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Transcript of SD-final-Older Person
Adapting Care and Practices
with the older person, their family and the multi disciplinary team
Adapt care and practices
to meet the needs of older people with cognitive and sensory impairment and physical disabilities
LO13: Exercise duties in a way that is respectful to
the person’s body after death
a range of aspects of care
for the older person to include empowerment, advocacy, independence, individualised care, dignity, respect, choice, self esteem and include family and carers as partners in care.
LO 15: Give assistance in the identification of how
health promotion issues
can be promoted in care settings for older people and in the provision of therapeutic interventions that will enhance the social interactions and quality of life of the older person
€66 per candidate
Neil McGeever / Nicky Scudds / Laura Quinlan
Age Related Issues
Care of the Older Person
Services Available to Older People
LO7: Recognise the
individual needs of the dying older person
and their families
LO8: Summarise t
he range of the care settings
for older people and the members of the healthcare team available in each care setting
LO9: Explore a range of specific services that are available for older people to include
education, lifelong learning, retirement/the workplace
LO10: Analyse current approaches towards developing quality in the provision of services for older people and their families to include
standards and quality assurance
15 Learning Outcomes grouped into 4 units
Skills Demonstration (60%)
LO4: Explore a range of older people’s needs to include
physical, social, emotional, psychological, recreational,
and spiritual needs
the role of the health care assistant
in providing care for the older person
LO6: Discuss the issues related to an older person with
and of living with
LO1: Discuss a range of age related issues to include
healthy ageing, global and national demographic trends
, the normal
physiological and psychological processes
of ageing, the
of ageing on older people and
to ageing and older people
LO2: Analyse the
roles of the health care assistant
in promoting positive attitudes to ageing and of statutory and voluntary agencies in promoting the well being of older people
LO3: Examine a range of concepts and practices to include
preparation for retirement
ethnic and cultural influences
on the older person
What does caring for someone involve?
What do want to achieve from this event?
What are your views on:
Are these views stereotypical?
the psychological changes in ageing?
the physical changes of ageing?
What is your attitude towards older people?
Using services like free travel etc
Do you think the media influence peoples’ attitudes towards older people?
Can you think of any television adverts that use stereotypical views of older people?
As a healthcare professional, it is important:
To be aware of negative attitudes people may have towards older people and try to help people change how they view the older person
To remove any stereotypical views towards older people e.g. believing that all older people are suffering from ill health, seeing older people as a burden on society
Preparation for retirement
What is the age for retirement in Ireland?
Why do people need to prepare for retirement?
What issues do you think one would need to consider when preparing for retirement?
Form 3 groups of 2 and develop a poster with the theme of “
attitudes towards older people
Present to the class when finished.
Using pictures from newspapers and magazines, make a poster that tells a story about older people. The story wil focus on attitudes towards older people (positive of negative).
e.g. you might find some pictures of Michael D.Higins as President of Ireland at 73, or Clint Eastwood acting and directing at 84 but also you might find some pictures of older people being used in a stereotypical way. Using these pictures, make a poster a present a story!
Physical Needs of the Older Person
Physical needs will vary from person to person and depend on other factors such as illness, dependency level and environment
Examples of physical needs:
Need for rest and sleep
Need for exercise
Relief of pain
Positioning- comfort, prevention of pressure ulcers
Holistic needs of older people
What is meant by the term holistic?
What is your understanding of holistic needs?
To meet the psychological needs of the client, the carer must recognise the beliefs, values, needs and wishes of the client without making judgements
Interpersonal skills are important as the carer needs to be able to communicate to the client that their beliefs, values, needs and wishes are understood and recognised in an unbiased non-judgemental way
Relatives and friends
Recreation and leisure activates
Emotional Needs of the Older Person
Fear of dying
Being a financial burden on children
Caring for spouse
Fears about treatment, nursing home
Loss of income
Loss of family members, friends
Loss of independence
Spiritual Needs of the Older Person
Respect for religion and customs
Accommodate clients to see Minister/Priest/Rabbi etc
Awareness of customs surrounding death and dying
Involving family members
Respecting the beliefs of clients
Dietary concerns related to religious or spiritual beliefs
Recreational Needs of the Older Person
Older people living alone or in nursing homes may feel isolated, bored or withdrawn
Recreational activities allow older people to meet other needs such as social, physical and psychological
Spending time with a client to ascertain what activities they enjoy is important
This may require the involvement of the family or friends of the client
Meeting recreational needs of the older person is often overlooked when in preference of other needs
The Role of the Healthcare Assistant / Support Worker
The roles and responsibilities of the health care assistant continue to grow as the demands on healthcare increase
The Department of Health and Children define the role of the Health Care assistant as..
‘To assist nursing/midwifery staff in the delivery of patient care under the direction and supervision of a Clinical Nurse Manager.. ‘
Work in pairs and list the roles of the healthcare assistant /support worker.
Give examples of each role.
Present to class as a group.
Roles of the Health Care Assistant:
Assisting clients with activities of daily living
Communicating with client, their family and friends
Documenting and recording information
Developing a trusting relationship
Prevention of pressure ulcers
Assisting with mobility
Assisting with nutritional needs
Encouraging participation in activities
To be a good Health Care Assistant, the following qualities are needed:
Reliable and punctual
Maintain dignity and privacy
Have good listening skills
Respect diversity and individuality of all clients
The health care assistant must have the ability to work on their own initiative but also be able to work as part of the team.
Issues Related to Mental Health, Dementia and Living with a Chronic Illness
Divide into groups of three. Group A will have the topic of mental health Unit 3, p6); Group B the topic of Dementia (Unit 3, p20); Group C the topic of chronic illness (Unit 3, p26).
Identify an example of each condition and how the condition impacts on the life of the older person, what care needs the person may have and how these can be met by the support worker.
Present back to the class.
The Range of Care Settings for Older People
What types of care settings are available to older people?
Do they suit the needs of the older person?
The HSE provides a wide range of services for people growing older in Ireland. Supports are also available from other agencies like the Department of Social Protection, Local Authorities and Voluntary Organisations. Choose from the options below to find out more about the services we provide, and how you can access them. If you have any questions, you can also call our staff at the HSE infoline on 1850 24 1850. The infoline is open from Monday - Saturday, 8am - 8pm, for the price of a local call.
Home Care Packages
Nursing Homes Support Scheme
Older People Services where you live
Benefits and Financial Entitlements
Tips for Healthy Living
Carers and Relatives
Protecting Older People
Patients' Private Property Accounts
Services Available for Older People
- Write down the different types of services you can think of that are provided to assist older people.
"It is widely recognised that Ireland is at a crossroads in the way we, as a society, care for our older people. In times past, the extended family meant that as people grew older they remained in the family home cared for by their relatives. This is no longer the norm, with more and more people moving into residential care settings as they grow older. This raises challenges in terms of how we protect the rights of older people who live in residential care settings and ensure that they are able to lead as full lives as possible in a caring, respectful environment.
In response to this challenge, the National Quality Standards for Residential Care Settings for Older People have been developed by the Health Information and Quality Authority (the Authority). They set out what a quality, safe service for an older person living in a residential care setting should be. For service providers, these Standards provide a road map of continuous improvement to support the continued development and provision of person-centred, accountable care."
In January 2016, HIQA released publication on statutory notifications and lists the types of notifications and reasons why a registered centre needs to notify HIQA of an event
Quality in the Provision of Services
The quality of care provided to older people in Ireland
Do you think there is enough funding provided to older peoples’ services?
Are waiting lists too long?
Should nursing homes be free to older people?
Video Clip: Older People and Quality of Life: Better Life in Residential Care (5 minutes)
Health Promotion in Care Settings
Apart from the benefits to the older person, a healthy ageing society benefits society at large
The focus of health these days is on quality of life as opposed to longevity of life
Health promotion for older people is being highlighted in an effort to reduce ill health, especially cardiovascular disease
Health promotion aimed at older people educates regarding the benefits of healthy living and how this is achieved
It also supports in healthy activities and offers advice on healthy diets, weight reduction, alcohol and other substance abuse such as smoking
Health promotion includes:
Reduced premature mortality
Enhanced quality of life
Expanded active life expectancy
Maintenance of functional independence for as long as possible
Preserving quality of life
Preventing illness and disability as far as possible, preventing infection and reducing harm
Enabling the person to cope with ill health or disability
Maintaining independence and self esteem
Supporting and assisting in preserving relationships with family members and friends
All residents should be given regular health checkups
Acting upon a potential risk that might harm the client e.g. fall or infection
It is part of the Health Care Assistants role to pay attention to possible risks such as a change in a clients condition or behaviour and report it
Residents should have access to health information to enable them to make choices
Regular dental care should be maintained
Food should be nutritious and appetising
Hearing and vision should be regularly checked
Glasses and hearing aids should be checked to ensure they function
Exercise programmes should be provided and encouraged
Mental stimulation should be provided
Family and friends should be welcomed
Smoking cessation promoted
Spiritual needs should be met
Can you think of ways in which health information and education could be promoted in the home/nursing home/resource centre?
Class debate: Home based care -v- Residential care- which is better?
Video Clip: Living with Dementia (10 minutes)
Communication skills are an important quality that the health care worker must posses. Communication with older people is no different to communication with a person of any age. However, when communicating with an older person that had a sensory impairment, greater skill must be taken to ensure that communication is effective.
What are the different methods of communication?
What do we mean verbal and non-verbal communication?
Adapting Care Practices to the Individual Service User
It is a process - the result of which is a written record
It puts the person, their needs and choices at the centre of the process
It focuses on goal setting and outcomes that support the person to achieve optimal health and well-being
It encourages prevention of disease and future complications
It promotes choice and control and facilitates better management of risk
It might include contingency plans to manage ‘crisis’ episodes (escalation plans)
What are the benefits?
For the individual
Empowerment, confidence and ability to manage their condition more effectively
For the professional
Improved consultations, more job satisfaction
Potential efficiency savings
For the whole system
A more cohesive system, coordinated services
Less duplication of effort
Framework- Activities of Daily Living
Maintaining a safe environment
Eating and drinking
Washing and dressing
Working and playing
Death and dying
"Using an holistic approach"
Exercising duties in a way that is respectful to the person’s body after death
The last offices are the procedures performed, usually by a nurse in the developed world, to a dead person shortly after death has been confirmed
They can vary from hospital to hospital, and culture to culture
Often the body of the deceased is left for up to an hour as a mark of respect. The procedure then typically includes the following steps, though they can vary according to an institution's preferred practices:
Removal of jewellery unless requested otherwise by the deceased's family. If left on it must be documented in the patient's property list.
Wounds, including pressure sores, should be covered with a waterproof dressing. Tube insertion points should be padded with gauze and tape to avoid purging.
The patient is laid on his/her back with arms by their side (unless religious customs demand otherwise). Eyelids are closed.
The jaw is often supported with a pillow or cervical collar.
Dentures should be left in place, unless inappropriate
The bladder is drained by applying pressure on the lower abdomen. Orifices are blocked only if leakage of body fluid is evident.
The body is then washed and dried, the mouth cleaned and the face shaved.
An identification bracelet is put on the ankle detailing: the name of the patient; date of birth; date and time of death; name of ward (if patient died in hospital); patient identification number.
The body is dressed in a simple garment or wrapped in a shroud. An identification label duplicating the above information is pinned to the wrap or shroud.
A stretcher drawsheet is placed under the body to enable removal to a trolley for transportation to the morgue.
Many cultures have different customs surrounding death and dying
Identify how older people are portrayed by the media
Does this portrayal of the older person create stereotypes or ageist attitudes?
What can the healthcare professional do to try promote positive attitudes towards the older person?
Retirement has its associated losses:
Income is lowered
There may be a loss of identity or role
Loss of status in the community
Loss of structure of daily life
Loss of sense of purpose
Loss of support from colleagues
What is meant by the following?
To make sure your clients are able to take control over as much of their lives as possible.
Many clients are sometimes unable to make decisions or choices about their lives - this may be due to a range of different circumstances or simply because of how care is provided.
As individuals, we make choices so often that we sometimes don’t even realise it. Most of the time we give little thought to this.
If you consider the clients you care for, you will realise that not all of them have the same options and choices as you do
To be able to understand the importance of the effects of empowerment you must understand what can happen to people who feel that they are powerless in relation to their daily activities. Clients that are unable to take control and have choice may start to suffer lower self-esteem and lose confidence in their own abilities.
They may become convinced that they are unable to do many tasks for themselves and that they need help in many daily activities and tasks.
Once a client starts to rely on others to make choices for them, it can be difficult to return to normal.
An advocate is a person who is responsible for acting and speaking on behalf of an individual when he or she is unable to do so
As a carer you may find many situations where you become an advocate of the client you care for
It is important to know as much about the client as possible, there likes/dislikes, hobbies and interests, medical condition, cultural/religious background
What is meant by the following?
Understanding the clients abilities and disabilities and know what he/she can do for themselves
Listen to the client and be aware of any concerns of fears they may have
Protect the safety of the client, this well help them feel more secure
Maintain a positive attitude
Encourage the use of equipment that promotes independence
Arrange items in a manner that will assist independence
Don’t rush the client
Positive reinforcement- praise the client for effort, even if it seems small
The client must be treated with dignity at all times
All people are different and should be accepted as such
The client should be shown respect to maintain dignity
Calling the client by the name or title they prefer
Knocking before entering their room
Promoting independence and empowering the client
What is meant by the following?
Assisting with personal care helps to improve the client’s self esteem needs
Allow the client to make choices whilst assisting with personal hygiene
Encourage the client to be involved and do as much as they are able to
Encourage the client to dress/ shave/ put on make up/ brush hair etc
Ensure dentures/oral care has been carried out
Ensure glasses are clean
If clothing becomes soiled from spillages etc, assist the client to change into clean clothing
Treat the client as an individual
Maintain a positive attitude when interacting with clients, don’t be disrespectful as this may shatter self-confidence
RESPECT & SELF-ESTEEM
All service user’s should have choice in:
Treatment/medication/menus/personal hygiene/care planning/activities/religious practices amongst others
Where clients want to make choices about what they want to happen in their lives, you should ensure that you do your best to help them to identify any barriers they meet and then offer support in overcoming them
According to Maslow, these needs although not essential to survival, they are essential to allow someone to live a well rounded life. Therefore, he placed them at the top of his hierarchy of needs. Most people will feel some if not all of these psychological needs during their lifetime and they difer from physical needs, such as food, clothing and shelter, because they have a strong impact on a person's mental status as well as his/her ,mental well-being