhavebeentoldyoucandothings

    thatyoucant AskyourSupervisorforsupportexplainingthingstothe

    family26

  • Communication Strategies for PSWs that Strengthen Therapeutic Relationships with li tclients

    Askopenendedquestionstoencouragemorethatyesp q g yornoresponses

    Listenactivelyandshowinterestinyourclients Inquireintounusualcommentsorbehaviours Understandyourclientscareneedsandgoals Provide sufficient information for clients to make choices Providesufficientinformationforclientstomakechoices

    andhaverealisticexpectations Collaboratewithclientstofindbestsolutionstoanyy

    problems Followthroughonyourclientscommitmentsandnotify

    li t f h i ticlientsofanychangesinroutine Reflectregularlyonhowyourclientsperceiveyou

    27

  • Ideas to improve the client and caregiver experiencecaregiver experience

    Moretimeforreflectivepracticep

    Moretrainingintherapeuticrelationshipsandcommunication

    Invitation to participate/inclusion as part of the team Invitationtoparticipate/inclusionaspartoftheteam

    Deeper understanding of their role and role boundariesDeeperunderstandingoftheirroleandroleboundaries

    Supportforgriefandloss

    28

  • Supporting PSWs

    Howyoucanhelp:y p Leadershiptomakechangehappen Recognition/awarenessoftheroleandcontributionto

    caregiversupport Providermoreeducationandtrainingonhowtodealwith

    caregivers and familiescaregiversandfamilies Familiesneedmoreeducationtounderstandwhatis

    happening

    29

  • Video testimonials

    Keeping the home in Home Carep g Keeping the home in home care is a research

    project is funded by Saint Elizabeth Health Cares (SEHC) C t K C t d th C di(SEHC) Care to Know Centre and the Canadian Health Services Research Foundation. The goal of the project is to improve home care clients experience of personal support services.

    htt // i /15889434http://vimeo.com/15889434http://paulholyoke.ca/?p=264

    30

  • Test Your Knowledge of Professional BoundariesBoundaries

    Josie works in the community and had provided y pcare to Mrs. Zakia for several years until another agency took over the care. Josie still keeps in contact with Mrs Zakia and visits occasionallycontact with Mrs. Zakia and visits occasionally because she feels that Mrs. Zakia is very isolated without regular caregiver support. During these visits, Josie criticizes the care that Mrs. Zakias new care giver Hanna, is providing. This upsets Mrs. Zakia, leading her to check with the doctor and her , gcase manager several times. Each time Hannas care is found completely satisfactory. Mrs. Zakia has mentioned to Josie that while she appreciateshas mentioned to Josie that while she appreciates her visits, Josie does not have to check up on her so frequently. 31