CHCAC317A – Support older people to maintain their independence: Assignment 2
Assignment overview
Read the case study below and answer all nine (9) questions that follow.
How you will be assessed
This unit is competency based. In order to be deemed competent in the unit you must satisfy all elements specific to the unit, the essential knowledge and the critical aspects of assessment in a range of situations. Each assignment has been developed to cover these criteria and your OTEN teacher will review all assignments and assess your overall result to deem you competent in each unit.
Please reference your work. Referencing guides are available on the OLS under Assessment Guidelines.
Task
Case study
You work for Grevillea Aged Care Services – Home and Community Care (HACC) – as an aged care worker.
You come to Mr Tolstoy’s home (he prefers to be called Leon) to explain the scope of the service that will be provided to support and assist him with his cleaning, laundry, shopping and medical appointments within the organisation’s protocols and procedures and to decide on suitable times with him to provide this service.
Leon is a retired chef who immigrated to Australia from the USSR (Russia) in 1950 after WWII. During the war, Leon was a prisoner in a concentration camp where he learnt to speak five languages (including English) fluently to retain his sanity.
Initial presentation:
You note on first contact that Leon is neatly dressed in shorts, shirt and hat, working in his garden.
Leon Tolstoy is a clean-shaven 80 year-old single gentleman who has deteriorating eyesight from macular degeneration and glaucoma. Leon has osteoarthritis that affects his mobility; he has symptoms of pain and tenderness; swelling and stiffness - especially in cold weather, muscle weakness and a grinding sensation in his joints - especially in his knees and hips.
In August 2011 you first started to assist Leon with the following chores:
• Clean the shower, bath and toilet.
• Vacuum and mop the floors throughout his single story one bedroom housing commission unit.
• Hang out the washing on the clothes line after Leon has washed the bed linen and towels in the washing machine on Tuesdays when you come to clean.
• Transport Leon to the local shopping centre on Wednesday for food.
• Transport Leon to regular medical appointments on day required.
Inside the house is neat and tidy and surfaces are clean and wiped down when you arrive. The garden and lawn is well kept. This is Leon’s pride and joy - especially his herb and vegetable garden that he grows for his table as he loves to cook.
Leon does not drive due to his failing eyesight (he wears reading glasses that at times you need to remind him to clean) and you drive him to the local supermarket to do his weekly grocery shopping. Leon pushes the shopping trolley around while you read and tick off the list of goods that Leon has written out. You often visit the local library to exchange big print library books then visit the library coffee shop where you both enjoy coffee and cake. You lift the shopping bags out of the trolley into the car boot. At Leon’s home both you and Leon carry the shopping bags inside to the kitchen. Leon puts his shopping away while you continue with your other tasks.
Leon usually goes out on Wednesday afternoon to play bowls with his mates. It is only a block from his home so he usually walks to the Bowling Club. Friday night he plays cards with his friends. Leon’s friend, Vladimir, usually drives them to the Russian Club on Friday night. Vladimir picks Leon up on Monday morning as they play golf together.
Leon enjoys reading the newspaper (which he walks to the corner shop to purchase) and completing the crossword puzzle each morning with his morning cup of tea before he has breakfast at 8:30am.
Questions
1. When you first start to work with Leon, it is important that you first identify what support Leon requires with his ADLs (Activities of Daily Living), chores or tasks.
List the support needs next to each of the following areas.
- ADLs
- Shopping
- Transport
- Cleaning
- Laundry
- Gardening
Make sure that your information is unique to Leon and matches the information given in the case study.
2. Service plans are used to direct aged care workers on how to provide the appropriate support for the clients.
Complete a service plan form for when you first met Leon in August (see form below). Please note the form continues across three pages.
• You need to fill in all sections of the service plan - do not leave any section blank.
• If there is no information available in the case study for a particular area, you will need to add NA (‘not applicable’) into the relevant section of the service plan.
Service sheet form 1 (Question 2)
SERVICE SHEET No. 1
Agency details: Grevillea Aged Care Services - HACC Client details: Leon Tolstoy
Home Care Worker name:
Client address: 5 Grevillea Road Grevillea
Supervisor’s name: Anne Cummings (RN)
Phone Contact: (02) 9715 8186 Carer’s details: None
Close friend is Vladimir Ph. 5151515
Frequency of service dates/days
Tuesday & Wednesday
Time allocated:
3 hours /day
Service sheet form 1 (Question 2 continued)
Service/task Required
? or ×
(Or Yes / No) Comments
Current situation and what is required Alerts
Any areas that require special care
Household assistance
e.g.
Vacuuming/sweeping
? The house is neat, tidy and surfaces are clean and wiped down when you arrive. Carer to vacuum. Leon has failing eyesight
Vacuum cord – trip hazard
Mopping
Dusting
Clothes washing
Changing bed linen
Ironing
Window cleaning
Meal preparation
Shopping
Transport
Home Maintenance
Gardening
Repairs & maintenance
Personal Care – assistance with:
Dressing and grooming
Showering and bathing
Continence and toiletry needs
Eating skills/dietary needs
Mobility
Service sheet form 1 (Question 2 continued)
Medication x Self-medicates Dr Smith Bow Rd Medical Centre Ph. 151515
Communication and language
e.g. hearing aids; glasses; vital call Speaks 5 languages, including English, fluently
Comments/other alerts: Note social activities e.g. Leon is an Orthodox Christian he attends St Nicholas Church with close friend Vladimir.
Review undertaken by: _______________________________
Date: / /20__
Case study - continued
Nine months later – Leon’s health is deteriorating. Read the case study to see how much Leon’s condition and circumstances have changed:
By May of the following year, you have been assisting Leon for 9 months. Now when you arrive you find that the washing machine has the clothes in it although it has not been turned on and he is complaining that his hands are weak and he is having trouble with turning the dial on the washing machine and taps on and off in the sink.
Leon is unshaven and some clothing is not fastened, just as buttons on his shirt are not done up. You notice Leon is tending to wear t-shirts rather than his shirts
Leon’s herb and vegetable garden is showing signs of neglect. The lawn at the front of the home is long and unkempt. The wire front door is not locking and the security light on the front patio is not activating when one arrives. The brick path to the clothes line has lifted in places.
When you drive Leon to the shops, you find a trolley for him to push around which Leon is using to support his walking. The shopping list is becoming harder to read as the writing is unclear. You are finding you have to direct Leon to where things are on the shelves. It is apparent that Leon’s sight is fading. Leon is not interested in going to the local library anymore and states he is “not interested in reading anymore” and often does not want to stop for coffee and cake.
Once home from the shops, you bring in the groceries and put them away. Leon sits down to rest. Leon is not going out on Friday nights to play cards and only occasionally joins his friends for a meal at the Russian Club, stating he is “too tired”. Leon has not played golf since having a fall 3 weeks ago (he tripped over in the club house as he did not see a bag on the floor, but did not hurt himself). Leon is concerned that his condition is getting worse and he is losing his sight. Leon says he is frightened that he will hurt himself and end up in an “old people’s home”.
You notice that the dusting is being done but not to the standard it was 9 months ago and that the newspapers are lying about but the crosswords are not always attempted. You realise you are actually doing more tidying up and picking up prior to cleaning, sweeping and mopping.
Questions
3. What are the signs that Leon’s support needs have changed?
Record these ten (10) signs as you would in the communication book (see sample answer).
COMMUNICATION BOOK
Agency details: Grevillea Aged Care Services - HACC Client details: Leon Tolstoy
Supervisor’s name: Anne Cummings (RN)
Phone Contact: (02) 9715 8186 Client address:
5 Grevillea Road Grevillea
Date/Time Comments
30/06/2012 0900hrs Leon states ‘hands feel tender and I have some pain, winter time always makes my arthritis worse’. Wears woollen gloves. Remains independent with ADLs. Jenny McGuiggan ACW J. McGuiggan
9/07/2012 1415hrs Hazard report form No. 2012/1 completed, on bathroom tap dripping emailed to supervisor for action. Jenny McGuiggan ACW J. McGuiggan
4. Mr Leon Tolstoy’s condition has changed and therefore requires a revised Service Sheet.
Complete a second service plan form (below) for Mr Leon Tolstoy that addresses his changed status.
• You need to fill in all sections of the service plan – do not leave any section blank.
• If there is no information available in the case study for a particular area, you will need to add NA (‘not applicable’) into the relevant section of the service plan.
• Please note the form continues across three pages.
Service sheet form 2 (Question 4)
SERVICE SHEET No 2
Agency details: Grevillea Aged Care Services - HACC Client details:
Home Care Worker name:
Client address:
Supervisor’s name: Anne Cummings (RN)
Phone Contact: (02) 9715 8186 Carer’s details:
Friend Vladimir
Service sheet form 2 (Question 4 continued)
Frequency of service dates/days
Monday, Wednesday, Fridays
Time allocated:
2 hours /day
Service/task Required
? or ×
(Or Yes / No) Comments
Current situation and what is required Alerts
Any areas that require special care
Household assistance
Vacuuming/sweeping e.g. Vacuum cord – trip hazard
Mopping
Dusting
Clothes washing
Changing bed linen
Ironing
Window cleaning
Meal preparation
Shopping
Transport
Home Maintenance
Gardening
Repairs & maintenance
Personal Care – assistance with:
Dressing and grooming
Showering and bathing
Continence and toiletry needs
Eating skills/dietary needs
Mobility
Service sheet form 2 (Question 4 continued)
Medication
(example provided) ? Needs assistance with opening bottles and Webster blister pack Friend Vladimir comes in AM & PM to assist Leon
Communication and language
e.g. hearing aids; glasses; vital call
Comments/other alerts:
Review undertaken by: ___________________________
Date: / /20__
5. Complete the Hazard table below:
a) List three (3) things from the case study that might not be safe in Leon’s environment?
b) How might each of these hazards be managed?
c) How would you report the safety issue for each hazard?
Hazard table
a) Hazard in Leon’s Environment b) How might they be managed? c) How would you report the safety issues?
6. Using one of the hazards identified in Question 5, complete a Hazard Form (provided below). Please note the form continues across two pages.
Hazard identification report and action form (Question 6)
HAZARD IDENTIFICATION, REPORT AND ACTION FORM
Report No: 2012/01
Agency details: Grevillea Aged Care Services - HACC Client details:
Name of person reporting hazard:
Client address:
Name of any Witnesses
Carer’s details:
Supervisor’s name:
Phone Contact: Date & Time reported:
Nature of hazard
Cause of hazard
(e.g. wet floor)
Date of hazard
Location of hazard
(e.g. in bathroom of client’s home)
Describe the hazard and what the risks of injury or harm may be
(e.g. leaking S-bend under sink, risk of slipping on wet floor, fracturing hip)
Hazard Identification Report & Action Form (Question 6 continued)
How did the hazard occur?
What immediate action was taken?
Has any person been injured or had a near miss due to the hazard?
(Describe the outcome: e.g. none, hospitalised, anger, deceased)
What further action is required to deal with the hazard?
Was this hazard preventable?
Corrective action to prevent such hazard occurring again?
Report note in communication book: Yes No
Supervisor contacted / form given: Yes How? No
Signature of person completing form: _________________________________
Date: / /20___
7. It is important to maintain a person’s independence if the person experiences a decline in their health and physical abilities.
Complete the following table:
Under each heading:
a) Identify two (2) areas that you wish to target.
b) For each area, name a strategy that would help Leon maintain his independence in completing his daily activities.
• Tip: Look at the Independent Living Centres Australia website for ideas.
a) Area b) Strategy
Activity Way to modify or adapt
1. •
2. •
Environment Way to modify or adapt
1. •
2. •
8. What services can you recommend to Leon that will assist him to remain independent in his home for as long as possible?
9. Is Leon experiencing signs of grief and loss?
a) Support your answer with research.
b) How and to whom would you report your observations?
c) What services could you recommend to Leon to support him in his current emotional state?
Tip: There are many support services to be found on Google, e.g.:
• Australian Centre for Grief and Bereavement
• Anglicare SA – Loss & Grief
• Australian Health Directory – Bereavement/Dying - Support