Unit of competency details

Descriptor 

This unit of competency describes the skills and knowledge required to provide therapeutic support services for clients and carers who are facing life-challenging conditions

Application 

This unit applies to work in a range of health settings where health services are provided with direct client contact involved

Application of this unit should be contextualised to reflect any specific workplace requirements, issues and practices

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Demonstrate awareness of life challenging conditions

1.1 Discuss the nature and impacts of a range of life threatening conditions 

1.2 Review current approaches to treatment/care

1.3 Discuss mainstream and complementary health approaches to management of life challenging illnesses

1.4 Discuss the stages of death and dying and the grief cycle

1.5 Discuss the principles and aims of a palliative approach 

1.6 Identify psychosocial factors  which may effect quality of life

1.7 Identify physical factors  arising from the disease and treatment process which may effect quality of life

1.8 Identify cultural factors  which may effect quality of life

1.9 Identify practical and financial factors  which may effect quality of life

2. Demonstrate knowledge of support resources  for client and careers

2.1 Recognise the importance of support persons and resources

2.2 Outline the scope of and utilisation of available resources

2.3 Promote client access to individualised information

3. Develop a care/treatment plan

3.1 Gather and record data for inclusion in care plan

3.2 Conduct physical examination if relevant/appropriate

3.3 Use knowledge of relevant complementary and alternative health care modality to identify an appropriate care/treatment plan

3.4 Take into account factors which may interfere with the effectiveness of the care/treatment for each

3.5 Take into account possible care/treatment reactions and contra-indications

4. Review factors effecting client wellbeing

4.1 Recognise the impact of diagnosis of a life challenging illness

4.2 Explain the stages of the healing process

4.3 Explain the fundamentals of supportive care

4.4 Awareness of possible limitations of the client resources

4.5 Support clients capacity to choose treatment /care options  that effect wellbeing

5. Communicate need for acute intervention

5.1 Understand the importance of timely intervention

5.2 Identify changes in client condition

5.3 Identify need for intervention

5.4 Communicate changes in client condition to carers where appropriate/relevant

5.5 Communicate need for additional or other intervention

5.6 Refer to other health professionals where appropriate

6. Empower the client to discover and utilise their inner resources

6.1 Respect client treatment choices

6.2 Employ conscious language

6.3 Demonstrate the use of silence, inner and outer

3.4 Create therapeutic healing space

6.5 Awareness of the transformational potential of the healing process

7. Evaluate services/treatment

7.1 Build and maintain a relationship of trust with the client, with active promotion of and strict adherence to confidentiality

7.2 Undertake monitoring of client health in line with plan of care

7.3 Question client/carer to ascertain their level of comfort and compliance with the treatment

7.4 Ascertain degree of improvement or changes in the client's condition and compare with expectations in the plan of care

7.5 Provide client with clear information about their level of improvement in relation to their plan of care

7.6 Assess and review of treatment as required

7.7 Document progress according to requirements

7.8 Evaluate impact of ongoing treatment in relation to client's physical, mental and emotional condition and behaviour

7.9 Encourage clients to maintain their health by active involvement in their treatment and plan of care

7.10 Consult with other treatment practitioners as necessary and appropriate

8. Demonstrate a commitment to self care

8.1 Own emotional responses  to death and dying are identified, reflected upon, issues raised and discussed with supervisor and/or other appropriate person

8.2 Potential impact of personal responses on self and others is acknowledged and actioned as appropriate

8.3 Demonstrate strategies for self care  including debriefing

8.4 Identify the need for additional assistance and emotional support

8.5 Identify practitioner/ client boundary issues

8.6 Identify conflict between professional demands and personal and family commitments

8.7 Demonstrate ability to process ethical  and moral dilemmas

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• A broad range of life challenging conditions and their implications
• Broad knowledge of other complementary and alternative health care treatments able to be used in the treatment of life challenging illness
• Broad knowledge of possible mainstream treatments being used to treat life challenging illnesses
• Detailed knowledge of therapies/treatment and/or care strategies used by the complementary and alternative health care modality being delivered
• Emergency care and first aid procedures
• Health care professionals/services locally, nationally, and internationally and of their relationship to other professions and organisations
• Health terminology
• Legal requirements for practice
• Occupational health and safety procedures
• Possible contraindications and interactions with other treatments
• Principles of confidentiality
• Relevant codes of practice
• The death and dying and grief cycle
• The special characteristics and strengths of supportive care.
• Understanding of psychophysical and psychosocial implications of trauma and life challenging illnesses
• Understanding of the nature of living and dying

Essential skills :

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Appropriately record details of client treatment according to clinic guidelines
• Communicate effectively with clients and colleagues
• Communicate in an appropriate manner considering age, ethnicity, gender, medical condition and social situation
• Consult colleagues for special expertise
• Correctly identify client information needs
• Demonstrate appreciation of the relative merits of the options available in regard to cost, benefit and availability of resources
• Demonstrate communication and negotiation skills
• Determine appropriate action to take on the basis of client's condition and identified needs
• Determine the meaning and significance of information given by the client
• Explain relevant services
• Give palliative treatment/care honestly and with compassion and respect for the individual and carers
• Give specific care according to the age and gender and specific care needs of the client
• Identify appropriate avenues for referral support
• Identify treatment/care options and establish treatment/care regimes
• Maintain professional boundaries throughout the progression of the condition
• Negotiate strategies to overcome any obstacles to cure
• Practise self care
• Prepare treatment plans
• Provide client with required information
• Provide treatment/care
• Read and interpret medical reports and other data relevant to the case
• Recognise conditions that may pose a serious risk to the client and to know when to seek immediate help or advice from other professional sources
• Refer to other health professionals if relevant
• Reflect upon own practice
• Support clients, carers in trauma, grief and loss
• Use interpersonal and questioning skills
• Use problem solving processes
• Work in a way that demonstrates an understanding of underpinning values of supportive care

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of workplace performance is essential for assessment of this unit
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
• Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
• Assessment of sole practitioners must include a range of clinical situations and different client groups covering at minimum, age, culture and gender
• Assessment of sole practitioners must consider their unique workplace context, including:

• interaction with others in the broader professional community as part of the sole practitioner's workplace
• scope of practice as detailed in the qualification and component competency units
• holistic/integrated assessment including:
• working within the practice framework
• performing a health assessment
• assessing the client
• planning treatment
• providing treatment

Context of and specific resources for assessment :

• An appropriately stocked and equipped clinic or simulated clinic environment
• Relevant resource and information material
• Relevant paper -based/ video assessment material
• Qualified assessors

Method of assessment 

• Observation in the work place (if possible)
• Written assignments/projects or questioning should be used to assess knowledge
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
• Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Related units :

• This unit should be assessed in conjunction with competency unit(s) related to planning/delivery of the specific complementary and alternative health care service being undertaken

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Range of life threatening conditions :

• Cancer
• Illnesses where it is expected that death will be a direct consequence of the specified illness. This definition is inclusive of both a malignant and non-malignant illness. Life limiting illnesses might be expected to shorten an individual's life expectancy (Draft Standards for Providing Quality Palliative Care to all Australians. PCA November 2004).

Palliative approach services include :

• Assisting in the psychological, cultural and spiritual aspects of care for the client
• Identify the clients, family and carer as the unit of care
• Maintaining the client's dignity
• Maximising self-care and self-determination for the client
• Participating in a team approach to address the needs of clients, families and carers ensuring a palliative approach
• Practice reflects an understanding of the impact of a palliative approach in an organisation
• Practice that reflects an understanding of the aims of a palliative approach
• Providing support for clients, family, worker and carer using a palliative approach
• Recognising symptoms of pain, discomfort and other symptoms and the clients need for pain relief
• Recognising the signs that death may be imminent
• Seeking advice from appropriate person e.g. supervisor, team leader or palliative care team
• Understanding the needs of clients approaching end-of-life

Support resources may include 

• Family and community resources
• Financial resources
• Inner resources
• Time resources

Strategies for self care may include :

• Accessing additional for emotional support
• Health care treatment
• Professional supervision
• Respite from the demands of displaying warmth and empathy towards others
• Self monitoring and reflection
• Support for negotiating moral dilemmas
• Support for personal and spiritual growth

Worker emotional responses may include :

• A range of emotions that may be demonstrated or displayed as a response to the process of loss and grief, for example:

• crying and feelings of sadness
• fear, anger, silence and may appear singularly or together and prolong the workers own grief
• poor concentration

Client need may include 

• Acute medical intervention
• Comfort
• Cultural and spiritual supports
• Emotional supports
• Pastoral care
• Personal care and hygiene
• Personal supports and relationships.
• Sexuality and Intimacy supports
• Social activities.

Treatment and support options may include 

• Family, friends, community, workplace
• Financial
• Intellectual,
• Time resource

Psychosocial factors affecting quality of life may include 

• Anxiety, depression, PTSD, risk of suicide
• Body image, self-concept and sexuality
• Denial of condition
• Family, social and workplace support
• Fear and stress experienced by family members, barriers to clients
• Gender issues
• Self concept and body image
• Sexuality issues
• Social impairment

Physical factors arising from disease and treatment process affecting quality of life may include :

• Bowel problems
• Cognitive problems
• Devitalisation
• Disfigurement
• Fatigue
• Incontinence
• Lymphedema
• Malnutrition
• Nausea and vomiting
• Odour
• Oral symptoms
• Pain
• Pregnancy, lactation and fertility issues
• Respiratory problems
• Sleep problems
• Stage of life issues

Cultural factors effecting quality of life may include 

• Communication
• Cultural sensitivities about diagnosis and treatment
• Knowledge of interpreter services
• Language barriers

Practical and financial factors affecting quality of life may include 

• Access to treatment and resources
• Costs associated with diagnosis and treatment, supportive therapies, prostheses, and aids
• Costs associated with travel and accommodation
• Discrimination with regard to insurance, business dealings, access to loans
• Geographical location isolation
• Loss of income

Strategies for self care may include 

• Access intervention if needed
• Attention to nutrition, adequate sleep and exercise
• Context for personal and spiritual growth
• Professional supervision
• Reflective practice

Ethical issues may include :

• Conflict between the client's and/or family's wishes and/or practitioner feelings
• Conflict that may occur in relation to personal values and decisions made by or for the client
• Decisions regarding medical treatment