Unit of competency details

Descriptor 

This unit describes the knowledge and skills required by the worker to develop and implement support plans for clients with dementia in a variety of settings including family homes, community day settings and residential care

Application 

This unit applies to workers in a range of community service contexts working with people with dementia

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. Prepare to plan support requirements for people impacted by dementia

1.1 Demonstrate an understanding of dementia 

1.2 Identify current best practice in the support of people with dementia 

1.3 Assess physical, social and emotional aspects of the person's environment to determine how well it supports the person with dementia

1.4 Review the impact  that the dementia has on family carers and significant others

1.5 Identify signs consistent with financial, physical or emotional abuse or neglect of the client and appropriate response in line with organisation requirements

2. Plan support requirements

2.1 Plan for and facilitate activities  which aim to maintain independence and use familiar and existing skills and activities

2.2 Plan for and facilitate activities that are appropriate to the individual, reflecting their likes and dislikes to maximise their enjoyment

2.3 Plan for and facilitate activities that provide focus on ensuring the safety and comfort of the client  balanced with autonomy and risk taking

2.4 Plan for and facilitate activities that ensure the safety and comfort of the person 

2.5 Involve family carers and significant others, team members and volunteers appropriately as resources to assist in developing appropriate activities by accessing information about client reminiscences and routines

2.6 Identify and implement appropriate adaptations to the environment to support the person

2.7 Provide guidance and support to family carers and significant others, where appropriate, to assist their understanding of the disease, its impact on the person and some approaches to providing care

3. Develop and implement strategies which minimise the impact of behavioural and psychological symptoms of dementia

3.1 Observe and document behaviours to determine triggers which may be related:

• Physical and emotional health
• Environmental
• Tasks
• Communication
• Past history

3.2 Consider the potential impact of the behaviours on the person or other clients in determining an appropriate response

3.3 Consider a range of options when developing effective responses for inclusion in the client's care plan

3.4 Implement best practice strategies which minimise the impact of behaviours

3.5 Regularly review strategies that are implemented to ensure maximum effectiveness

4. Provide guidance and support workers and carers to implement plan

4.1 Assist workers and/or carers to understand the purpose of an individual's care plan and supports identified in it

4.2 Guide workers and/or carers to provide the support identified in the plan according to duty of care, ethical and legal requirements and in a manner that respects the person's self-esteem and dignity and maximises their participation

4.3 Guide workers and/or carers to provide the support identified in the plan in a manner that respects the person's preferences and history

4.4 Guide workers and/or carers, where appropriate to monitor progress against the plan

4.5 Evaluate ability of worker and/or carers to implement requirements of the individualised plan, including processes, procedures and the use of equipment

4.6 Monitor implementation of the plan and provide feedback and/or make revisions to care plan as required

4.7 Monitor self care ability of workers and carers and provide support and guidance where appropriate

5. Complete documentation

5.1 Comply with the organisation's reporting requirements

5.2 Complete documentation according to organisation policy and protocols

5.3 Maintain documentation in a manner consistent with reporting requirements

5.4 File documentation organisation policy and protocols

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

These include knowledge of:

• Nature of dementia as a neurological condition which is progressive
• Common indicators and symptoms of dementia
• Progression of dementia and potential impact on the person with dementia, their family and significant others
• Current research or dementia including relevant statistics
• Aspects of elder abuse, including:

• indications of neglect or abuse
• emotional impact of abuse
• appropriate management of abuse

• Support services available
• Plan of care for the clients
• Understanding of the principles of person-centred approach to care
• Organisation protocols and policies related to own area of work
• The importance of the physical, social and emotional environment for people with dementia
• Importance of relevant activities and communication in working with people with dementia
• Limitations and legal ramifications of physical, chemical and psychological restraint
• The range of appropriate strategies to be implemented when working with people with dementia
• Organisation reporting and record-keeping policy and procedures

Essential skills :

It is critical that the candidate demonstrate the ability to:

• Communicate effectively with clients with dementia
• Utilise creative, least restrictive approaches to behaviours of clients with dementia
• Assess environment and make changes that support the person

In addition, the candidate must be able 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

These include the ability to:

• Demonstrate a broad range of communication approaches e.g. reminiscences
• Establish and maintain a relationship that takes into account client and family individual differences (e.g. cognitive abilities, cultural background, language skills)
• Apply oral communication skills (language skills) and non-verbal communication skills (e.g. touch, smiling, gestures) necessary to develop a trusting relationship with a person who has dementia and their family
• Use communication techniques to enhance communication and facilitate client's interaction within their environment
• Adapt activities to meet individual needs
• Demonstrate cultural sensitivity
• Undertake observation and analysis of client needs
• Respond appropriately to indications of neglect or abuse
• Provide training to staff and family members
• Maintain records according to organisation policy and procedures

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 unit of competency :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• This unit is most appropriately assessed in the workplace under the normal range of workplace conditions but partial assessment could be undertaken under simulated conditions
• Assessment may include observations, questioning and evidence gathered from the workplace on more than one occasion
• 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

Access and equity considerations :

• All workers in community services should be aware of access, equity and human rights 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 issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on 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 Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment :

• This unit can be assessed independently, however holistic assessment practice with other community services units of competency is encouraged
• Resources required for assessment include:

• access to appropriate workplace where assessment can take place

Method of assessment :

• In cases where the learner does not have the opportunity to cover all relevant aspects in the work environment, the remainder should be assessed through realistic simulations, projects, previous relevant experience or oral questioning on 'What if?' scenarios
• Assessment of this unit of competence will usually include observation of processes and procedures, oral and/or written questioning on Essential knowledge and skills and consideration of required attitudes
• Where performance is not directly observed and/or is required to be demonstrated over a 'period of time' and/or in a 'number of locations', any evidence should be authenticated by colleagues, supervisors, clients or other appropriate persons

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.

Understanding of dementia may include :

• Knowledge of different manifestations of dementia, including:

• Alzheimer's disease
• Huntington's disease
• Pick's disease
• Vascular dementia

• Basic understanding of pathological features, including

• Amyloid plaques
• Neurofibrillary tangles
• Loss of connection between cells and cell death

• Advances in research

Impacts of dementia on family carers and significant others may include 

• Depression
• Loss and grieving
• Anger
• Despair
• Social embarrassment a family member might feel
• Isolation
• Financial burden on the family

Significant others may include 

• Spouse
• Family
• Friends

Strategies to respond to behaviours of concern may include :

• Distraction
• Current events
• Reminiscences
• Music, dancing
• Walking
• Talking reassuringly about familiar and favourite topics
• Behaviour modification (if appropriate)
• Addressing physical triggers to behaviour including pain and constipation, urinary tract infections
• Alternative therapies

Activities include :

• Daily living activities such as:

• Maintaining personal safety
• Communication (speech, writing, non-verbal communication)
• Eating and drinking
• Mobilising and transferring (moving from place to place and position to position)
• Attending to personal hygiene (bathing, laundering personal linen)
• Dressing and undressing
• Attending own spiritual needs
• Grooming
• Expressing sexuality

Instrumental activities such as :

• Accessing financial resources and allowances
• Paying bills and regular outgoings
• Shopping
• Preparing meals
• Climbing stairs
• Maintaining household (cleaning, laundry, décor, repairs)
• Travelling by private and public transport
• Interacting with others and socialising
• Accessing leisure, recreational and sporting activities
• Recreational and sporting activities
• Craft and creative activities
• Socialising
• Reminiscing activities
• Spiritual activities

Ensuring the safety and comfort of client while addressing the risks associated with :

• Ability to find their own way
• Ability to negotiate traffic
• Wandering or other behaviours relating to agitation
• Behaviours relating to psychotic experiences or mood disorders
• Ability to safely prepare, cook and store food and drink
• Ability to control temperature of water
• Ability to use home appliances
• Ability to maintain personal and home security
• Ability to manage own finances
• Ability to recognise dangers in their environment
• Ability to recognise the safety of others

Environmental strategies may include :

• Orientation to day, date, time of day, place, person, carer, family relationships, weather
• Adequate lighting to decrease risk of misinterpreting their environment
• Manipulate stimuli such as activity, noise, music, lighting, decor
• Provision of space (to pace, wander)
• Security
• Safe storage of toxic chemicals

Behaviours of concern :

Refer to:

• Changed behaviour or
• BPSD (Behavioural and Psychological Symptoms of Dementia)

And may include but are not limited to:

• Physical aggression
• Social withdrawal
• Verbal disruption
• Repetitive actions or questions
• Resistance to personal care
• Sexually inappropriate behaviour
• Refusal to accept services
• Problems associated with eating
• Socially inappropriate behaviour
• Wandering or intrusiveness
• Sleep disturbances