CHCAGE001

Facilitate the empowerment of

older people
Learner Guide

CHCAGE001 Learner Guide V 2.0 Page 1 of 65

 Table of Contents

Unit of Competency .......................................................................................................................... 5

Application ........................................................................................................................................... 5
Performance Criteria............................................................................................................................ 6
Foundation Skills .................................................................................................................................. 8
Assessment Requirements ................................................................................................................... 8
1. Develop relationships with older people ...................................................................................... 10
1.1 – Conduct interpersonal exchanges in a manner that promotes empowerment and develops and
maintains trust and goodwill ................................................................................................................. 11
Interpersonal exchanges .................................................................................................................... 11
Positive ageing ................................................................................................................................... 12
Personal attitude................................................................................................................................ 12
1.2 – Recognise and respect older people’s social, cultural and spiritual differences .......................... 14
Social, cultural and spiritual differences ............................................................................................ 14
Legal obligations ................................................................................................................................ 14
'Living Longer Living Better' ............................................................................................................... 15
1.3 – Maintain confidentiality and privacy of the person within organisation policy and protocols .... 16
Ensuring information is kept confidential .......................................................................................... 16
Ensuring client privacy ....................................................................................................................... 16
Sharing information within a team .................................................................................................... 17
1.4 - Work with the person to identify physical and social enablers and disablers impacting on health
outcomes and quality of life .................................................................................................................. 18
Enablers and disablers ....................................................................................................................... 18
Key issues facing older people ........................................................................................................... 19
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 ............................................................................................ 20
Shared responsibility.......................................................................................................................... 20
2. Provide services to older people .................................................................................................. 22
2.1 – Identify and discuss services which empower the older person .................................................. 23
Identify and discuss services .............................................................................................................. 23

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 2.2 – Support the older person to express their own identity and preferences without imposing own
values and attitudes ............................................................................................................................... 24
2.3 – Adjust services to meet the specific needs of the older person and provide services according to
the older person’s preferences .............................................................................................................. 24
Identifying preferences ...................................................................................................................... 24
Supporting client preferences............................................................................................................ 25
Adjusting services .............................................................................................................................. 25
2.4 – Provide services according to organisation policies, procedures and duty of care requirements 27
Following policy and procedures ....................................................................................................... 27
Duty of care ........................................................................................................................................ 27
Legislation .......................................................................................................................................... 29
3. Support the rights of older people ............................................................................................... 30
3.1 – Assist the older person to understand their rights and the complaints mechanisms of the
organisation ........................................................................................................................................... 31
Protecting the client's rights .............................................................................................................. 31
Complaints ......................................................................................................................................... 31
3.2 – Deliver services ensuring the rights of the older person are upheld ............................................ 33
Older people's rights .......................................................................................................................... 33
3.3 – Identify breaches of human rights and respond appropriately .................................................... 36
3.4 – Recognise signs consistent with financial, physical or emotional abuse or neglect of the older
person and report to an appropriate person......................................................................................... 36
Breaches of human rights .................................................................................................................. 36
Defining elderly abuse ....................................................................................................................... 36
Signs of abuse .................................................................................................................................... 39
Acting on elder abuse ........................................................................................................................ 40
3.5 – Assist the person to access other support services and the complaints mechanisms as required
............................................................................................................................................................... 41
Give the client the knowledge and ability to complain ..................................................................... 41
Assist the client in lodging a complaint ............................................................................................. 42
Handling complaints .......................................................................................................................... 44
4. Promote health and re-ablement of older people......................................................................... 45
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 ........................................................................................ 46

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 Encouraging living activities ............................................................................................................... 46
Re-ablement....................................................................................................................................... 46
4.2 – Assist the older person to recognise the impact that changes associated with ageing may have
on their activities of living ...................................................................................................................... 49
General physical changes associated with ageing ............................................................................. 49
Arthritis and other musculoskeletal problems .................................................................................. 50
Diabetes ............................................................................................................................................. 50
Frailty and deconditioning ................................................................................................................. 51
Heart and lung disease....................................................................................................................... 51
Incontinence ...................................................................................................................................... 52
Skin disorders (including skin cancers) .............................................................................................. 53
Stroke ................................................................................................................................................. 53
Vascular disease ................................................................................................................................. 54
Gender and sexuality ......................................................................................................................... 55
4.3 – Identify strategies and opportunities that maximise engagement and promote healthy lifestyle
practices ................................................................................................................................................. 57
Encouraging healthy lifestyle ............................................................................................................. 57
Eating healthily................................................................................................................................... 58
Exercising ........................................................................................................................................... 60
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 ....................................................... 60
Identifying aids and modifications ..................................................................................................... 61
4.5 – Discuss situations of risk or potential risk associated with ageing ............................................... 63
Potential risk associated with ageing ................................................................................................. 63
Communication strategies ................................................................................................................. 64
References ............................................................................................................................................. 65

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Unit of Competency
Application

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.

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Performance Criteria
Element Performance Criteria
Elements describe the Performance criteria describe the performance needed to
essential outcomes. demonstrate achievement of the element.

1. Develop relationships 1.1 Conduct interpersonal exchanges in a manner that promotes

with older people 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 2.1 Identify and discuss services which empower the older
older people 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 3.1 Assist the older person to understand their rights and the
older people 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
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

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Element Performance Criteria
Elements describe the Performance criteria describe the performance needed to
essential outcomes. demonstrate achievement of the element.

4. Promote health and 4.1 Encourage the older person to engage as actively as possible
re-ablement of older in all living activities and provide them with information and
people 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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Foundation Skills
This section describes language, literacy, numeracy and employment skills incorporated in the
performance criteria that are required for competent performance.

Foundation skills essential to performance are explicit in the performance criteria of this unit of
competency.

Assessment Requirements
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:
o employing flexible, adaptable and person-centred approaches to empower the individual
o 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:
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:
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 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.

Assessment Conditions

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:

o relevant organisation policies and procedures
o relevant aids to assist with independent living.

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF
mandatory competency requirements for assessors.

Links

Companion volumes from the CS&HISC website -

http://companion_volumes.vetnet.education.gov.au/Pages/TrainingPackage.aspx?pid=7

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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

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1.1 – Conduct interpersonal exchanges in a manner that promotes
empowerment and develops and maintains trust and goodwill

By the end of this chapter, the learner should be able to:

➢ Establish rapport with clients

➢ Incorporate empowering phrases into their speech

➢ Use active listening techniques to better engage with clients.

Interpersonal exchanges
Interpersonal skills involve communicating effectively with different people. If you have good
interpersonal skills you will usually be able to talk with ease to a variety of people with differing
backgrounds and at a wide range of levels. Your communication will be confident, eloquent and
adaptable to suit different situations.

To establish rapport:
➢ Try and find something you have in common

➢ Use positive, confident and co-operative language.

➢ Be interested in what people are saying and ask questions

to demonstrate this

➢ Interpret non-verbal and verbal messages and react

accordingly or mirror their body language

➢ Your use of language, verbal or non-verbal – try to be

accommodating and adapt your style

➢ Be aware of cultural differences:

o different cultures and communities have different euphemisms and accents,

which you should bear in mind when speaking.

Empathic/active listening is a form of communicating that requires the listener to relate what they hear
to the speaker, by way of restating or paraphrasing what they have heard in their own words. This helps
both the counsellor and client clarify and confirm what is being communicated.

This relation shows understanding and involves both verbal and non-verbal communication. Often,
clients can find it difficult to express their feelings in words and non-verbal cues can express a client's
feelings more effectively.

Non-verbal cues can include:

➢ Pauses
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 ➢ Gestures

➢ Bargaining

➢ Eye contact

➢ Length of response

➢ Pitch and tone of voice.

When you communicate through active listening, it shows respect for the client/service provider and
validates their worth. This enhances their self-esteem which, in turn, enables them to relax and means
they are less likely to put up defensive barriers.

OARS skills (open ended questions, affirmations, reflections, summaries) are one example of empathic
listening skills because they are all about listening in a heartfelt manner without trying to change or
push the individual. These OARS skills come from a therapy called Motivational Interviewing, developed
by Professor William R Miller.

Empowering phrases could include:

➢ ‘It sounds like…’

➢ ‘You seem to be…’

➢ As I understand…’

Negative/disempowering phrases:
➢ Attempting to rescue client from problems

➢ Too many questions (can act as a barrier to conversation)

➢ Commands such as ‘stop worrying’, ‘don’t be so upset’ etc.

➢ Threatening comments

➢ Not paying attention

➢ Changing the subject.

Positive ageing
Positive ageing is about being proactive and facing the challenges of growing old. Rather than looking at
the downsides of growing old, you look at the opportunities and make the best of them.

Personal attitude
It is important to maintain a personal attitude that promotes the empowerment of older people. A
personal attitude that is ageist can have a hugely negative impact on the client.

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For example, if you hold the view that ‘you can’t teach an old dog new tricks’, then an elderly person
who may be very capable of engaging in a re-ablement process and gaining greater responsibility and
independence, may find that they are not given such an opportunity.

A poor attitude towards the elderly can deprive them of opportunities and decrease their sense of self-
esteem and self-worth.

As a care provider, therefore, it is your responsibility to develop an attitude that works to promote the
independence and wellbeing of all clients in your care, and to support them towards independence and
dignity.

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1.2 – Recognise and respect older people’s social, cultural and spiritual
differences

By the end of this chapter, the learner should be able to:

➢ Handle cross-cultural issues with sensitivity and professionalism

➢ Act in a manner that does not discriminate on the basis of a person’s cultural, social or
spiritual differences

➢ Comply with their legal obligations in relation to anti-discrimination law.

Social, cultural and spiritual differences

When working with any client, you will have to consider their personal preferences, religious
background and cultural upbringing. All play an important part in client care and how they may choose
to live their life. You may find that you have been asked to advocate on behalf of a client because a
counsellor wants to talk to your client about personal issues, which culturally, they would not normally
discuss.

You may come across a number of cross-cultural issues, all of which should be handled with great
sensitivity, care and respect

Discrimination is unacceptable in the workplace and this includes within the realm of aged care. As a
carer, you should provide equal services to older people, regardless of their race, cultural background,
spiritual beliefs or sexual preferences.

Legal obligations
Under equal opportunity and anti-discrimination laws, service providers must comply with their
obligations and avoid both direct and indirect discrimination.

Aged care providers are not lawfully allowed to refuse custom to clients who require culturally adapted
services – this includes those who speak a different language, as well as religious or spiritual
preferences. If your provider receives a complaint to the Equal Opportunity Commission, it can cost
them up to $25,000 in costs before the case even goes to court.

Therefore, it is vital to be proactive with the strategies you employ to make sure you comply with
legislation – this includes educating your staff and creating clear policies and procedures for cultural
awareness. As well as the service provider being liable for the discrimination, the service provider who
employs them is also responsible.

The following areas are illegal to discriminate against someone on the basis of:

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 ➢ Disability

➢ Age

➢ Sexuality

➢ Gender

➢ Pregnancy

➢ Marital status

➢ Physical features

➢ Race

➢ Religious belief

➢ Nationality

➢ Political beliefs

➢ Industrial beliefs.

'Living Longer Living Better'

This is an aged care reform package announced on April 20 2012 – it is a ten year plan that aims to make
aged care fairer, more effective and more nationally consistent. It aims to provide older people with
greater choice, control and easier access to aged care services.

It means that more priority and support for home care, better access to residential care, greater
support to dementia sufferers and also a push at strengthening the aged care workforce. This is
nationwide and doesn't discriminate against anyone, regardless of their race, cultural, spiritual or sexual
preferences.

The full details of the plan can be found on the website of the Department of Health and Ageing.

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1.3 – Maintain confidentiality and privacy of the person within organisation
policy and protocols

By the end of this chapter, the learner should be able to:

➢ Comply with the Privacy Act 1988

➢ Take steps to ensure client privacy, e.g. knocking before entering a room, asking
permission before performing certain tasks, etc.

➢ Determine when it is necessary and appropriate to share information with colleagues.

Ensuring information is kept confidential

Confidentiality is required by law in certain respects; the privacy of client records is a highly important
aspect of confidentiality. Failure to maintain privacy of client records is punishable by law and
organisations can be sued by the client.

The Privacy Act 1988 comprises of 13 Privacy Principles that legally must be adhered to and also, as
explained by the Office of the Australian Information Commissioner (OAIC) website:
➢ “Regulates the collection, storage, use, disclosure, security and disposal of individuals'
tax file numbers

➢ Permits the handling of health information for health and medical research purposes in
certain circumstances, where researchers are unable to seek individuals' consent

➢ Allows the information commissioner to approve and register enforceable app codes
that have been developed by an app code developer, or developed by the information
commissioner directly

➢ Permits a small business operator, who would otherwise not be subject to the
Australian privacy principles (apps) and any relevant privacy code, to opt-in to being
covered by the apps and any relevant app code

➢ Allows for privacy regulations to be made.”

Source: http://www.oaic.gov.au/privacy/privacy-act/the-privacy-act

Ensuring client privacy

Providing clients with as much privacy as possible will have a significant impact on their happiness and
self-worth, and make life much more agreeable and attractive; having the privacy and opportunity to do
things also encourages and provides levels of independence that clients may not necessarily expect.

Tips for ensuring privacy:

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 ➢ Knocking before you enter a room and awaiting an invitation inside will show clients
that they have much more autonomy and respect than having them walked in on with
no warning.

➢ Closing doors or curtains while treatment is in progress can maintain privacy and
dignity. Signs that treatment is in progress can sometimes be used effectively.

➢ A care worker asking permission before touching clients when treatment commences
e.g. ‘okay so we are all ready now, I just need to apply slight pressure on your back – is
that alright?’

➢ Providing clients with a private room where they can take or make phone calls or
discuss personal issues.

The following guidelines serve as a good basis for maintaining client confidentiality:
➢ Never discuss client information in social circles.

➢ Documented information should only ever relate to service delivery

and related factors.

➢ Confidential documents must be stored securely, out of

reach of the public and unauthorised personnel.

➢ Client information should never be disclosed to external

agencies that are not part of the client's service delivery system.

➢ Names and details of clients should not be disclosed in public forums e.g.
meetings, seminars, etc.

There are cases where confidentiality can be broken:

➢ If the person is at serious risk of harm

➢ Where there is an imminent, serious threat to the public or a specific person

➢ Where there is a police request for information under the Police Powers and
Responsibilities Act 2000

➢ For use by healthcare professional (as long as a recognised standard of treatment is

being delivered).

Issues of confidentiality should never be taken lightly – you should discuss them with your supervisor.
Senior staff should always be involved for complex, competing decisions e.g. confidentiality vs. safety.

Sharing information within a team

Even if the client asks that you not share their information with others on your team, it is necessary to
do this to ensure service quality is coordinated and of the highest quality. You should inform them of
CHCAGE001 Learner Guide V 2.0 Page 17 of 65
this, explaining that all of the team need to have access to appropriate information to ensure the best
outcomes for them. Reassure them that their confidentiality will be maintained outside of a
professional context.

The only situation where it may be appropriate to withhold client information from colleagues is when
there is a conflict of interest. However, if information isn't shared, it makes team-based care reviews
impossible and appropriate decisions are harder to make.

1.4 - Work with the person to identify physical and social enablers and disablers
impacting on health outcomes and quality of life

By the end of this chapter, the learner should be able to:

➢ Identify factors that act as enablers in a client’s life

➢ Identify factors that act as disablers in a client’s life.

Enablers and disablers

Enablers are those factors that encourage elderly people to do something – for example, attend a class.
Disablers are those factors that discourage elderly people from doing something. Every individual will be
different, so it is important to work with them to identify the enablers and disablers impacting on their
choices. Some common disablers and enablers can be found below.

Disablers:
➢ Health problems

➢ Fear of falling

➢ Inconvenience

➢ Transport issues

➢ Lack of friends or support

➢ Self-esteem

➢ Tiredness.

Enablers:

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 ➢ The expectation of positive outcomes, for example:

o social benefits

o health benefits

➢ Social support e.g. if attending as part of friendship

group

➢ Easily accessed, for example:

o if individual drives

o if there is a bus service

o if it is not far away

o if wheelchair access/lifts, etc.

Helping clients to identify what is preventing them from taking part in certain things can lead to a better
understanding of how you can help them, and also identify solutions to overcome disablement. Think
about what it is that would enable this particular client to attend a class, go shopping, etc. Being able
and feeling comfortable doing things helps clients achieve a better quality of life through independence.

Key issues facing older people

There are many issues facing older people that can have an impact on their care.

Some of these key issues are found below along with a possible solution:
➢ Stereotypes and ageist attitudes – education on elderly people

➢ Financial hardship – grant and community schemes

➢ Grief – counselling

➢ Living too remotely to receive services – residential care

➢ Physical and psychological disabilities – home adaptations and medical assistance.

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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

By the end of this chapter, the learner should be able to:

➢ Discuss the responsibilities of all parties involved in the care of a client

➢ Assess and agree upon responsibilities that the client is able to take upon themselves.

Shared responsibility
You will need to discuss responsibilities of all parties involved with the client’s care.

These may include:

➢ The client

➢ The client’s family, which may include contacting separately:

o client’s partner

o siblings

o children.

o other relatives or friends.

➢ Service providers:

o other carers

o cleaners

o maintenance people e.g. for changing lightbulbs, gardening, etc.

This is so that you can establish who will do what and when, what is acceptable and what is not, for all
parties concerned. Your client will also need to know what your role or service covers/doesn’t cover. It
is important to remember that these may well change over time as your client’s needs change. You
should plan to review these changes on a regular basis.

Client’s responsibilities
Client’s responsibilities will be unique to each client. You will need to agree what it is that they are
willing and able to do for themselves.

For example:
➢ A client may want some help getting their socks on, but are able to manage their shoes
themselves.

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 ➢ You may be asked to prepare dinner for a client, but the client may want to wash up
afterwards.

➢ The client needs help with transport to and from places, but makes and keeps
appointments, such as doctors, dentists, vets, etc. themselves.

➢ A client may be able to vacuum and dust, but needs help with cleaning the oven and
mopping.

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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

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2.1 – Identify and discuss services which empower the older person

By the end of this chapter, the learner should be able to:

➢ Identify services which will empower the client by taking into account the specific
needs of the client.

Identify and discuss services

One of the main fears of ageing is the loss of independence and having involvement in decisions.
Therefore, you should do everything in your power to empower the older person regarding their service
requirements, so that they can remain active members of their community.

Empowerment includes anything that will enable older people to do things. Such examples are:
➢ Assistive equipment (wheelchairs, Zimmer frames, etc.)

➢ Taking them shopping – independence to live at home

➢ Taking them places – provides self-esteem and social involvement

➢ Treating them with respect and as adults

➢ Domestic personal assistance (home help)

➢ Financial planning assistance

➢ Home modifications (shower and toilet adaptations, stair lifts, etc.)

➢ Financial aid (so they can afford bills and maintain a quality of life).

The overall aim is to ensure that they can continue to carry out the lifestyle in surroundings they are
used to and feel comfortable with.

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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

By the end of this chapter, the learner should be able to:

➢ Gather information that helps to identify a client’s preferences using an appropriate
method

➢ Take steps to support a client’s preferences and ensure they are carried out. This may
involve:

o keeping record of the client’s preferences, requests and stipulations

o continually consulting with the client to provide them with the opportunity to
express their preferences

➢ Make adjustments to services according to the specific needs and preferences of the
client.

Identifying preferences
While there are a lot of aspects of aged care that will bear similarities to one another, you must also
learn to treat each aged person as an individual. Therefore, you should conduct a full background
assessment of the elder you are working with, so that you understand all of their needs. This should be
combined with the ACAT assessment – another simple yet effective technique is to get to know the
client's you work with. If possible, try to ensure that care workers work with the same people for an
extended period of time, whether in residential or home care. This is because familiarity will instil
confidence and make for a more personalised service.

Information regarding preferences may be gathered in a number of ways:

➢ An informal chat with the client.

➢ Friends and family.

➢ Observation e.g. you could notice photographs of them in their garden and ask them if
they like to garden. (You could then ask if they would like to come with you to the
garden centre to pick some plants out for the garden at the centre/home).

➢ A more formal written document e.g. a questionnaire.

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Supporting client preferences
Clients have the right to assert their preferences about any aspect of their care, whether they are in
residential or private accommodation. Clients should be given the opportunity to make decisions and
voice their preferences wherever possible.

➢ When clients have preferences that are applicable to a situation, they should be
confirmed with both the client and the supervisor, where required.

➢ Client preferences, requests and stipulations should be

recorded in their notes; this ensures that their preferences are
not overlooked, misunderstood or miscommunicated; for
example, if a client states that they would like to be woken
early in the morning so that they can listen to a radio show or
watch a television show, this message may not reach the
person on duty in the morning if it is only mentioned verbally,
or the caregiver forgets to pass on the message.

➢ Other preferences, such as that a client does not like to be

called by their first name, should be recorded so that anyone
who works with the client is informed of this.

➢ Clients should be consulted as much as possible on aspects of

their care and lifestyle; this empowers them and allows them to live more comfortably
and happily.

➢ Over time, it is good practice to confirm that clients’ preferences are still accurate by
asking them whether they are still satisfied with all aspects of their care. If they express
a desire for a change, aim to rectify this ASAP.

➢ Unless clients inform you of changes directly, their preferences may have changed
without you knowing – you should consult family members and advocates periodically
to check if they are aware of any such desires for change.

Having their particular preferences recorded and accessible allows you to provide a more friendly and
personalised service, even if the care worker has never worked with a particular client before. By
consulting notes, other care staff are able to see that the client prefers certain things, such as not being
called by a nickname, not being touched on their shoulders and that they have difficulty taking tablets.
This means that different carers can avoid making mistakes and portraying the service as impersonal by
having to ask many questions.

Adjusting services
You have a responsibility to ensure a safe environment for the client. You may want to try and empower
the client and have them make decisions for themselves and help to give them some independence.
However, you must be careful not be negligent of the risks involved in increased independence. For
CHCAGE001 Learner Guide V 2.0 Page 25 of 65
example, if a client enjoys gardening and there is a garden centre nearby, but the client is suffering from
dementia, it would not be appropriate for you to suggest the client goes to the garden centre by
themselves as you would be neglecting your duty of care.

Carers should think about any risks that would be increased through the client partaking in an activity or
anything that could prevent the client from obtaining that service.

You may need to adjust:

➢ Times

➢ Equipment

➢ The type of service

➢ Location.

For example, if your client wanted to attend an exercise class and they had brittle bones or
osteoporosis, there may be a risk of falling. How could you overcome this risk? One option could be to
water aerobics; another could be for the carer to attend the class with the client. You will need to weigh
up the options with the client and come to a decision on the best way forward.

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2.4 – Provide services according to organisation policies, procedures and duty of
care requirements

By the end of this chapter, the learner should be able to:

➢ Carry out work that is in accordance with their job role and personal responsibilities

➢ Uphold their duty of care requirements, including anticipating hazards and taking
reasonable care to maintain the client’s safety and wellbeing

➢ Act in compliance with organisation policies and procedures, and with duty of care
legislation.

Following policy and procedures

A key element of working within policies, protocols and procedures is to only perform duties that fall
within your job role – you should never attempt to carry out or provide professional advice on
something that you are not qualified to. You should also know what to do when you are unsure of your
job role and work instructions.

Knowing your job role and responsibilities

In order to ensure that you know you specific job role and responsibilities, you can practice the
following:
➢ Seek regular support and supervision from your supervisor and team leader, using
structured sessions

➢ Seek advice from colleagues during staff meetings and through consultation

➢ Check professional guidelines when you are unsure

➢ Clarify your position description clarified and/or have it refer to professional

standards/legislation

➢ Perform a competency assessment

➢ Document all major work activities

➢ Consult with unions and professional bodies regarding your job role and appropriate
responsibilities.

Duty of care
Duty of care is written legally into the Workplace Health and Safety Act 1995 – it is a moral duty to
anticipate possible hazards and causes of injury and do everything reasonably practicable to
prevent/remove/minimise these causes.

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This means that duty of care cannot be delegated – all adults in the workplace are responsible for health
and safety.

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Courts will determine breaches of duty of care based on the following criteria:
➢ What is typically expected of another person in the same situation

➢ The person's roles and responsibilities within their organisation

➢ The experience/level of training for the individual

➢ The practicalities of the situation

➢ What is deemed acceptable practice within the community

➢ Generally acceptable standards in the situation

➢ Relevant laws e.g. the Workplace Health and Safety Act 1995.

Legislation
There is a variety of legislation to consider when facilitating the empowerment of older people. Some of
the legislation in place is outlined below, but you may need to do additional research to gain more
understanding.

Aged Care Act 1997

The purpose of this legislation is to make sure that everyone has access to aged care if they require it,
regardless of their race, gender, culture, language, geographic location or economic situation. It
promotes the protection of health and well-being through high quality care and services – these should
be flexible, responsive and diverse in their nature. It also protects the consumer, legal, personal and civil
rights. It covers residential, home and flexible care – the providers will receive funding according to the
quality of service they supply and it also holds them accountable for any care they provide. It also
includes stipulations that aged care must be made affordable, setting out fee payment rules and
charging those who can afford to contribute to their services.

Aged Care (Bond Security) Act 2006

This guarantees a financial refund if your aged care provider goes bankrupt or ceases to trade. If your
provider can't pay back your bond, the Commonwealth will then refund this money to you (including
interest). The only deductions will be retention amounts that apply and other agreed fees.

Then, on your behalf, the Commonwealth will chase and recover the money from the initial provider. It
also covers entry contributions paid by people entering care before October 1997.

Age Discrimination Act 2004

This ensures that everyone is treated equally, regardless of their age. Older people are often
discriminated against because of their age, so the Act makes it illegal to do so in areas such as
employment, accommodation, information requests and goods and services provision.

The Residential Care Manual

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The purpose of it is to help care providers comply with their responsibilities as per the Aged Care Act
1997, as well as helping staff understand rules and regulations. However, it only applies government-
subsidised residential aged care.

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

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

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3.1 – Assist the older person to understand their rights and the complaints
mechanisms of the organisation

By the end of this chapter, the learner should be able to:

➢ Assist clients to lodge complaints with the service provider, where necessary

➢ Assist clients to escalate complaints to the Aged Care Complaints Scheme, where
necessary

➢ Direct clients to advocacy services, where necessary.

Protecting the client's rights

Everyone that receives any kind of aged care has certain rights when it comes to their treatment and
protection.

They are entitled to:

➢ Privacy

➢ Confidentiality

➢ Access to information on themselves

➢ Respect and dignity

➢ Have their social, physical and cultural needs met

➢ Complain about improper service

➢ Informed choice

➢ Be informed about service, policy, procedures, expectations and conditions of the

service

➢ Freedom of association (choosing who they want to have deliver care)

➢ A right to express ideas and opinions

➢ An agreed standard of care.

The clients should be made aware of these rights and be given the chance to exercise them.

Complaints
The government has an Aged Care Complaints Scheme, which is a free service for anyone to raise
concerns about the quality of care/services delivered to any aged care services subsidised by the
Australian government; this includes residential care, home care and HACC services.

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The first process should be to lodge a complaint with the service provider before anything else – this will
result in the quickest and most direct resolution to the problem. The complainant is allowed to take an
advocate with them to meetings with providers as support and to ensure they are not taken advantage
of. This advocacy service is free, confidential and independent – call 1800 700 600 to have Aged Care
Advocacy contact an advocacy service on behalf of the complainant.

If discussion with aged service providers is impossible or proves unproductive, the next stage is to lodge
a complaint with the Aged Care Complaints Scheme. They can be contacted online by filling in a
complaint form or via phone on 1800 550 552.

The topics that can be complained about include:

➢ Quality of care

➢ Choice of activities

➢ Catering

➢ Personal care

➢ Physical environment

➢ Communication quality.

The people who can complain include:

➢ Care recipients

➢ Representatives of care recipients

➢ Family members

➢ Friends

➢ Legal representatives

➢ Aged care staff

➢ Volunteers

➢ Health professionals.

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3.2 – Deliver services ensuring the rights of the older person are upheld

By the end of this chapter, the learner should be able to:

➢ Work in a manner that upholds the Principles for Older Persons – independence,
participation, care, self-fulfilment, and dignity.

Older people's rights

In December 1991, the United Nations created a set of Principles for Older Persons – they
recommended that all member governments should incorporate them into their frameworks for older
people and their care.

They are based upon the following five principles:

➢ Independence

➢ Participation

➢ Care

➢ Self-fulfilment

➢ Dignity.

The following table outlines the specific aspects of each principle:

Right to: Specific details

Independence ➢ 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;
➢ To live in environments that are safe and adaptable to personal preferences and
changing capacities;
➢ To reside at home as long as possible;

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 Participation ➢ 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 ➢ 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, beliefs, needs and
privacy and for the right to make decisions about their care and quality of life.

Self-fulfilment ➢ To pursue opportunities for the full development of their potential;

➢ To access the education, cultural, spiritual and recreational resources of society.

Dignity ➢ 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
life.
Source: http://www.sa.agedrights.asn.au/

All clients of aged care should be treated fairly and equally and your work behaviour should reflect this.
This means delivering all the essential services to everyone who requires them without prejudice.

Therefore, the types of conditions and situations you need to provide services for regardless are:
➢ Disabilities

➢ Different cultural backgrounds

CHCAGE001 Learner Guide V 2.0 Page 34 of 65

 ➢ Different financial backgrounds

➢ Different geographical locations

➢ Different genders

➢ Different beliefs

➢ Sexual orientation.

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3.3 – Identify breaches of human rights and respond appropriately
3.4 – Recognise signs consistent with financial, physical or emotional abuse or
neglect of the older person and report to an appropriate person

By the end of this chapter, the learner should be able to:

➢ Recognise signs of abuse or other indications that the human rights of a client are being
breached

➢ Report abuse or other breaches of human rights to appropriate person(s)

➢ Intervene appropriately when abuse is identified.

Breaches of human rights

If you are witness to a violation of the human rights of an older person, it is your duty to report this to
the appropriate person(s).

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.

Elderly people may be abused in their own homes, in care facilities or in relatives' homes.

Defining elderly abuse

Elderly abuse is any instance where someone takes advantage of an elderly person. It can include:

CHCAGE001 Learner Guide V 2.0 Page 36 of 65

 ➢ Financial exploitation – this is the
unauthorised use of an older person's
money or their property by either a
caregiver or an external party. The
types of practices include:

o stealing money

o forging cheques/credit
cards/accounts

o forging the older person's

signature

o identity theft

o requesting them to pay money to claim a 'prize'

o charity scams

o investment fraud

➢ Physical abuse – this is the deliberate use of force on an older person, causing them
pain, injury or disability. It includes violent assaults, using drugs (inappropriately),
restraining them or keeping them captive.

➢ Emotional abuse – also known as psychological abuse, this involves treating elderly
people in any way that causes them distress or emotional pain.

This can include:

o verbal abuse – threats, intimidation, yelling, humiliation, placing blame

o non-verbal abuse – ignoring, social isolation, terrorising behaviour

➢ Sexual abuse – this includes contact with an older person without their consent; this
can mean physical sex acts but also includes making them watch sex acts, pornography,
or forcing them to undress.

➢ Neglect/abandonment – this includes failure to fulfil carer duties and is responsible for
over half of elderly abuse cases. It can be intentional or unintentional, based on
ignorance or denial of the care requirements for the elderly person.

➢ Healthcare fraud – this can be committed by care providers or medical personnel; it

includes:

o charging for healthcare they don't provide

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 o overcharging for services

o taking 'kickbacks' (bonuses) for referring patients to providers of certain drugs

o over/under-medicating

o recommending incorrect/fraudulent remedies for medical conditions/illnesses

o Medicare fraud.

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Signs of abuse
Symptoms can be difficult to recognise as they may mirror those of dementia or frailty. It can be easy
for people to explain away the signs and many people may dismiss them as a minor issue. However, you
should not believe a caregiver at face value and investigate if you are at all concerned. The following are
things you should be on the lookout for.

General abuse:
➢ Arguments (frequent) between elderly person and caregiver

➢ Changes in personality of the elderly person

➢ Odd/unusual/different behaviour.
Physical abuse:
➢ Unexplained injuries

➢ Broken bones/sprains/dislocations

➢ Medication irregularities

➢ Broken glasses

➢ Signs of restraint

➢ Caregiver refuses to let elder be seen alone.

Emotional abuse:
➢ Experience of threatening, bullying or controlling behaviour from caregiver

➢ Dementia-like behaviour from elder – rocking, mumbling, sucking thumb.

Sexual abuse:
➢ Bruises around genitals

➢ Unexplained genital infections or STDs

➢ Unexplained vaginal/anal bleeding

➢ Torn/stained clothing.

Neglect:
➢ Weight loss, malnutrition, dehydration

➢ Being left unclean

➢ Untreated physical problems

➢ Unsuitable clothing for the conditions

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 ➢ Unsanitary living conditions

➢ Unsafe living conditions

➢ Desertion in a public place.

Financial exploitation:
➢ Unexplained withdrawals from elder's accounts

➢ Sudden changes in financial situation

➢ Missing items/cash from the elder's house

➢ Suspicious will/policy/power of attorney changes

➢ Addition of names of documents

➢ Unpaid bills/lack of medical care (despite a healthy

financial situation)

➢ Financial activity taking place when the older

person is incapacitated

➢ Unnecessary services being provided.

Healthcare fraud:
➢ Duplicate medical bills

➢ Evidence of over/under-medication

➢ Evidence of inadequate care pertaining to the amount paid

➢ Problems in the care facility.

Acting on elder abuse

There are three things you must do to prevent elder abuse:
➢ Listen to elders and caregivers

➢ Intervene when you suspect abuse

➢ Educate others on how to identify and report elder abuse.

As a caregiver, you can do the following if you are overwhelmed by the demands:
➢ Request help from colleagues, friends and family (of the elder)

➢ Maintain your own health

➢ Practice stress reduction exercises

CHCAGE001 Learner Guide V 2.0 Page 40 of 65
 ➢ Seek counselling if you are depressed

➢ Finds support groups (if necessary)

➢ Seek help for any substance abuse

➢ Contact elder abuse helplines.

3.5 – Assist the person to access other support services and the complaints
mechanisms as required

By the end of this chapter, the learner should be able to:

➢ Give the client the knowledge and ability to complain

➢ Assist the client in lodging complaints in accordance with organisational complaints

procedure

➢ Demonstrate professionalism and sensitivity in handling complaints, being open to

listening to clients with complaints.

Give the client the knowledge and ability to complain

You should research ways to enable clients to complain. There may be a complaints scheme in place so
that clients can put in formal complaints about services.

The first process should be to lodge a complaint with the service provider before anything else – this will
result in the quickest and most direct resolution to the problem. The complainant is allowed to take an
advocate with them to meetings with providers as support and to ensure they are not taken advantage
of.

If discussion with aged service providers is impossible or proves unproductive, the next stage is to lodge
a complaint with a government complaints scheme. For example, the government has an Aged Care
Complaints Scheme, which is a free service for anyone to raise concerns about the quality of
care/services delivered to any aged care services subsidised by the Australian government; this includes
residential care, home care and HACC services. They can be contacted online by filling in a complaint
form or via phone on 1800 550 552.

As mentioned previously mentioned, the topics that can be complained about include:
➢ Quality of care

CHCAGE001 Learner Guide V 2.0 Page 41 of 65

 ➢ Choice of activities

➢ Catering

➢ Personal care

➢ Physical environment

➢ Communication quality.

The people who can complain include:

➢ Care recipients

➢ Representatives of care recipients

➢ Family members

➢ Friends

➢ Legal representatives

➢ Aged care staff

➢ Volunteers

➢ Health professionals.

Assist the client in lodging a complaint

Clients are entitled to complain if they are dissatisfied with a service or any aspect of it – they must be
made aware of this and the process for lodging a complaint; this should be standard practice in your
organisation. Most organisations have a client grievance policy or procedure which will outline the
accepted way to handle complaints, and how to support the client throughout the process.

People have the right to express themselves whether that is artistically, politically or commercially. You
should not prohibit the expression of opinions or not give the opportunity to do so.

The complaints process

Your organisation will have a process for complaints and how to treat them. It is important that you
know what this is and your role within it.

In complaints management, it is usually a three step process:

➢ Talk to the people directly involved with the complaint, to attempt to solve the
problem

➢ Take the issue higher up, if initial discussions are unproductive

➢ Take the complaint to an agency or refer the client to an advocacy service.

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Depending on the nature of the complaint there are several outcomes of complaints:
➢ No further action is taken (but the incident documented)

➢ The complaint is investigated

➢ The complaint is referred to another person/department

➢ The client takes action (after having their options explained to them)

➢ The client is compensated or appeased e.g. through an apology.

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Handling complaints
You will need tact and empathy to handle complaints from clients so that you can help to get to the root
of the problem and minimise hostility.

When dealing with complaints, there are some general tips to help minimise hostility:
➢ Establish and maintain a rapport with the client

➢ Discuss issues in a broad sense

➢ Be open to talking about anything the

client wishes to discuss

➢ Have an open mind

➢ Try to get to the bottom of what caused

the problem

➢ Look for solutions

➢ Don't directly disagree with the client

➢ Take swift action to rectify the problems using identified solutions

➢ Refer matters to your supervisor if you are unable to the deal with the complaint.

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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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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

By the end of this chapter, the learner should be able to:

➢ Engage in re-ablement processes to assist clients in relearning skills necessary to
engage in living activities

➢ Identify actions that can be taken, or adaptations that can be made, to assist clients to
engage as actively as possible in all living activities.

Encouraging living activities

Living activities are those activities that a client will need to partake to live independently.

These may include:

➢ Cooking and feeding oneself

➢ Cleaning oneself/bathing

➢ Dressing

➢ Grooming

➢ Household chores

➢ Leisure.

Re-ablement
Re-ablement involves helping people learn or perhaps more often relearn the skills they need for
everyday living. Older people may have lost these skills through the deterioration of health and their
reliance on support. It is a new approach to care that means carers guide client’s on tasks, doing them
with the client instead of doing them for the client.

Care workers will have to take the role of guide and supervisor – this will mean standing back and
letting the client have a go instead of doing it for them.

Care workers will have to discuss the goals of the client with them so that they can think of tasks that
can help the client to achieve them. Larger goals should be split into smaller targets that result in the
larger goal being accomplished. For example, a large goal for a client could be to prepare their own
meals; this could be split into smaller goals specific to their needs.

Support should be adjusted for each client on an individual basis; support should be decreased for
clients who are making progress and achieving their targets, but it should be increased for those who
are struggling.

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CHCAGE001 Learner Guide V 2.0 Page 47 of 65
Case study
A client called Mr S has recently asked for a care worker to visit her at home for help preparing meals.
He is slightly visually impaired and has osteoporosis and arthritis and uses a walking aid. An assessment
was undertaken and found that he would need ongoing support for his washing and dressing tasks,
although encouragement from carers could allow for some independence in this area.

Mr S used a delivery food service where frozen meals were delivered to him. He found it difficult to heat
the meals because of his visual impairment – he could not read the instructions and the struggled to see
the microwave, which resulted in many burned meals.

The care workers decided to:

➢ Move the microwave towards the window

➢ Stick labels with cooking times written onto meals in the freezer e.g. 6 minutes

➢ Stick bright labels with raised sections to represent some of the common numbers used
on the microwave e.g. 1 minute, and 5 minutes.

This resulted in Mr S being able to prepare meals on his own. After a few weeks, he was able to manage
with just two visits instead of the three he had been having. These visits were for help with getting
washed and dressed either for the day or for bed.

CHCAGE001 Learner Guide V 2.0 Page 48 of 65

4.2 – Assist the older person to recognise the impact that changes associated
with ageing may have on their activities of living

By the end of this chapter, the learner should be able to:

➢ Recognise the symptoms of a range of age-related conditions and be able to assist
older persons to assess the impact of these conditions on their daily lives.

General physical changes associated with ageing

As people age, their body naturally deteriorates – this can lead to changes in their physical conditioning.

Some common factors are:

➢ Vision – eyes dry up and lens becomes less accurate. Therefore, sight
can become blurry and out of focus – glasses and contact lenses may
need to be used as corrective measures.

➢ Hearing – the changing ear structure and nerves can lessen hearing
ranges, with higher frequencies more difficult to hear.

➢ Taste and smell – the senses of smell and taste can fade, leading to a
decreased appetite and weight loss.

➢ Immunity – the immune system gets weaker as we age, with white

blood cells being less effective – leading to more frequent infections.

➢ Hair and nails – hair becomes thinner and drier, leading to possible
itching and discomfort, as well as hair loss. Nails become brittle and
fungal infections can become more common.

➢ Hormones – these can result in a multitude of problems and can affect metabolism,
endocrine glands and sexual function.

➢ Teeth and gums – teeth weaken and dry out, with less saliva produced by glands.
Coupled with receding gums, these can result in a dry mouth, tooth decay/loss, bad
breath, infections and gum disease.

➢ Face – as well as wrinkles and age spots, facial contours may shift, leading to droopy,
sagging skin.

➢ Body shape – bone changes can lead to spine curvature and a decrease in standing
height. Muscle may waste away and fat metabolism can become impaired, making
maintaining weight more difficult.

➢ Skin – skin oil is produced less, leading to dry and itchy skin. It becomes less flexible
and more fragile – this can lead to easy bruising, wrinkles, age spots and skin tags.

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 ➢ Bones, joints and muscles – bones become less dense and shrink, making them more
prone to breaks; muscle mass decreases and they become weaker; joints become
painful, less flexible and inflamed.

Arthritis and other musculoskeletal problems

This condition causes pain, stiffness and inflammation within a joint – it can affect people of all ages,
with 3.85 million Australians affected by it (set to rise to seven million by 2050). In actual fact, the term
arthritis covers over 100 medical conditions, so the degree and impact it has on a particular person can
vary depending on the type of arthritic condition they have. The three most common conditions are
osteoarthritis, rheumatoid arthritis and gout, with over 95 per cent of cases in Australia being these.

In general, it impairs the ability to move the joints freely and can interfere with daily tasks such as
driving, walking and handling things.

However, it is not a natural part of ageing and shouldn't be accepted as such – 2.4 million of those
affected in Australia are of working age. The problem is that it's not curable yet, and can only be
managed via medication (such as anti-inflammatory drugs, painkillers) or physiotherapy.

Common arthritic symptoms include:

➢ Joint pain, tenderness and stiffness
➢ Inflammation in and around the joints
➢ Restricted movement of the joints
➢ Warmth and redness of the skin over the affected joint
➢ Weakness and muscle wasting

Diabetes
This is where insulin is not produced in sufficient amounts by the body to convert sugar (glucose) into
energy. Instead, it stays in the bloodstream – this can be harmful to internal organs. It can be controlled
with medication though, and most diabetics carry a medical alert bracelet, necklace or card (as well as
glucose sources for emergencies).

Symptoms are:
➢ Confusion

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 ➢ Sweating
➢ Dizziness
➢ Weakness
➢ Headache
➢ Lack of focus
➢ Hunger
➢ Numbness (lips and fingers)
➢ Trembling
➢ Irritability
➢ Slurred speech
➢ Fitting
➢ Loss of coordination
➢ Loss of consciousness.
There are two types of diabetes – type 1 and type 2.

Type 1 diabetes is an auto-immune condition where the immune system destroys insulin-producing cells
in the pancreas. There is no known cause a there is no known prevention or cure for it at present. It
accounts for around 15 percent of all diabetes cases, with symptoms including excessive thirst and
urination, inexplicable weight loss, blurred vision, fatigue and weakness. The management of the
condition is done by multiple daily insulin injections or the use of an insulin pump. Making healthy
lifestyle choices can also minimise the impact of it, even though bad lifestyle choices didn't cause the
condition.

Type 2 diabetes is where insulin is not produced in sufficient amounts by the pancreas to convert sugar
(glucose) into energy. Instead, it stays in the bloodstream – this can be harmful to internal organs. It can
be controlled with medication though, and most diabetics carry a medical alert bracelet, necklace or
card (as well as glucose sources for emergencies). This is the most common form of diabetes,
accounting for around 85 percent of cases. While the cause is partly genetic, lifestyle factors such as
being overweight, having a poor diet, high blood pressure and having excess fat around the weight.

Frailty and deconditioning

Frailty is closely linked to ageing and covers disability, chronic diseases or dependency. It can result in
things like delirium and falls and means that those who are considered "frail" must be closely
monitored.

Heart and lung disease

Causes of heart and lung disease are:
➢ Smoking

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 ➢ Obesity
➢ High cholesterol.
The types of lung disease are:
➢ Asthma
➢ Chronic obstructive pulmonary disease (COPD)
➢ Bronchitis
➢ Emphysema
➢ Cystic fibrosis
➢ Pneumonia
➢ Tuberculosis
➢ Lung cancer
➢ Acute respiratory distress syndrome (ARDS)
➢ Pneumoconiosis
➢ Interstitial lung disease (ILD)
Heart disease happens when the blood supply to the heart becomes blocked or interrupted by a build-
up of fatty substances in the coronary arteries. If left untreated, it can lead to a heart attack.

The best way to deal with heart and lung disease is through positive lifestyle changes and some
medications that may thin the blood.

Incontinence
This is when people pass urine unintentionally and becomes more common with age, affecting about
twice as many women as men. There are two types of incontinence – stress and urge incontinence.
Stress incontinence is when the pelvic muscles are too weak to contract and prevent urination – this can
cause leakage when the bladder is under pressure when people laugh or cough. Urge incontinence is
when urine leaks soon after you have passed urine or when there is an intense urge to urinate.

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Again, it is not an inevitable part of ageing and can affect younger people too. Effective treatments
include making positive lifestyle changes, strengthening the pelvic floor muscles and bladder training
(waiting longer between urination).

Other treatments include:

➢ Absorbent pads

➢ Portable external bladder systems

➢ Surgical treatment

o to reduce pressure on the bladder

o to strengthen the muscles preventing urination

o to increase the bladder size

o to implant a device to stimulate the detrusor muscles.

Skin disorders (including skin cancers)

Skin cancer is the abnormal growth of skin cells and occurs often on areas of skin that have been heavily
exposed to sunlight. The three major types of skin cancer are basal cell carcinoma, squamous cell
carcinoma and melanoma. It is vital that early detection is facilitated, as this gives the best chance of
curing the cancer.

Other skin conditions include things like eczema, and warts, etc. These need to be managed with
appropriate creams and lifestyle choices, which should be prescribed by a doctor.

Stroke
This happens when the blood supply to part of the brain is cut off. In this case, prompt medical
treatment is essential in preventing lasting damage to the body. You will need to phone 000 if you
suspect a client is having a stroke.

It is diagnosed used the concept of FAST – face, arms, speech, time:

Face – drooping of the face on one side, around the eyes and mouth, an inability to smile

Arms – may not be able lift one or both arms and maintain their position

Speech – slurred and muddled speech, inability to talk at all

Time – dial 000 immediately if you see any of these symptoms

People most at risk of strokes are over-65s and underlying conditions such as heart disease and diabetes
increase the risk. Things like being overweight, high cholesterol, poor diet, lack of exercise, high blood
pressure, and an irregular heartbeat are all contributing factors to a stroke.

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They can be treated with medications but surgery may be required at times. In terms of aged care
though, the most common things you will be dealing with are people after a stroke. This can involve
long rehabilitation periods which may or may not recover the independence of the affected individual.
It can involve specialists such as physiotherapists, psychologists, occupational therapists, speech
therapists and specialist nurses and doctors.

Vascular disease
This is a hardening of the arteries caused by a thickening of the artery lining from fatty deposits. This
makes it hard for blood to flow freely around the body – the areas where the blood cannot get will
suffer impaired function, tissue damage and it can even cause death if vital organs are not receiving
enough blood. The most common arteries affected are those of the heart, brain and legs.

Symptoms can include:

➢ Pain at and beyond the site of the blockage

➢ Heart attack (heart)

➢ Stroke (brain)

➢ Cramping (legs)

Again, in terms of managing the disease, it is about adopting a healthy lifestyle –

however, medication may cause strokes or heart attacks as a side effect, so this is avoided. If
you are already on treatment for high blood pressure or diabetes, you should maintain this.

As people age and their bodies and minds may cease to function as well as in their younger
days, the activities they can carry out will change. However, people may struggle to
accept the lifestyle changes that this entails.

When working with older people, you may need to inform them of their limitations; for
example, they cannot carry out routine physical tasks like they may have done in their younger days.
Things like home DIY tasks that involve coordination and balance can cease to be safe if your senses are
not functioning at their best – if they are going up and down a ladder, they may fall off and seriously
injure themselves.; if they are using sharp objects, they may cut themselves, etc.

This may affect their scheduling – they cannot simply get up and do things as freely as they used to and
they may require assistance in daily life. This does not necessarily mean they are incapable of
performing everyday tasks.

Other changes on their living activities may include:

➢ Taking medication at specified times

➢ Budgeting (as they may have limited income)

➢ Need to rest more (as muscles and body weaken)

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 ➢ More visits to the doctors (to monitor and identify conditions associated with ageing)

➢ Cannot drive anymore (due to deteriorating vision)

➢ Need for home help

Older people who are affected by any of the above need to be aware of their limitations by their carers
and family; however, you should work with them to ensure that they can enjoy as much of the activities
they desire as possible. This can involve making provisions for assistance or the encouragement for
them to partake in new activities more suited to their ability, so that their life doesn't feel void.

Gender and sexuality

Whilst it may be expected that older people may experience changes in the areas of gender and
sexuality as they age, this belief may actually be a form of ageism that is damaging to the individual.
Older persons may still experience sexual desire, and will still identify with a sexual orientation, which
may be heterosexual, homosexual, or bisexual.

As they age, older people may find that they are discriminated against in the fields of gender and
sexuality, and are unable to express or engage in sexual activity for this reason. As a care provider for
the elderly, it is important to recognise the presence of sexual desire in your clients, and to allow them
to express this as part of their lifestyle.

However, it is also important to recognise when sexual behaviour becomes inappropriate and to
intervene appropriately. For example, if an elderly person is displaying inappropriate sexual behaviour
toward a staff member or other service users.

Mental health and sexual behaviour

The sexual behaviour of older people may be affected by the presence of conditions such as Alzheimer’s
or dementia.

As these conditions affect the brain, they may cause unpredictable changes in a person’s sexual
attitudes and behaviours.

This may involve:

➢ More or less interest in sex

➢ Less sexual inhibition

➢ Decreased ability to engage in sexual activity

➢ Sexual aggression

➢ Challenging sexual behaviour.

These changes in sexual behaviour can create difficulties for the client and their families as they adjust
to the person’s changing mannerisms.
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Other difficulties may arise for a care provider. Issues may include misinterpretation of non-sexual
behaviours as sexual; for example, if a person with dementia believes that a person in the room is a
previous or deceased partner, they may act affectionately, or even sexually, towards them.

More information may be found at:

https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=129 (Access date:
26/10/16)

Policy and procedure

You must be aware of your own legal and ethical obligations when handling issues of gender and
sexuality in the aged care sector.

This includes:
➢ Following your organisation’s sexuality policy

➢ Complying with privacy law

➢ Respecting the rights of individuals to express their sexuality

➢ Following policy and procedure to respond to inappropriate sexual behaviours, or

suspicion of sexual abuse.

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4.3 – Identify strategies and opportunities that maximise engagement and
promote healthy lifestyle practices

By the end of this chapter, the learner should be able to:

➢ Identify, and implement, a range of strategies to improve the health and wellbeing of
clients according to the specific needs and capability of the client

➢ Promote healthy eating and exercise.

Encouraging healthy lifestyle

A healthy lifestyle is important to preventing and managing many of the debilitating conditions
associated with ageing. Social and recreational activities are vital to an individual’s general health and
wellbeing as they help to keep them fit, active and ‘keeps the mind working.’

If your client does not already have social or recreational activities in place, it is your duty to find out
what their preferences are and inform them of the activities available to them in their area. Social and
recreational activities help to combat isolation that many elderly individuals or others in care can
encounter. The client may have a network of individuals that either visit them or are available to help
with the problem of isolation or general care when you are not around.

There are various strategies that older people can adopt to live a healthier lifestyle:
➢ Taking regular exercise (even just walks)

➢ Maintaining a healthy diet (eat at least three solid meals a day, with nutritional variety)

➢ Mental stimulation (playing games, problem-solving activities, puzzles)

➢ Hobbies

➢ Embrace variety (maintaining the same routine and always doing the same things can
affect you psychologically, causing a depression
and monotony)

➢ Engage with remaining family members

➢ Learn new things

➢ Take a class/join a club

➢ Travel (if possible)

➢ Get vaccinations for common infections.

Doing most or all of these will ensure that elderly people are physically and mentally stimulated enough
to minimise the deterioration to their bodies.

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They should also be tailored to the individual's interests and life activities, if possible. Forcing people to
partake in things they are not interested in will only worsen their satisfaction levels with the care. Try
and find things in common, if possible, between yourself and the elders or (if at a residential home)
between the residents. If they have hobbies, see if you can accommodate them into their daily routine.

If dealing with home care, they may have activities and interests scheduled on a day-to-day basis and
you should try and fit their care needs in around these things – if you force them to give up their life
activities and interests to receive home care, then the whole advantage of living in the community
disappears for them; consequently, they may become socially isolated and depressed.

Eating healthily
Eating healthily is about ensuring that your diet is balanced – not having too much or too little of any of
the five food groups.

‘The Australian Dietary Guidelines inform people of different ages, life stages and gender, the minimum
number of serves from each food group they need to eat each day, to make sure they get the full
amount of nutrients their body needs’ source: http://www.eatforhealth.gov.au/food-essentials

The five food groups include:

➢ Vegetables and legumes/beans

➢ Fruit

➢ Grain (cereal) foods, wholegrain and /or high cereal fibre varieties

➢ Lean meats and poultry, fish, eggs tofu, nuts and seeds and legumes/beans

➢ Milk, yoghurt, cheese and/or alternatives, mostly reduced fat.

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CHCAGE001 Learner Guide V 2.0 Page 59 of 65
Exercising
Exercise is also important as part of a healthy lifestyle. Exercising gives your heart a workout and keeps
you fit. It is important for preventing certain types of disease and has many other benefits.

The benefits of exercise are that it:

➢ Makes you feel good

➢ Can provide an opportunity to have fun/socialise

➢ Helps to prevent weight gain that is unhealthy

➢ Helps you to relax

➢ Reduces risk of diseases such as:

o cardiovascular disease

o type 2 diabetes

o some cancers

➢ Encourages healthy growth and development

➢ Helps build strong bones, muscles and joints.

Like the recommendations for healthy eating, there are recommendations for exercise, including how
much and how often you should exercise; these will, of course, depend on age.

National recommendations for exercise are contained in the following documents:

➢ Australia’s physical activity and sedentary behaviour guidelines for adults (18-64 years)

➢ Choose Health: Be Active – A physical activity guide for older Australians.

You can use these resources to recommend certain types of exercise for different circumstances, the
duration recommended, how to fit exercise into daily routine or schedule, etc.

You may be able to open a discussion with clients about healthy eating and exercise, give out leaflets or
point them to further information e.g. via the government website.

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

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By the end of this chapter, the learner should be able to:
➢ Listen to and carefully observe the client in order to assess which aids and
modifications are required

➢ Take into account any financial limitations facing the client, and assist the client in
seeking funds or subsidies, if necessary.

Identifying aids and modifications

There are a range of aids and modifications to help individuals to carry on with independent living in
whichever environment.

Aids and modifications:

➢ Home modifications:

o walk in shower or bath

o stair lifts

o handrails

o slopes and ramps

o wide access for wheelchair

o emergency alarms

➢ Aids such as:

o wheelchairs

o walking sticks

o walking frames

o hearing aids

o guide dogs.

To identify the best aids and modifications, it is important to listen to and observe the client carefully.
For example, if a client has repeatedly fallen – where did it occur? What were they doing at the time,
etc.? This can give you more information so that you can help the client in the best possible way. A
client who has repeatedly fallen on the stairs may need a stair lift to help them. A client who has fallen
in random or different places may need a walking aid, such as a stick or frame.

Financing the costs associated with modifications and aids

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Your client may qualify for help with the installation of home modifications and other services such as
garden maintenance, repair work, electrical works and some renovations. The Australian Government
provides funds or subsidies for those who need aids and modifications to allow them to continue
independent living. However, if your personal circumstances permit, you should be prepared to
contribute to the cost of your care or modifications.

For more information please go to: http://www.myagedcare.gov.au/help-home/home-maintenance-

and-modifications

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4.5 – Discuss situations of risk or potential risk associated with ageing

By the end of this chapter, the learner should be able to:

➢ Effectively communicate potential risks to clients and advise how to minimise these.

Potential risk associated with ageing

For all the aforementioned risks/potential risks associated with ageing, it is important to communicate
them to the older people they apply to.

Such examples of risks associated with ageing include:

➢ Loss of balance

➢ Muscle wastage

➢ Joint pain/stiffness

➢ Brittle bones

➢ Hearing impairment

➢ Visual impairment

➢ Increased risk of disease.

You will need to be sensitive in communicating the risks associated with ageing and ensure that your
language is positive and empowering, rather than negative and restrictive. You can offer helpful
suggestions as to how to minimise the risks associated with ageing. These could include regular
exercise, aids and modifications, healthy diet and being simply careful.

You should discuss with your client the risks that they may be open to as they get older and more
vulnerable. Ensuring clients are aware of certain situational risks can help to minimise them.

As clients get older they may be prone to:

➢ Falls

➢ Road accidents

➢ Getting lost

➢ Victims of crime.

Though making clients aware that they need to be careful, you should never scare a client or discourage
them from taking part in activities.

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Communication strategies
There are a variety of ways you can get the information across.

Understand that different people will respond to different methods; below are a few that you can
use:
➢ Verbal communication

➢ Brochures

➢ Leaflets

➢ Posters

➢ Online

➢ Advertising.

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 References

These suggested references are for further reading and do not necessarily represent the contents of
this unit.

Websites

Privacy Act:
Source: http://www.oaic.gov.au/privacy/privacy-act/the-privacy-act

Principles for Older Persons:

http://www.sa.agedrights.asn.au/

Eating healthily:
http://www.eatforhealth.gov.au/food-essentials

Modification and aids information:

http://www.myagedcare.gov.au/help-home/home-maintenance-and-modifications

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