CHCAGE011 Provide Support to People Living With Dementia, Student Assessment Booklet

Assessment Overview

This Student Assessment Booklet includes all your assessment tasks for CHCAGE011 Provide support to people living with dementia.

Assessment Task Summary

This unit requires you to complete five assessment tasks. You must satisfactorily complete all tasks to achieve competency for this unit.

Assessment Plan

The following outlines the assessment requirements for this unit. You are required to complete all assessment requirements outlined below to achieve competency for this unit.

Your assessor will provide you with the due dates for each assessment task. Write them in the table below.

Assessment Task 1: Knowledge Questions

The following assessment tasks use a simulated aged care facility called Banksia Care. To complete the assessment tasks, students will need to access information, templates, policies and procedures associated with Banksia. These documents can be accessed on Banksia’s intranet (accessible via the website). To access, head to Banksian Care , navigate to the staff intranet and enter your RTO’s username and password prior to completing your assessment tasks.

TASK SUMMARY

In this task, you will demonstrate your knowledge by answering a series of questions that relate to this unit of competency. 
You must answer all questions correctly to achieve a satisfactory outcome for this task. 

TASK INSTRUCTIONS

    Answer all questions below by indicating your response to each question in the space provided. 
    You may use your learning materials as reference if required.
    You must answer all questions and their parts correctly to achieve a Satisfactory outcome for this task.

QUESTION 1

Complete the following table on dementia types and what functional changes happen to the person who has been diagnosed with that type of dementia.

QUESTION 2 
a)   Access Dementia Australia website and summarise in your own words the aspects of dementia currently investigated.
b)  The most common type of dementia is Alzheimer's. Outline current Australian research on this dementia type and summarise what the research is targeting.

QUESTION 3
a)  List two benefits of using ‘person-centred’ practice when caring for clients with dementia.
b)    List three principles of a person-centred approach.

QUESTION 4

Scenario
Banksia Care is expecting an audit and all staff members review their own paperwork to ensure it’s ready for the auditors. Jenny is up to her ears in paperwork. She must check all the client care plans before the auditor comes next week. She has client files all over her desk, on top of the cabinet and on the floor.

There is a big pile of loose papers that need to be filed, so she is doing that first. 
Today is Friday. When it is time to go home for the weekend, Jenny puts up a large sign in her office: ‘DO NOT TOUCH ANY OF THESE FILES’. 
She thinks she has done well to remember to do this as the cleaner comes in over the weekend and she doesn’t want the cleaner moving things around otherwise she won’t know where she is up to.

a) Access Banksia Care’s website. Identify the Banksia Care policy and procedure and the legislation Jenny is breaking by her actions and explain why.
b)  Provide three examples of how client information should be protected in the workplace.
c) In your own words, summarise the term ‘confidentiality’ and explain how it impacts your work when working with clients that have dementia.
d)    Provide two examples of duty of disclosure that apply to people working with clients that have dementia.

QUESTION 5

Dementia is a progressive neurological condition. Provide a brief description for each of the following pathological features of dementia.

QUESTION 6
Communicating with a person that has dementia can be challenging, provide a description on how you can engage with your clients using the methods in the table below.

QUESTION 7
Read the daily activity statement in the table below and list two types of assistive technology that could be used to help. Tick the life domain that each daily activity aligns to.

QUESTION 8
a)    Briefly explain the role of assistive technology for maintaining and promoting independence of people with dementia.
b)    Briefly explain the role of assistive technology for enabling inclusion and participating in daily life activities for your clients.

QUESTION 9

Scenario

Graeme has dementia and has been exhibiting some challenging behaviours at the support workers. You come on shift and read the case notes left. 

The last entry said that Graeme spat the food out at the carer and refused to eat anything else. You take note of this and go in to say good evening to Graeme. As you enter, you see him swilling his dentures around in his mouth. You verbally say, ‘Good evening, Graeme, how was your dinner?’ knowing that he hasn’t had much. Graeme tells you that the service here is terrible and that his teeth are talking to him and stopping him from being able to eat. You ask Graeme if you could have a look at his teeth and he says, ‘Sure thing love’ and he takes them out and shows you his gummy smile. You tell Graeme he has a wonderful smile and ask if his mouth feels okay, inspecting the dentures and noting that they weren’t fitting in his mouth correctly. 

You take an observation that there is a slight pressure mark on Graeme’s gum and note that in your observations chart.

a)    Explain why Graeme’s behaviour may have changed towards you and not the other staff.
b)    Explain who should you report your observations to.
c)    List three ways that Graeme’s behaviour may be impacted from his injury of the pressure mark in his mouth.
d)    Outline three potential interventions and three proactive strategies workers can use to address behaviour caused by un-met needs.

QUESTION 10

Scenario

Joan is a Banksia Care client. They are a type 2 diabetic who takes medication daily, has Alzheimer’s and limited mobility on her left side due to a stroke. She can walk but has difficulty washing herself in the shower. You come on shift to do her personal care activities and get her ready for the day.

As you are supporting her and getting her from the bed to the ground to transfer her to the shower chair, Joan winces in pain. You stop and ask her where the pain is. She points to her toe and after a thorough inspection you see the red, swollen area.

a)    Explain what you have identified and who this needs to be reported to.
b)    List three ways that Joan’s behaviour may be impacted from her painful toe.

Scenario
Joan’s physician has asked that the facility must refer her to a podiatrist for ongoing review of her toes and as part of her management for diabetes.

c)   Access the Banksia Care website and read PC6 Referrals Policy and Procedure. Outline the referral process that Banksia Care would need to take to get the care that Joan requires.

QUESTION 11

Scenario

Shona is a Banksia Care client who suffers from dementia. She doesn’t want to get out of bed today when you go in to get her ready for the day. She tells you to go away because she has a headache and needs more blankets because she is cold. 

You ask her if you can take her temperature quickly and she swats you away with her hands. You respect that she is unwell and tell her that you will be back in 30 minutes to check on her. Shona pokes her tongue out at you as you walk out of her room

a)    Outline what you have identified, what and who this needs to be reported to.
b)    List three ways that Shona’s behaviour may be impacted from her illness.

QUESTION 12

Scenario

Mabel is a very strong-willed client of Banksia Care who is suffering from dementia. She suffered a stroke prior to the onset of dementia which left her wheelchair bound. 

During your shift, you check in on Mabel and she has slipped while transferring herself from the armchair to her wheelchair and has been trying to call out for help for some time. You assist Mabel back into sitting in the chair until the Registered Nurse and the doctor can see her. You notice that she has a large bruise on her head, but she is talking as if she is fine and ready to go to work. 

a)  Explain what you have identified, how and to whom this needs to be reported. Ensure that you identify the Banksia Care Policies and Procedures you would need to follow.
b)    List three ways that Mabel’s behaviour may be impacted from her injury.

QUESTION 13
What are seven common indicators or symptoms of dementia?

QUESTION 14:
In the table below, provide a minimum of one example of how the following aspects in the progression of dementia impact on the person and on their family and/or other carers: 

QUESTION 15
Indicate true or false to the statement that demonstrates the principles of person-centred care practices below.

QUESTION 16
a)   People with dementia often experience boredom, loss of self-esteem, self-worth and confidence. How would you use a person-centred approach to support them improving these feelings and enjoy life?
b) Outline minimum two activities that could increase self-esteem and pleasure.
c)  Outline minimum two activities that could minimise boredom.
d)  Outline minimum two activities that could improve the sense of self-worth.

QUESTION 17
Describe the different types of stressors and list two examples on the impact that people with dementia may experience.

QUESTION 18
Briefly explain the implication dementia has on the following life aspects of a person progressing through dementia.

Terms    
a)    Financial implications    
b)    Accommodation    
c)    Isolation    
d)    Heightened vulnerability to abuse and exploitation    

QUESTION 19

a)   Provide two reasons why older people with dementia are more vulnerable to abuse than those without dementia.
b)   List the five forms of abuse that can be described as Elder Abuse.
c)  Identify three signs that could be considered Elder Abuse.
d)  Explain the legislative and statutory reporting requirements that you need to undertake if you suspect elder abuse of a person suffering from dementia.

QUESTION 20

Scenario
John's carer is his wife, Elise. John has two daughters, Casey, and Joanne, who do not get along with Elise. Joanne lives abroad and calls every month to talk to her father. Elise sets time limits, and when John starts to talk too much, she takes the phone from him and tells Joanne that she is making her father tired.

John has Alzheimer's and is about to be transferred to Banksia Care. While getting John used to the facility, Elise takes John every few days and leaves John there for a few hours so she can run errands during this time.

One of the support staff notices John's beautiful watch and talks to him about it and the maker. John loves timepieces, and he could tell her all about this one and how his daughter Joanne had sent it from Germany, where she lives.

The next time John comes in, the staff member asks John where his watch is. John places his hand on his wrist and says he doesn't know. The staff member said, ‘Oh, that is okay; we will talk to Elise when she comes back.’ John's behaviour starts to change; he asks when Elise will be back and if he can stay the night at Banksia Care.

When Elise comes back, John asks her where his watch has gone. She says, ‘Don’t you remember? You wanted to give it to my son as a keepsake.’ John replies, ‘Oh I must have forgotten. I am sorry dear; I hope you don’t think I was accusing you of something else.’

a)    Explain what John is experiencing in the form of abuse, neglect, or exploitation.
b)    Explain what the worker should do in this situation using following legislation and Banksia Care policies and procedures for reporting.

QUESTION 21

Scenario
A friend of Tony's visited him at home. Tony has home services come and help him. Tony told his friend that no one sees him, and they only talk to him for his money. Tony's friend rang an advocacy service as they felt that Tony was not receiving appropriate care and services.
When an advocate from the advocacy service contacted Tony, he disclosed that he had trouble with his eyes and had requested help for an extended period, but nothing had been done. When his friend visited Tony, Tony's clothes were threadbare and falling off him. Tony told his friend, ‘I wouldn't say I like the food that gets delivered; it is for older people, not me; it is bland and tastes like water.’ He also disclosed that he had left home several times and was returned by the police each time, Tony has mild dementia and sometimes gets disoriented on his walks.
Explain what Tony is experiencing in the form of abuse, neglect, or exploitation.

QUESTION 22 
a)   In your own words, describe what constitutes a restrictive practice in residential aged care when working with clients that have dementia.
b)    Complete the table about the regulated restrictive practices. 

Regulated restrictive practice type          Provide a brief explanation and an example 
a)    Seclusion
b)    Chemical restraint 
c)    Mechanical restraint 
d)    Physical restraint 
e)    Environmental restraint 

QUESTION 23
a)  Indicate true or false to the questions about restrictive practices below

Question                                                                                                                           True or False
1) Informed consent is required to use a restrictive practice in an emergency.    
2) Locking doors to keep clients safe is a restrictive practice.    
3) Controlling a behaviour using restrictive practices can trigger other behaviours of concern. 
4) Informed consent is required to use a restrictive practice in an emergency.    
5) Locking doors to keep clients safe is a restrictive practice.    
6) Controlling a behaviour using restrictive practices can trigger other behaviours of concern.    

b) Identify the federal legislation that was updated to regulate and strengthen restrictive practice arrangement and describe what these amendments aimed to do.
c) Access the Banksia Care website and read SE5 Restrictive Practices Policy and Procedure. Summarise when restrictive practices can be used.
d)  If a restrictive practice is used, explain where the practice is to be documented.

QUESTION 24

List three positive strategies that can be utilised instead of using restrictive practices in residential aged care against the restrictive type in the table below. 

QUESTION 25
a)    Describe three legal issues that may arise when working with clients with dementia and suggest how to deal with these.
b)    Describe three ethical issues that may arise when working with clients with dementia and suggest how to deal with these.

QUESTION 26
a)   Explain the Universal Declaration of Human Rights.
b)   List four examples of holistic human needs.

QUESTION 27
In the following table, briefly describe each of the legal and ethical considerations, their importance in working with people with dementia and one possible consequence for the breach of each.

QUESTION 28
Employers and employees have differing responsibilities under the Work Health and Safety Legislation.
a)    List four responsibilities of employers of staff that are working with people with dementia.
b)    List three responsibilities of employees that are working with people with dementia.

QUESTION 29
a)  Provide three examples of proactive strategies and three examples of potential interventions to address the identified behaviours that are caused by both, physical and social environment.
b) The environment in which a person lives can have a significant impact on their ability to interact and engage with others. There are several ways in which the environment can support or obstruct interaction and engagement. Provide two examples.

Assessment Task 2: Assist Edna

For this task, you are required to respond to questions from a provided case study to demonstrate your applied knowledge of restrictive practice use in residential aged care.

TASK INSTRUCTIONS

    For this task, begin by reading the case studies and then provide detailed answers to the questions that follow. 
    You must answer all questions and their parts correctly to achieve a Satisfactory outcome for this task.

Case Study: Edna
Edna has dementia and lives at Banksia Care. Edna often refuses personal care, including after episodes of faecal incontinence. There have been complaints from her family and other consumers about her hygiene. To provide care, support staff have started to hold her arms to prevent her from hitting while another staff member washes and changes her. Edna resists this and finds it distressing, often triggering more challenging behaviours, especially when getting dressed after the personal care activities have been done.

QUESTION 1.1
Using the Banksia Care policy and procedure for restrictive practices, identify the restrictive practice used and explain your answer.

QUESTION 1.2
List three alternative strategies that the support staff can use as methods to identify Edna’s triggers before the Behaviour Support Plan is reviewed.

QUESTION 1.3
List three behaviour changes the support staff should look to see in Enda once the alternative strategies are put in place the next time they Become to attend to her personal care.

QUESTION 1.4
Explain what Banksia Care must report to the Aged Care Quality Commission to use a restrictive practice in the facility.

Case study continued
Edna is 92 years old and has had dementia for fifteen years. She has lived at Banksia Care for the past seven years. 

Edna has been waking up during the night and wandering around the facility, she gets lost and disorientated and displays aggression when the staff try to re-direct her back to her room and bed. 

Because Edna is distressed and aggressive, Banksia Care staff request the assistance of available behaviour support resources and assistance from the family, to reassure her and give staff strategies to help her settle at night. 

Edna’s GP is also asked to help. They assess her and suggest that a low dose of risperidone in the short-term might help with the behaviour. Edna’s son (who is her authorised representative) agrees and gives his informed consent. Edna is calmer. She is monitored for side effects such as drowsiness and there is a clear plan to document her behaviour and to review the need for the risperidone in the following weeks.

QUESTION 1.5
Reading through the case study, identify if a restrictive practice has been used by the Banksia Care staff and what the Banksia staff are required to document.

QUESTION 1.6
a)    What is your duty of care as a personal support worker to Edna?
b)    What is your duty of care as a personal support worker to Edna’s son?

Assessment Task 3: Recognise Signs of Abuse

TASK SUMMARY

For this task, you will be observed participating in a role play to confirm you can perform to industry standards and expectations when recognising signs of abuse.
You will play the part of Casey Reilly.
There will be two other people working with you.
Role play should take approximately 15 minutes.
Complete your documentation after your role play. 

STEP 1

Scenario 
Edith Jones is a 77-year-old petite lady who has been suffering with Alzheimer’s for the last five years. She has been widowed for eight years and requires assistance with getting changed and showering. For Christmas, Edith has gone to her son Garth’s residence to celebrate for a few days. It is the 30 December and Casey Reilly, a Personal Care Worker, has arrived to commence her shift and sees that the Registered Nurse on duty with her today is Nurse Smith.

Edith returned four days after Christmas. Edith is assigned to Casey’s care on her shift the day after she comes back from staying with her family. Casey makes light chatter with Edith and asks how Edith’s time spent with Garth and the rest of the family was. Edith’s behaviour changes and becomes fearful and anxious and at first doesn’t want to talk about her time with Garth. While attending to Edith’s personal care duties, she winces when she moves her arm out of the hole of her pyjamas and Casey notices bruising around her arms and down the back left hand side of her chest area.

STEP 2
Once you have completed the role play, you will need to complete the incident record and complete your case notes. 

Assessment Task 4: Support Clients with Dementia

TASK SUMMARY

In this task, you will be observed performing skills in a real workplace environment to confirm you can perform to industry standards and workplace expectations. 

You are to provide support following the individualised plans for one client that are living with dementia. You will be asked questions to confirm your knowledge during your demonstration.

TASK INSTRUCTIONS

    Your assessor will visit you in the workplace to observe you performing a number of specific workplace duties. 
    During the visit, you are required to complete the following duties/tasks while your assessor observes you. 
    During the observation or after, your assessor will ask you a range of verbal questions relating to the tasks you are carrying or carried out.
    Consult the client’s Individual Care Plan (ICP), Individual Action Plan (IAP) or equivalent documents, and relevant workplace policies and procedures that apply to complete the following steps. 
    Consult with the client and their carer to maintain a stable and familiar environment that supports their interests, needs, and wants while maintaining a person-centred approach.
    Identifying how to best support the clients in their daily routines and activities.
    Applying person-centred care through encouragement when decision making.
    Using different communication techniques, such as verbal and non-verbal.
    Using reality orientation to gain cooperation and provide reassurance to the clients during the interactions.
    Use validation strategies to relieve the clients stress and agitation during the interactions.
    Organise and assist the client with appropriate activities which maintain their independence in accordance with their daily routines.
    Ensuring the safety and comfort of the clients whilst encouraging autonomy when supporting the clients.
    Complete documentation according to the workplace procedures.