Individual Support, Ageing and Disability - Draft 2

CHCAGE011 Provide support to people living with dementia Draft 2.0

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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 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 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

2 Comments

Update of the unit

"The Queensland Nurses and Midwives' Union (QNMU) supports the update of this unit as it is critical for those who will work in the aged care sector. It has also addressed one of the recommendations from the final report from the Royal Commission into Aged Care Quality and Safety that specialist dementia care services be reviewed immediately highlighting how critical dementia care is, given the significant number of older Australians in the residential setting who have some degree of cognitive impairment. We also acknowledge the inclusion of demonstrated knowledge of pathophysiology of dementia, types of dementia and behaviour management that the QNMU has previously advocated for to SkillsIQ. "

Deborah Twigg 28.07.2021 08.11AM

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Great information in this unit

"Hello, I am wondering how big this unit is there is so much information to be covered. I would be very interested to see the whole unit. Kind regards, Lisa"

Lisa Stark 20.07.2021 07.49PM

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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. Read 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 that supports the person’s wellbeing.
    4. Recognise and refer situations outside scope of own role to supervisor or health professional.
    5. Recognise signs consistent with abuse or neglect of the person and report according to legislative requirements and organisational policies and procedures.
  1. Use effective communication strategies.

 

 

 

 

 

 

    1. Communicate in a supportive manner that respects the person’s needs, rights and preferences and upholds their dignity.
    2. Support engagement of the person with dementia using verbal and non-verbal communication strategies.
    3. Provide reassurance and use a range of validation strategies with the person to relieve distress and agitation.
    4. Communicate with carers and families in a supportive manner to provide care information and opportunities for discussion.
  1. Support the person to participate in activities according to the individualised plan.
    1. Work with the person, carer and family to develop an understanding of their likes, dislikes, strengths and interests.
    2. Support the person to engage in activities that facilitate ongoing independence according to their needs and preferences.
    3. Access information about the person’s reminiscences and routines from person, carer and family to inform activities that reflect the person’s preferences and provide pleasurable experiences.
    4. Assist the person to maintain dignity of risk, whilst balancing duty of care.
    5. Identify and support the person’s use of assistive technologies relevant to the activity, according to their individual needs.
  1. Use a strengths-based approach to meet the person’s needs.
    1. Refer to the individualised plan to gain awareness of identified behaviours and potential triggers.
    2. Recognise behaviours of the person that indicate stressors including un-met needs.
    3. Use knowledge of the person to determine strategies to reduce stressors and meet their needs.
    4. Implement identified strategies to reduce the likelihood of negative outcomes for the person and others.
  1. Complete documentation.
    1. Observe and document any changes in behaviour of the person and report to supervisor.
    2. Complete, maintain and store documentation according to legislative requirements and 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.

4 Comments

5. Complete Documentation

"There should be an explicit criterion relating to advance care planning documentation. Students should be aware of different advance care planning documents available including advance care directives, appointment of a substitute decision-maker, advance care plans etc. Students should be familiar enough with the concept of advance care planning to point individuals into the direction of the appropriate forms, and where appropriate, support the person to complete them. "

Advance Care Planning Australia 22.07.2021 03.21PM

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Possible additions

"1.1 and 2.1 should also include references to the person's values. 3.1 should extent to the person's values and preferences. Reference should be made to the person's substitute decision-maker in 1.3, 2.4, 3.1. For e.g. work with the person, carer, substitute decision-maker and family to develop an understanding of their likes, dislikes, strengths, and interests."

Advance Care Planning Australia 22.07.2021 03.20PM

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There is so beautiful points here

"The information to be delivered in this unit sounds fantastic. I would very much like to read the full unit. And I believe that this valuable information would be best delivered over 4 or 5 units. To ensure the best learning outcome. Kind regard, Lisa"

Lisa Stark 20.07.2021 07.53PM

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Element 4

"This is about a strengths based approach, which is not reflected in the performance criteria. Delete 4.1 Change 4.2 - Recognise when the demeanour of the person indicates distress, including unmet need 4.3 & 4.4 remain the same"

Sharon Richards 16.07.2021 12.32PM

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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

3 Comments

Overall Unit

"Why is this the only unit that refers to the the care worker needing to care for themselves?"

Sharon Richards 16.07.2021 12.43PM

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2 Replies

"I agree - why isn't that section (PC 6) built into a core unit - isn't it necessary for all care workers not just ones working with dementia clients"

Jessica Gwynne 21.07.2021 02.23PM

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"I agree Individual Support workers care for a wide variety of clients in many different situations. The stressors of travelling between clients in peak hour traffic in home and community just 1 example. Residential facilities are under staffed and constantly under pressure to deliver quality care in the time allowed."

Carol Dunlevey 22.07.2021 01.19PM

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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 strategies to minimise negative outcomes associated with identified behaviours specific to the person. These negative outcomes may impact the person or others
    • completing reports and documentation
  • use two different self-care strategies to manage work-related stress.

7 Comments

Wording - Behaviour

"Please consider deleting the word "behaviour" from the unit and using more contemporary terminology such as " the persons response to a situation" ."

Christine Kilmartin 20.07.2021 07.04PM

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2 Replies

"I agree, the client is living with the disease of Dementia, they do not have bad behavior. They are reacting to what they perceive the situation to be. "

Carol Dunlevey 22.07.2021 01.22PM

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"Agree the language should reflect unmet needs and responsding to sututations, rather than behaviour"

Karen Voce 25.07.2021 10.56PM

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Self Care

"Self care for health workers is important but it should be within the CHCAGE013 unit, which is the industry introduction unit. The dementia unit is about providing support to people living with dementia not support workers. Having it within the CHCAGE011 unit perpetuates stigma often felt by PLWD."

Sharyn Trent 20.07.2021 01.19PM

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3 Replies

"I agree. This topic belongs in the introductory unit. "

Christine Kilmartin 20.07.2021 06.31PM

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"Agree self care should be in CHCAGE013 as this will provide students with full understanding that working within this industry they will need to have self care strategies identified to use when needed."

Vicki Zammit 23.07.2021 02.26PM

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"Agree, Self care to be in CHCAGE013"

Karen Voce 25.07.2021 10.53PM

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Knowledge evidence

KNOWLEDGE EVIDENCE

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

  • awareness of current research on dementia
  • pathophysiology of 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
  • potential interventions and proactive strategies that may be used to address identified behaviours:
    • identification of triggers
    • behaviour as an indicator of un-met needs
    • de-escalation processes
    • impact of environment
  • restrictive practices:
    • what constitutes a restrictive practice
    • legislative and regulatory requirements
    • organisational policies and procedures relating to restricted practices
    • positive strategies
    • ethical considerations
    • documentation requirements
  • identifying and reporting indicators of injury, infection, illness and pain and the impact on the person’s behaviour
  • 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
    • delirium
    • social embarrassment
    • dysphagia
    • loss of speech and cognition
    • loss of inhibition
    • isolation
    • self-harm
    • social devaluation
    • suicidal ideation
    • violence toward carer or others
  • psychosocial implications of the progression of dementia for the person, including but not limited to:
    • accommodation
    • financial implications
    • isolation
    • heightened vulnerability to abuse and exploitation
  • principles of a person-centred approach to support
  • activities which:
    • enhance self-esteem and pleasure
    • minimise boredom
    • creating a sense of personal value and self-worth
  • the impact of the environment on supporting a person to interact and engage
  • different forms of abuse, neglect and exploitation
  • methods to engage with the person with dementia:
    • verbal and non-verbal communication strategies
    • culturally sensitive and safe communication strategies
    • reality orientation
    • reassuring words, phrases and body language
    • validation
      • acceptance of the person’s reality
      • acknowledgement
    • accepting expressions of distress
    • reminiscence
  • types of stressors and their impact, including but not limited to:
    • environmental
    • accumulated
    • cumulative
  • role of assistive technologies in supporting a person’s life activities:
    • maintaining and promoting independence
    • enabling inclusion and participation
  • scope and breadth of assistive technologies used across the life domains, including but not limited to:
    • self-care
    • continence and hygiene
    • communication
    • mobility and transferring
    • cognition and memory loss
    • vision and hearing
    • daily living activities
    • recreation and leisure
    • education and employment
    • home and other environments
    • eating and drinking
    • pressure management
    • carer support
  • 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, trauma and vicarious trauma
  • legal and ethical considerations for working with people with dementia, including:
    • duty of care
    • dignity of risk
    • human rights
    • relevant codes of conduct
    • legislative and statutory requirements for reporting
    • privacy, confidentiality and disclosure
    • mandatory reporting
    • work health and safety
  • organisational policies and procedures for:
    • reporting and documentation, including the importance of accurate, objective and appropriately detailed records
    • storage of information
    • referrals.

10 Comments

ACWIC Response

"From the Aged Care Workforce Industry Council: The Council believes that the sufficiency of evidence is too much for some of these Units. For example, some units are asking for the collection of feedback from older people and carer and supervisor/health professional to assess their competency. Kind regards,"

Mark Berezdecky 28.07.2021 11.20AM

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ACWIC Response

"From the Aged Care Workforce Industry Council: The Council believes that the Knowledge Evidence may be overly complex. For example, the knowledge evidence section for providing support to people living with dementia is asking for clinical knowledge of dementia (ie: amyloid plaques, neurofibrillary tangles and loss of connection between cells and cell death). It would seem as though this knowledge may not be needed for the support worker and is a bit too complex for what is needed to carry out their duties in the workplace. There are also various other examples of this throughout the Knowledge Evidence section. Kind regards,"

Mark Berezdecky 28.07.2021 10.58AM

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Possible addition

"Knowledge evidence should be inclusive of advance care planning, which is particularly important in relation to dementia, as individuals with dementia are likely to lose decision-making capacity to make medical treatment decisions. Specifically, the knowledge evidence should reflect the importance of talking to dementia patients about their values and preferences relating to future medical treatment when they have decision-making capacity and where appropriate encouraging them to formally document these values and preferences in an advance care directive, so they can be relied on in the event the person loses decision-making capacity and can no longer make medical decisions themselves. Where possible, these individuals should also be encouraged to appoint a substitute decision-maker. "

Advance Care Planning Australia 22.07.2021 03.21PM

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Arcuate Information and specific for dementia.

"There is a lot of information to get through. and I believe that not enough time would be given to each of these areas if it is delivered as a dot point. Students really need to have additional dementia-specific training to allow for the best outcome of student learning. I do think a certificate III care worker, working with people living with dementia, needs this level of information. By pulling each dot point apart and delivering more teaching with each one, the needed skill to work with people living with dementia is meet. Dividing up the information into more thorough units will allow the student to learn at a Certificate III level. I can see there is some information carried through from other units and I believe for this level of training repetition is needed. This is often when the student really understands the connection of the teaching with the practical side of their skill. Happy to explain more in regards to the potential focus for modules. Kind regards, Lisa"

Lisa Stark 20.07.2021 08.28PM

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1 Reply

"I agree, students need the information to work effectively with clients living with dementia. They need to know how living with Dementia affects the person and their family, to enable them to understand the day to day family interactions and how this may affect them. The loss and grief a person with Dementia may experience will affect them differently in the early stages as opposed to the later stages of someone living with Dementia."

Carol Dunlevey 22.07.2021 01.38PM

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Assistive Technology

"I commented about this in relation to the Personal Care unit. This topic needs its own unit due to the proliferation of technologies and the emergence of new ones over the life of the Training Package, "

Christine Kilmartin 20.07.2021 07.14PM

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Depth of knowledge of causes of dementia

"Suggest changing the word "pathophysiology" to "general knowledge of ", to lessen misinterpretation of the level of knowledge required for a certificate. "

Christine Kilmartin 20.07.2021 07.09PM

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"The 'legal and ethical considerations of working with people with dementia' should already be covered in the CHCLEG001 unit, which is a Core unit. Also language like 'including but not limited to' creates an unclear expectation of RTOs and assessors. An auditor could find us lacking if we ONLY cover the types of dementia listed in the knowledge evidence but not including any further types because it says 'not limited to'. Absolute clarity is required around what to deliver and assess. I also agree with other commenters, this unit focuses a lot on what causes dementia (do PCAs really need to know pathophysiology, amyloid plaques etc?) and how impactful dementia is on the person and their life, but less on strategies. Strategies is included a bit, but it needs to be the focus- thats what a PCAs job mainly involves, to provide strategies during their care. "

A. K. 19.07.2021 03.52PM

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1 Reply

"Agree"

Sharyn Trent 20.07.2021 01.22PM

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Knowledge evidence

"Do support workers really need this level of knowledge about the pathophysiology of different types of dementia, research etc"

Sharon Richards 16.07.2021 12.47PM

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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 threaten the dignity of the person with dementia.

 

Assessment must ensure access to:

  • individualised plans for the support of people living with dementia that reflect a range of dementia symptoms and identified behaviours and support services
  • facilities, equipment and resources relevant to individualised plans that are used when supporting people with dementia
  • legislative and statutory instruments related to reporting
  • 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

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