Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:

CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 61

 HOW TO USE THIS COMPETENCY BASED LEARNING
MATERIAL

Sector HUMAN HEALTH/HEALTH CARE

SECTOR

Qualification Title CAREGIVING (ELDERLY) NC II

Unit of Competency PERFORM SPECIALTY CARE

PROCEDURES

Module Title PERFORMING SPECIALTY CARE

PROCEDURES

PHILIPPINE ACADEMY FOR TECHNICAL AND VOCATIONAL SKILLS INC.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 62

Welcome to the module in “Performing Specialty Care Procedures”. This module
contains training materials and activities for you to complete.

The unit of competency " Performing Specialty Care Procedures " deals with the skills,
knowledge and attitude required to support client with their technical care needs within the
framework of the individualized care support plan.

This module will lead you through different learning activities in order to complete each
learning outcome of the module. Each learning outcomes is provided with Information Sheets
(Reference Materials for further reading to help you better understand the required activities).
Follow these activities and answer the self-check at the end of each learning outcome. You
may remove a blank answer sheet at the end of each module (or get one from your
facilitator/trainer) to write your answers for each self-check. If you have questions, don’t
hesitate to ask your facilitator for assistance.

Recognition of Prior Learning (RPL)

You may already have some or most of the knowledge and skills covered in this
learner's guide because you have:
✓ been working for some time
✓ already completed training in this area.

If you can demonstrate to your trainer that you are competent in a particular skill or
skills, talk to him/her about having them formally recognized so you don't have to do the same
training again. If you have a qualification or Certificate of Competency from previous trainings,
show it to your trainer. If the skills you acquired are still current and relevant to the unit/s of
competency they may become part of the evidence you can present for RPL. If you are not sure
about the currency of your skills, discuss this with your trainer.

At the end of this module is a Learner’s Diary. Use this diary to record important dates,
jobs undertaken and other workplace events that will assist you in providing further details to
your trainer or assessor. A Record of Achievement is also provided for your trainer to
complete once you complete the module.

This module was prepared to help you achieve the required competency, in Performing
Specialty Care Procedure. This will be the source of information for you to acquire knowledge
and skills in this particular trade independently and at your own pace, with minimum
supervision or help from your instructor.

• Talk to your trainer and agree on how you will both organize the Training of this unit.
Read through the module carefully. It is divided into sections, which cover all the skills,
and knowledge you need to successfully complete this module.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 63

 • Work through all the information and complete the activities in each section. Read
information sheets and complete the self-check. Suggested references are included to
supplement the materials provided in this module.

• Use the self-check questions at the end of each section to test your own progress.

• When you are ready, ask your trainer to watch you perform the activities outlined in
this module.

• As you work through the activities, ask for written feedback on your progress. Your
trainer keeps feedback/ pre-assessment reports for this reason. When you have
successfully completed each element, ask your trainer to mark on the reports that you
are ready for assessment.

• When you have completed this module (or several modules), and feel confident that
you have had sufficient practice, your trainer will arrange an appointment with
registered assessor to assess you. The results of your assessment will be recorded in
your competency Achievement Record.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 64

 PARTS OF A COMPETENCY – BASED LEARNING
MATERIAL PACKAGE

In our efforts to standardize CBLM, the above

parts are recommended for use in Competency
Based Training (CBT) in Technical Education
and Skills Development Authority (TESDA)
Technology Institutions. The next sections will
show you the components and features of each
part.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 65

 CAREGIVING (ELDERLY) NC II

COMPETENCY-BASED LEARNING MATERIALS

List of Competencies

No. Unit of Competency Module Title Code

1. Develop the ability to recognize Developing the ability to HHC532320

aging process recognize aging process

2. Participate in the Participating in the HHC532321

implementation and monitoring implementation and
of client’s care plan monitoring of client’s care
plan

3. Perform caring skills Performing caring skills HHC532322

4. Perform specialty care Performing specialty HHC532323

procedures care procedures

5. Assist clients in administering Assisting clients in HHC532324

prescribed medication administering prescribed
medication

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 66

 MODULE CONTENT

UNIT OF COMPETENCY: PERFORM SPECIALTY CARE PROCEDURES

MODULE TITLE: PERFORMING SPECIALTY CARE PROCEDURES

MODULE DESCRIPTOR: This module covers the knowledge, skills and attitudes
required to support client with their technical care needs
within the framework of the individual care support
plan.

NOMINAL DURATION: 32 hours

LEARNING OUTCOMES:

At the end of this module, you MUST be able to:

1. Assist in basic wound care
2. Apply in basic and cold therapy
3. Assist in providing palliative care

ASSESSMENT CRITERIA:

• Wound dressing paraphernalia are prepared based on established standard

• Wound dressing techniques is applied aseptically based on established procedure
• Wound assessment is observed during the procedure based on established standard
• Wound healing progress is monitored and recorded based on established standard
procedures
• The goals and benefits of hot and cold therapy in pain management as outlined in the
care plan, is understood and explained to the client as prescribed by the doctor.
• Possible risks and complications of hot and cold therapy on the client are understood
• Appropriate heat / cold therapy techniques are applied to the client
• Concepts of death, dying and other related terminologies are applied based on
established standard
• The Dying Person’s Bill of Rights is applied based on established standard
• Principles of Palliative care is applied based on established standard
• Strategies to keep clean and comfortable is applied when discussing death and dying
• Document accurately client’s response to palliative

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 67

 LEARNING OUTCOME NO. 2
APPLY HOT AND COLD THERAPY
Contents:
1. General Science of pain

2. Heat and cold therapy principles and uses

3. Appropriate heat and cold therapy

Assessment Criteria
1. The goals and benefits of hot and cold therapy in pain management as outlined in the
care plan, is understood and explained to the client as prescribed by the doctor.

2. Possible risks and complications of hot and cold therapy on the client are understood

3. Appropriate heat / cold therapy techniques are applied to the client

4. Risks and limitations are identified and reported based on established standard
procedures

Conditions:
The participants will have access to:

1. Appropriate elderly care workplace

2. Appropriate facilities equipment and materials relevant to the unit of competency

3. Relevant textbooks or manuals

4. Relevant paper-based assessment instrument

5. Appropriate assessment venue

Assessment Methods:
1. Interview

2. Demonstration with oral questioning

3. Written Test

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 68

 Learning Experiences

Learning Outcome 2
APPLY HOT AND COLD THERAPY

Learning Activities Special Instructions

Read Information Sheet No. 4.2-1 on The focus of this learning outcome is to help the trainee to
General science of pain master the application of hot and cold therapy to elderly client.
This includes the nature of pain, the principle of hot and cold
therapy, its application and the risks, limitations, and
Answer self check 4.2-1 on General compilations of the said procedure.
science of pain
Read and understand the information sheets and check yourself
by answering the self-check. You must answer all the questions
Read Information Sheet No. 4.2-2 on correctly before proceeding to the next activity.
Heat and cold therapy principles and
uses Watch videos of the skills that you will perform, this will help
you have an idea about the procedure.

Answer self check 4.2-2 on Heat and Task/Job sheets will help you practice your skills. You may refer
cold therapy principles and uses to training activity matrix posted on the wall, to know the date
time of your assigned task, your work station and the
facilities/tools and equipment needed for the said activity.
Read Information Sheet No. 4.2-3 on
Appropriate heat and cold therapy The performance Criteria Checklist will guide and help you
technique evaluate your work as you are practicing your skill. Evaluate
your own work using Performance Criteria.
Answer self check 4.2-3 on When you are ready, present your work to your trainer for final
Appropriate heat and cold therapy
evaluation and recording.
technique
Feel free to ask for guidance of your trainer as you undergo the
learning activities outlined for you in the left column.
Watch video presentation about ice
bag application
After doing all activities of this Learning Outcome, you are
ready to proceed to the next topic.
Perform Task Sheet No. 4.2-3 on e
heat and cold therapy technique

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 69

 Information Sheet No. 4.2-1
GENERAL SCIENCE OF PAIN

Learning objectives:

After reading this Information Sheet, YOU MUST be able to:

1. Define pain;
2. Discuss how the body perceives pain
3. Differentiate the types of pain
4. Assess properly the patient’s pain
5. Discuss the elderly considerations on pain

What is the definition of pain?

Through their life experiences, individuals learn the concept of pain. A person’s report of an
experience as pain should be respected.

Pain is an unpleasant sensory and emotional experience associated with, or resembling that
associated with, actual or potential tissue damage. Pain is always a personal experience that is
influenced to varying degrees by biological, psychological and social factors.

Nociception refers to the nervous system’s encoding of potentially damaging events (e.g.
touching a hot stove, accidentally cutting yourself). But one can experience pain without
nociception and have nociception without pain. Pain does not equal nociception. Nociception
is objective, but pain is subjective and does not emerge solely from activity in sensory neurons.

Although pain usually serves an adaptive role, it may have adverse effects on function and on
social and psychological well-being. Verbal description is only one of several behaviors to
express pain, as the inability to communicate does not negate the possibility that a human or a
nonhuman animal experiences pain.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 70

There are four main types of pain, namely;

a. Acute pain – this is felt suddenly form an

injury, disease, trauma, or surgery. Acute pain
lasts only for short time.

Picture of an elderly suffering from acute

pain

b. Chronic pain – this type of pain lasts for a

long time (usually for months or years, and
sometimes it even occurs on and off). One
example is Arthritis

Picture of an elderly with Arthritis

c. Radiating pain – is characterized by pain at the site of tissue damage and in nearby
areas. Example of this is urinary tract
infection where the pain radiates from the
lower back up to the lower abdomen.

Picture of elderly suffering from pain of UTI

d. Phantom pain – is felt in a body part that is no

longer there. Example of this is an amputated
leg.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 71

ASSESSMENT OF PAIN

Other persons pain cannot be seen, heard, smelled, or felt. The caregiver must listen
carefully and take note the person’s exact words for the following questions.

• Location
• Onset and duration
• Intensity
• Description
• Factors causing pain
• Factors affecting pain
• Vital signs
• Other signs and symptoms.

Can we measure pain?

Yes. Measures are self-reported. There are no currently no valid objective measures – e.g. a
blood test or scan for detecting pain.

The only way of knowing if a person has pain is if they tell you – as pain is a subjective and
personal experience.

A number of questionnaires are used to measure the intensity of a person’s pain or the disability
related to the pain. The most popular measures are numerical and visual analogue
scales where patients will be asked to rate their pain on a scale of 0-10 or 0-100.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 72

ELDERLY CONSIDERATION OF PAIN

There is little merit in considering

the treatment of pain in elderly patients
as a separate entity unless there are real
and practical differences from its
management in younger subjects. Few
would argue that these differences do not
exist, although the definition of when a
patient becomes “elderly” is problematic.

The elderly are more likely to have

sensory impairments, memory difficulties,
and lack of social backup that can all
interfere with treatment and illness recovery.
As educated practitioners, it is easy for us to
suggest treatments that may well have the
potential for being effective with that patient.
However, the patient cannot read the drug
label that states the dose and dose frequency,
cannot open the container because of
arthritic hands, and cannot get assistance
with drug administration because sh e or he
lives on her or his own. Therefore, an
awareness of all those factors that
accompany aging is significantly more important than just the knowledge of how drug
treatments for pain differ in the elderly.

As well as increased incidence of illness with advancing years, problems of communication

with older patients can arise. Impairment of sight and hearing can have obvious consequences.
Even more problematic are patients with dementia. They suffer pain as much as anyone else
but may lack the cognitive function that allows them to communicate their pain or the response
to drug intervention.

Always report early signs and symptoms to

the nurse to address pain as early as possible.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 73

 Self Check No. 4.2-1

GENERAL SCIENCE OF PAIN

TRUE OR FALSE. Read the following statement carefully. Write TRUE if the
statement is correct and FALSE if it is incorrect. Write down
your answer on the space provided.

___________1. Acute pain may last for more than a months or years.

___________2. Pain is the main reason why people often seek medical attention.

___________3. A person who feels pain may become restless and cries easily.

___________4. Pain can be seen, heard, smelled or felt on the other person.

___________5. An elderly in pain has an increased appetite.

___________6. One sign of pain in elderly is increased confusion.

___________7. Early signs and symptoms of pain should reported Immediately to the nurse.

___________8. Radiating pain is characterized by pain at the side of tissue damage and in
nearby areas.

___________9. One example of chronic pain is arthritis

___________10. Phantom pain is felt in a body part that is still there.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 74

 Answer Key 4.2-1

GENERAL SCIENCE OF PAIN

1. FALSE
2. TRUE
3. TRUE
4. FALSE
5. FALSE
6. TRUE
7. TRUE
8. TRUE
9. TRUE
10. FALSE

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 75

 Information Sheet No. 4.2-2

HEAT AND COLD THERAPY PRINCIPLES AND USES

Learning objectives:

After reading this Information Sheet, YOU MUST be able to:

1. Differentiate heat and cold application

2. Enumerate the risks, limitation, and complication of hot and cold Treatment
3. Discuss elderly considerations on heat and cold therapy

HEAT AND COLD THERAPY

Heat and cold therapy has its differences in terms of their uses and benefits. The table
below summarizes the things about heat and cold therapy.

General Instructions

1. Asses the condition the clients before and after the hot and cold applications.
2. Maintain the correct temperature for the entire duration of the application
3. Expose the client only to the safe temperature.
4. Do not allow the clients to adjust the temperature control of appliance such as short
wave diathermy, electric heating pads etc.
5. Never ignore the complaints of clients however small they appear to be.
6. Always make sure that the client is in position to remove the application
7. The client must have a calling signal within reach
8. Never leave a client alone even for a short period that cannot move from the
appliances.
9. A thin layer of petroleum jelly or oil should be applied to the skin prior the
application of moist heat application.
10. Do not use electrical appliances near to open oxygen. A small spark may cause
explosion.
11. Do not handle electrical appliances with the wet hands.
12. Hot and cold applications must be very carefully used when the clients is
unconscious, anaesthetized or otherwise unable to respond pain.
13. Any signs of complications should be recognized early, the procedure should be
stopped immediately.
14. After the procedure, dry the part gently by patting and not by rubbing to remove the
moisture.
15. In hyperpyrexia, the temperature of the body should be brought down gradually and
steadily, sudden cooling is dangerous to the client.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 76

 Therapeutic Uses / Applications Contraindications of Applications

HOT COLD HOT COLD

Heat decreases Cold relieves pain Heat is not used in malignancies Cold should not be
pain applied on clients who are
in the stage of shock and
collapse
Heat decreases Prevents gangrene Heat is not used in patients with Cold should not be
muscle tone heart, kidney and lung diseases applied when there is
edema.

Heat promotes Prevents edema and Should not used in acute Cold should not be
healing reduce inflamed areas. applied on clients with
inflammation circulatory disorders.
Heat promotes Controls Should not be applied on Cold should not be
suppuration hemorrhages patients with paralysis. applied on patients with
decreased sensation
Heat provides Checks the growth Should not be applied on open Patients with shivering
warmth of bacteria wounds and very low temperature,

Heat stimulates Reduce the body Should not be applied when Cold should not be
peristalsis temperature there is an edema associated applied when there is
with venous or lymphatic infected wound.
diseases.
Cold anaesthetize Should not be applied on
an area patients with metabolic
disorders.
Should not be applied on very
young and very old patients.
Should not be applied on clients
with high temperature.

Principles of Hot and Cold Applications

1. Water is good conductor of heat.

2. Air is poor conductor of heat.
3. Heat always flows from hotter area to the less hot area.
4. Prolong exposure to moisture increases the skin susceptibility to maceration and skin
breakdown, reducing the protection of the intact skin.
5. Moisture left on the skin cause rapid cooling due to evaporation of the moisture.
6. Presence of steam increases the temperature of the hot application
7. Oil acts as the insulator and delays the transmission of the heat.
8. Woolen materials absorb moisture slowly, but hold the moisture longer and cold off
less quickly than the cotton materials.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 77

 9. When immersed in water the body becomes buoyant therefore the exercises are
performed under water with less effort.
10. The temperature tolerance varies with individuals and according to the site and area
covered.
11. The end organs of the sensory nerves of the skin convey the sensation of cold, heat
pain and pressure. The sensation is interpreted in the brain.
12. Friction produces heat.

Table 4.2.2 Approximate Range of Temperatures for Hot and Cold Applications

ELDERLY CONSIDERATION ON HEAT AND COLD THERAPY

Older people are unable to regulate their

body temperatures to the same degree as young
adults because their responses to changes in body
temperature are altered. When assessing body
temperature, it is important to take the age of the
patient into consideration. Also, the reference point
of 36.5 degrees C is inappropriate in older people,
especially when diagnosing a febrile illness.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 78

 Self-Check No. 4.2-2

HEAT AND COLD THERAPY PRINCIPLES AND USES

TRUE OR FALSE. Read the following statement carefully. Write TRUE if the
statement is correct and FALSE if it is incorrect. Write down
your answer on the space provided.

___________1. The temperature tolerance varies with individuals and according to the site and
area covered.

___________2. Cold Application should be applied when there is infected wound.

___________3. Tepid temperature is within 8.3℃ – 26.6℃ or 65℉-80℉.

___________4. Hot Application should be applied on open wounds.

___________5. Therapeutic uses of cold application reduce the body temperature.

___________6. Moisture left on the skin cause rapid cooling due to evaporation of the
moisture.

___________7. Water is good conductor of heat.

___________8. Therapeutic uses of heat decrease pain.

___________9. Friction does not produces heat.

___________10. Cold application should not be applied on clients who are in the stage of shock
and collapse

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 79

 Answer Key 4.2-2

GENERAL SCIENCE OF PAIN

1. TRUE
2. FALSE
3. FALSE
4. FALSE
5. TRUE
6. TRUE
7. TRUE
8. TRUE
9. FALSE
10. TRUE

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 80

 Information Sheet No. 4.2-3

APPROPRIATE HEAT AND COLD THERAPY TECHNIQUE

Learning objectives:

After reading this Information Sheet, YOU MUST be able to:

1. Discuss the rules for heat and cold application

2. Discuss the procedure for ice bag application on elderly
3. Perform ice bag application on elderly

SAFETY PRECAUTIONS FOR HEAT AND

COLD THERAPY APPLICATION

Even though heat and cold treatment may be quite

helpful, some safety measures should be followed
to ensure its efficiency. It is crucial to:

• Avoid using extreme heat or cold to avoid tissue damage or burns.

• To avoid skin irritation, provide a barrier between the skin and hot/cold packs, such as
a cloth or towel.

• To minimize extended exposure, keep therapy sessions to a reasonable length.

• If you have circulation problems or certain medical disorders, talk to a doctor before
utilizing heat or cold treatment.

• Observe the directions and recommendations offered with particular heat or cold
treatment products.

• Know the exact site of the application before applying them. Use a flannel cover
towel or other cover as directed.

• Know how long to leave the application in place. Heat and cold are applied no longer
than 15 to 20 minutes.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 81

 ICE CAP / ICE BAG APPLICATION

Definition: Ice cap/ ice bag application is a procedure done to provide cold anesthetic
effect on inflamed or edematous part of the patient’s body.

Purpose:
1. To relieve pain.
2. To limit inflammation and suppuration
3. To control bleeding

Steps Procedure Rationale

1 Gather all necessary equipment:
To facilitate ease of skill performance.
• Ice bag
• Ice cubes or crushed ice
• Flannel cover or other cover as directed
• Paper towels
• Small basin
• Bottle with water
• Ties, tape or rolled gauze
• Water proof pad
• Bath blanket
• Clean gloves (if needed)
• Hospital bed/sofa bed

2 Wash hands before starting the procedure. To cleanse hands from any pathogens
3 Identify the right client. Introduce yourself and To avoid doing the procedure to wrong
state the purpose of the procedure to be client. Introducing yourself will elicit
performed. the client’s trust and will be oriented to
the procedure that you are going to
perform.
4 Provide for client’s privacy This will save the client form
embarrassment while the caregiver do
the procedure.
5 Lower the side rails of the bed and position the Proper positioning will help the
client for the procedure caregiver to accomplish the procedure
faster and easier.
6 Assemble all the needed equipment within reach. For a continuous flow of procedure
and to avoid delay.
7 Test ice bag or ice cap for leakage. Fill the bag To avoid soiling the patient’s gown.
with water secure the cap, invert to check for
leaks, and pour out water; or Inflate ice bag or ice
cap, and press.
8 Fill the bag with small pieces of ice about 2/3 full. To make the bag light and to cover
enough ice for the procedure

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 82

9 Release any air from the ice bag or ice cap by Excess air interferes with conduction
squeezing its sides before securing the cap. of cold. Warm air causes ice to melt
rapidly.
10 Wipe off excess moisture. Excess moisture outside the bag or cap
increase evaporation, making the ice
melt more quickly.
11 Cover the ice bag or ice cap with a flannel cover, Prevents direct contact of the skin to
towel or pillowcase. the cold and acts as an insulator
making ice melt slowly and preserving
its coldness.
12 Apply the device and note the time This will help the caregiver keep track
on when to remove the application
13 Explain procedure to patient. Explanation gains patient’s
cooperation.
14 Pull curtain around the bed or close room door. To provide and maintain privacy.
15 Apply it on the specified area for 20-30 minutes To prevent the effect of prolonged
and remove the ice cap. Wait for one hour before exposure to cold
re- applying it if necessary.
Longer exposure to the cold
application may cause increased
vasoconstriction and hypothermia. It
may also cause injury and damage to
surrounding tissue due to extreme cold
and loss of blood supply.
16 Examine the area and record client’s response. This will signal the caregiver to notify
the nurse or whether the application
should be continued or stopped.
17 Leave the patient in a comfortable position. To promote patient’s well-being.
18 Raise side rails of the bed To prevent the patient from falling to
the side of the bed.
19 Clean the ice cap / ice bag. Hang it to dry or place To lessen moisture and to prepare for
on a tray turning it upside down without cover. the next use.
Return to its proper place.
20 Use clean gloves (if necessary) in handling soiled To avoid nosocomial infection.
linens. Remove and discard gloves after use.
21 Perform handwashing To prevent cross contamination.
22 Report and record your observation To document the procedure that are
done to the patient as well as its
effects.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 83

 Self-Check No. 4.2-3

APPROPRIATE HEAT AND COLD THERAPY TECHNIQUE

TRUE OR FALSE. Read the following statement carefully. Write TRUE if the
statement is correct and FALSE if it is incorrect. Write down
your answer on the space provided.

____________1. Always Perform handwashing to prevent cross contamination.

___________2. Do not cover dry heat or cold application before applying them.

___________3. Let the patient change the temperature of the application.

___________4. To minimize extended exposure., Never keep therapy sessions to a reasonable

length

____________5. To avoid skin irritation, provide a barrier between the skin and hot/cold
packs, such as a cloth or towel.

___________6. Observe the directions and recommendations offered with particular heat or
cold treatment products.

___________7. Know the exact site of the application before applying them. Use a flannel
cover towel or other cover as directed.

___________8. Know how long to leave the application in place. Heat and cold are applied no
longer than 15 to 20 minutes.

___________9. Always use extreme heat or cold to avoid tissue damage or burns.

___________10. When performing ice bag application always report and record your
observation to document the procedure that are done to the patient as well as
its effects.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 84

 Answer Key 4.2-3

APPROPRIATE HEAT AND COLD THERAPY TECHNIQUE

1. TRUE
2. FALSE
3. FALSE
4. FALSE
5. TRUE
6. TRUE
7. TRUE
8. TRUE
9. FALSE
10. TRUE

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 85

 JOB SHEET 4.2-3

Title: ICE CAP / ICE BAG APPLICATION

Performance Objective:
Given appropriate equipment, and materials relevant to the unit of competency, you should
be able to perform ice bag application following the standard for 1 hour.

Supplies/Materials:
Ice bag, Ice cubes or crushed ice, Flannel cover or other cover as directed, Paper
towels, Small basin, Bottle with water, Ties, tape or rolled gauze, Water proof pad,
Bath blanket, Clean gloves (if needed), Hospital bed/sofa bed

Equipement: hospital bed/sofa bed

Steps/Procedure:
1. Gather all necessary equipment:
2. Wash hands before starting the procedure.
3. Identify the right client. Introduce yourself and state the purpose of the procedure to
be performed.
4. Provide for client’s privacy
5. Lower the side rails of the bed and position the client for the procedure
6. Assemble all the needed equipment within reach.
7. Test ice bag or ice cap for leakage. Fill the bag with water secure the cap, invert to
check for leaks, and pour out water; or Inflate ice bag or ice cap, and press.
8. Fill the bag with small pieces of ice about 2/3 full.
9. Release any air from the ice bag or ice cap by squeezing its sides before securing
the cap.
10. Wipe off excess moisture.
11. Cover the ice bag or ice cap with a flannel cover, towel or pillowcase.
12. Apply the device and note the time
13. Explain procedure to patient.
14. Pull curtain around the bed or close room door.

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 86

 15. Apply it on the specified area for 20-30 minutes and remove the ice cap. Wait for
one hour before re- applying it if necessary.
16. Examine the area and record client’s response.
17. Leave the patient in a comfortable position.
18. Raise side rails of the bed
19. Clean the ice cap / ice bag. Hang it to dry or place on a tray turning it upside down
without cover. Return to its proper place.
20. Use clean gloves (if necessary) in handling soiled linens. Remove and discard
gloves after use.
21. Perform handwashing
22. Report and record your observation

Assessment Method:
Evaluate using Performance Criteria Checklist 4.2-3

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 87

 Performance Criteria Checklist 4.2-3
ICE CAP / ICE BAG APPLICATION

CRITERIA YES NO
Did know…
1. Gather all necessary equipment:
2. Wash hands before starting the procedure.
3. Identify the right client. Introduce yourself and state the
purpose of the procedure to be performed.
4. Provide for client’s privacy
5. Lower the side rails of the bed and position the client for the
procedure
6. Assemble all the needed equipment within reach.
7. Test ice bag or ice cap for leakage. Fill the bag with water
secure the cap, invert to check for leaks, and pour out water;
or Inflate ice bag or ice cap, and press.
8. Fill the bag with small pieces of ice about 2/3 full.
9. Release any air from the ice bag or ice cap by squeezing its
sides before securing the cap.
10. Wipe off excess moisture.
11. Cover the ice bag or ice cap with a flannel cover, towel or
pillowcase.
12. Apply the device and note the time
13. Explain procedure to patient.
14. Pull curtain around the bed or close room door.
15. Apply it on the specified area for 20-30 minutes and remove
the ice cap. Wait for one hour before re- applying it if
necessary.
16. Examine the area and record client’s response.
17. Leave the patient in a comfortable position.
18. Raise side rails of the bed
19. Clean the ice cap / ice bag. Hang it to dry or place on a tray
turning it upside down without cover. Return to its proper
place.
20. Use clean gloves (if necessary) in handling soiled linens.
Remove and discard gloves after use.
21. Perform handwashing
22. Report and record your observation
* Critical aspects of competency

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 88

 REFERENCES

1. https://www.sciencedirect.com/topics/medicine-and-dentistry/pain-in-elderly

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9345206/

3. https://europeanpainfederation.eu/what-is-pain/

4. https://www.curavi.com/blogs/all/lower-back-pain-7-causes-in-older-adults

5. https://hcalabtheoryandpractice.pressbooks.tru.ca/chapter/13-2/

6. https://link.springer.com/referenceworkentry/10.1007/978-3-540-89656-2_16

7. https://www.coursehero.com/file/90626813/Ice-Bag-or-Ice-Cap-Applicationdocx/

8. https://www.verywellhealth.com/how-to-ice-an-injury-2548842

9. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=134&cont
entid=95

10. https://www.linkedin.com/pulse/heat-cold-therapy-comprehensive-guide-pain-relief-
kiyash-healthcare

Date Developed: Document No.

Feb. 16, 2024 – April 23, 2024 Issued By:
CAREGIVING ELDERLY PHILIPPINE ACADEMY FOR TECHNICAL AND
Developed By:
VOCATIONAL SKILLS INC.
NCII GENESES ARO VILLACORTE

Developed By: GENESES A. VILLACORTE Competency Based Learning Material pg. 89