The person’s ability to complete all or some of their personal care tasks will vary.
Some people may only need help with parts of tasks or with some but not all tasks. Others may need much more support. A person’s abilities and preferences may change over time. For example, their condition may worsen, meaning they can no longer perform tasks they were able to before. On the other hand, some people may regain or learn skills and not need as much support.
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Person-centred approaches
In a person-centred approach, planning is tailored to the person and focuses on their unique aspirations. The resulting service is the outcome that matters to the individual.
This approach means the person’s choices and preferences are the most important factors in the way that you provide support. This means that you must:
- encourage and help the person to make choices
- listen to and follow their choices wherever possible and when it is safe to do so
- find ways to try and understand the person’s preferences, even if they are nonverbal.
Helping a person to make decisions about their own lives should be a part of every task. If the person needs
guidance, you might ask them to consider between two options, such as two different outings, rather than vaguely
asking, ‘What would you like to do today?’.
A person-centred approach means that you pay more attention to the person’s choices than to task lists or staff
routines.
Case study
This case study is about respecting a resident's wishes for their morning routine.
Mr Morissetti is an 89-year-old resident at Greenview Residential Care who typically follows a strict morning routine
outlined in his care plan: He wakes up at 7 am, showers with assistance and joins other residents for breakfast in
the
dining room at 8 am, where he enjoys poached eggs and toast with coffee.
Today, Mr Morissetti decides he wants to change his routine. He informs his support worker, James, that he would prefer to have breakfast in bed and get up later than usual, requesting cereal and milk instead of his usual breakfast. James respects Mr Morissetti's request and arranges for the kitchen to prepare and deliver his breakfast choice to his room at 8:30 am.
Reflect
Other than being flexible with his meals, how else could a person-centred approach from care workers benefit Mr Morissetti?
Add your responses to your digital device.
Watch the video
Watch ‘Person-centred care in practice’ to hear about how people living with dementia can be supported using a person-centred approach.
Holistic needs
While there are many needs common to all of us, people at different life stages and ages can have changing
needs.
Most people have needs that are complex and varied. Our common needs as humans can be broken down using the holistic
approach. Holistic approaches look at the whole person, not just at their physical needs, as services may have done
in
the past.
Select to learn more
Select the items on the
image to reveal different categories of holistic needs.Image
by SHVETS
production, Pexels, Pexels Licence
Individual preferences
Older people and people with disabilities are all different. Just like anyone else, they have preferences, including
how personal support activities are done. Their preferences may be influenced by their upbringing, abilities, and
level of
comfort or willingness to accept assistance.
The most important way to find out the person’s needs and preferences is to discuss their plan with them. It is
important to make sure the person has a say and knows what to expect when you are providing support. This helps the
person maintain a sense of control over their own support.
Here are some examples of preferences that people you work with might have:
|
People may prefer to: |
People may prefer not to: |
|---|---|
|
Have a shower rather than a bath |
Get up early on the weekend |
|
Wear brightly coloured clothing |
Be showered by a person of the opposite sex |
|
Have breakfast before getting dressed |
Wear stockings |
|
Have two sugars in their coffee |
Use an electric shaver |
|
Have a beer before dinner |
Wash their clothes in cold water |
Confirm preferences
You can find out a great deal about the person’s preferences by being specific about how the plan asks you to proceed.
Here are some examples:
- ‘The plan says you like to have your hearing aid put in after your shower rather than before. Is that correct?’
- ‘If you are happy, I will help you shower right now. I’m going to help you get out of bed and into the shower chair. Are you happy to be transported in the shower chair?’
Even if the person is confused or unable to communicate with you, it is still important to talk them through the process as you perform each task.
Emotional and behavioural needs
People with disabilities and older people may experience mood or behavioural changes linked to their circumstances, disability, disease or ageing processes.
As a support worker, you may observe behavioural clues that indicate that a person’s emotional needs have changed. It is important that you observe these changes and report them to your supervisor to ensure that the person obtains the emotional support they need.
Individual needs
Every person you work with will be different. Their support needs can vary depending on their:
- age and abilities
- disabilities, impairments or medical conditions
- place of residence and who lives with them
- personal beliefs
- cultural background
- preferences and life experiences.
Some people may have difficulty communicating clearly or may not be able to convey their personal preferences. In
these situations, it may be necessary for the person’s family or carer to assist in sharing information about their
abilities and preferences.
Select to learn more
There are many differences you will come across while supporting older people and people with disabilities. Select each bar to expand and reveal further information about these.
Watch the video
Watch ‘Sensory loss – Hearing and vision’ to discover strategies for assisting a person experiencing sensory loss.
Can you identify strategies workers can use to support an older person experiencing vision and hearing
impairments?
Individualised plans
Individualised plans provide instructions to the support worker and ensure that the support provided is responsive to the person’s needs and preferences. Individualised plans emphasise the goals, aspirations and activities that foster the person’s participation and independence in a meaningful way. They are written in consultation with the person and/or their family.
Plans in the community sector have many different names, including:
- support plans
- care plans
- lifestyle plans
- person-centred plans
- individual program plans
- individual employment plans
- service delivery plans.
The person’s support plan will describe the types of assistance they require. Formally documented plans must be
completed according to the policies of the service organisation. In some organisations, a support worker may have
some
input into writing and developing individualised plans. In other services, this role will be carried out by a team
leader or supervisor, and the support worker is only responsible for following the plan.
Plans usually include the following details:
- the person’s individual goals
- the services to be provided on a day-to-day basis
- other necessary activities required to meet goals
- the people responsible for implementation
- review dates
- review strategies.
A plan may include information or instructions that are directed at other professionals, such as managers and allied
health professionals. You must always be aware of your role in an individualised plan and carefully follow the
information in it. If you are unsure, talk to your supervisor to ensure that you are working within your job role,
experience and training.
Read to learn more
Download the following document for an example of an individualised support plan:
Personal care plans
People with personal care needs may require support in the home, in residential care or during activities at a centre
such as a day program. Support workers provide assistance with these activities to people who would normally perform
these tasks themselves but now require assistance because of frailty, disability or illness.
Select to learn more
Select the items on the image to reveal more information about personal care tasks.
Case study
This case study is about following a plan to properly take care of hygiene needs.
Mr Lockyear has partial lower dentures. The rest of his teeth are his own. Mr Lockyear needs prompting to clean his dentures and his other teeth or he forgets. He also needs assistance with cleaning his dentures.The plan outlines details about how this is done:
- Remind Mr Lockyear to remove his dentures at night.
- Rinse dentures and brush with denture paste.
- Place dentures in a container with water and a cleaning tablet.
- Put toothpaste on toothbrush and have a glass of fresh water ready.
- Remind Mr Lockyear to brush his teeth.
- Monitor him and prompt him to clean top and bottom properly.
- Prompt him to rinse properly.
- Rinse toothbrush and cup when he is finished.
- Toothpaste being poured onto a toothbrush
Check your understanding
Respond to the question
below and select ‘Check’
to see if you are correct. Activities of daily living
The tasks people do every day are called activities of daily living (ADLs). These are the things we do to keep ourselves and where we live clean, safe and organised. Try to support the person to do as many of these tasks for themselves and only provide assistance for tasks they cannot do. This helps foster a sense of independence.
Instrumental ADLs are more complex and require greater organisational skills such as shopping, transportation, managing medications, communicating, managing finances, house cleaning and maintenance.
Select to learn more
Select each bar to expand and reveal further examples of support for various ADLs.
Case study
This case study is about creating a plan that ensures the activities of daily living are taken care of.
Mrs Hawkins is 58 years old and lives alone in a small unit. She has been diagnosed with advanced emphysema. She has tubes providing oxygen directly through her nostrils at all times, and she has an oxygen tank on a trolley if she needs to move more than a couple of metres.She has meals delivered five days a week and has home help for cleaning, laundry and shopping once a week. She spends
most days sitting in a chair watching television. Mrs Hawkins cannot walk more than 10 or 12 steps without becoming
breathless. The most she can do on her own is walk to the toilet or the kitchen to make a cup of coffee.
Support workers from the local home and community service follow a plan to assist Mrs Hawkins every morning and night. The plan outlines the tasks they need to help with. This includes:
- having a shower
- getting dressed
- getting ready for bed each night
- preparing some of her meals.
Reflect
How can Mrs Hawkins' support workers help her retain her sense of independence while being supported at home?
Add your response to your digital device.
Develop trust and rapport
Working with a person to develop their personal goals and plan for services and support can include discussing their health status, complex relationships and other personal details. This can understandably make people feel vulnerable, and they are less likely to be comfortable discussing these personal details with a person they do not trust.
Trust is an ongoing part of a relationship with a person. You can continue to develop trust by showing empathy for the person’s concerns and taking the time to listen. And trust can be broken by actions such as not respecting the person’s confidentiality, privacy or dignity when communicating.
People who are accessing community services can often feel overly worried about pleasing you or not adding to your workload. This means they may be less likely to seek assistance or let you know when they have preferences that you have not met.
This can sometimes be overcome by giving the person time to trust you.
Select to learn more
Select the items on the
image to reveal some insights into establishing a trusting and respectful
relationship. Image
by pikselstock, Shutterstock, Shutterstock
licence
Case study
This case study covers treating people with empathy and actively listening, even if you do not always agree with their views.
Nancy has been receiving home support services for about four weeks. Daniel has heard a number of comments and complaints from support workers and other staff about Nancy. Many staff say that she is unreasonable and grumpy. Daniel has consciously decided to put aside what he has heard before meeting with Nancy, thinking about her in a positive light and respecting her as a person.
Daniel realises it is important to gain Nancy’s trust. He respects that he is in her home. Daniel introduces himself and waits to be asked in. He asks Nancy how she prefers to be addressed. His priority is to listen to her and to demonstrate empathy. Daniel allows plenty of time for his discussion with Nancy so that she does not feel rushed.
Some aspects of Nancy’s complaints seem trivial to Daniel, but he reminds himself that he is seeing the situation from his own perspective and tries not to be judgemental or apply his own values. Daniel actively listens to Nancy’s complaints and only interrupts to clarify or paraphrase to ensure he understands her fully. He does not agree or disagree. Even when he is not asking questions, Daniel shows he is listening by leaning slightly forward, making eye contact and making noises, such as ‘Hmmm’.
When Nancy has finished speaking, Daniel summarises everything she has said to ensure he has got it right. This demonstrates to Nancy that Daniel has really heard what she has said, and it enables Daniel to show empathy without making any judgement.
There are aspects of Nancy’s complaints that Daniel is able to respond to and follow up. There are some things Daniel is unsure of, so he commits to finding out and getting back to Nancy by the end of the week.
Check your understanding
Respond to the question below about Nancy and Daniel and select ‘Check’ to see if you are correct.
Maintain dignity
When helping a person follow personal care routines, it is important to help them maintain their dignity and privacy.
You must follow your organisation’s policies and procedures when providing personal care. Personal care routines often require the person to be exposed and feel vulnerable. Safety, dignity and privacy are very important.
Examples of protecting dignity and privacy include the following:
- Close all doors, and do not allow other people, including other workers, to enter the room or bathroom while the person is uncovered.
- Make sure the person stays covered (e.g. with a towel or clothing) for as long as possible during washing routines.
- If the person only requires a little help or supervision, avoid watching them closely and be present only when they need help.
- Talk about other things while providing personal care to avoid embarrassment.
- Do not talk over the person to other workers while you are providing care. Always include the person in conversations rather than treating them as if they were not there.
- Do not talk about personal matters, such as toileting habits, to a person in a way that can be overheard by others.
Confirm the plan's details
It is not enough to simply follow the instructions in the plan without talking to the person (or their family or carers) about whether they are happy with the details in the plan.
People’s needs and preferences change from day to day, and so should your approach to support. Talk to the person about your role in the plan so that they feel they are part of the process. Provide them with the opportunity to discuss or even refuse support, rather than assuming that they will passively accept your help in the same way every day.
Here are some examples of questions that you might ask:
- Your plan says that you have a shower before breakfast. Are you happy for me to help you with that?
- The plan says you usually have this task done in this particular way. Is that correct?
- What are you able to do without help, and what tasks will you need assistance with?
- Do you need help with anything else today?
Case study
This case study is about asking a person their preferences and the level of support they need and feel comfortable with.
Cole has read the individualised plan of Mr Lilley, who has moderate dementia and who he is supporting for the first time. Mr Lilley’s individualised plan outlines the requirement to help him to shower, but it does not give details about the level of support needed.
Cole asks Mr Lilley whether he is able to perform some of the showering unassisted. Mr Lilley tells him that he would rather do it alone and does not need help at all. Cole is a little puzzled by this, but after speaking with Mr Lilley’s wife, he learns that although Mr Lilley is reluctant to receive help, he needs someone nearby to supervise and help wash his back and dry him.
Cole speaks to Mr Lilley sensitively, reassuring him that he will be there for guidance only and will only step in to help when Mr Lilley needs it or is at risk of falling. Mr Lilley seems happy with this, and Cole stays true to his word, helping only when Mr Lilley agrees.
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by pics
five, Shutterstock, Shutterstock
licence
Check your understanding
Respond to the question below about the case study and select ‘Check’ to see if you are correct.
Include the family
Family members play an important role in the lives of most people you support. They may have a spouse, family member, friend or primary carer who lives with them or who visits and provides some support.
If the person is unable to communicate their preferences, their carers or family members will often have detailed knowledge about the person. Family members can often help confirm that you are supporting the person according to their previous preferences. The family can help you to understand the person’s preferred daily routines and how they like things done.
Even if the person can still communicate and contribute themselves, the carer or family member is still an important part of the planning process. They can be there to provide support and jog the person’s memory or make suggestions that the person might not have considered.
The individualised plan should be built around the relationships that the person has with family and friends. For example, if a person has entered residential care but has always enjoyed a Sunday family roast lunch, the person and their family member can help to make sure this is included and supported.