Individual Support, Ageing and Disability - Draft 1

CHCAGE011_Provide support to people living with dementia_Consultation Draft 1

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Unit application and prerequisites

UNIT CODE

CHCAGE011

UNIT TITLE

Provide support to people living with dementia

APPLICATION

This unit describes the performance outcomes, skills and knowledge required to provide person-centred care and support to people living with dementia. It involves following and contributing to an established individualised plan.

 

This unit applies to workers in a residential or community context, including family homes. Work performed requires some discretion and judgement and may be carried out under regular direct or indirect supervision.

 

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian standards and industry codes of practice.

 

No occupational licensing, certification or specific legislative requirements apply to this unit at the time of publication.

PREREQUISITE UNIT

Nil

COMPETENCY FIELD

Nil

UNIT SECTOR

Aged Care

1 Comments

Overall Unit

"Although there are some small changes to the unit the language used does not reflect contemporary thinking"

Sharon Richards 05.03.2021 05.45PM

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Elements and performance criteria

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

  1. Prepare to provide support to people living with dementia.
    1. Interpret individualised plan and familiarise self with the specific needs and preferences of the person living with dementia.
    2. Apply person-centred care approaches to all interactions with the person living with dementia.
    3. Consult with the person and their carer to provide and maintain a stable and familiar environment.
    4. Recognise signs consistent with abuse or neglect of the person and report according to organisational policies and procedures.
  1. Use appropriate communication strategies.
    1. Communicate in a supportive manner that respects the person’s needs, rights and cultural background and upholds their dignity.
    2. Maximise engagement of the person with dementia using verbal and non-verbal communication strategies.
    3. Provide reassurance to the person and facilitate cooperation using reality orientation.
    4. Use a range of validation strategies with the person to relieve distress and agitation.
  1. Provide activities for maintenance of dignity, skills and health.
    1. Access information about the person’s reminiscences and routines from carer.
    2. Organise activities which aim to maintain independence, using familiar routines and existing skills.
    3. Provide opportunities for autonomy and risk-taking according to the needs and preferences of the person, while preserving their safety and comfort.
    4. Identify and support the person’s use of assistive technologies in meeting their individual needs.
    5. Organise activities that reflect the preferences and culture of the person, to stimulate pleasurable memories.
    6. Provide support to the person’s carer as applicable.
  1. Implement strategies which minimise the impact of behaviours of concern.
    1. Refer to individualised plan to identify documented behaviours of concern and potential triggers.
    2. Contribute to team discussions on support planning and review.
    3. Use identified strategies to minimise the likelihood of and reduce the impact of behaviours on the person and others.
    4. Evaluate implemented strategies with support planning team to determine effectiveness of strategies in minimising behaviours.
  1. Complete documentation.
    1. Complete reports including reporting observations to supervisor according to organisational policies and procedures.
    2. Complete, maintain and store documentation according to organisational policies and procedures.
  1. Implement self-care strategies.
    1. Monitor own stress level when working with people with dementia.
    2. Use self-care strategies and seek support if required according to organisational policies and procedures.

6 Comments

Element 3.3

"3.3 states-Provide opportunities for autonomy and risk-taking according to the needs and preferences of the person, while preserving their safety and comfort. - I feel autonomy and risk taking in related to dignity of risk and enablement - more about supporting a person's rights than 'preserving safety and comfort'"

Debbie Zulch 11.03.2021 06.29PM

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Element 3, 3.4 Identify and support the prson's use of assistive technologies in meeting their indiv

"What is meant by assistive technologies? Please define this - and will all people with dementia use assistive technologies how will trainees demonstrate this skill if there are no people at the workplace with dementia who use assistive technologies - this is also in another unit CHCCCS031 does it need to be in here also?"

Melissa Beeston 11.03.2021 12.19PM

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1 Reply

"Assistive technologies could be as simple as a calendar/ orientation board- we know that these help with reality orientation; or can obviously be more complex equipment as prescribed by allied health professionals- all help with supporting independence. The Royal Commission final report and recommendations into aged care- encourage 'reablement' and assistive technologies can help with this goal."

Debbie Zulch 11.03.2021 06.36PM

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Element 3.1 Access information about the person's reminiscences and routines from carer

"this seems a bit too specific - not all people with dementia have a carer - if the word carer in this instance means family members or friend etc. could you add Access information about the person's reminiscences and routines from carer and/or the individuals support plan."

Melissa Beeston 11.03.2021 12.15PM

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2 Replies

"agree - can the term be broader to cover any family members or friends who can help us understand a person's story"

Debbie Zulch 11.03.2021 06.38PM

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"Also a student on placement would not have access to the family member or carer and would not be put into a position by the agency to speak with or interview families of the residents."

anne tierney 12.03.2021 11.08AM

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Foundation skills

FOUNDATION SKILLS

Foundation skills essential to performance are explicit in the Performance Criteria of this unit of competency.

UNIT MAPPING INFORMATION

CHCAGE005 Provide support to people living with dementia.

LINKS

Companion Volume Implementation Guide

0 Comments

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Performance evidence

TITLE

Assessment Requirements for CHCAGE011 Provide support to people living with dementia.

PERFORMANCE EVIDENCE

Evidence of the ability to complete tasks outlined in elements and performance criteria of this unit in the context of the job role, and:

  • provide support according to an individualised plan, to two different people living with dementia, including:
    • using a person-centred approach to support that upholds the rights and dignity of the person
    • demonstrating use of communication strategies tailored to the needs of the person
    • implementing activities that meet the person’s needs
    • using identified strategies to minimise behaviours of concern that are specific to the person
    • completing reports and documentation according to organisational policies and procedures
  • use two different self-care strategies to manage work-related stress.

1 Comments

Performance evidence

"This is more comprehensive than previous unit- but obviously covers all of the elements well"

Debbie Zulch 11.03.2021 06.39PM

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Knowledge evidence

KNOWLEDGE EVIDENCE

Demonstrated knowledge required to complete the tasks outlined in elements and performance criteria of this unit:

  • current research on dementia and the different manifestations of dementia, including but not limited to:
    • Alzheimer’s disease
    • Creutzfeldt-Jakob disease
    • vascular dementia or multi-infarct dementia
    • Lewy bodies
    • excessive alcohol intake or Korsakov Syndrome
    • fronto temporal lobar degeneration (FLTD) including Pick’s disease
    • Huntington’s disease
    • Parkinson’s disease
    • younger onset dementia
  • dementia as a progressive neurological condition, including pathological features:
    • amyloid plaques
    • neurofibrillary tangles
    • loss of connection between cells and cell death
  • common indicators and symptoms of dementia
  • behaviours of concern, needs driven behaviour model and de-escalation procedures
  • progression of dementia and potential impact on the person with dementia and their carer, including but not limited to:
    • depression
    • loss and grieving
    • anger
    • despair
    • social embarrassment
    • dysphagia
    • loss of speech and cognition
    • loss of inhibition
    • isolation
    • financial burden
    • self harm
    • social devaluation
    • suicidal ideation
    • violence toward carer or others
  • principles of person-centred approach to support
  • activities which:
    • enhance self-esteem and pleasure
    • minimise boredom
    • distract from or eliminate behavioural and psychological symptoms of dementia
  • different forms of abuse and neglect
  • competency and image enhancement as a means of addressing devaluation
  • methods to engage with the person with dementia:
    • verbal and non-verbal communication strategies
    • culturally sensitive communication strategies
    • reality orientation
    • reassuring words, phrases and body language
    • validation
      • acceptance of the person’s reality
      • acknowledgement
    • accepting expressions of distress
    • reminiscence
  • role of assistive technologies in supporting a person’s life activities:
    • maintaining and promoting independence
    • enabling inclusion and participation
  • techniques to determine own stress levels and options for managing work-related stress
  • internal and external services that can be accessed for management of work-related stress and trauma
  • legal and ethical considerations for working with people with dementia, including:
    • duty of care
    • dignity of risk
    • human rights
    • privacy, confidentiality and disclosure
    • work health and safety
  • organisational policies and procedures for:
    • documentation, including the importance of accurate, objective and appropriately detailed records
    • storage of information
    • referrals.

10 Comments

Knowledge evidence 8- abuse

"In light of recent final report and recommendations put forward from the aged care royal commission- incidence of abuse and the overuse of restrictive practices was a major concern. Rather than just listing knowledge of different forms of abuse and neglect- include knowledge of alternatives to restrictive practice"

Debbie Zulch 11.03.2021 07.41PM

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Knowledge evidence 7- activities

"Focus on meaningful activities achieves these goals. These are not a distraction- but an engagement in activities that will support self esteem and quality of life. Avoid BPSD entirely please. Even avoid minimise boredom- if the person is engaged in meaningful activities we see far less behavioural changes as social and emotional needs are met."

Debbie Zulch 11.03.2021 07.14PM

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Knowledge evidence 5- progression and impact of dementia

"I can understand we want students to have a good grasp of the impact - but this is a very long list!! can some points be joined- suggest: - depression/ despair -loss and grieving -anger/ violence -social embarrassment/ loss of inhibition -social devaluation/ isolation -loss of speech/ dysphasia -loss of safe swallow/ dysphagia -confusion/ loss of cognition -financial burden -self harm/ suicidal ideation"

Debbie Zulch 11.03.2021 07.05PM

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Knowledge evidence 2

"the pathological features listed (amyloid plaques/ tangles) are those found in Alzheimer's disease - and not the other types. Can this be written more clearly?"

Debbie Zulch 11.03.2021 06.48PM

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Knowledge evidence 1

"Can we separate current research of dementia- from knowledge of a range of different types of dementia? The types of dementia (better than manifestations) need to reflect current terminology (taken off the national dementia australia website) and rank the more common types over rarer types: -Alzheimer's disease -Vascular dementia -Lewy body disease -Frontotemporal dementia -Alcohol related dementia -Young onset dementia -Parkinson's dementia -Huntington's dementia -HIV associated dementia (CJD is more rare in Australia- does it need to be included here?) "

Debbie Zulch 11.03.2021 06.46PM

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language

"I notice that we are still referring to "behaviours" or BPSD when positive dementia care is all about recognising unmet need and working with the individual to meet these needs. The list of negative impacts does little to reduce the stigma for people living with dementia and only serves to isolate people further"

Sharon Richards 05.03.2021 05.54PM

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1 Reply

"We need to eliminate the use of BPSD is this is not a current term used or even a current view of why we see a change in behaviour. However behaviours of concern, needs driven behaviour and responsive behaviour are currently used in industry= and do reflect that behaviour is often due to unmet needs. Maybe adding in- knowledge of behaviour as a form of communication to express unmet need?"

Debbie Zulch 11.03.2021 06.53PM

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Knowledge evidence

"There is a strong medical element in the knowledge evidence and whilst basic understanding of dementia the disease is important the emphasis should be on the impact of dementia on the person not the physiology of the disease "

Sharon Richards 05.03.2021 05.48PM

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1 Reply

"I feel if a student has a good understanding of what is happening in the brain- at a basic level- then it helps them to show compassion and realise why the person is impacted- so do believe a certain amount of medical details are still needed in this unit."

Debbie Zulch 11.03.2021 07.24PM

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HIV-Associated Neurological Disorder (HAND) and HIV-Associated Dementia (HAD)

"It is also important to note that in considering new and emerging trends in dementia and other neurocognitive disorders, ageing and aged care, there are also emerging populations that are ageing. For example, this is the first time in history that people are living with HIV long-term so that they enter the aged care system by virtue of age, require care and support services, and develop age-related neurocognitive disorders such as HIV-Associated Neurological Disorder (HAND) and HIV-Associated Dementia (HAD). This challenge to personal care workers (PCWs) should not be minimised or ignored. In addressing the needs of ageing people living with HIV (PLHIV) with HIV-related dementias, including HAND and HAD, PCWs should be knowledgeable of aged care provision being conducted in coordination with HIV specialist neurology services at Centres of Excellence (such as St Vincent’s Hospital, Sydney), as well as management of PLHIV with HAND and HAD within the aged care facility. Furthermore, the section outlining the impacts of dementia omits the concept of impact on a person with dementia where their privacy and confidentiality may be breached. The “Knowledge evidence” portion of the draft unit covers: “Legal and ethical considerations and organisational policies and procedures for working with older people, including: duty of care; dignity of risk; human rights; privacy, confidentiality and disclosure; work health and safety.” We suggest that a specific addition of privacy and confidentiality around a person’s HIV or BBV status must be covered in this unit. This is particularly the case considering the section addressing families and carers, where a person living with HIV and dementia’s family and/or carer may not know about their HIV status, thus confidentiality must be maintained at all times, even when a personal care worker may otherwise assume that there is no risk of breach of confidentiality."

Liz Sutherland 04.03.2021 01.47PM

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Assessment conditions

ASSESSMENT CONDITIONS

Skills must have been demonstrated in the workplace, with the addition of simulations and scenarios where the full range of contexts and situations have not been provided in the workplace.

 

These are situations relating to emergency or unplanned procedures where assessment in these circumstances would be unsafe, impractical or threatens the dignity of the older person.

 

Assessment must ensure access to:

  • individualised plans for the support of people living with dementia that reflect a range of dementia symptoms and behaviours of concern and support services
  • facilities, equipment and resources relevant to individualised plans that are used within an ageing support workplace
  • organisational policies and procedures
  • opportunities for engagement with people living with dementia and their family, carer and others involved in service provision.

 

Assessors must satisfy the Standards for Registered Training Organisations’ requirements for assessors.

LINKS

Companion Volume Implementation Guide

1 Comments

Assessment Conditions

"Fully support that skills must be demonstrated in the workplace. Use of simulation only used if can't have the opportunity to show in the workplace. These meets current best practice around dementia training."

Debbie Zulch 11.03.2021 07.20PM

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