FACILITATE THE EMPOWERMENT OF OLDER PEOPLE
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T A B L E O F C O N T E N T S
TABLE OF CONTENTS ………………………………………………………………………………………………………………………. 1
COURSE INTRODUCTION …………………………………………………………………………………………………………………. 4
ABOUT THIS GUIDE ……………………………………………………………………………………….. ERROR! BOOKMARK NOT DEFINED. ABOUT THIS RESOURCE …………………………………………………………………………………………………………………….. 4 ABOUT ASSESSMENT ………………………………………………………………………………………………………………………… 5
ELEMENTS AND PERFORMANCE CRITERIA …………………………………………………………………………………………. 7
PERFORMANCE EVIDENCE AND KNOWLEDGE EVIDENCE ……………………………………………………………………… 9
PERFORMANCE EVIDENCE ……………………………………………………………………………………………………………………….. 9 KNOWLEDGE EVIDENCE ………………………………………………………………………………………………………………………….. 9
ASSESSMENT CONDITIONS ……………………………………………………………………………………………………………. 11
PRE-REQUISITES …………………………………………………………………………………………………………………………… 11
TOPIC 1 – DEVELOP RELATIONSHIPS WITH OLDER PEOPLE………………………………………………………………….. 12
CONDUCT INTERPERSONAL EXCHANGES IN A MANNER THAT PROMOTES EMPOWERMENT AND DEVELOPS
AND MAINTAINS TRUST AND GOODWILL ………………………………………………………………………………………… 12
RECOGNISE AND RESPECT OLDER PEOPLE’S SOCIAL, CULTURAL AND SPIRITUAL DIFFERENCES …………………. 15
MAINTAIN CONFIDENTIALITY AND PRIVACY OF THE PERSON WITHIN ORGANISATION POLICY AND
PROTOCOLS ………………………………………………………………………………………………………………………………… 18
DUTY OF CARE REQUIREMENTS ………………………………………………………………………………………………………………… 18 ORGANISATIONAL CODE OF CONDUCT ………………………………………………………………………………………………………… 18 ORGANISATIONAL REQUIREMENTS ……………………………………………………………………………………………………………. 19 PRIVACY ………………………………………………………………………………………………………………………………………….. 20
ENCOURAGE THE PERSON TO ADOPT A SHARED RESPONSIBILITY FOR OWN SUPPORT AS A MEANS OF
ACHIEVING BETTER HEALTH OUTCOMES AND QUALITY OF LIFE…………………………………………………………… 21
TOPIC 2 – PROVIDE SERVICES TO OLDER PEOPLE ………………………………………………………………………………. 23
IDENTIFY AND DISCUSS SERVICES WHICH EMPOWER THE OLDER PERSON AND SUPPORT THE OLDER PERSON
TO EXPRESS THEIR OWN IDENTITY AND PREFERENCES WITHOUT IMPOSING OWN VALUES AND ATTITUDES 23
EXPLAIN THE SCOPE OF SERVICE ………………………………………………………………………………………………………………. 25
ADJUST SERVICES TO MEET THE SPECIFIC NEEDS OF THE OLDER PERSON AND PROVIDE SERVICES ACCORDING
TO THE OLDER PERSON’S PREFERENCES ………………………………………………………………………………………….. 27
ACCESS AND EQUITY …………………………………………………………………………………………………………………………….. 27 WHAT IS PERSON-CENTRED PRACTICE? ………………………………………………………………………………………………………. 27 WHY IS PERSON-CENTRED PRACTICE IMPORTANT? …………………………………………………………………………………………. 28 CREATION OF A CLIENT ORIENTATED CULTURE AND A NON-DISCRIMINATORY APPROACH TO ALL INDIVIDUALS USING OR ACCESSING
THE SERVICE ……………………………………………………………………………………………………………………………………… 29 RESPECT FOR INDIVIDUAL DIFFERENCES ………………………………………………………………………………………………………. 29
PROVIDE SERVICES ACCORDING TO ORGANISATION POLICIES, PROCEDURES AND DUTY OF CARE
REQUIREMENTS …………………………………………………………………………………………………………………………… 31
POLICIES AND PROCEDURES ……………………………………………………………………………………………………………………. 31
TOPIC 3 – SUPPORT THE RIGHTS OF OLDER PEOPLE …………………………………………………………………………… 34
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ASSIST THE OLDER PERSON TO UNDERSTAND THEIR RIGHTS AND THE COMPLAINTS MECHANISMS OF THE
ORGANISATION …………………………………………………………………………………………………………………………… 34
COMPLAINTS …………………………………………………………………………………………………………………………………….. 35 AGED CARE COMPLAINTS SCHEME …………………………………………………………………………………………………………… 35
DELIVER SERVICES ENSURING THE RIGHTS OF THE OLDER PERSON ARE UPHELD AND IDENTIFY BREACHES OF
HUMAN RIGHTS AND RESPOND APPROPRIATELY ……………………………………………………………………………… 37
INTERNATIONAL FEDERATION OF AGEING DECLARATION ON THE RIGHTS AND RESPONSIBILITIES OF OLDER PERSONS ……………. 37 INDEPENDENCE ………………………………………………………………………………………………………………………………….. 37 PARTICIPATION ………………………………………………………………………………………………………………………………….. 38 CARE ……………………………………………………………………………………………………………………………………………… 38 SELF – FULFILMENT ……………………………………………………………………………………………………………………………… 39 DIGNITY ………………………………………………………………………………………………………………………………………….. 39
RECOGNISE SIGNS CONSISTENT WITH FINANCIAL, PHYSICAL OR EMOTIONAL ABUSE OR NEGLECT OF THE
OLDER PERSON AND REPORT TO AN APPROPRIATE PERSON ………………………………………………………………. 41
DEFINITION ………………………………………………………………………………………………………………………………………. 41 FORMS OF ABUSE ………………………………………………………………………………………………………………………………. 41 PHYSICAL ABUSE ………………………………………………………………………………………………………………………………… 42 SEXUAL ABUSE ………………………………………………………………………………………………………………………………….. 42 FINANCIAL ABUSE ……………………………………………………………………………………………………………………………….. 43 PSYCHOLOGICAL/ EMOTIONAL ABUSE ……………………………………………………………………………………………………….. 44 SOCIAL ABUSE …………………………………………………………………………………………………………………………………… 44 NEGLECT …………………………………………………………………………………………………………………………………………. 45
ASSIST THE PERSON TO ACCESS OTHER SUPPORT SERVICES AND THE COMPLAINTS MECHANISMS AS
REQUIRED …………………………………………………………………………………………………………………………………… 47
LODGING A COMPLAINT WITH THE AGED CARE COMPLAINTS SCHEME ………………………………………………………………….. 47 WHAT CAN YOU COMPLAIN ABOUT? …………………………………………………………………………………………………………. 47 WHO CAN MAKE A COMPLAINT? ……………………………………………………………………………………………………………… 47 WHAT TYPES OF SERVICES ARE COVERED BY THE SCHEME? ……………………………………………………………………………….. 48 WHAT HAPPENS AFTER YOU LODGE A COMPLAINT? ………………………………………………………………………………………… 48
TOPIC 4 – PROMOTE HEALTH AND RE-ABLEMENT OF OLDER PEOPLE …………………………………………………… 49
ENCOURAGE THE OLDER PERSON TO ENGAGE AS ACTIVELY AS POSSIBLE IN ALL LIVING ACTIVITIES AND
PROVIDE THEM WITH INFORMATION AND SUPPORT TO DO SO AND ASSIST THE OLDER PERSON TO
RECOGNISE THE IMPACT THAT CHANGES ASSOCIATED WITH AGEING MAY HAVE ON THEIR ACTIVITIES OF
LIVING ……………………………………………………………………………………………………………………………………….. 49
AGE-RELATED CHANGES ……………………………………………………………………………………………………………………….. 51 MUSCLE AND BONE CONDITIONS IN OLDER AGE …………………………………………………………………………………………….. 51 AGE-RELATED CHANGES IN MUSCLE ………………………………………………………………………………………………………….. 51 AGE-RELATED CHANGES IN BONE ……………………………………………………………………………………………………………… 52 AGE-RELATED CHANGES IN JOINTS ……………………………………………………………………………………………………………. 52 PHYSICAL ACTIVITY CAN HELP ………………………………………………………………………………………………………………….. 52 TYPICAL PHYSICAL CHANGES ………………………………………………………………………………………………………………….. 53
IDENTIFY STRATEGIES AND OPPORTUNITIES THAT MAXIMISE ENGAGEMENT AND PROMOTE HEALTHY
LIFESTYLE PRACTICES AND WORK WITH THE PERSON TO IDENTIFY PHYSICAL AND SOCIAL ENABLERS AND
DISABLERS IMPACTING ON HEALTH OUTCOMES AND QUALITY OF LIFE ………………………………………………… 57
PROMOTING INDEPENDENCE AND AUTONOMY ……………………………………………………………………………………………… 57 PURPOSEFUL ACTIVITIES ……………………………………………………………………………………………………………………….. 59 WHAT NEW INTERESTS COULD BE INTRODUCED? …………………………………………………………………………………………… 61 BENEFITS OF HEALTHY ACTIVITIES …………………………………………………………………………………………………………….. 62
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IDENTIFY AND UTILISE AIDS AND MODIFICATIONS THAT PROMOTE INDIVIDUAL STRENGTHS AND CAPACITIES
TO ASSIST WITH INDEPENDENT LIVING IN THE OLDER PERSON’S ENVIRONMENT ………………………………….. 63
DISCUSS SITUATIONS OF RISK OR POTENTIAL RISK ASSOCIATED WITH AGEING …………………………………….. 66
SECURITY SYSTEMS ……………………………………………………………………………………………………………………………… 67 SHELTER AND PROTECTION …………………………………………………………………………………………………………………….. 67 COMFORT AND SELF EXPRESSION ……………………………………………………………………………………………………………… 67 SAFETY AND ADAPTATIONS …………………………………………………………………………………………………………………….. 68 RECOGNISING HAZARDS ………………………………………………………………………………………………………………………… 69 ASSESSING HAZARDS ……………………………………………………………………………………………………………………………. 69 SEVERITY …………………………………………………………………………………………………………………………………………. 70 ANALYSING THE LIKELIHOOD AND CONSEQUENCES OF RISK ……………………………………………………………………………….. 70 HAZARD RATING MATRIX CHART ………………………………………………………………………………………………………………. 71 REPORTING RISKS AND HAZARDS ……………………………………………………………………………………………………………… 71
PALLIATIVE CARE …………………………………………………………………………………………………………………………. 72
SUMMARY ………………………………………………………………………………………………………………………………….. 73
REFERENCES ………………………………………………………………………………………………………………………………… 74
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U N I T I N T R O D U C T I O N
This resource covers the unit CHCAGE001 – Facilitate the empowerment of older people.
This unit describes the skills and knowledge required to respond to the goals and aspirations of older people and provide support services in a manner that focuses on improving health outcomes and quality of life, using a person-centred approach.
This unit applies to support workers in residential or community contexts.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.
ABOUT THIS RESOURCE
This resource brings together information to develop your knowledge about this unit. The information is designed to reflect the requirements of the unit and uses headings to makes it easier to follow.
Read through this resource to develop your knowledge in preparation for your assessment. You will be required to complete the assessment tools that are included in your program. At the back of the resource are a list of references you may find useful to review.
As a student it is important to extend your learning and to search out text books, internet sites, talk to people at work and read newspaper articles and journals which can provide additional learning material.
Your trainer may include additional information and provide activities. Slide presentations and assessments in class to support your learning.
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ABOUT ASSESSMENT
Throughout your training we are committed to your learning by providing a training and assessment framework that ensures the knowledge gained through training is translated into practical on the job improvements.
You are going to be assessed for:
Your skills and knowledge using written and observation activities that apply
to your workplace.
Your ability to apply your learning.
Your ability to recognise common principles and actively use these on the job.
You will receive an overall result of Competent or Not Yet Competent for the assessment of this unit. The assessment is a competency based assessment, which has no pass or fail. You are either competent or not yet competent. Not Yet Competent means that you still are in the process of understanding and acquiring the skills and knowledge required to be marked competent. The assessment process is made up of a number of assessment methods. You are required to achieve a satisfactory result in each of these to be deemed competent overall.
All of your assessment and training is provided as a positive learning tool. Your assessor will guide your learning and provide feedback on your responses to the assessment. For valid and reliable assessment of this unit, a range of assessment methods will be used to assess practical skills and knowledge.
Your assessment may be conducted through a combination of the following methods:
Written Activity
Case Study
Observation
Questions
Third Party Report
The assessment tool for this unit should be completed within the specified time period following the delivery of the unit. If you feel you are not yet ready for assessment, discuss this with your trainer and assessor.
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To be successful in this unit you will need to relate your learning to your workplace. You may be required to demonstrate your skills and be observed by your assessor in your workplace environment. Some units provide for a simulated work environment and your trainer and assessor will outline the requirements in these instances.
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E L E M E N T S A N D P E R F O R M A NC E C R I T E R I A
1. Develop relationships with older people
1.1 Conduct interpersonal exchanges in a manner that promotes empowerment and develops and maintains trust and goodwill
1.2 Recognise and respect older people’s social, cultural and spiritual differences
1.3 Maintain confidentiality and privacy of the person within organisation policy and protocols
1.4 Work with the person to identify physical and social enablers and disablers impacting on health outcomes and quality of life
1.5 Encourage the person to adopt a shared responsibility for own support as a means of achieving better health outcomes and quality of life
2. Provide services to older people
2.1 Identify and discuss services which empower the older person
2.2 Support the older person to express their own identity and preferences without imposing own values and attitudes
2.3 Adjust services to meet the specific needs of the older person and provide services according to the older person’s preferences
2.4 Provide services according to organisation policies, procedures and duty of care requirements
3. Support the rights of older people
3.1 Assist the older person to understand their rights and the complaints mechanisms of the organisation
3.2 Deliver services ensuring the rights of the older person are upheld
3.3 Identify breaches of human rights and respond appropriately
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3.4 Recognise signs consistent with financial, physical or emotional abuse or neglect of the older person and report to an appropriate person
3.5 Assist the person to access other support services and the complaints mechanisms as required
4. Promote health and re- ablement of older people
4.1 Encourage the older person to engage as actively as possible in all living activities and provide them with information and support to do so
4.2 Assist the older person to recognise the impact that changes associated with ageing may have on their activities of living
4.3 Identify strategies and opportunities that maximise engagement and promote healthy lifestyle practices
4.4 Identify and utilise aids and modifications that promote individual strengths and capacities to assist with independent living in the older person’s environment
4.5 Discuss situations of risk or potential risk associated with ageing
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P E R F O R M A N C E E V I D E N C E A N D K N O W L E D G E E V I D E N C E
This describes the essential knowledge and skills and their level required for this unit.
PERFORMANCE EVIDENCE
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:
Responded to the goals and aspirations of at least 2 older people, 1 in a
simulated environment and 1 in the workplace:
Employing flexible, adaptable and person-centred approaches to empower
the individual
Recognising and responding appropriately to situations of risk or potential
risk
Used oral communication skills to maintain positive and respectful
relationships
KNOWLEDGE EVIDENCE
The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:
Structure and profile of the aged care sector:
o Residential aged care sector
o Home and community support sector
o Current best practice service delivery models
o Relevant agencies and referral networks for support services
Key issues facing older people, including:
o Stereotypical attitudes and myths
o The impact of social devaluation on an individual’s quality of life
Implications for work in the sector, including:
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o Concepts of positive, active and healthy ageing
o Rights-based approaches
o Person-centred practice
o Consumer directed care
o Palliative approach
o Empowerment and disempowerment
o Re-ablement and effective re-ablement strategies
The ageing process and related physiological and psychological changes,
including sexuality and gender issues
Strategies that the older person may adopt to promote healthy lifestyle
practices
Legal and ethical considerations for working with older people, including:
o Codes of practice
o Discrimination
o Dignity of risk
o Duty of care
o Human rights
o Privacy, confidentiality and disclosure
o Work role boundaries – responsibilities and limitations
o Work health and safety
Indicators of abuse and/or neglect, including:
o Physical
o Sexual
o Psychological
o Financial
Reporting requirements for suspected abuse situations
The impact of own attitudes on working with older people
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A S S E S S M E N T C O N D I T I O N S
All aspects of the performance evidence must have been demonstrated using simulation prior to being demonstrated in the workplace. The following conditions must be met for this unit:
Use of suitable facilities, equipment and resources, including:
Relevant organisation policies and procedures
Relevant aids to assist with independent living
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.
P R E – R E Q U I S I T E S
This unit must be assessed after the following pre-requisite unit:
There are no pre-requisites for this unit.
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T O P I C 1 – D E V E L O P R E L A T I O N S H I P S W I T H O L D E R P E O P L E
CONDUCT INTERPERSONAL EXCHANGES IN A MANNER THAT PROMOTES EMPOWERMENT AND DEVELOPS AND MAINTAINS
TRUST AND GOODWILL
The older person’s willingness and ability to direct the processes relating to the provision of their care may be attributed to both how well informed they are and a recognition that they have the right to refuse services.
In order to exercise choice and maximise independence, people require access to accurate information that will help them manage their own lives, understand their options and engage with and actively participate in their community.1
The client has the power to determine the direction that their care takes. Those providing support services should not presume what direction their care will take. As it is the older person who makes the ultimate decision regarding the provision of their care and services, they are the person who is providing direction to the support worker.
Whilst the support person can provide the client with information and suggestions which they feel may be beneficial to their care, the older person has the right to refuse these suggestions and choose the path they wish to take. They may wish to determine their ongoing care on a daily basis or institute planning for their needs in the future. In the case where the support worker identifies potential issues in the way the care in being planned or instituted then they may wish to raise this with the client, but ultimately they need to respect the client’s decision.
Providing information to the older client may assist them in making decisions about how they may improve their lifestyle. The information needs to be relevant to their needs and lifestyle, how improvements might be made, and should identify the services which could be of assistance to them in meeting their needs. This information may be in relation to issues such as the provision of health care services, equipment which might be beneficial to them, financial services or perhaps referrals that might provide them
1 http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
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with the further information they need. Providing this information enable the individual to gain a better sense of control over their life.
If the older person is not given the responsibility of directing their care, then there is a risk that they will become compliant with the direction of the person or organisation providing the services. Subsequently, this can negatively impact upon their independence. In this situation, the provision of care and services is directed by the provider and the older person risks losing their sense of empowerment. Whilst the support worker may be compliant with respect to the provision of care and services, the overall effect may be detrimental to the older person in that they can become reliant on others making decisions for them.
There may be compliance issues arise when the support worker who is in a position of influence promotes what they see as being beneficial to the client. If the worker promotes their ideas in such a way that they are perceived to be insistent of intimidating to the older person, then this may result in the older person feeling disempowered and having to do what they are told.
A more appropriate way of approaching the client regarding the way in which they utilise a particular service would be to explain not only what services are available to them but how they might be beneficial. i.e. there should be reasoning behind the suggestions given.
If the support worker identifies the need for an intervention which will be of benefit to the client, and the client subsequently refuses, then there should be supporting documentation outlining the refusal as well as the reasoning behind the refusal. Instances of non-compliance without the appropriate supporting reasoning can sometimes be viewed as the client being merely obstinate or irrational. Providing the reasoning behind their choice to refuse the implementation of services can assist in validating their decision.
The older person may wish to consult with an advocate before making a decision based on the suggestions of a support worker.
Advocacy services support people to actively participate in decision making processes and conversations that impact on their lives.
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Advocates will listen and act in the best interests of the individual and support people with the aim to increase independence and confidence to represent their own interests, and help them to be aware of the different ways they can have a say.2
2 http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
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RECOGNISE AND RESPECT OLDER PEOPLE’S SOCIAL, CULTURAL AND SPIRITUAL DIFFERENCES
Older people from culturally and linguistically diverse (CALD) backgrounds are a significant and growing section of the older population. In some areas, they comprise the majority of users of community care services. They bring a diversity of experience to older age shaped by cultural attitudes, family roles and responsibilities, and beliefs about health and disability. Also relevant are factors such as length of time since arriving in Australia, reasons for migration, post-migration experiences, and English language proficiency. These in turn influence their expectations and use of community care services.3
It is important that you ensure that you provide a quality service to every older Australian regardless of their diversity of race, cultural, spiritual, or sexual preferences. Every older Australian has the right to be treated equally and receive the services to meet their need. This is not only part of your duty of care, but it is also the law.
In order to be an effective worker in the Community Services Industry (CSI), you must be able to reflect upon and recognise your personal values and attitudes. Being able to identify how you think and feel about certain issues, for instance, those related to older people and people with disabilities will enable you to understand how your personal views might impact on your role as a care worker. Being empathic, unbiased and non- judgemental are essential attributes if you intend to work in the community services field. It is important to understand your personal values and attitudes because it enhances your professionalism and ethical work practice. 4
In all cases you must ensure you consider each of the following when working with aging people:
Values – Values are part of each person’s belief system. They develop from
rules learnt as we grow up and become internal messages about how we
should behave and what we believe in.
Attitudes – Attitudes vary in intensity. When we feel strongly about
something they are called values. Attitudes that are less important to us are
called opinions.
Stereotypes – A stereotype is a simplified image that develops when you
group people together on the basis of a similarity or characteristic.
3 http://www.islhd.health.nsw.gov.au/Carer_Program/Documents/State_documents/Resea… 4 http://www.islhd.health.nsw.gov.au/Carer_Program/Documents/State_documents/Resea…
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Diverse values – Views about drug use, culture, sexual preference, politics
and gender roles will always be present in one way or another, so we all need
to be aware of the impact our values have on processes inside and outside of
the workplace. We do not all think about and respond to issues in the same
way!
False beliefs – Some of these misconceptions of older people and people with
disabilities include:
o Being dependent
o Incapable of contributing to the community
o Unproductive
o Living on the pension
o Being in need of services
o Ending up in nursing homes
o Having poor health
o Being a burden on family
o Being unable to work
Pre-existing beliefs – As a worker in the CSI, the pre-existing beliefs you may
have could be related to stereotypes that have developed for you around
issues like sexuality, alcohol and other drugs, ageing and disabilities,
independence, health, the rights of people, your idea of health and what it’s
like to be older and/or disabled.
Work practice and stereotypes – It is important that you explore your
personal beliefs and become more aware of the way you view older people
and people with disabilities. This will assist you in your work to:
o Develop objectivity and avoid stereotyping
o Develop a better understanding of clients as individuals
o Identify individual needs and use a client centred approach
o Encourage clients independence
o Improve communication skills
o Plan and implement services appropriately
o Work professionally and ethically
Discrimination – As a care worker, you must understand the implications of
anti-discrimination legislation. Every day at work you will be in dealing with
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people from varied backgrounds and different issues. By being aware of the
anti-discrimination guidelines, you will be a more effective worker.
Being fair and consistent – It is essential that workers be fair and consistent
when working with clients.
Developing cultural sensitivity – There are a number of steps we can take to
develop cultural sensitivity with clients:
Identify our attitudes and values before entering the workplace
Try not to make value judgements about what is right and wrong for other
people
Communicate and respond to the client in a professional manner regardless
of your opinions about their behaviour and values
Try to imagine what life is like from the client’s perspective
Keep in mind that the client has the right to respect and dignity; this includes
respecting their choices
Enhancing communication – Here are some useful communication tips when
working with clients:
Don’t rush—be prepared to spend time
Provide a comfortable environment for the client, interpreter and you the
worker
Speak in plain English. Use simple phrases. Avoid using jargon
Show empathy and positive body language—ie use good eye contact, be
relaxed.
Paraphrase, reflect and summarise to clarify what is being said and
demonstrate your understanding
Accept your client’s cultural and spiritual practices5
5 http://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/lo/8511/8511_00.htm#ID0E4F
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MAINTAIN CONFIDENTIALITY AND PRIVACY OF THE PERSON WITHIN ORGANISATION POLICY AND PROTOCOLS
When providing support and assistance to the older person, it is imperative that you do so according to the policies and procedures of your organisation. Policies aim to tell workers and people being supported what the service values and how it goes about putting those values into practice.
Most written policies are clear, concise sets of guidelines outlining how that service operates. The policies tell you what management expects will happen in certain situations to support the service’s mission/ philosophy (belief statement). The policies state what practices should be implemented, so work is done efficiently and consistently.
Organisational policies relating to the provision of services may encompass issues such as:
Duty of care requirements
Organisational code of conduct
Organisational requirements
DUTY OF CARE REQUIREMENTS
Organisational policies will incorporate the duty of care requirements, which serve to guide the workers in the delivery of their care. This is to ensure that the client does not incur any harm or injury, particularly as a result of the actions of the worker. Duty of care policies will include ensuring that care and service plans are followed, case notes are followed and acted on as appropriate, and that new entries in relation to the health of the individuals are documented accordingly. Having knowledge of the requirements of the duty of care is instrumental in ensuring that the older person is supported in their independence. It is the responsibility of the worker to be aware and familiar of their requirements in relation to the duty of care.
ORGANISATIONAL CODE OF CONDUCT
Every organisation will have its own code of conduct, which outlines the functions that it intends to perform. Usually, there are statements about the mission, values and commitments of the organisation along with how it is guided in the provision of services. Organisations are guided by a charter of rights and responsibilities. These reflect the legislation that the organisation must abide by, and the types of services that
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are provided. Every type of work that occurs within the organisation will have its own code of conduct specific to that type of work. In some instances, members of that group will be accountable to an external professional body.
ORGANISATIONAL REQUIREMENTS
In addition to duty of care requirements, each organisation will have its own organisational requirements. Tis may vary according to the services that it provides. However, there will be similarities relation to the provision of those services to the clients. Organisational requirements need to be known and understood by the workers in order for them to be able to effectively perform their work.
Your service probably has a policy and procedures manual available to workers containing policies on a range of subjects. Some organisations may refer to these as SOP or Standard Operations and Procedures Manual.
Policies are developed to help you in several ways such as:
Avoiding hurried or spur of the moment decisions
Guiding your actions so you are aware of due process
Ensuring consistency in the way things are done by everyone
Ensuring consistency in duties is carried on even though someone from the
staff may leave
Ensuring decisions can be made without consulting everyone else
Generally, policies can help the staff team by:
Empowering individuals who are able to make decisions with confidence as
they are based on written documentation
Protecting staff who make decisions and act on established policies
Helping teamwork and cooperation by collectively establishing common
goals, procedures, and understanding
When commencing work within the community services sector, all employees need to be aware of the policies, protocols and procedures relating to the provision of services
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within their organisation and follow them accordingly in the provision of their care of the client.
PRIVACY
As with respect, the older client should feel that their privacy is maintained at all times. The worker should never divulge any information relating to the client to neighbours or any others with respect to the services they are receiving or any other personal matters. When working in the home, consideration should be given to the fact that conversations can be easily heard by others in the vicinity, so therefore you should limit the volume level of your voice.
Tasks such as answering the phone or collecting and reading of the mail should be left to the client unless otherwise requested to do so.
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ENCOURAGE THE PERSON TO ADOPT A SHARED RESPONSIBILITY FOR OWN SUPPORT AS A MEANS OF ACHIEVING
BETTER HEALTH OUTCOMES AND QUALITY OF LIFE
The older person’s willingness and ability to direct the processes relating to the provision of their care may be attributed to both how well informed they are and a recognition that they have the right to refuse services.
In order to exercise choice and maximise independence, people require access to accurate information that will help them manage their own lives, understand their options and engage with and actively participate in their community.6
The client has the power to determine the direction that their care takes. Those providing support services should not presume what direction their care will take. As it is the older person who makes the ultimate decision regarding the provision of their care and services, they are the person who is providing direction to the support worker.
Whilst the support person can provide the client with information and suggestions which they feel may be beneficial to their care, the older person has the right to refuse these suggestions and choose the path they wish to take. They may wish to determine their ongoing care on a daily basis or institute planning for their needs in the future. In the case where the support worker identifies potential issues in the way the care in being planned or instituted then they may wish to raise this with the client, but ultimately they need to respect the client’s decision.
Providing information to the older client may assist them in making decisions about how they may improve their lifestyle. The information needs to be relevant to their needs and lifestyle, how improvements might be made, and should identify the services which could be of assistance to them in meeting their needs. This information may be in relation to issues such as the provision of health care services, equipment which might be beneficial to them, financial services or perhaps referrals that might provide them with further information they need. Providing this information enable the individual to gain a better sense of control over their life.
If the older person is not given the responsibility of directing their care, then there is a risk that they will become compliant with the direction of the person or organisation providing the services. Subsequently, this can negatively impact upon their
6 http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
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independence. In this situation, the provision of care and services is directed by the provider and the older person risks losing their sense of empowerment. Whilst the support worker may be compliant with respect to the provision of care and services, the overall effect may be detrimental to the older person in that they can become reliant on others making decisions for them.
There may be compliance issues arise when the support worker who is in a position of influence promotes what they see as being beneficial to the client. If the worker promotes their ideas in such a way that they are perceived to be insistent and intimidating to the older person, then this may result in the older person feeling disempowered and having to do what they are told.
A more appropriate way of approaching the client regarding the way in which they utilise a particular service would be to explain not only what services are available to them but how they might be beneficial. i.e. there should be reasoning behind the suggestions given.
If the support worker identifies the need for an intervention which will be of benefit to the client, and the client subsequently refuses, then there should be supporting documentation outlining the refusal as well as the reasoning behind the refusal. Instances of non-compliance without the appropriate supporting reasoning can sometimes be viewed as the client being merely obstinate or irrational. Providing the reasoning behind their choice to refuse the implementation of services can assist in validating their decision.
The older person may wish to consult with an advocate before making a decision based on the suggestions of a support worker.
Advocacy services support people to actively participate in decision making processes and conversations that impact on their lives.
Advocates will listen and act in the best interests of the individual and support people with the aim to increase independence and confidence to represent their own interests, and help them to be aware of the different ways they can have a say.7
7 http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
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T O P I C 2 – P R O V I D E S E R V I C E S T O O L D E R P E O P L E
IDENTIFY AND DISCUSS SERVICES WHICH EMPOWER THE OLDER PERSON AND SUPPORT THE OLDER PERSON TO EXPRESS THEIR OWN IDENTITY AND PREFERENCES WITHOUT IMPOSING OWN
VALUES AND ATTITUDES
Ageing is a normal part of the life process, and as we age, we need to make plans for the later part of our lives. This includes maintaining health, preparing for retirement, and establishing and maintaining social networks and activities. Whilst we are all individuals and each of us has different needs; there are common influences that are experienced by the ageing person which will have a marked effect upon their lives.
As a person gets older they are influenced by changing factors in their lives in relation to:
Health
Cultural background
Education
Socioeconomic status
Social interaction with others
It is important that older people have the opportunity to maintain their established connections and achieve the optimal support to maximise the fulfillment in their lives. Positive ageing involves providing people with the opportunity to continue to make a valuable contribution to the community. It promotes the involvement of senior people and facilitates them maintaining their independence by allowing them to care for themselves as much as possible and enabling them to enjoy the later stages of their lives.
Before discussing the ways in which the older person can be encouraged to access support services, it is important to recognise that engaging these services is often a matter of choice. Because of individual differences, not all people wish to utilise or maximise the services available to them. Some older people may choose to remain fiercely independent, and choose to carry on their lives with as little assistance and support as possible. It is, therefore, pertinent to respect their decisions and only offer support where appropriate. i.e. if a person expresses’ that they don’t wish to participate
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in the use of particular services, then they should not feel that they are being pressured into doing so.
There are many support services for older people provided by community and government agencies. Innovative, sustainable and community-based approaches are required to increase access to support services and extend them beyond the traditionally accepted forms. This may include such things as:
Pet care
Home maintenance
Shopping assistance
Garden care
Financial advice
Financial discounts
Transportation assistance
Advocacy support
Legal advice
Mobility assistance
Health support services
Community support groups
Aged care facilities
The older person may choose to all some or none of these services. It is the responsibility of the community services worker to promote the availability of the services that they feel might be of benefit to their clients and assist them to link with the services that they see as being of benefit in meeting their needs.
Promoting the utilisation of support services may not always be an easy task. As mentioned some older people may be reluctant to employ the services available. The community service worker may choose to use significant other in the person’s life to communicate the benefits they may experience. Such people may include:
Family members
Close friends
Health professionals
Advocates
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Case managers
All people who are significant in the lives of the older person can be instrumental in assisting to encourage the use of available support services.
EXPLAIN THE SCOPE OF SERVICE
If the older person and their advocate, if applicable, are to be encouraged to employ the use of support services, then they must have a clear perspective about what the service actually offers. It is, therefore, necessary that they are provided with clear and understandable information. They need to know what the relevant services provide, in order to identify the benefits.
For the scope of the service to be understood there needs to be a clear path of communication between the community service worker and the client. This means that the worker must employ effective communication skills to convey the information to the intended audience. Because of the diversity of the clients that you are working with there will be instances where there are barriers which may need to be overcome. Barriers may be attributed to;
Age
Cultural diversity
Physiological barriers such as having, speech and visual impairments
Psychological factors e.g. the development of dementia in older clients
Resistance to change
The worker must, therefore, use their communication skills and the necessary resources to overcome these obstacles. They may wish to use the services of other professionals to assist them with their communication needs, or they may choose to use the persons advocate to assist them in relaying the information to the client. The advocate is generally someone who has an established rapport with the client. This may be a professional person, a friend other carer or family member. Because of their close relationship with the person they are often one of the best ways to effectively communicate with them.
Let’s examine some of the services that you may wish to communicate to the older client.
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You may wish to provide information regarding some of the aids and equipment that are available, to assist them in maintaining their independence. The older person will require clear information about how the equipment works, in what situations they might use it, and the benefit it might have for them. For example: you may suggest to them to use the services of an occupational therapist visit their home to assess the need for handrails and other supports. Your explanation to them might include, that it may reduce the possible risk of falls in the home, and reduce the risk of injury and subsequent health complications which might jeopardise their future independence.
Another service that you may wish to discuss is the transformational assistance that might be available to them. Discussing the transportation options to the person and/or their advocate can highlight ways in which to maintain their independence or perhaps maintain or enhance their communication with their social network. Being able to freely move around within the community may be a way in which they can maintain contact with others who are significant their lives, and ensuring that they are still in touch with the environment beyond their residence.
As a person ages, often their financial affairs need attention. Once a person exits the workforce, there is often changes to their regular stream of income. For some people, this may not be significant or daunting due to their acquired wealth, but for others whose only source of income is the pension, significant issues to their well-being may arise.
There may be a need to discuss financial matters with them, particularly in relation that they are financially catered for as their circumstances change. In this situation, it may be appropriate to link them with the services of someone who is experienced in the management of financial affairs. It is also important that the person be assured in the knowledge that whatever financial resources they do have, are appropriately and safely managed.
All information provided relating to the provision of services should be done in consultation with your supervisor or manager to ensure that you have the necessary skills to provide the appropriate information, as well as working within the policies, procedures and guidelines of your organisation.
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ADJUST SERVICES TO MEET THE SPECIFIC NEEDS OF THE OLDER PERSON AND PROVIDE SERVICES ACCORDING TO THE OLDER
PERSON’S PREFERENCES
ACCESS AND EQUITY
What is access and equity, and how can you conduct work that demonstrates a commitment to the access and equity principles.
Access – means to physically access different parts to a facility or service.
Equity – means to treat every person fairly
Note: Equity does not mean to treat every person the same, this is a common misconception in the community.
Access and equity principles may include
Provide a client-centered care
Creation of a client orientated culture
Non-discriminatory approach to all individuals using or accessing the service
Respect for individual differences
WHAT IS PERSON-CENTRED PRACTICE?
Person-centred practice is treatment and care provided by health services that places the person at the centre of their own care and considers the needs of the older person’s carers. It is also known as:
Person-centred care
Patient-centred care
Client-centred care
Person-centred practice is treating patients as they want to be treated.
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WHY IS PERSON-CENTRED PRACTICE IMPORTANT?
It makes sense that:
When you get to know the patient well, you can provide care that is more specific to their needs and, therefore, provide better care.
By promoting and facilitating greater patient responsibility, patients are more likely to engage in treatment decisions, feel supported to make behavioural changes and feel empowered to self-manage.
A recent literature review found that person-centred practice can make a positive difference to health outcomes and patient satisfaction and can improve health care workers’ sense of professional worth.
What are the principles of person-centred practice?
Getting to know the patient as a person – Health care workers need to get to
know the person beyond the diagnosis and build relationships with patients and
carers.
Sharing of power and responsibility – Respecting preferences and treating
patients as partners in setting goals, planning care and making decisions about
care, treatment or outcomes.
Accessibility and flexibility – Meeting patients’ individual needs by being
sensitive to values, preferences and expressed needs. Giving patients choices by
providing timely, complete and accurate information they can understand, so
they can make choices about their care.
Coordination and integration – Working as a team to minimise duplication and
provide each patient with a key contact at the health service. Teamwork allows
service providers and systems working behind the scenes, to maximise patient
outcomes and provide positive experiences.
Environments – Physical and organisational or cultural environments are
important, enabling staff to be person centred in the way they work.8
8 http://www.health.vic.gov.au/older/toolkit/02PersonCentredPractice/
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CREATION OF A CLIENT ORIENTATED CULTURE AND A NON- DISCRIMINATORY APPROACH TO ALL INDIVIDUALS USING OR ACCESSING
THE SERVICE
Stigmatisation and discrimination are two major impediments to the enjoyment of human rights by older persons. Stigma is often based on myths, misconceptions and fears about older people and ageing. These myths, misconceptions and fears include beliefs that everyone loses decision-making capacity, gets dementia, becomes dependent and a burden, and ends up in residential care.
Older people are not an homogeneous group. Older women and men age differently, and the discrimination that they experience is often multi-dimensional, based not only on age but on other factors, such as gender, ethnic origin, where they live, and disability, poverty, sexuality or literacy levels.
Policy related to the delivery of aged care needs to be developed within an ageing-well framework and in a manner that respects difference and diversity. Careful consideration of health resource allocations is required to ensure that the development and implementation of an ageing-well policy promotes equality rather than perpetuating inequalities.9
The notion that there are people who are treated differently and do not receive the same satisfactory service as others is not only inappropriate but also against the law.
RESPECT FOR INDIVIDUAL DIFFERENCES
There are a number of benefits of working within the community; one of those benefits would be that you can meet a range of people from different culture, origins, and backgrounds.
It is important that no matter what the background of the individual that you show them the respect that you would want yourself to be shown:
The background could include:
Age
9 www.humanrights.gov.au/…/human_rights_framework_for_ageing_and..
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Gender
Sexual orientation
Political views
Race
Religion
Disability
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PROVIDE SERVICES ACCORDING TO ORGANISATION POLICIES, PROCEDURES AND DUTY OF CARE REQUIREMENTS
It is important that you ensure your work practices reflect the organisation’s policies and procedures. Staff can ensure that they meet organisation policies and procedures by;
Checking that they understand them
Clarifying with supervisors any uncertainties about any of the policies or
procedure
Clarifying with other senior workers about any uncertainties about any of the
policies or procedure
Requesting assistance in developing new skill and knowledge in regards to
their duties
Actually reading the policies and procedures
Requesting feedback on their performance
Requesting ongoing training to improve their skills and knowledge
POLICIES AND PROCEDURES
Most written policies are clear, concise sets of guidelines outlining how that service operates. The policies tell you what management expects will happen in certain situations to support the service’s mission/ philosophy (belief statement). The policies state what practices should be implemented, so work is done efficiently and consistently.
Policies aim to tell workers and people being supported what the service values and how it goes about putting those values into practice.
Your service probably has a policy and procedures manual available to workers containing policies on a range of subjects. Some organisations may refer to these as SOP or Standard Operations and Procedures Manual.
They may include topics such as (but not limited to):
Code of conduct
Timesheet
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Employment requirements
Rights and duty of care
Health care management
Privacy and confidentiality
Violence and safe work policy, practices, and
Infection control and standard precautions
Medication policy
First aid kit work instruction
Use of utility gloves
Crisis situation and response
Using the occupational health and safety
Assessment work instruction
Leave:
o Sick leave
o Applying for sick leave, annual leave,
o Or long service leave
o Bereavement leave
o Parental leave
o Leave without pay
Employee information
Disciplinary procedures
Induction training checklist
Recruitment checklist
Job applicant interview
Policies are developed to help you in several ways such as:
Avoiding hurried or spur of the moment decisions
Guiding your actions so you are aware of due process
Ensuring consistency in the way things are done by everyone
Ensuring consistency in duties is carried on even though someone from the
staff may leave
Ensuring decisions can be made without consulting everyone else.
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Generally, policies can help the team by:
Empowering individuals who are able to make decisions with confidence as
they are based on written documentation
Protecting staff who make decisions and act on established policies
Helping teamwork and cooperation by collectively establishing common
goals, procedures, and understanding.
All workers need to support the philosophy of their workplace to ensure support and care is provided according to the philosophy which guides your agency. Not understanding the policies which are built upon the philosophy, may mean they are not written clearly and can be interpreted in various ways, leading to confusion and inefficiencies. When you are involved in the process of developing and reviewing policy, you are likely to feel some ownership of the results and therefore are likely to be more supportive of the implementation and put into practice what the guidelines suggest.
How you can contribute:
If your service has a suggestion box for identifying improvement, add your
comments
If your service has a sub-committee to work on developing or evaluating
policy, volunteer your time
If your service seeks nominees for a self-evaluation committee, put your hand
up
By adding your contribution, you make others informed of what you do as
well as adding to your own skills and knowledge
Find opportunities at your regular staff meetings to raise policy issues, and
ensure they are documented.10
10 www.enablelearning.biz/…/Addendum%20CHCAC318A%20October%2..
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T O P I C 3 – S U P P O R T T H E R I G H T S O F O L D E R P E O P L E
ASSIST THE OLDER PERSON TO UNDERSTAND THEIR RIGHTS AND THE COMPLAINTS MECHANISMS OF THE ORGANISATION
It is not only important but essential that you encourage and support the older person and/or their advocate/s to be aware of their rights. A right is an entitlement that every person has in the community. If you support the older person to be aware of their rights, then they are more likely to know when their rights are being breached so that they can take the relevant action to achieve their rights.
Rights may include:
Privacy
Confidentiality
Dignity
Freedom of association
Informed choice
To lodge a complaint
Right to express ideas and opinions
To an agreed standard of care
Right not to be abused
To use an advocate service
To receive the care that promotes wellness
Not to be discriminated against
The rights of the older person are detailed in a number of areas these include:
Legislation
Residential Care Manual
Aged Care Act
Industry and organisation service standards
Industry and organisation codes of practice and ethics
Accreditation standards
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International and national charters
Organisation policy and procedure
It is also important that you support the older person in understanding their responsibilities, they include:
To respect the rights and needs of other people within the residential care
service, and to respect the needs of the residential care service community as
a whole
To respect the rights of staff and the proprietor to work in an environment
free from harassment
To care for his or her own health and well-being, as far as he or she is capable
To inform his or her medical practitioner, as far as he or she is able, about his
or her relevant medical history and current state of health
Maintain a safe environment, as far as they are practicable
COMPLAINTS
It is important that you provide information to the older person and/or their advocate/s regarding the mechanisms for lodging complaints. The federal government has a scheme which is designed for the older person to be able to lodge a complaint about the service that they are or are not receiving.
AGED CARE COMPLAINTS SCHEME
The Aged Care Complaints Scheme (the Scheme) provides a free service for anyone to raise their concerns about the quality of care or services being delivered to people receiving aged care services subsidised by the Australian Government, including:
Residential care
Home care packages
HACC services
Most Australian aged care providers do their best to provide quality care and services for older Australians. However, issues can occur, so it is important to have a way for people to raise their concerns in a constructive and safe way.
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If they have a concern about the care they or someone else is receiving, it is important that they talk about it. Complaints can help providers improve the services and quality of care they provide to them or their loved one. Resolving one complaint can help other people too.11
11 http://www.health.gov.au/internet/main/publishing.nsf/content/ageing-complaints-index.htm
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DELIVER SERVICES ENSURING THE RIGHTS OF THE OLDER PERSON ARE UPHELD AND IDENTIFY BREACHES OF HUMAN
RIGHTS AND RESPOND APPROPRIATELY
If you notice, observe or suspect that the rights of an older person are not being upheld it is your duty (duty of care) to report this to an appropriate person.
INTERNATIONAL FEDERATION OF AGEING DECLARATION ON THE RIGHTS AND RESPONSIBILITIES OF OLDER PERSONS
In December 1991, the United Nations adopted a set of United Nations Principles for Older Persons, recommending that all member governments incorporate them into their programs for older people. The Principles are based on the following Declaration on the Rights and Responsibilities of Older Person.
The United Nations General Assembly summarised the Declaration as follows:
‘Add life to the years that have been added to life by assuring all older
persons: independence, participation, care, self-fulfilment and dignity.’
These principles form the foundation of the rights-focused approach to elder abuse that is promoted throughout this website. Go to the principles section for more specific information about these principals in action.
INDEPENDENCE
Older persons have the right:
To access to adequate food, water, shelter, clothing, and health care through
the provision of income, family and community support and help
To work and pursue other income generating opportunities with no barriers
based on age
To retire and participate in determining when and at what pace withdrawal
from the labour force takes place
To access education and training programs to enhance literacy, facilitate
employment, and permit informed planning and decision making
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To live in environments that are safe and adaptable to personal preferences
and changing capacities
To reside at home as long as possible
PARTICIPATION
Older persons have the right;
To remain integrated and participate actively in society, including the process
of development and the formulation and implementation of policies which
directly affect their well-being
To share their knowledge, skills, values and life experiences with younger
generations
To seek and develop opportunities for service to the community and to serve
as volunteers in positions
To form movements or associations of the elderly
CARE
Older persons have the right:
To benefit from family support and care consistent with the well-being of the
family
To access health care to help them maintain or regain the optimum level of
physical, mental and emotional well-being and to prevent or delay the onset
of illness
To access social and legal services to enhance capacity for autonomy and
provide protection and care
To utilise appropriate levels of institutional care which provide protection,
rehabilitation and social and mental stimulation in a humane and secure
environment
To exercise human rights and fundamental freedoms when residing in any
shelter, care and treatment facility including full respect for their dignity,
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beliefs, needs and privacy and for the right to make decisions about their care
and quality of life
SELF – FULFILMENT
Older persons have the right:
To pursue opportunities for the full development of their potential
To access the education, cultural, spiritual and recreational resources of
society
DIGNITY
Older persons have a right;
To be treated fairly regardless of age, gender, racial or ethnic background,
disability or other status, and to be valued independently of their economic
contributions
To live in dignity and security and to be free of exploitation and physical or
mental abuse
To exercise personal autonomy in health care decision making, including the
right to die with dignity by assenting to or rejecting treatment designed solely
to prolong life12
It is very important that once you recognise that an older person’s rights are not being upheld, it is your duty to report to an appropriate person. Report may be done either:
Verbal:
Telephone
Face-to-face
Non-verbal (written):
Progress reports
12 http://www.sa.agedrights.asn.au/residential_care/preventing_elder_abuse/rights_of_older_person
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Case notes
Incident reports
The appropriate person/s may include:
Supervisor
Member of senior management
Colleagues
Carers
Health professionals
External agencies (complaints and advocacy services and professional
registering authorities)
Law enforcement officer
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RECOGNISE SIGNS CONSISTENT WITH FINANCIAL, PHYSICAL OR EMOTIONAL ABUSE OR NEGLECT OF THE OLDER PERSON AND
REPORT TO AN APPROPRIATE PERSON
DEFINITION
Abuse of an older person “is any act occurring within a relationship where there is an implication of trust, which results in harm to an older person. Abuse may be physical, sexual, financial, psychological, and social and/ or neglect.”
The definition helps us clearly understand the nature and types of abuse being experienced by older people. Abuse is carried out by someone close to them, with whom they have a relationship implying trust, and may include family members e.g., son, daughter, spouse, brother, grandchild, niece or friend.
Also, note that any staff member, regardless of the position held, may behave or act in an abusive manner. If you suspect a colleague or any other staff member is abusing older people, talk to your supervisor or contact the Department of Health and Ageing Complaints Investigations Scheme (1800 550 552) and seek advice.
A range of factors can contribute to elder abuse. Abuse of an older person:-
Can happen to anyone regardless of gender, where people live, cultural or
religious background or income
Is a breach of a person’s rights. Some of these breaches may be criminal or
civil offences
Can be complex due to the relationships involved, the possibility of more than
one form of abuse occurring at the same time, or more than one alleged
abuser
FORMS OF ABUSE
The forms of elder abuse are similar to other forms of interpersonal violence (for example, domestic violence). Select the type you are interested in from the list below in order to get more information.
Physical
Sexual
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Financial
Psychological / Emotional
Social
Neglect
PHYSICAL ABUSE
A non-accidental act which results in physical pain or injury, it includes physical coercion and physical restraint.
Abusive Physical Behaviour Includes hitting, slapping, burning, pushing, punching, pinching, biting, arm twisting, cutting, hair pulling, forced confinement to room, chair or bed.
Signs of physical abuse – these signs could indicate abuse:
– Injuries in different stages of healing – Unexplained hair loss
– Abrasions – Bruises – Welts – Burn blisters
– Rashes – Contusions
– Swelling – Tenderness
– Lacerations – Pain or restricted movements – Lack of awareness – Drowsiness
– Cringing or acting fearful – Noticeable change in physical well-being
– Weight loss – Broken or healing bones – Agitation
SEXUAL ABUSE
Non-consensual sexual contact, language or exploitative behaviour.
Abusive Sexual behaviours Includes rape, indecent assault, sexual harassment, sexual interference.
Signs of sexual abuse – These signs could indicate abuse:
Unexplained sexually transmitted disease or infections
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Bruising in genital areas or inner thighs
Bleeding from the genital area
Difficulty in walking or sitting not associated with a medical condition
Fear
Agitation
Disturbed sleep
Withdrawal
FINANCIAL ABUSE
The illegal, improper use and/or mismanagement of a person’s money, property or resources.
Abusive financial behaviour Includes:
Fraud
Stealing Forgery
Embezzlement
Reluctance to pay for accounts or debts
Unwillingness to bring items in for the older person
Withholding funds from the older person Resident forced to hand over management of their finances
Forced changes to a Will Enduring Power of Attorney’s refusal to provide information about financial affairs to the older person Pressure from others to hand over money or items
An unprecedented transfer of money or property to another person Unwillingness of others to repay money loaned
Signs of Financial abuse – These signs could indicate abuse:
Older person frequently changing their mind about their Enduring Power of Attorney Lack of money for items needed Loss of jewellery or personal belongings
Older person expresses fear and anxiety when discussing finances
Unexplained amounts of money missing from bank accounts Unpaid accounts
Receiving accounts for items not belonging to the person
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