Reference no: EM133623051

Facilitate the empowerment of older People

Assessment activity 1
Henrietta is a 79 year old woman. She is a meek woman who does not openly participate in :onversation and tends to shy away from group interactions. She has lived in the remote north west or many years and has experienced social and geographical isolation as her husband was a grazier. She home schooled her six children and only went to town monthly to shop or once a year to the Jcal race day.

The last time Henrietta came to town she fell down the local council stairs and fractured her femur oroken hip). She has had an operation to stabilise the fracture and is now ready to go home. She -as been referred to your service to enable her to transition back into her home.

Henrietta's daughter has offered to stay with her for six months when she gets home, however Henrietta is determined that she will be able to make the transition herself once she is out of hospital and into the community setting that has been arranged for her. Her temporary accommodation is in an assisted living village which her daughter's feel she should remain in rather than returning to the family home in the country. You agree with the daughter's although you know you are unable to express your feelings.

a) Outline how you would ensure that you and Henrietta could have an open and frank discussion regarding her needs and preferences.

b) Why is it important that you respect the information that Henrietta exchanges with you?

c) While talking with Henrietta you are collecting information on her strengths and challenges. Identify two of these and identify how you would incorporate them into her care needs.

d) Henrietta confides in you that she has not seen a doctor regularly and that she is having some continence issues. She asks you not to tell anyone as she knows that this will be the thing that ensures that she will not be allowed to go back home as her daughters are so much against her return. What do you do?

e) It is identified that Henrietta has urge incontinence. Who could you refer Henrietta to if you were asked to make the referral?

f) In the space below, design an information brochure that you could provide to Henrietta to assist her to better understand continence and continence aids.

g) Identify two aspects of continence management that may be physical and social enablers and disablers that may affect Henrietta's quality of life.

h) Why is it important that Henrietta is encouraged to manage her own continence aids?

i) Why is it important that you do not impose your own values and beliefs on Henrietta when she is discussing her continence support needs?

Assessment activity 2
People face many issues as they age, particularly as the population are living longer and refuses to conform to the ageist stereotypes.

There are pressures for people to work longer, there is a tighter economy and many people live in virtual isolation within homes separated from their families due the transience of society.

1. Identify and outline three issues facing older people that relate to this statement.

2. Outline your understanding of the following

Statement
The purpose of residential care
The purpose of respite care
The purpose of home and community care
Referral agencies and networks
www.myagedcare.gov.au
Quality auditing

3. Define the following

Rights based service delivery
Person centred practice
Consumer directed care
Empowerment
Disempowerment
Re-ablement

4. When considering positive ageing why is it important to understand biases and stereotypes when discussing planning options with individual clients?

5. Complete the following table related to ageing and associated disorders.

Change                                     Effect on lifestyle or ADLs                                               Support activity
Eg loss of lung capacity           Decreased endurance to complete activities            Promote deep breathing, have regular rest stops
Loss of skin elasticity / skin disorders / skin cancer
Muscle wasting/ loss of position sense / arthritis / frailty
Changes to eyesight
Changes to hearing
Depression
Diabetes
Deconditioning and heart disease
Incontinence
Neurological disorders
Stroke
Vascular disease
Normal ageing

6. Why is it important to understand differing gender and sexuality issues when caring for people who are ageing?

7. Outline why it is important to consider the clients physical and cognitive abilities when planning programs and activities and delivering services

8. When discussing activities and routines with clients why is it important to discuss potential and actual risk as well as dignity of risk?

9. In the table below is a list of the types of abuse that can occur in the aged, community and disability services. For each type of abuse, provide indicators that could be used to identify that a client is being abused.

Type of abuse Indicator
Physical
Sexual
Psychological
Verbal

10. What do you understand by the term "mandatory reporting" of abuse?

11. Define the following

Terminology Definition
Code of practice
Discrimination
Dignity of risk
Duty of care
Human rights
Privacy and confidentiality
Disclosure
Work role boundaries
Work health and safety

Assessment activity 3

Malcolm lives in a share house. He had been living independently until a recent fall. He now requires assistance with shopping and social activities as he has lost the confidence to walk over long distances. You are Malcolm's designated worker.
You pick Malcolm up to take him shopping, and he is chatty and in quiet good spirits. He realises that his mobility is "a bit shaky" at the moment and he is keen to walk as much as possible. You are asking general questions regarding his living arrangements, when suddenly Malcolm becomes quiet and starts looking out the window. You realise that this conversation is not the best way to establish rapport with Malcolm and decide to change the direction of the conversation.

1 How would you develop a sense of trust and goodwill with Malcolm?

2 Malcolm walks around the shopping centre quiet well. You are providing positive praise, but he keeps mumbling "stupid old thing" this concerns you. You decide that Malcolm would benefit from some reassurance. You speak with your supervisor who advises you to speak with the providers of the local falls prevention program. Research who this is in your local area and identify how you might assist Malcolm to access this support.

3 Why is it important to identify strategies such as rest breaks after short distances and ensuring appropriate footwear for Malcolm?

When you return Malcolm to his room he shows you a picture that he says is dear to him as he was a "rocker in the past" and there is nothing he would like more than to be able to be a part of the picture. The picture is copied below.

You tell Malcolm that you are able to assist him to join the local music group at the Senior Citizens centre. His response is that he has already been ridiculed by the management of the Share House for being a "stupid old fool". He confides in you that he has thought about "just disappearing" as he feels that most of his life choices have been stupid.

4 Identify one strategy that you might use to encourage Malcolm to engage with a music group

5 What is your response to Malcolm's statement that he has thought about "just disappearing"? Who would you report this to?

6 Why is it important to encourage Malcolm to share the responsibility for finding ways to boost his self esteem?

7 Review the case study and identify possible situations where Malcolm's rights have been withheld or there is possible abuse

Reflecting back to your original conversation with Malcolm, you decide that now you know him a little better you will try to re-establish the conversation regarding his living arrangements. You are talking with Malcolm about his room, meals, how he gets his clothes etc. and he responds that he doesn't have to worry about clothing as the manager makes sure he has what he needs as part of the "total service". He confides that manager buys the toiletries and clothing as it is easier for them to know that everyone has appropriate clothing to meet their needs, that the requirements for personal hygiene are met and that they are not appearing to be homeless.

You ask Malcolm how he pays for this "total service" and he explains that as part of the admission process the manager takes banking details and pin numbers for all residents which allows purchases to be made on his behalf. Malcolm says that this is not ideal but he doesn't really have a choice as he needs somewhere to live.

8 Do you find this acceptable? If so why, if not why not? Explain your answer.

9 Malcolm has decided that he might like to live somewhere else and that once he has found alternate accommodation that he would like to make a complaint about how the others in the share house are treated. Identify the agency web site and phone number that should be able to provide information on accommodation choices for aged care.

10 What role might an advocate have in this scenario?

Assessment activity 4

1 Identify three aspects of healthy ageing and the impact/associated risks that they may have on the health and wellbeing of a client.

2 Considering these changes, provide one strategy that an older person could put in place to promote a healthy life style.

3 This is Marion. She is 77 years old and a little "different" to the other older women in her town. She has just moved to town and confides in you that she has been recognised by her past friends as being strong willed and eccentric, with some people saying that her appearance is bizarre for someone her age. This has led to her finding it difficult to make friends. She has a tattooed neck and chest and right arm sleeve, she also has spacers in her ears and several face piercings. Marion dresses in subtle pastels, wears boots and black socks with all her outfits regardless of the occasion.

Marion has become a client of your service. Her support plan indicates that she has had some changes to her psychological wellbeing due to bullying and harassment by her colleagues at the local thrift shop where she used to volunteer. She has made a self referral to your service for psychological support and to find a social outlet that will support her chosen lifestyle. She notes that she has some past behavioural challenges that led to her going to court but that her behaviour is now controlled by medication. She has had little time for social groups in the past but has decided that as she ages she will need the support of others and coming to a new town means it is time for a new start.

a) Outline how you would develop a relationship that was supportive of Marion and her chosen lifestyle choices

b) Marion's goal is to find a social outlet that will support her chosen lifestyle. As she feels devalued after her previous experience how would you support this?

c) Outline any risks that you feel Marion may be potentially exposed to and how you might respond to these.

d) Is it important to be selective regarding the groups that you introduce Marion to? why? why not?

6) Why is it important to validate information, that the client with dementia has given, with family and significant others?

Annette's family are distressed about her accusations of the daughter wanting money as well as the way that she is lashing out at you. They are finding it difficult to come to terms with the changes in Annette's behaviour

7) How would you reassure the family and identify a service that you could refer them to for further information?

Assessment activity 2

1. Identify five common indicators and symptoms of dementia?

2 Define the following
Amyloid plaques
Neurofibrillary fibres
Lewy bodies
Loss of connection between cells and cell death
Alzheimer's Disease
Huntington's disease
Pick's Disease
Vascular dementia
Korsakoff Syndrome
Parkinson's Disease
Younger onset dementia

3 In the table below is a list of impactors and their impacts on the client or their family. Read each impactor and link it to its corresponding impact.

 

Impactor	Joins to	Impact on client / family
Depression		Loss of self, loss of real person who was a loved one
Loss and grief		Fear of making mistakes, lack of confidence, impacting problems
Anger		Feeling of alones and desperation, confusion regarding direction
Despair		Demotivation, worthlessness, hopelessness
Social embarrassment/ devaluation		Part of grieving process, behaviour of concern
Isolation		Loss of self image, social exclusion
Behaviour of concern		Causes physical harm or potential harm to a person or the environment

 

4 Dementia is a progressive neurological condition. Research the meaning of this statement and outline your findings below.

5 Outline 4 strategies that you may consider when building an awareness of the person centred needs of the person with dementia.

6 What potential impact/s do you think that the progression of dementia has on the person and the significant others within their lives?

7 What do you understand by the term dignity of risk?

Assessment activity 3

1 Why do you think that it is important to consider a person's culture, personal and historical background, and the impacts that dementia may have upon them particularly as they relate to behaviour management and potential risk?

2 List five signs of abuse and neglect.

3 Who should a person witnessing signs of abuse or neglect report to?

4 What is your understanding of mandatory reporting?

5 Provide a response to each of the following behaviours

Behaviour                                         Response
Physical aggression
Verbal aggression, calling out, repetitive questioning
Agitation, hallucinations
Wandering, pacing, sun downing
Uncooperativeness, inappropriate actions/ reactions

6 What is the function of case conference? What is its role in contributing to team discussion on support planning and review and minimising the impact of behaviours on others?

Assessment activity 4

1 Desmond is a 63 year old male in the early stages of dementia. He is having difficulties with verbal communication. He gets some words wrong, others he does not pronounce correctly and on occasion he mumbles a lot. As a result, he gets frustrated and tends to give up. He is sometimes heard to say 'it doesn't matter' as he walks away. What strategies would you adopt to help Desmond communicate more effectively?

2 Why is it important that your verbal and non-verbal communication is complementary when conveying a message to someone who has dementia?

3 Bill has dementia and is quite agitated because his wife will not bring the children to see him anymore. You are aware that he is not married and has no children. What actions would you take if using validation strategies? explain your answer.

4. Explain what is meant by reality orientation.

5. You are trying to get a client to participate in an activity, but they have no inclination to do so and start arguing about it. They become agitated and this is having a marked effect on the other clients.

a. How would you manage the situation?
b. What could have been done to minimize the chance of the incident happening?

6. Why is it important to use creative, least restrictive approaches to behaviour management for a client with dementia?

7. In the table below is a list of behaviours of concern. List some possible triggers to the following behaviours and identify strategies to promote cooperative behaviour.

Assessment activity 5

1 How do you recognise when your stress level is reaching its limit?

2. What self-care strategies do you use to keep yourself healthy and more resilient to stress?

3. Are there any self-care strategies you would like to adopt? If so what are they? If not, why not?

4. Who could you seek support from if you are feeling overwhelmed by stress?

5. In the space below, design a poster to orientate a new staff member starting work with clients with dementia. Information should be centred around communication requirements, education regarding behaviour management, skills maintenance, the management of behaviours of concern or self care.