In this section of the module, we will concentrate on ensuring timely reporting of any changes in your client's health conditions and addressing behaviours of concern effectively. Additionally, we will explore the importance of complying with infection control and prevention policies and procedures to maintain a safe and healthy environment for residents and staff.
In this course, we have covered essential topics, including common health conditions, conducting observations, and implementing care plans to address changes in the health of individuals under your care.
You already grasp the significance of closely monitoring your client's condition and promptly reporting any changes to the care team. This encompasses changes in physical and mental health, shifts in behaviour or mood, and any other concerns that may arise.
Take a moment to review the modules and topics below to refresh your understanding of changes in health conditions. This will help you with the learning in this module.
- Review the symptoms of diseases in aged care in module 1.
- Refresh your understanding of dementia in module 3, including the signs and indicators of dementia and behaviours of concern.
- Review complex needs and comprehensive care assessments in module 4.
- Take a fresh look at performing routine observations in module 5.
No one expects you to understand the full range of diseases or conditions that might affect the people you support. However, it is important that you can look for and report changes in health and well-being. Such changes might indicate that the person is unwell or needs additional support or referral to another health provider.
Signs that a person might be experiencing illness or that they are at risk of poor health include:
- Pain or discomfort, especially if it is ongoing.
- Sudden signs of confusion.
- A high temperature or feeling hot and sweaty for no good reason.
- Nausea and vomiting.
- Dizziness or weakness.
- Rashes, redness or other skin problems.
- Pale or flushed skin.
- Changes in the person’s physical abilities.
- Withdrawal or depression.
When working with someone with complex needs, support workers must recognise and respond to sudden changes in health conditions. Here are some more specific sudden changes, along with their potential indicators and what they might indicate:
Indicators: Rapid onset of aggressive behaviour, increased restlessness, or heightened irritability.
Potential Indication: It might indicate pain, discomfort, or an unmet need, especially for individuals who may have difficulty communicating verbally.
Indicators: Sudden difficulty breathing, rapid or shallow breaths, or increased use of accessory muscles for breathing.
Potential Indication: It could signify respiratory issues, aspiration, or an allergic reaction, requiring immediate attention.
Indicators: Sudden loss of consciousness or fainting.
Potential Indication: It could be indicative of various underlying issues such as low blood sugar, dehydration, or cardiac concerns.
Indicators: Sudden confusion, disorientation, or significant deterioration in cognitive function.
Potential Indication: It might signal an acute medical issue, infection, or neurological event requiring urgent assessment.
Indicators: Sudden onset of convulsions, muscle spasms, or altered consciousness.
Potential Indication: It may suggest a seizure disorder or an underlying medical condition requiring immediate intervention.
Indicators: Rapid changes in blood pressure, heart rate, or temperature.
Potential Indication: It may signal a medical emergency, such as sepsis or cardiovascular issues, necessitating urgent medical attention.
Indicators: Abrupt expressions of severe pain, grimacing, or protective behaviours.
Potential Indication: It could indicate a sudden injury, worsening of an existing condition, or an acute medical problem.
Indicators: Unexpected loss of bowel or bladder control.
Potential Indication: It may be a sign of an infection, gastrointestinal issue, or neurological change, requiring prompt assessment.
Activity - Drop and Drag
Signs that a person might be experiencing illness or that they are at risk of poor health include:
- Pain or discomfort, especially if it is ongoing
- Sudden signs of confusion
- A high temperature or feeling hot and sweaty for no good reason
- Nausea and vomiting
- Dizziness or weakness
- Rashes, redness or other skin problems
- Pale or flushed skin
- Changes in the person’s physical abilities
- Withdrawal or depression.
Your organisation will have a system for reporting these and other signs of illness. If you have concerns, report them immediately because some signs and symptoms can indicate a serious health problem.
You will also need to document the person’s signs and symptoms carefully. Documentation helps to support your verbal report and can help to ensure that the information is passed on correctly to others, such as health professionals.
Activity - Scenario
Read the following scenario and answer the three questions below.
In the dedicated care environment of Evergreen Gardens, Eric, a committed support worker, is entrusted with the well-being of Mr. Tairua, a 78-year-old resident with complex health needs.
During Eric's routine morning check, an unexpected shift in Mr. Tairua's demeanour catches his attention. Mr. Tairua appears visibly uncomfortable, guarding his left leg. Eric recognises sudden expressions of severe pain, signalling a potential health concern.
Upon closer inspection, Eric discovers a new wound on Mr. Tairua's left leg. The site is red, swollen, and emits a foul odour – potential indicators of infection. Acting swiftly, Eric reports his findings to the healthcare team, emphasising the need for immediate attention to prevent the infection from worsening.
While awaiting the healthcare team, Eric diligently monitors Mr. Tairua's vital signs, noting a low-grade fever and a slight elevation in heart rate. Eric converses with Mr. Tairua, asking questions about the wound and his overall feelings.
Upon the healthcare team's arrival, they conduct a thorough assessment, perform additional tests, and prescribe antibiotics to address the infection. Eric meticulously documents his observations in Mr. Tairua's notes and discusses his findings with the healthcare team.
In the subsequent days, Eric consistently monitors Mr. Tairua's health condition. The wound shows improvement, with reduced redness and swelling. Eric maintains close collaboration with the healthcare team, promptly reporting any changes and providing ongoing support to Mr. Tairua on the path to recovery.
Experiencing behaviours of concern in a care setting can be emotionally distressing for everyone involved. These behaviours often serve as indicators that something is amiss, suggesting an unmet need that the individual struggles to communicate clearly. Such behaviours may manifest as signs of worry, fear, or frustration.
In Module 3 of your dementia training, you explored behaviours of concern. To revisit and reinforce your understanding, please take a moment to watch the accompanying video and respond to the provided questions.
Activity - Watch
Watch the short video below (1:00) and answer the questions that follow.
What to do if you experience behaviours of concern as a support worker.
Responding to challenging behaviours requires a thoughtful and person-centred approach. Here are some guidelines:
- Remain Calm: Stay composed and maintain a calm demeanour to help diffuse tension.
- Identify Triggers: Understand potential causes for the behaviour, such as pain, discomfort, or unmet needs.
- Effective Communication: Use clear and simple language and actively listen to the individual's concerns.
- Seek Support: Collaborate with your team, seeking advice from experienced colleagues or supervisors.
- Document Incidents: Keep detailed records of behaviours, triggers, and interventions to facilitate ongoing care planning.
Remember, addressing challenging behaviours requires ongoing observation, assessment, and collaboration with the care team to ensure the well-being of the individuals under your care.
Activity - Watch
Watch this ‘Simulation Scenario – Dementia Care Aggression’ video (7:00) and note down ways in which the care professionals manage the resident’s challenging behaviour.
Reflecting on your experiences is a valuable way to enhance your understanding and skillset as a support worker in aged care. Please take a moment to share your insights on behaviours of concern in the challenging behaviour forum thread. You may help other support workers learn valuable ways to respond to challenging behaviours.
Activity: Forum
Use these questions to prompt your reflections in the forum.
1. Can you recall a specific instance where you encountered challenging behaviour in your role as a support worker? Please provide a brief description of the situation and share any emotions or challenges you faced.
2. What effective procedures or strategies have you learned, either through training or experience, to address behaviours of concern? How did you apply these techniques in the situation you mentioned?
As support workers, you are aware of the critical importance of infection control, particularly when caring for vulnerable clients. In your daily work, you will follow the infection prevention and control policies and procedures established by your workplace. These policies are designed to create a safe and hygienic environment for residents and staff. In addition to workplace guidelines, we will investigate Te Whatu Ora, Health New Zealand's specific guidance for infection control of pathogens.
Activity - Drag and Drop
Firstly, let’s review the ways in which infections can be transmitted and the different causes of infections.
Activity - Quiz
Te Whatu Ora, Health New Zealand – Infection prevention and control
New Zealand Health, Te Whatu Ora serves as a foundational guide for health professionals, including those in advanced care settings, to manage and control infections effectively. It encompasses standard precautions for preventing the spread of pathogens and maintaining a safe environment for residents and staff.
Standard Precautions
Standard Precautions are a set of routine infection prevention and control practices used to prevent transmission of diseases associated with healthcare.
Standard Precautions should be used for all patient/client care activities, regardless of their diagnosis or suspected infectious status. This helps to protect healthcare workers from infection and prevents the spread of infection from patient to patient.
Before any patient interaction, all healthcare workers should also assess the infectious risks posed to themselves, their colleagues, other patients and visitors.
The key elements of Standard Precautions are as follows:
- Hand hygiene
- PPE
- Respiratory hygiene and cough etiquette
- Aseptic ‘non-touch’ technique
- Patient care equipment
- Appropriate cleaning and disinfection
- Safe waste management
- Safe handling of linen.
(Infection Prevention and Control – Te Whatu Ora - Health New Zealand, n.d.)
Activity - Reflection
Infection Prevention and Control Guidance
To deepen your understanding of infection prevention and control in advanced care settings, let’s explore the specific guidance provided by New Zealand Health, Te Whatu Ora. Follow the steps below:
- Go to the New Zealand Health, Te Whatu Ora website.
- Navigate to Infection Prevention and Control Guidance.
- Read the specific guidance provided for the prevention and control of different infectious diseases, including Candida auris, Norovirus and Vancomycin-Resistant Enterococci (VRE).
- Complete the following activity using the information you gather from the website.
Activity - Specific guidance for Candida auris
Choose the correct answer(s) for the following questions:
Activity - Specific guidance for Norovirus
Activity - Specific guidance for Vancomycin Resistant Enterococci (VRE)
Choose the correct answer for the following questions:
