Individual Support, Ageing and Disability - Draft 2

CHCPAL003 Deliver care services using a palliative approach Draft 2.0

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Unit application and prerequisites

UNIT CODE

CHCPAL003

UNIT TITLE

Deliver care services using a palliative approach

APPLICATION

This unit describes the performance outcomes, skills and knowledge required to provide care for people with life-limiting illness and those within the normal ageing process within a palliative approach as well as end-of-life care.

 

This unit applies to workers in a residential or community context. Work performed requires some discretion and judgement and is 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

Nil

2 Comments

Update of the unit

"The Queensland Nurses and Midwives' Union (QNMU) supports the update of this unit. The Royal Commission into Aged Care Quality and Safety has identified palliative care as an area for immediate action. However, like the issue of medication administration, the QNMU would point out that the delivery of high quality, appropriate and accessible palliative care is the domain of specialist clinicians (nurses, doctors, allied health). While the role of unregulated care workers is an essential part of aged and disability care, they are not, and should not be seen to be, a substitute for those specialised clinicians providing often complex palliative care. We also suggest that as part of the legal and ethical considerations for working in palliative care is education on specific state regulations pertaining to voluntary assisted dying."

Deborah Twigg 28.07.2021 08.30AM

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Palliative approach

"Not currently a term in use. Replace with palliative care"

DEBORAH PARKER 16.07.2021 06.44PM

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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. Apply principals and aims of a palliative approach when supporting people.
    1. Recognise the holistic needs of the person extending over time, not just end-of-life.
    2. Support the person, carer, family and others identified by the person to express needs and preferences and report information to supervisor.
    3. Communicate with the person, carer, family and others identified by the person in relation to the person’s quality-of-life, pain and comfort and report information to supervisor.
    4. Adjust communication techniques to meet the individual needs of the person and their carer, family and others.
    5. Respect the carer, family and others as an integral part of the care team and ensure that they have the information and support needed.
  1. Respect the person’s preferences for quality-of-life choices.
    1. Create a supportive environment that encourages the person, carer, family and others to share information regarding changing needs and preferences.
    2. Respect the person’s individuality, values and beliefs in the context of support provision.
    3. Identify needs and issues outside the scope of own job role and refer to supervisor.
    4. Communicate with person, carer, families and others in a manner that shows empathy and provides emotional support.
  1. Follow the person’s advance care directives in the individualised plan.
    1. Interpret and follow advance care directives in the individualised plan in accordance with own job role and organisation, legal and ethical requirements.
    2. Comply with end-of-life decisions as documented in the individualised plan and in accordance with legal requirements.
    3. Report the person’s changing needs and issues in relation to end-of-life for documentation in the individualised plan according to organisational policies and procedures.
    4. Monitor the impact of the person’s end-of-life needs, issues and decisions on carer, families and others and refer to appropriate member of the care team for support according to organisational policies and procedures.
    5. Deliver services in a manner that supports the person’s right to choose the location of their end-of-life care.
  1. Respond to signs of pain and other symptoms.
    1. Observe and document the person’s pain and other symptoms in line with individualised plan and report to appropriate member of the care team.
    2. Implement strategies to manage pain and promote comfort in line with individualised plan and within scope of own job role.
    3. Document effectiveness of pain management strategies.
    4. Refer to supervisor any misconceptions in the workplace surrounding the use of pain-relieving medication.
  1. Follow end-of-life care strategies.
    1. Regularly check for any changes on individualised plan that indicate decisions made by the person have been reviewed.
    2. Provide a supportive environment to the person, carer, families and others involved in end-of-life care.
    3. Respect and support the person’s preferences and culture when providing end-of-life care according to individualised plan and within scope of own job role.
    4. Maintain dignity of the person when providing planned end-of-life care and care immediately following death.
    5. Recognise any signs of the person’s deterioration or imminent death and dying and report to appropriate member of care team according to organisational policies and procedures.
    6. Provide emotional support to carer, families and others when a death has occurred within scope of own job role.
  1. Manage own emotional responses and ethical issues.
    1. Follow organisational policies and procedures to manage own emotional responses and ethical issues.
    2. Identify and reflect on own emotional responses to death and dying and raise and discuss any issues or reactions with supervisor or other appropriate person.
    3. Raise any ethical issues or concerns with supervisor or other appropriate person.
    4. Identify and action self-care strategies to address the potential impact of personal responses on self.
    5. Access bereavement care and support of other team members as needed.

5 Comments

Possible amendment to 5.3

"This criterion should also be inclusive of the person's values."

Advance Care Planning Australia 27.07.2021 11.38PM

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Element 3

"ACPA commends the inclusion of element 3 ‘follow the person’s advance care directives in the individualised plan’; however, such an element should not be limited to following advance care directives but should also extend to supporting consumers to complete them and review them at appropriate time intervals to ensure that the advance care directive contains statements that are reflective of their current values and preferences. Obligations in relation to the storage, access, and enactment of advance care planning documents including advance care directives for preferences of care and appointment of substitute decision-makers should be reinforced."

Advance Care Planning Australia 27.07.2021 11.38PM

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Possible amendments

"The following criteria should also refer to the person's substitute decision-maker (1.3,1.4,1.5,2.1,2.4,3.4,5.2,5.6)"

Advance Care Planning Australia 27.07.2021 11.32PM

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Possible amendment to 1.2

"This criterion should also extend to substitute decision-makers and incorporate the person’s values. This information should not only be reported to a supervisor, but documented in a consumer’s notes. Furthermore, where appropriate, the consumer should be encouraged to formally document these values and preferences themselves in an advance care directive. "

Advance Care Planning Australia 27.07.2021 11.31PM

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Terminology

"End of life according to Quality and Safety Commission can be last 12 months or last weeks of life. End of life in the curriculum is referring to last weeks of life. It is important to define terms and match with those of the Aged care standards"

DEBORAH PARKER 16.07.2021 06.46PM

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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

CHCPAL001 Deliver care services using a palliative approach.

LINKS

Companion Volume Implementation Guide

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Performance evidence

TITLE

Assessment Requirements for CHCPAL003 Deliver care services using a palliative approach

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:

  • supported, reported and documented issues and needs of three people in palliative care, including:
    • demonstrating support for the person’s needs and preferences in relation to their care
    • responding to changing needs and circumstances in the person’s care
    • providing emotional support to the person, carer and family as required
    • completing documentation in a timely, accurate and objective manner according to organisational policies and procedures
  • at least one of the above people must be in end of life care
  • reflect on own emotional responses to death and dying and discuss with supervisor on at least one occasion.

1 Comments

Terminology

"People are not generally in palliative care. They require palliative care or end of life care"

DEBORAH PARKER 16.07.2021 06.48PM

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Knowledge evidence

KNOWLEDGE EVIDENCE

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

  • philosophy, principles, benefits and scope of palliative care
  • the needs of people dealing with a life-limiting illness and the emotional impact of diagnosis
  • cultural, religious and spiritual differences in relation to death and dying
  • impact of unconscious bias when providing care
  • the stages of grief and personal strategies for managing reactions to grief
  • advance care directives and end-of-life care strategies
  • pain relief and comfort promotion
  • process to seek clarification and guidance from health professional regarding pain relief and comfort provision
  • psychological and emotional impact on the person, family, carer and others during palliative or end of life care
  • nutritional and hydration requirements during a palliative approach
  • legal and ethical considerations for working in palliative care, including:
    • dignity of risk
    • duty of care
    • human rights
    • privacy, confidentiality and disclosure
    • work role boundaries, responsibilities and limitations
  • organisational policies and procedures for the provision of both a palliative approach and palliative care
  • responsibilities to self and colleagues
  • various signs of imminent death and deterioration
  • processes for care of deceased person’s body, including:
    • links to Advance Care Directives
    • person’s preferences:
      • cultural
      • spiritual and religious
    • infection control
    • support for family and others
    • handling of personal effects and belongings
    • awareness of State/Territory medico-legal requirements and processes
    • documentation requirements
  • communication strategies to build trust, show empathy, demonstrate support and empower the person, carer, family and others.

5 Comments

responsibilities to self and colleagues

"This KE point is vague; responsibilities in regards to self-care, infection control, fitness for practice?"

Steph Dickinson 28.07.2021 12.14PM

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Possible amendment

"ACPA suggests that having Advance Care Directives under the “processes for care of deceased person's body” is not appropriate and should be separated out. "

Advance Care Planning Australia 27.07.2021 11.40PM

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Possible amendment

"The knowledge evidence area 'psychological and emotional impact on the person, family, carer and others during palliative or end of life care' should also be inclusive of substitute decision-makers."

Advance Care Planning Australia 27.07.2021 11.40PM

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Possible amendment

"Whilst it is important to consider advance care directives in the knowledge evidence, it is also important to consider the role of advance care planning more broadly and substitute decision-makers. "

Advance Care Planning Australia 27.07.2021 11.39PM

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Stages of grief

"This is not contemporary practice"

DEBORAH PARKER 16.07.2021 06.49PM

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Assessment conditions

ASSESSMENT CONDITIONS

 

 

 

 

 

 

 

Skills must be demonstrated in the workplace or a simulated environment that reflects workplace conditions.

 

Provision of support for a person in end of life care as outlined in the performance criteria must be completed in a simulated environment.

 

Assessment must ensure access to:

  • facilities, equipment and resources that reflect real working conditions and model industry operating conditions and contingencies
  • organisational policies and procedures
  • individualised plans
  • equipment and resources outlined in individualised plans
  • opportunities for engagement with people in palliative or end of life care or people who participate in simulations and scenarios that involve provision of palliative or end of life care in a range of contexts.

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

LINKS               

Companion Volume Implementation Guide

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