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November 2021
Health Care Assistant Program Supplement to the Provincial Curriculum Guide (2015) - Third Edition by Province of British Columbia is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License, except where otherwise noted.
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Ebook ISBN: 978-1-77420-148-0
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Visit BCcampus Open Education to learn about open education in British Columbia.
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The web version of Health Care Assistant Program Supplement to the Provincial Curriculum Guide (2015) has been designed with accessibility in mind by incorporating the following features:
In addition to the web version, this book is available in a number of file formats including PDF, EPUB (for e-readers), MOBI (for Kindles), and various editable files. Here is a link to where you can download the guide in another format. Look for the “Download this book” drop-down menu to select the file type you want.
Those using a print copy of this resource can find the URLs for any websites mentioned in this resource in the footnotes.
While we strive to ensure that this resource is as accessible and usable as possible, we might not always get it right. Any issues we identify will be listed below.
The web version of this resource has been designed to meet Web Content Accessibility Guidelines 2.0, level AA. In addition, it follows all guidelines in Accessibility Toolkit: Checklist for Accessibility. The development of this toolkit involved working with students with various print disabilities who provided their personal perspectives and helped test the content.
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The first Health Care Assistant Program Provincial Curriculum 2015 Supplement, released in August 2015, was produced to support the delivery and assessment of the required learning outcomes and course content set out in the Health Care Assistant Program Provincial Curriculum 2015. The third edition of the supplement was completed in November 2021 to ensure that materials and resources are current and reflective of educator and workforce needs. This edition, now called the Health Care Assistant Program Supplement to the Provincial Curriculum (2015), Third Edition, November 2021, (the Supplement) continues to be a supplement for the Health Care Assistant Program Provincial Curriculum 2015.
This third edition of the Supplement has been influenced by the changing health care context in British Columbia. In September 2020, the Premier released the B.C. Economic Recovery Plan announcing that thousands of new health care workers would be hired to help manage the response to the global COVID-19 pandemic and to ensure seniors get the quality care they need and deserve.Government of British Columbia. (n.d.). Stronger B.C. for Everyone: B.C.’s Economic Recovery Plan, p. 17. https://news.gov.bc.ca/files/StrongerBC_BCs-Economic-Recovery-Report.pdf) The Health Career Access Program was established to provide “a path for applicants with no health care experience to get hired and receive on-the-job training.”Government of British Columbia. (n.d.) Work in the Health Care Sector. (https://www2.gov.bc.ca/gov/content/covid-19/economic-recovery/work-in-health-care). The Ministry of Health and the Ministry of Advanced Education and Skills Training strategized on ways to introduce approximately 3,000 additional Health Care Assistants into the B.C. health care system. The Health Care Assistant Partnership Pathway (HCA-PP) project was born, enabling health authorities to hire Health Care Support Workers (HCSWs) to serve in a non-direct resident/patient/client care role in the long-term care or assisted living facilities where they were hired. Health authorities would partner with post-secondary institutions to enrol these HCSWs into HCA programs. The HCSWs would commit to attending an HCA program and their tuition and most educational expenses would be covered.
A Clinical Instruction Working Group of the HCA-PP project explored many strategies to help the project be successful. Considering the need to educate an additional 3,000 HCAs, there will also be a need to hire, orient, and support many new clinical instructors. Many of the strategies discussed by the Clinical Instruction Working Group involved augmenting current resources to support new and existing clinical instructors.
BCcampus was contracted in January 2021 to support the development of new resources as follows:
The above work was initiated with the distribution of an HCA Resources Environmental Scan to all approved post-secondary institutions in B.C.:
The Environmental Scan was sent to 38 HCA programs in B.C. and 32 programs responded (84% response rate).
An Advisory Committee was established to oversee the project and three working groups were created:
All amendments to the third edition are outlined in the Revisions Summary Table.
Note: The third edition has kept the many changes and additions that were made for the second edition, including the debate topics, research activities, role play/critical thinking activities, and case scenarios. The unfolding case study is still integrated throughout the third edition to emphasize concepts related to caring within each course, and resources are still formatted to support instructional delivery and student distribution. This edition also includes the standardized templates and sample evaluation tools that educators can adapt to support theory, lab, and clinical evaluation.
Using the Materials in the Supplement
Educational institutions delivering the Health Care Assistant Program may already have effective teaching and learning methodologies and assessment mechanisms in place. The resource material within the Supplement provides recommended activities, resources, and assessments and is not considered to be comprehensive. It should be noted that given the open licensing of the Supplement under Creative Commons, material within this document may be revised, remixed, and shared as long as attribution is given to the copyright holder, the Province of British Columbia; changes to the source material are noted and the adaptations are licensed with the same license. To streamline educator use, where student handouts are provided, attribution to the source has also been supplied.
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The following table provides an overall summary of the revisions.
Third Edition Updates |
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Updated Introduction and the Third Edition Revisions Summary Table. |
Updated the Recommended B.C. Program Textbooks list. |
Updated the Resources section for all courses in Section 1. The Online Resources and Online Learning Tools sections were updated: new resources were added, out-of-date resources were removed, and all broken links were updated. An extensive Online Videos section was also added to the Resources for all the courses. |
Added a new section called Self-Assessment Video Scenarios to the Healing 3: Personal Care and Assistant course. This section includes links to five video scenarios for students to watch to prepare for their practice experiences. The videos focus on the following topics:
|
Changed title of Section 3 from Additional Content to Additional Content in Acute Care. |
Added a new Section 4 called Preceptor and Clinical Instructor Orientation Tools. The new Section 4 contains links to these tools, which are available for download as Word or PDF files. |
Changed the title of Section 4: Sample Tools to Section 5: Sample Evaluation Tools. |
Updated the Acknowledgements. |
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The following individuals, organizations, and groups are gratefully acknowledged for their contributions to the HCA Program Supplement to Provincial Curriculum (2015), third edition, November 2021.
Thanks are also due to the many people who contributed to the HCA Resources Environmental Scan, which helped update the Resources and inform the Advisory Group on topics to cover in the self-assessment videos.
Jocelyn Bergeron, College of New Caledonia
Lisa Beveridge, Vancouver Community College
Sarina Corsi, B.C. Care Aide and Community Health Worker Registry
Kim Fraser. Vancouver Island University
Jackie Godia, Stenberg College
Angela Goltz, Ministry of Advanced Education and Skills Training
Edith Kirkpatrick, Douglas College
Sarah Lechthaler, Selkirk College
Sharon Leitch, Kwantlen Polytechnic University
Joanne Maclaren, Ministry of Health
Nadja Matheson, Capilano University
Dawna Williams, University of the Fraser Valley
Heather Frame, Camosun College
Kristi Jukes, Discovery College
Chantal Lortie, Selkirk College
Sophia Mattioli, College of New Caledonia
Kim Morris, Thompson Rivers University
Lara Williams, B.C. Care Aide and Community Health Worker Registry
Elena Zenzerova, Discovery College
Jocelyn Bergeron, College of New Caledonia
Lynnette Fleury, Thompson Rivers University
Fe Patricia Forteza, Vancouver Career College/CDI
Sarah Lechthaler, Selkirk College
Hadiah Mizban, B.C. Care Aide and Community Health Worker Registry
Sonayna Rana, Kwantlen Polytechnic University
Lisa Beveridge, Vancouver Community College
Sarina Corsi, B.C. Care Aide and Community Health Worker Registry
Lorraine Guild, Kwantlen Polytechnic University
Sarah Lechthaler, Selkirk College
Nadja Matheson, Capilano University
Kim Morris, Thompson Rivers University
Note: It was decided that test banks would be reconsidered once the HCA Curriculum is updated.
Robynne Devine, Project Manager, BCcampus
Barbara Johnston, Writer and Editor
Declan Robinson Spence, Program Coordinator, BCcampus
Debbie Sargent, Project Consultant
Liz Warwick, Instructional Designer
Kaitlyn Zheng, Pressbooks Coordinator, BCcampus
This was funded by the Government of British Columbia.
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This section includes suggested learning strategies, case studies, approaches to assessment, and resources that can be used to enhance student learning for each HCA course. A comprehensive list of recommended HCA program textbooks has been compiled and included in this section as well.
For each course in the HCA Curriculum Guide (2015), this section includes:
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Textbooks listed could be used for specific HCA program courses or serve as overall program texts. Preference has been given to Canadian editions and those with online ancillary resources. In addition, a number of the textbooks listed are available online through BCcampus as open educational resources.
Adams, C., & Jones, P. H. (2010). Therapeutic communication for health professionals (3rd ed.) McGraw-Hill.
Adler R. B., Rosenfeld, L. B., Proctor, R. F., & Winder, C. (2012). Interplay: The process of interpersonal communication (3rd Canadian ed.). Oxford University Press.
Beebe, S. A., Beebe, S. J., Redmond, M. V., & Salem-Wiseman, L. (2017). Interpersonal communication: Relating to others (7th Canadian ed.). Pearson Canada.
Betts, J. G., Young, K. A., Wise, J. A., Johnson, E., Poe, B., Kruse, D. H., Korol, O., Johnson, J. E. Womble, M., & DeSaix, P. (2016). Anatomy and physiology. OpenStax. https://openstax.org/details/books/anatomy-and-physiology
Blackmore, T. (2020). Community palliative care and COVID-19: A handbook for clinicians who care for palliative patients with COVID-19 in community settings. Class Publishing.
Carr, E. & Mizock, L. (2021). Women with serious mental illness: Gender sensitive and recovery-oriented care. Oxford University Press.
Christie, J., (2020). Promoting resilience in dementia care: A person-centred framework for assessment and support planning. Jessica Kingsley Publishers.
Devereaux Ferguson, S., & Lennox Terrion, J. (2014). Communication in everyday life: Personal and professional contexts. Oxford University Press.
Donatelle, R., Chow, A., & Kolen-Thompson, A. (2017). Health: The basics ((7th Canadian ed.). Pearson Education, Inc.
Doyle, R. G., & McCutcheon, J. A. (2016). Clinical procedures for safer patient care. BCcampus. https://opentextbc.ca/clinicalskills/
Elsevier Inc. (2020). Job readiness for health professionals: Soft skills strategies for success (3rd ed.). Elsevier.
Jones, M. (2007). Gentlecare: Changing the experience of Alzheimer’s disease in a positive way (2nd ed.). Moyra Jones Resources Ltd.
Lidstone, R. & Camosun College. (2016). Line B: Employability skills competency B-3– Use interpersonal communication skills. ECampusOntario. https://openlibrary-repo.ecampusontario.ca/xmlui/handle/123456789/319
Lowey, S. E. (2015). Nursing care at the end of life [Open Textbook]. Open SUNY Textbooks. https://milnepublishing.geneseo.edu/nursingcare/
Melrose, S., Dusome, D., Simpson, J., Crocker, C., & Athens, E. (2015). Supporting individuals with intellectual disabilities and mental illness: What caregivers need to know. BCcampus. https://opentextbc.ca/caregivers/
Melrose, S., Park, C., & Perry, B. (2015). Creative clinical teaching in the health professions. Athabasca University. http://solr.bccampus.ca:8001/bcc/file/c6d0e9bd-ba6b-4548-82d6-afbd0f166b65/1/CREATIVE-CLINICAL-TEACHING-IN-THE-HEALTH-PROFESSIONS.pdf
Murray, K. (2014). Integrating a palliative approach: Essentials for personal support workers (2nd ed.). Life and Death Matters.To support B.C. HCA educators in adopting this textbook (and accompanying workbook), the author has prepared and published a resource map [http://lifeanddeathmatters.ca/for-educators-2/mapping-documents/] that outlines how a palliative approach could be integrated across the B.C. HCA Provincial Curriculum (2015).
Nightengale, D. J. (2020). The pocket guide to mouth and dental hygiene in dementia care: Guidance for maintaining good oral health. Jessica Kingsley Publishers.
Nouwen, H. (2011). A spirituality of caregiving. Upper Room Books.
Richards, C. (Ed.) (2020). Living well with dementia through music: A resource book for activities providers and care staff. Jessica Kingsley Publishers.
Schachter-Shalomi, Z. & Miller, R. (1997). From age-ing to sage-ing: A profound new vision of growing older. Warner Books.
Sorrentino, S. A., Remmert, L., & Wilk, M. J. (2021). Mosby’s Canadian textbook for the support worker (5th Canadian ed.). Elsevier.This textbook, as well as the accompanying workbook, are typically used as the core program resources in B.C. HCA Programs. The ancillary tools for this textbook are available for instructors and students at https://evolve.elsevier.com/. The 5th edition was released in the fall of 2021, but some post-secondary institutions may continue to use the 4th edition of this textbook.
Thelker, C. (2020). For this I am grateful: Living with dementia. Austin Macauley.
Wolgin, F., Smith, K., French, J., Butt, A., Patterson, D. (2017). The Canadian personal care provider. Pearson Canada, Inc.
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Invite students to work in small groups to discuss situations in which they have felt cared for or cared about and situations in which they did not feel cared about.
Invite students to read the Values, Beliefs, and Principles section in the Introduction to the HCA Program Provincial Curriculum Guide 2015, with particular emphasis on the section about Caring and Caregiving. Encourage them to identify as many characteristics of caring as they can from their reading.
Now ask students if they can identify other characteristics of caring based on their own experience. Ask students to see if the characteristics of caring can be grouped (i.e., themes that come through).
Possible groupings might include:
Invite students to work in small groups to examine two or more situations. For each situation, ask the group to consider: What is there about this situation that reflects person-centred care and what does not? Could the situation have been handled differently? If so, how? Refer to situations included on the STUDENT HANDOUT below.
STUDENT HANDOUT
Situations: Reflections on Person-Centred Care
DIRECTIONS: Review and discuss the following situations. What is there about each situation that reflects person-centred care and what does not? Could the situation have been handled differently? If so, how?
Joan is a Health Care Assistant working in a complex care facility. She enjoys her work a lot – especially, as she says, “working with my sweet little old ladies.” Joan is well-organized and makes every effort to assure that the clients in her care are safe, clean, and comfortable. Today, when she completed bathing Mrs. DeVito, Joan dressed her in a flowery dress and placed a bright red bow in Mrs. DeVito’s white hair, saying, “There you go, dearie. You look so cute.” Mrs. DeVito is deaf so she didn’t hear Joan’s comment. She just smiled and nodded.
The instructor enters a room where a student, Evira, is giving a client a bed bath. The instructor stands on the opposite side of the bed from Evira and talks directly to her, saying, “We will have our group meeting at 11:00 a.m., Evira. See you then.” The instructor immediately hurries out of the room.
An HCA, Alex Ipe, is working for a home support service in a small city. He was recently assigned to provide care for a rather cantankerous older gentleman named Gordon. After his first two visits to Gordon’s small apartment, Alex feels frustrated and discouraged because he can’t seem to please Gordon. Alex decides to talk with an experienced colleague, Viv, in hopes of getting some helpful advice. After hearing his concerns, Viv responds by saying, “Well, you know how it is with these old guys. They are all like children – just so picky and needing attention. It can be pretty frustrating, I know, but you mustn’t let it get to you.”
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Situations: Reflections on Person-Centred Care [PDF].
As a homework assignment, have students read their textbook and other relevant course or online materials describing the five principles of compassionate, person-centred care (dignity, independence, preferences, privacy, and safety).
Note: Students could be instructed to add a copy of the client profile and schedule to their client portfolio for Peter Schultz.
STUDENT HANDOUT
Unfolding Case Study: Caring for Peter Schultz
Providing Person-Centred Care
DIRECTIONS: You are an HCA working as a home support worker. You have been assigned to provide respite care to Peter for a four-hour period from 3:00 p.m. to 7:00 p.m. while his wife, Eve, attends an event. Keeping in mind the five principles of compassionate care, use the information provided about Peter to develop a schedule for how you could spend your time with him.
Client Profile: Peter Schultz
Peter was born on January 1, 1918. When he was seven years old, Peter emigrated from the former Yugoslavia to a small town in Alberta. After completing grade nine, Peter left school and worked as a farmer and logger. In the 1950s, Peter moved with his wife, Eve, and their family to the Lower Mainland of B.C., where he worked in construction, life insurance, and real estate. During the 1970s, Peter owned and operated a small hobby farm. He retired at the age of 75 and moved to a small city near Vancouver, B.C.
Born into a large family, Peter was the second oldest of eight siblings. Peter and Eve have two sons and three daughters, 17 grandchildren, and over 30 great-grandchildren. With the exception of one daughter who lives in Alberta, Peter’s children live within one hour of driving distance from him and his wife.
Peter comes from an ethnic German family and German culture and traditions are important to him. As a child, Peter learned to speak German, Serbian, and English. He learned many German songs, hymns, and poems and often recites his favourites. Peter also enjoys traditional German cooking. Peter is a Lutheran Christian and has been active in his faith since childhood. During his adulthood, Peter was involved in church leadership and is well regarded in his faith community. Until recently, Peter acted as Bible study leader.
Peter has always been a social and outgoing person. As a young man, he enjoyed going to community events and was known to be an excellent dancer. Peter and Eve entertained regularly and enjoyed playing pool, cards, and Scrabble with their guests. He and his wife were both avid gardeners. Peter always enjoyed large and small building projects. After retirement, Peter built simple furniture and made latch hook rugs for his grandchildren.
Recently, he has been unable to participate in these activities due to increasing confusion and an inability to make the calculations necessary to complete these projects.
Other than back problems resulting from physical work, Peter has always been healthy and active. When he was 77 years old, Peter experienced a stroke, also known as a cerebral vascular accident (CVA), which resulted in short-term speech difficulties and affected his swallowing ability. Following the CVA, Peter’s wife began to notice changes in his cognition, personality, and behaviour. He progressively lost the ability to participate in activities that he previously enjoyed. Approximately five years following the CVA, Peter started to receive community-based health services.
Time | Proposed/Possible Activity | Rationale for Activities | Principle of Person-Centred Care |
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3:00–4:00 p.m. | Greeting and conversation about life and family; propose ideas for time together | Create comfort and ease with client | Independence and preference – so client can suggest and choose activities that interest him |
4:00–5:00 p.m. | Walk in garden | ||
5:00–6:00 p.m. | |||
7:00–8:00 p.m. |
Metzger, Z. B. (2010). The Last Lap of the Long Run, Addendum to “On the Long Run”: An Account of our Travels with Dementia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Providing Person-Centred Care [PDF].
Since this course is the first time students will be presented with the concept of a systemic problem-solving process as it relates to the HCA role, it is important that they grasp how important it is that a careful analysis of the situation precedes decisions.
Ask students to work in small groups. Give them a fictitious problem that they can relate to. For example, “Imagine you have taken the first major exam in the HCA program and received a failing grade.”
In analyzing this problem students should ask:
Once the problem has been analyzed, have students (again, in small groups) identify as many options or choices as possible. For each option, ask them to identify the positive and negative consequences of that particular action. For example:
Option | Positive Consequence | Negative Consequence |
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Withdraw from the program |
|
|
Once the students have completed their analysis of the problem, have them decide on the “best” decision or solution. How did the analysis help them come to a decision?
Could a different decision be “better” for other people or situations?
Have students discuss how HCAs can best help others to analyze problems and look at possible options before jumping to a solution. Have them discuss the ways in which problem-solving can be a caring process.
Have students, individually, conduct the same analysis using a real problem from their own lives (see STUDENT HANDOUT below for use with this exercise). This process could be used as an assignment for this course.
STUDENT HANDOUT
Problem-Solving/Decision-Making Exercise
DIRECTIONS: Select a problem you now face and use the problem-solving, decision-making process you’ve learned in class to analyze the situation and come to a decision. Follow the points below and use the template on the next page to document your processes and outcomes.
Self-Reflect: Was this a new way for you to deal with a problem? How did it feel to you? Were you happy with the outcome? What did you learn from the process?
Problem-Solving Exercise: Template for Report
PROBLEM:
ANALYSIS OF THE PROBLEM:
YOUR GOAL OR DESIRED OUTCOME:
Options | Positive Consequences | Negative Consequences |
---|---|---|
SOURCES OF ASSISTANCE:
YOUR DECISION:
EVALUATION / REFLECTION ON THE DECISION AND THE PROCESS:
Download Student Handout: Problem-Solving/Decision-Making Exercise [PDF].
The following steps for decision-making regarding care provision are used with permission of Island Health.Island Health Authority, the B.C. Health Education Foundation and the Ministry of Health Services are acknowledged for granting permission to adapt material from the Island Health Transitional Learning Continuum, Health Care Assistant in Acute Care Curriculum (2012). The “Six Steps” below provide a framework for decision-making by the HCA and could be used in a variety of situations. The case study on the STUDENT HANDOUT below outlines how these steps can be applied and could also be used in Healing 3: Personal Care and Assistance.
Six Steps
STUDENT HANDOUT
A Case Example: Assisting a Patient to Mobilize with Oxygen in Acute Care
Ms. Jackson lives in an assisted living residence and is 87 years old. She receives assistance with housekeeping and meals, which are taken in the common dining room. She has a history of COPD and uses a four-wheeled walker. The walker is outfitted with a portable oxygen tank for use in the dining room, as well as for outings into the community.
Twelve days ago, Ms. Jackson had a fall in her home getting up to go to the bathroom at night. As a result of the fall, she fractured her hip and required a dynamic hip screw surgery. She is now recovering in acute care and is being encouraged to mobilize daily. Her goal is to be walking independently with her four-wheeled walker, so that she is able to walk the 75 feet necessary to get to the dining room when she gets home. When walking, she is permitted to put her full weight, as tolerated, on her operated side. She is currently using 2.0 L of oxygen by nasal prongs. She is mobilizing with a two-wheeled walker and requires stand-by assistance for safety. As the HCA, you have been asked to assist Ms. Jackson with her mobilization routine, which involves walking up and down the hospital corridor.
The six steps below highlight some factors to consider.
Evaluate your performance and consider the following:
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: A Case Example: Assisting a Patient to Mobilize with Oxygen in Acute Care [PDF].
Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined; one group will take a pro position towards the topic and the other group will take a con position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate topics for Health and Healing: Concepts for Practice:
Have students, in groups, use the STUDENT HANDOUT below to consider the case studies and how they are related to key course concepts.
STUDENT HANDOUT
Case Studies: Working with Diverse Clients and Families
DIRECTIONS: In groups, consider the following case studies and respond to the discussion questions below:
Juliana is an HCA who was recently hired by a home support agency. One of the first clients she is assigned to visit is Mr. James Johnson. Jim is a 63-year-old man and former intravenous drug user who is living with HIV and is receiving end-of-life care for Stage 4 liver cancer. He has been prescribed medical marijuana to manage his pain.
Jim’s wife, Karen, cares for him 24 hours per day. Juliana is assigned to visit for respite care, four hours, twice per week. On this first visit, Karen does not want to leave the house because she doesn’t know Juliana and is concerned Juliana won’t know what Jim wants or needs. Karen shows Juliana around the house and is friendly towards her, but spends most of the time sitting by Jim’s bedside, frequently patting his hand or hugging him.
Juliana’s training did not include much information on HIV, drug use, or medical marijuana. Her personal values and beliefs make her uncomfortable with the situation. She is polite, but makes sure to wear gloves whenever she touches Jim, any of his belongings, or even when she shakes hands with Karen. When it is time to leave, she tells Karen that maybe another HCA will come for the next visit.
Manpreet works as a home support worker and is assigned to work with Mr. Brent Mead. Brent is a 43-year-old man who is paralyzed from the waist down as the result of a motor vehicle accident. Brent works as a freelance writer and lives with his husband, Jordan. Manpreet is assigned to assist with personal care, for two hours, five mornings per week.
On the first visit, Brent and Jordan show Manpreet the morning routine. This is Manpreet’s first time working with a gay couple and she hasn’t received much education about sexual diversity. Brent and Jordan are friendly towards Manpreet, but she feels uncomfortable and is unsure of how to respond when Brent and Jordan are affectionate towards one another. Manpreet avoids eye contact with Brent and Jordan and is quiet and reserved during the visit. She considers contacting her employer to ask if she can be excused from this assignment.
For each scenario, discuss:
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Case Studies: Working with Diverse Clients and Families [PDF].
The course learning outcomes may be assessed by the following tasks:
Anderson, J. (2016, March 21). 14 ways to help seniors avoid isolation. A Place for Mom. http://www.aplaceformom.com/blog/help-seniors-avoid-social-isolation-8-14-2014/
Baillie, L., Gallagher, A., & Wainwright, P. (2008). Defending dignity: Challenges and opportunities for nursing. Royal College of Nursing. https://www.dignityincare.org.uk/_assets/RCN_Digntiy_at_the_heart_of_everything_we_do.pdf
Battams, N. (2018). A Snapshot of Family Diversity in Canada. Vanier Institute of Canada. https://vanierinstitute.ca/a-snapshot-of-family-diversity-in-canada-february-2018/
B.C. Care Providers Association. (2020). Aging with pride. https://bccare.ca/aging-with pride/
Campion-Smith, B. (2012, Sept 20). Canadian families growing more diverse, Census data shows. Toronto Star. https://www.thestar.com/news/canada/2012/09/20/canadian_families_growing_more_diverse_census_data_shows.html
Canadian Human Rights Commission. (Nov, 2020) What is discrimination? https://www.chrc-ccdp.gc.ca/en/about-human-rights/what-discrimination
CBC Radio. (2014). Gay and grey: LGBT seniors fear care facilities, and Bridget Coll and Chris Morrisson’s story. [Radio special series]. CBC. https://www.cbc.ca/player/play/2441517900
Culo, S. (2011, October). Risk assessment and intervention for vulnerable older adults. BCMJ, 53, (8), October 2011, 421-425. http://www.bcmj.org/sites/default/files/BCMJ_53_Vol8_risk_assessment_0.pdf
Earle, L. (2011). Traditional Aboriginal diets and health. National Collaborating Centre for Aboriginal Health, University of Northern British Columbia. http://www.nccah-ccnsa.ca/docs/social%20determinates/1828_NCCAH_mini_diets_health_final.pdf
Eden Alternative. http://www.edenalt.org/
First Nations Health Authority. (n.d.). Creating a climate for change. https://www.fnha.ca/Documents/FNHA-Creating-a-Climate-For-Change-Cultural-Humility-Resource-Booklet.pdf
First Nations Health Authority. (2020). Cultural safety and humility. https://www.fnha.ca/wellness/cultural-humility
First Nations Health Authority. (2015). Declaration of commitment. https://www.fnha.ca/Documents/Declaration-of-Commitment-on-Cultural-Safety-and-Humility-in-Health-Services.pdf
First Nations Health Authority. (n.d.). Traditional healing. https://www.fnha.ca/what-we-do/traditional-healing
Government of British Columbia. About B.C.’s health care system. http://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system
Government of British Columbia. Caring for seniors. http://www2.gov.bc.ca/gov/content/family-social-supports/seniors/caring-for-seniors
Government of British Columbia. Gender equity in B.C. https://www2.gov.bc.ca/gov/content/gender-equity?keyword=gender&keyword=diversity
Government of British Columbia. Self care. http://www2.gov.bc.ca/gov/content/family-social-supports/seniors/caring-for-seniors/caring-for-the-caregiver/self-care
Government of British Columbia (2015) Seniors. http://www2.gov.bc.ca/gov/content/family-social-supports/seniors
Government of British Columbia, Ministry of Health. (2015). The British Columbia patient-centered care framework. https://www.health.gov.bc.ca/library/publications/year/2015_a/pt-centred-care-framework.pdf
Government of British Columbia, Ministry of Health. (2011). Director of licensing standard of practice: Incident reporting of aggressive or unusual behaviour in adult residential care facilities. https://www2.gov.bc.ca/assets/gov/health/accessing-health-care/finding-assisted-living-residential-care-facilities/standard-practice-peportable-incidents.pdf
Government of British Columbia, Ministry of Health Services Policy Communique. (2011). Standardized hospital colour codes. https://www2.gov.bc.ca/assets/gov/health/keeping-bc-healthy-safe/health-emergency-response/standardized-hospital-colour-codes.pdf
Government of British Columbia, WelcomeBC. (2020). Multicultural B.C. https://www.welcomebc.ca/Choose-B-C/Explore-British-Columbia/Multicultural-B-C
Government of Canada. (2017). Indigenous peoples and communities. https://www.rcaanc-cirnac.gc.ca/eng/1100100013785/1529102490303
HealthCareCAN. (2016). Issue brief: The Truth and Reconciliation Commission of Canada: Health-related recommendations. https://www.healthcarecan.ca/wp-content/themes/camyno/assets/document/IssueBriefs/2016/EN/TRCC_EN.pdf
HealthLinkBC. http://www.healthlinkbc.ca
HealthLinkBC. (2019). Sexual orientation. https://www.healthlinkbc.ca/health-topics/abj9152
Island Health. (n.d.). Developing inclusive and affirming care for LGBTQ2+ seniors toolkit. https://bccare.ca/wp-content/uploads/2019/07/Inclusive-Care-Toolkit-Island-Health.pdf
Killermann, S. (2020). Breaking through the binary: Gender explained using continuums. https://www.itspronouncedmetrosexual.com/2011/11/breaking-through-the-binary-gender-explained-using-continuums/
Mas, S. (2015). Truth and Reconciliation offers 94 “calls to action. CBC News. https://www.cbc.ca/news/politics/truth-and-reconciliation-94-calls-to-action-1.3362258
McLeod, S. A. (2020, March 20). Maslow’s hierarchy of needs. Simply psychology. https://www.simplypsychology.org/maslow.html
Public Guardian and Trustee of British Columbia. http://www.trustee.bc.ca
Paul, R. & Eider, L. (2006). The miniature guide to critical thinking: Concepts and tools. The Foundation for Critical Thinking. https://www.criticalthinking.org/files/Concepts_Tools.pdf
Provincial Health Services Authority in B.C. (n.d.). San’yas Indigenous cultural safety training. http://www.sanyas.ca/
QMUNITY. (2018). Queer terminology from A to Q. https://qmunity.ca/wp-content/uploads/2019/06/Queer-Glossary_2019_02.pdf
QMUNITY. http://www.qmunity.ca/
Revera Inc. and International Federation on Ageing. (2014). Revera report on ageism. https://cdn.reveraliving.com/-/media/files/reports-on-aging/report_ageism.pdf?rev=8835002714be4f1da65588ad7d92a316&_ga=2.266237199.1252853060.1620072730-928366378.1620072730
SafeCareBC. http://safecarebc.ca/
SafeCareBC. Violence prevention. https://www.safecarebc.ca/initiatives/violenceprevention/
Simon Fraser University, Gerontology Research Centre. http://www.sfu.ca/grc/
Social Care Institute for Excellence. (2015, January). Promoting independence in care homes [Video and messages]. https://www.scie.org.uk/personalisation/practice/residential-care-homes/promoting-independence
Statistics Canada. (2020). Older adults and population aging statistics. https://www.statcan.gc.ca/eng/subjects-start/seniors_and_aging
Thompson, S. (2017, August 17). Cultural differences in body language to be aware of. Virtual Speech. https://virtualspeech.com/blog/cultural-differences-in-body-language
Truth and Reconciliation Commission of Canada. (2015). Truth and reconciliation commission of Canada: Calls to action. http://trc.ca/assets/pdf/Calls_to_Action_English2.pdf
University of Victoria, Equity and Human Rights. (2020). Unconscious biases. https://www.uvic.ca/equity/employment-equity/bias/index.php
U.S. National Library of Medicine. (n.d.) Medicine ways: Traditional healers and healing. In Native Voices: Native Peoples’ Concepts of Health and Illness [Online exhibition]. https://www.nlm.nih.gov/nativevoices/exhibition/healing-ways/medicine-ways/medicine-wheel.html
Ward, C., Branch, C., Fridkin, A. (2016). What is Indigenous cultural safety – and why should I care about it? Visions Journal, 11(4), 29. https://www.heretohelp.bc.ca/visions/indigenous-people-vol11/what-indigenous-cultural-safety-and-why-should-i-care-about-it
WorkSafeBC. (2006). Home and community health worker handbook. https://www.worksafebc.com/en/resources/health-safety/books-guides/home-and-community-health-worker-handbook?lang=en&direct
WorkSafeBC. What’s wrong with these photos (home care aide) [Photographs]. https://www.worksafebc.com/en/resources/health-safety/posters/home-care-worker-bathroom/full-booklet?lang=en&direct
AgeismComs369. (2012, November 30). Representation of seniors in popular media [Video]. YouTube. https://www.youtube.com/watch?v=c94_eIYeBuI&feature=youtu.be
CBC News. (2017, June 1). How to talk about Indigenous people [Video]. YouTube. https://www.youtube.com/watch?v=XEzjA5RoLv0
CNN. (2013, July 30). CNN’s world’s untold stories: Dementia village [Video]. YouTube. https://www.youtube.com/watch?v=LwiOBlyWpko
Crashcourse. (2012, August 6). Digestive system: Crashcourse biology #58 [Video]. YouTube. https://www.youtube.com/watch?v=s06XzaKqELk&feature=youtu.be
Happiness.com. (2017, November 6). What is: Maslow’s pyramid – The hierarchy of needs [Video]. YouTube. https://www.youtube.com/watch?v=zLHiWjMFYUU
The Health Foundation. (2014, December 10). Compassion, dignity and respect in health care [Video]. YouTube. https://www.youtube.com/watch?v=HVF0273iHus
The Health Foundation. (2015, February 2). Person-centred care made simple [Video]. YouTube. https://www.youtube.com/watch?v=6Dk3CV-Wt38
Knovva Academy. (2018, March). Me or we? Cultural difference between East and West [Video]. YouTube. https://www.youtube.com/watch?v=78haKZhEqcg
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Royal Liverpool Hospitals. (2018, April 12). Managing risks, Part 1 [Video]. YouTube. https://www.youtube.com/watch?v=GR8BZXC1vXI
Royal Liverpool Hospitals. (2018, April 12). Managing risks, Part 2 [Video]. YouTube. https://www.youtube.com/watch?v=nVadQGh-3Ec
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Ted-Ed. (2017, December 14). How the digestive system works – Emma Bryce [Video]. YouTube. https://www.youtube.com/watch?v=Og5xAdC8EUI
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Wright, L. Mr. Nobody. National Film Board [Film]. https://www.nfb.ca/film/mr_nobody/
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
Sagan, A. (2015, May 3). Canada’s version of Hogewey dementia village recreates “normal” life. CBC News. http://www.cbc.ca/news/health/canada-s-version-of-hogewey-
Social Care Institute for Excellence. (2014). Choice and control: Dignity in care [Video]. https://www.scie.org.uk/dignity/care/videos/social-inclusion
Social Care Institute for Excellence. ( 2014). Social inclusion: Dignity in care [Video]. http://www.scie.org.uk/socialcaretv/video-player.asp?v=social-inclusion
4
Invite students to form small groups and discuss what qualities and characteristics they would want in a care provider for themselves or a family member.
Have them work to describe the “perfect” care provider in terms of:
Which qualities/characteristics would be considered MOST important? What does this tell you about the qualities and characteristics of an effective care provider?
Questions that could be used to elicit discussion on caring:
As a homework assignment, have students read their textbook and other relevant course or online materials describing the role of the HCA in various health care settings, including community day programs, home care, and residential care. Ask the students to identify the positive aspects and challenges associated with working in each of these settings.
Note: Students could be instructed to add the scenario(s) and notes from this session to their client portfolio for Peter Schultz.
STUDENT HANDOUT
Unfolding Case Study: Caring for Peter Schultz
Client and Family Experiences with Different Health Care Settings
DIRECTIONS: In your group, review your assigned scenario(s) describing the client and family experience with various health care agencies and settings. After reading, work together to identify the positive aspects and challenges described in the scenario and be prepared to share your observations with the larger group.
Metzger, Z. B. (2010). The Last Lap of the Long Run, Addendum to “On the Long Run”: An Account of our Travels with Dementia. This material is licensed under a CC BY-SA 4.0 licence.
Download Student Handout: Client and Family Experiences with Different Health Care Settings [PDF].
Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined; one group will take a pro position towards the topic and the other group will take a con position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate Topics for Health Care Assistant: Introduction to Practice.
In order to develop HCA students’ ability to self-reflect and recognize and respond to their own self-development needs as care providers, consider introducing a model that can be used for reflective practice review, such as Gibbs’ Reflective Cycle (1988).Gibbs’ Reflective Cycle (1988). Retrieved from https://brightknowledge.org/medicine-and-healthcare/what-is-reflective-practice
Working together as a class, apply the Gibbs’ Reflective Cycle model to the following scenarios:
Today at your annual performance review, your supervisor tells you that she has received a report from another HCA that you were impatient with a client. The HCA stated that he had tried to approach you about the situation, but you would not discuss it. You remember that you had been feeling anxious that day about a personal matter and had felt bad for sighing loudly and saying, “I don’t have all day,” when your client, Mrs. Smith, was taking a longer time than usual to pick her outfit.
Today while you are assisting a client in the dining room, you overhear two of your co-workers recalling a story about another client and laughing loudly. Taken aback by the situation, you don’t approach your co-workers, but afterwards it bothers you and you are unsure of how to move forward.
As a recent HCA graduate, you are feeling excited about your new job at a residential care home. During the orientation session, you realize that the lift equipment being used is different from what you used during your clinical placement and despite the practice you receive during training, you still feel uncomfortable with using the equipment. You don’t want to leave a negative impression with your employer, so don’t speak up when the session leader asks if anyone has any questions or concerns.
You are an HCA who has recently been hired at a residential care home. Today you are assigned to work with Dorothy, an HCA who has been employed by the care home for 18 years. When you suggest that the two of you come up with a brief plan for how to schedule your morning, Dorothy insists that you follow her regular routine. Throughout the day, Dorothy makes all of the decisions and disregards any suggestions that you make, saying, “This is the way we do things here.” At the end of the day, you learn you will be working with Dorothy for the rest of the week.
Have students, either alone or with colleagues, discuss an issue that presents itself to them. One that might be appropriate is the following:
As you move towards completion of the HCA program, you will have to decide within which health care context you’d like to find a job and/or whether you might want to continue your education.
The STUDENT HANDOUT below will help students analyze this problem and come to a decision that best “fits” for them at this point in time.
STUDENT HANDOUT
Problem-Solving and Decision-Making Exercise
DIRECTIONS: Consider the following problem:
As you move towards completion of the HCA program, you will have to decide within which health care context you’d like to find a job and/or whether you might want to continue your education.
Use a problem-solving, decision-making process to analyze this problem and come to a decision that best fits for you at this point in time. Document each step in your process.
Use a table like the following to analyze the pros and cons (for YOU) of each choice.
Options | Positive Consequences | Negative Consequences |
---|---|---|
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Problem-Solving and Decision-Making Exercise [PDF].
Major elements of a professional approach to practice | What I’ll need to know and be able to do in order to reflect professionalism in my practice |
---|---|
EXAMPLE
Working collaboratively with other members of the health care team |
Need to know and understand:
Need to be able to:
|
STUDENT HANDOUT
Case Scenarios – Ethical Practice Considerations and Employer Policy
DIRECTIONS: Consider and discuss the following scenarios involving ethical dilemmas. Put forward suggestions based on what you have learned in the course. As relevant, go to your health authority website to refer to a policy that could be used for guidance.
You are an HCA student and it is your first day of clinical. After the afternoon debrief, you receive a text message from a fellow student that states the following, “Can’t stand working with Susan – slowest partner possible!” You notice that the text message is addressed to the entire clinical group, except for Susan. What do you think of this text? How will you respond?
You enjoy working with your colleague, Sandy, because she is friendly and outgoing with the health care team and clients of the care home where you work. You have noticed that Sandy spends a lot of time on her smartphone, checking texts and emails during her shift. One day you are eating lunch with her and she shows you some pictures of her posing with one of the clients that she has taken with her phone. She shares that she has posted these pictures to her social media page. What do you think about Sandy’s use of her phone at work? How will you respond to the current situation?
You are an HCA working in acute care. One day, while you are assisting a client, his daughter takes a video of you and the client on her cell phone. She tells you that you have been very helpful to her father and she would like to post the video on his recovery blog so that friends and family can see the progress he has been making. How will you respond to this situation?
Mr. Singh was a well-known business man and was considered a leader in your community. You got to know him and his family well as you served as one of his many care providers during his final illness. Shortly after his death, you are approached by one of your neighbours who is a newspaper reporter. She asks you for information about Mr. Singh. You were fond of Mr. Singh and would like him to be remembered for the fine gentleman he was. What will you do?
Mrs. Rosen is a 93-year-old woman who is physically frail but able to walk. She has been exhibiting signs of moderate dementia. When you are at work, at the complex care facility where Mrs. Rosen lives, Mrs. Rosen often follows you and tries to gain your attention. This makes it difficult for you to get your work completed, as Mrs. Rosen also follows you into the rooms of other clients. Another HCA suggests that you take Mrs. Rosen into to the lounge and tie her in a chair in front of the TV so she can’t bother you so much. What do you think of this suggestion and how would you respond to it? What are some other approaches that you could take?
Mrs. Subin mobilizes with a wheelchair and requires assistance with transferring. While eating lunch, she tells you that she needs to go to the bathroom right away. You are very busy, but you quickly take Mrs. Subin to the bathroom and assist her onto the toilet. After washing your hands, you rush back to the dining room. You forget to go back to help Mrs. Subin off the toilet. She gets tired of waiting, tries to get herself back onto the wheelchair and falls. Fortunately, Mrs. Subin is not badly hurt, just a bit shaken by the incident. What happened in this situation that might be legally compromising? How might the situation have been avoided? What can be done now?
Ms. Cedar is a 57-year-old client of your home support agency. Her diagnosis is multiple sclerosis. She is a bariatric client and has poor muscle control. She requires two HCAs to provide care on the days she has a shower. Today, you and your co-worker Jessie are helping Ms. Cedar with her shower. You notice that Jessie is quite rough in the way she handles Ms. Cedar. She also sounds angry when she talks to Ms. Cedar and raises her voice, even though Mrs. Cedar has no hearing loss. While you and Jessie are helping Ms. Cedar to transfer from the shower to her wheelchair using the ceiling lift, Ms. Cedar reaches out and puts her hand on Jessie’s arm for stability. Jessie slaps Ms. Cedar’s hand away, saying, “Don’t grab me.” What will you do at that moment? What will you do later?
Mr. Garret is a 77-year-old man who is a client on the acute medical ward where you work. His admitting diagnosis was pneumonia, and he is finishing a course of IV antibiotics. His history includes a CVA six years ago which resulted in swallowing difficulties and an inability to walk. He mobilizes using an electric wheelchair. He has a permanent J-tube for nutrition and can also have fluids by mouth if they are thickened to pudding consistency. Mr. Garret has not been off the ward very much since he has been in hospital the past few days. At home, he usually travels about his local community in his electric wheelchair, shopping or attending various activities. He is feeling much better today and has left the ward “to get some air.” When you go to the cafeteria to get your lunch, you see him sitting at a table with two other hospital clients. He has a large bottle of soda pop. You know this is not safe for him to drink because of his swallowing problems. What will you do?
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Case Scenarios – Ethical Practice Considerations and Employer Policy [PDF].
The following case study is used with permission of Island Health.Island Health. (2012). Transitional Learning Continuum, Health Care Assistant in Acute Care Curriculum.
Jane is an HCA who works on an inpatient orthopaedic unit and has worked on this unit as a casual for the past three months. Jane is participating in a morning huddle and hears about Gladys, a patient who was admitted two days ago with a fractured right hip that she sustained when she slipped on an icy patch outside her church.
Gladys lives alone in a two-level townhome, with a cat. She has one son who lives in town, who reports that his mom has lost a lot of weight since her husband passed away six months ago. The team leader reports that Gladys is one day post-op from a right hemiarthroplasty (partial hip replacement); she does not have hip precautions and is weight bearing as tolerated (WBAT). Gladys would like to be discharged home with supports in a week.
Discussion Questions:
This activity is designed to support students in better understanding HCA rights and responsibilities, the role of the supervisor and supervision, and the importance of workplace orientation and training. It is recognized that there may be some overlap with content covered in other courses but given the overall view to occupational health and safety, it is being included in this HCA Introduction to Practice course.
It is suggested that educators:
STUDENT HANDOUT
Workers’ Rights and Responsibilities
Workers have the right to:
As a worker, you are responsible for working without undue risk to yourself or others.
To keep safe on the job:
Source Document: WorkSafeBC (2013). Student WorkSafe Infosheet: Workplace Rights and Responsibilities. https://www.worksafebc.com/en/resources/health-safety/information-sheets/student-worksafe-infosheet-workplace-rights-and-responsibilities?lang=en
Download Student Handout: Workers’ Rights and Responsibilities [PDF].
DISCUSSION GUIDE
Workers’ Rights and Responsibilities
WORKERS’ RIGHTS
WORKERS’ RESPONSIBILITIES
Download Discussion Guide: Workers’ Rights and Responsibilities [PDF].
The course learning outcomes may be assessed by the following tasks:
Access to Information Act, RSC 1985, c A-1. http://laws-lois.justice.gc.ca/eng/acts/a-1/
Adult Guardianship Act. RSBC 1996, c. 6. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96006_01
B.C. Care Providers Association. http://bccare.ca/
B.C. Centre for Disease Control. (2020). Ethics. http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/ethics
B.C. Government and Service Employees’ Union. http://www.bcgeu.ca/
B.C. Housing. (2016). Assisted living residences. http://www.bchousing.org/Options/Supportive_Housing/SSH/AL
Berta, W., Laporte, A., Deber, R., Baumann, A., & Gamble, B. (2013). The evolving role of health care aides in the long-term care and home and community care sectors in Canada. http://www.human-resources-health.com/content/11/1/25
Bright Knowledge from Brightside. (2017). What is reflective practice? https://brightknowledge.org/medicine-and-healthcare/what-is-reflective-practice
British Columbia College of Nurses and Midwives. (n.d.). Assigning and delegating to unregulated care providers. https://www.bccnm.ca/Documents/learning/RN_NP_Assigning_Delegating_UCP.pdf
British Columbia College of Nurses and Midwives. (2021). Licenced practice nurses-practice standards-working with health care assistants. https://www.bccnm.ca/LPN/PracticeStandards/Pages/WorkingwithHealthCareAssistants.aspx
Canadian Human Rights Act. RSC, 1983, c. H-6. https://laws-lois.justice.gc.ca/eng/acts/h-6/
Canadian Human Rights Commission. http://www.chrc-ccdp.ca
Canadian Interprofessional Health Collaborative. (2010). A national interprofessional competency framework. https://drive.google.com/file/d/1Des_mznc7Rr8stsEhHxl8XMjgiYWzRIn/view
Canadian Network for the Prevention of Elder Abuse. http://www.cnpea.ca/en/
Canadian Nurses Association. (2018). Interprofessional collaboration. https://www.cna-aiic.ca/en/nursing-practice/the-practice-of-nursing/health-human-resources/interprofessional-collaboration
Community Care and Assisted Living Act, SBC 2002 c. 75. http://www.bclaws.ca/Recon/document/ID/freeside/00_02075_01
Community Care and Assisted Living Act. Residential Care Regulation. [B.C. Reg. 96/2009.] https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009
E-Health (Personal Health Information Access and Protection of Privacy) Act, BC 2008 c. 38. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/08038_01
Employment Standards Act, RSBC 1996 c. 113. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/00_96113_01
First Nations Health Authority. http://www.fnha.ca/
First Nations Health Authority. (2021). Cultural safety and humility. http://www.fnha.ca/wellness/cultural-humility
Fraser Health Authority. http://www.fraserhealth.ca
Government of British Columbia, (n.d.). About B.C.’s health care system. https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system
Government of British Columbia. (n.d.). Accessing health care. https://www2.gov.bc.ca/gov/content/health/accessing-health-care
Government of British Columbia. (n.d.). Assisted living in B.C. https://www2.gov.bc.ca/gov/content/health/assisted-living-in-bc
Government of British Columbia. (2014). B.C. health care assistants core competency profile. https://www.health.gov.bc.ca/library/publications/year/2014/HCA-Core-Competency-Profile_March2014.pdf
Government of British Columbia. Welcome to the B.C. Care Aide & Community Health Worker Registry. http://www.cachwr.bc.ca/Home.aspx
Government of British Columbia. (2016). Employment standards. http://www.labour.gov.bc.ca/esb/esaguide/guide.pdf
Government of British Columbia. (n.d.). Employment and workplace standards. https://www2.gov.bc.ca/gov/content/employment-business/employment-standards-advice
Government of British Columbia. (n.d.). Guide to good privacy practices. https://www2.gov.bc.ca/gov/content/governments/services-for-government/information-management-technology/privacy/good-privacy-practices
Government of British Columbia. (n.d.). Health authorities. https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/partners/health-authorities
Government of British Columbia. (n.d.). Home and community care. https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care
Government of British Columbia. (n.d.). Human rights in British Columbia. What you need to know [Fact sheet]. https://www2.gov.bc.ca/assets/gov/law-crime-and-justice/human-rights/human-rights-protection/what-you-need-to-know.pdf
Government of British Columbia. (n.d.). Human rights protection. https://www2.gov.bc.ca/gov/content/justice/human-rights/human-rights-protection
Government of British Columbia. (n.d.). Long-term care services. https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/long-term-care-services
Government of British Columbia. (2013, February). My voice. Expressing my wishes for future health care treatment. https://www.health.gov.bc.ca/library/publications/year/2013/MyVoice-AdvanceCarePlanningGuide.pdf
Government of British Columbia. (n.d.). Pharmacare for B.C. residents. https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents
Government of British Columbia. (n.d.). Policy and standards. https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/accountability/policy-and-standards
Government of British Columbia. (2015). Primary and community care in B.C.: A strategic policy framework. Cross-sector discussion policy paper. https://www.health.gov.bc.ca/library/publications/year/2015/primary-and-community-care-policy-paper.pdf
Government of British Columbia. (n.d.). Professional regulation. https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/professional-regulation
Government of British Columbia. (n.d.). Protecting personal information. https://www2.gov.bc.ca/gov/content/employment-business/business/managing-a-business/protect-personal-information
Government of British Columbia. (n.d.). Protection from elder abuse and neglect. https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health-safety/protection-from-elder-abuse-and-neglect
Government of British Columbia. (n.d.). Regional health authorities. https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/partners/health-authorities/regional-health-authorities
Government of British Columbia. (n.d.). Residents’ bill of rights. https://www2.gov.bc.ca/assets/gov/health-safety/home-community-care/accountability/pdf/adultcare_bill_of_rights.pdf
Government of British Columbia. (n.d.). Respect in the workplace and health. https://www2.gov.bc.ca/gov/content/careers-myhr/all-employees/working-with-others/promote-respect/health
Government of British Columbia. (2013). Together to reduce elder abuse – B.C.’s strategy: Promoting well-being and security for older British Columbians. https://www2.gov.bc.ca/assets/gov/people/seniors/health-safety/pdf/trea_strategy.pdf
Government of Canada. (2016). Canada’s health care system. https://www.canada.ca/en/health-canada/services/canada-health-care-system.html
Government of Canada. (2021, January). Federal labour standards. https://www.canada.ca/en/services/jobs/workplace/federal-labour-standards.html
Government of Canada. (2012). It’s not right: What you can do when abuse or neglect is happening to an older adult in your life. https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/health-risks-safety/what-you-can-do-elder-abuse/pub1-eng.pdf
Government of Canada, Department of Justice. (1982). The Canadian charter of rights and freedoms. https://www.justice.gc.ca/eng/csj-sjc/rfc-dlc/ccrf-ccdl/
Government of British Columbia. (n.d.). Medical Services Plan of B.C. https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp
Government of British Columbia, Ministry of Health. http://www.gov.bc.ca/health/
Government of British Columbia, Ministry of Health. (n.d.). Assisted living registry. https://www2.gov.bc.ca/gov/content/health/assisted-living-in-bc/assisted-living-registry
Government of British Columbia, Ministry of Health Services. (2008). Personal assistance guidelines. http://www.health.gov.bc.ca/library/publications/year/2008/Personal_Assistance_Guidelines.pdf
Health Employers Association of B.C. (n.d.). Collective agreements. https://www.heabc.bc.ca/Page20.aspx#.YLEo5KhKjIV
Health Employers Association of B.C. (n.d.). Labour relations. https://www.heabc.bc.ca/page4480.aspx#.X2Uvw2hKg2x%20\
Health Professions Act, RSBC 1996 c 183. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/00_96183_01
Hospital Employees’ Union. http://www.heu.org/
Hospital Employees Union (n.d.). Facilities collective agreement. https://www.heu.org/collective-agreements/facilities
Hospital Employees Union (n.d.). Community health collective agreement. https://www.heu.org/collective-agreements/community-health
Hospital Employees Union (n.d.). Care aides. https://www.heu.org/taxonomy/term/454
Interior Health. http://www.interiorhealth.ca
Interior Health. (n.d.). Policies. https://www.interiorhealth.ca/AboutUs/Policies/Pages/default.aspx
InterRAI. http://www.interrai.org
Island Health. https://www.islandhealth.ca/
Island Health. (n.d.). Code of conduct and policies. https://www.islandhealth.ca/about-us/accountability/code-conduct-policies
MasterClass. (2021). How to recognize the five stages of group development. https://www.masterclass.com/articles/how-to-recognize-the-5-stages-of-group-development#what-is-tuckmans-model-of-group-development
National Healthcareer Association. (n.d.). Healthcare job interview questions (and how to answer them). https://info.nhanow.com/blog/healthcare-job-interview-questions-and-how-to-answer-them
Nidus Personal Planning Resource Centre and Registry.
Northern Health. http://www.northernhealth.ca
Northern Health (n.d.). Policies. https://www.northernhealth.ca/about-us/accountability/policies
Office of the British Columbia Ombudsperson. https://bcombudsperson.ca/
Office of the Seniors Advocate British Columbia. http://www.seniorsadvocatebc.ca/
Province of British Columbia. (2014). Elder abuse reduction curricular resource. BCcampus. http://solr.bccampus.ca:8001/bcc/items/8d5b3363-396e-4749-bf18-0590a75c9e6b/1/
Provincial Health Services Authority. http://www.phsa.ca/
Public Guardian and Trustee of British Columbia. (2014). Protecting adults from abuse, neglect, and self-neglect: Supporting self-determination for adults in British Columbia. https://www.trustee.bc.ca/Documents/adult-guardianship/Protecting%20Adults%20from%20Abuse,%20Neglect%20and%20Self%20Neglect.pdf
SafeCare BC (2020). Civility Matters. https://www.safecarebc.ca/civilitymatters/
Trentham, B., Andreoli, A., Boaro, N., Velji, K., & Fancott, C. (2010). SBAR: A shared structure for effective team communication: An implementation tool kit. (2nd ed.) http://www.uhn.ca/TorontoRehab/Education/SBAR/Documents/SBAR_Toolkit.pdf
Truth and Reconciliation Commission of Canada. (2015). Truth and Reconciliation Commission of Canada: Calls to action. http://trc.ca/assets/pdf/Calls_to_Action_English2.pdf
Vancouver Coastal Health. http://www.vch.ca
Vancouver Coastal Health. (n.d.). Policies. http://www.vch.ca/about-us/accountability/policies/
Workers Compensation Act, RSBC 2019 c. 1. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/19001_00
WorkSafeBC. (July, 2020). Back talk for workers. https://www.worksafebc.com/en/resources/health-safety/interactive-tools/back-talk-for-workers
WorkSafeBC. (n.d.). Bullying and harassment. https://www.worksafebc.com/en/health-safety/hazards-exposures/bullying-harassment
WorkSafeBC. (2012). Communicate patient information: Prevent violence-related injuries to health care and social services workers (for public bodies). https://www.worksafebc.com/en/resources/health-safety/information-sheets/communicate-patient-information-prevent-violencerelated-injuries-to-health-care-and-social-services-workers-for-public-bodies
WorkSafeBC. (2012, October). Communicate personal information: Prevent violence related injuries to health care and social services workers (for non-public bodies). https://www.worksafebc.com/en/resources/health-safety/information-sheets/communicate-personal-information-prevent-violencerelated-injuries-to-health-care-and-social-services-workers-for-nonpublic-bodies
WorkSafeBC. (2020). Industry claims analysis: Time-loss claims in B.C. https://public.tableau.com/app/profile/worksafebc/viz/IndustryclaimsanalysisTime-lossclaimsinB_C_/Didyouknow
WorkSafeBC. (2020). Occupational health and safety regulation. https://www.worksafebc.com/en/law-policy/occupational-health-safety/occupational-health-safety-regulation
WorkSafeBC. (July, 2018). Point-of-care risk assessments in long-term care [Videos].https://www.worksafebc.com/en/resources/health-safety/videos/point-of-care-risk-assessments-in-long-term-care/full-video
WorkSafeBC. (2013, December). Student WorkSafe Infosheet: Workplace rights and responsibilities. https://www.worksafebc.com/en/resources/health-safety/information-sheets/student-worksafe-infosheet-workplace-rights-and-responsibilities
WorkSafeBC. (2013, December). Toward a respectful workplace: A handbook on addressing and preventing workplace bullying and harassment. http://www.worksafebc.com/en/resources/health-safety/books-guides/a-handbook-on-preventing-and-addressing-workplace-bullying-and-harassment?lang=en
WorkSafeBC. (2016, November). Worker orientation checklist for healthcare. https://www.worksafebc.com/en/resources/health-safety/checklist/worker-orientation-checklist-health-care
World Health Organization. http://www.who.int/en/
Young, J. M. & Everett, B. (2018, July/August). When patients choose to live at risk: What is an ethical approach to intervention? BCMJ, 60(6), 314–318. https://bcmj.org/articles/when-patients-choose-live-risk-what-ethical-approach-intervention
Alberta Health Services. (2016, July 26). Patient and family centered care: Moments that make all the difference [Video]. YouTube. https://www.youtube.com/watch?v=Tej5g6w34BA&feature=youtu.be
Global News. (2014, April 3). Elder abuse victims speaks [Video]. YouTube. https://www.youtube.com/watch?v=3R5L_3Yu2wc
Indeed. (2020, January 7). How to write a cover letter [Video]. YouTube. https://youtube/hrZSfMly_Ck
Indeed. (2020, January 3). Top interview tips: Common questions, body language and more [Video]. YouTube. https://youtu.be/HG68Ymazo18
University of British Columbia. (2012, September 17). Resumes 101: Accomplishment statements [Video]. YouTube. https://www.youtube.com/watch?v=bOSKynkOgQE&t=2s
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
Government of British Columbia. (2014). Elder abuse reduction curricular resource. BCcampus. http://solr.bccampus.ca:8001/bcc/items/8d5b3363-396e-4749-bf18-0590a75c9e6b/1/
British Columbia College of Nurses and Midwives, (n.d.). Social media scenarios: Complaints to the college. https://www.bccnm.ca/RPN/learning/socialmedia/Pages/Social_media_scenarios.aspx
Social Care Institute for Excellence. ( n.d.). Dignity in care videos. https://www.scie.org.uk/search?sq=Dignity+in+Care+videos
Social Care Institute for Excellence. (2014). Dignity in care: Privacy [Video]. http://www.scie.org.uk/socialcaretv/video-player.asp?v=privacy
WorkSafeBC. (n.d.). My handbook. https://www.worksafebc.com/en/law-policy/occupational-health-safety/searchable-ohs-regulation/personal-handbook
WorkSafeBC. (2011, July). Supervision in health care: Know your responsibilities. https://www.worksafebc.com/en/resources/health-safety/books-guides/supervision-in-health-care-know-your-responsibilities
WorkSafeBC. (2013). Two-person care needs a planned approach. https://www.worksafebc.com/en/resources/health-safety/videos/two-person-care-needs-a-planned-approach
5
Invite students to form small groups to discuss the following:
Think of a time when you really felt comfortable with another person and you were both able to talk freely. What were some of the characteristics of that interaction? Have the groups share their responses with the whole class.
From these discussions, the class can develop a list of the characteristics of effective interpersonal communication which will likely include points such as:
All effective interpersonal communications have one thing in common: each person involved feels valued, respected, and worthwhile.
Based on this understanding of effective interpersonal communication, ask students to discuss some examples of communication approaches they have experienced that they found to be particularly unpleasant, even dehumanizing. Some examples might include:
Invite students to think of times when they may have used these approaches and the outcomes of these responses. Why do we sometimes use dehumanizing communication?
Application to the workplace: Invite students to discuss how approaches to elderly clients might inadvertently be dehumanizing (ageism). What are some better choices?
Questions that could be used to elicit discussion about caring:
STUDENT HANDOUT
Unfolding Case Study: Caring for Peter Schultz
Evaluating Communication Techniques
DIRECTIONS: Read the following conversation between Peter and his wife, Eve. Make a list of the communication techniques that Eve uses to connect with Peter during the conversation and then prepare to share your findings with the larger group.
I found Peter sitting alone on the loveseat just around the corner from the nurses’ station, so I sat down beside him. A couple of HCAs were passing us once in a while as they tended to their duties. Peter didn’t speak and neither did I for quite some time. Then he said, “Do you think you could arrange a wedding for some time in the fall?”
“Oh, who is getting married?”
“I am.”
“Who are you going to marry?”
“The girl next door.”
“Really? What is her name?”
“I don’t remember.”
“Is it Jenny?”
“Yes, that’s her name.”
Aha! Jenny lived across the road from Peter when he was a kid. “You can’t marry her. She is already married.”
He gave me a look of incredulity, but said nothing. A few minutes of silence. Then he said, “Well, do you think you can arrange a wedding for some time in the fall?”
“Peter, how old are you?”
“I am 15 in about half a year.”
“I really think you are too young to get married. A girl might be able to handle it, but it’s really much too young for a man to marry.”
“I’d really like your opinion, though. Do you think she would make a good farmer’s wife?”
“Yes, I do. I’m sure she would make an excellent farmer’s wife. She has lived on a farm all her life, and I’m sure she knows exactly how to be a good farmer’s wife, but I still feel you are both too young to be getting married.”
More silence. “Well, I’d like you to try to arrange a wedding for the fall.”
“But, Peter, do you have a farm?”
“No, I don’t.”
“Well, how can you think of getting married if you don’t have a farm? You would have to live with your parents. That wouldn’t be fair to Jenny.”
He thought that over for a while. “You’re right. I guess I’d better concentrate on getting a farm first.”
Who did Peter think I was as he asked for my opinion? Could it have been his mother or perhaps his elder sister? Soon the snack cart came along. We each enjoyed a cup of coffee and a cookie. I kissed him goodbye and went home smiling, because Jenny was still not married when Peter married me.
Metzger, Z.B. (2010). The Last Lap of the Long Run, Addendum to “On the Long Run”: An Account of our Travels with Dementia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Evaluating Communication Techniques [PDF].
Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined; one group will take a pro position towards the topic and the other group will take a con position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate topics for Health 1: Interpersonal Communication.
When students are learning about conflict resolution, it might be helpful for them to grasp how a problem-solving process might be applied even (and possibly especially) in situations of heightened emotions.
Using one or more scenarios taken either from clinical practice or personal experience, invite students to work in small groups to analyze the problem, suggest alternative choices, determine the best outcome, and suggest how it will be evaluated.
The STUDENT HANDOUT below could be used to direct this discussion.
STUDENT HANDOUT
Problem-Solving Exercise: Resolving Conflicts
DIRECTIONS: Consider the following problem/dilemma:
Carol and Jason, both in their early 30s, have been living together for less than a year. They have a lot in common and enjoy each other’s company – going to hockey games and movies together, skiing in the mountains in the winter and hiking in the summer. They share responsibilities around the apartment and each contributes equally to the costs.
A conflict has arisen, however, that is causing considerable strife in their relationship. Jason has a small group of buddies that he has socialized with since high school. Carol has made it clear that she does not want to socialize with these friends (all guys). She refers to them as “losers” and “adolescents.” Jason is devoted to his friends and enjoys the crazy and comfortable camaraderie he experiences when he is with them.
Both Carol and Jason had thought that their relationship had potential to blossom into a long-term commitment, even marriage. This conflict is causing them both to reconsider.
Is there further information you need to adequately understand this problem? If so, what is it and where would you get this information?
Options | Positive Consequences | Negative Consequences |
---|---|---|
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Problem-Solving Exercise: Resolving Conflicts [PDF].
The following case study is used with permission of Island HealthIsland Health (2012).
Barbara is an HCA who has been working on the general medicine unit for the past year. Today she is being asked to mentor David, a newly hired HCA. David has been working as a casual in residential care and will be working as a casual HCA on Barbara’s medical unit, as well. Today is David’s first mentorship time with Barbara.
Just as Barbara and David are about to get Mr. Roberts out of bed, Barbara is called by the LPN to offer assistance to Mrs. Jones in the next room. When she returns to Mr. Roberts’ room, she sees David struggling to get Mr. Roberts out of bed. David identifies that the physiotherapy assistant who just popped in the room a few moments ago stated that Mr. Roberts can get out of bed on his own.
Mr. Roberts is an ALC patient and has been on the medical unit for the past 30 days and is well-known to Barbara. A second patient on this unit, also a Mr. Roberts, had been admitted for pneumonia several days ago and is awaiting his discharge.
Discussion Questions:
A professional approach to practice presupposes an ability to “tune in” and respond appropriately to clients in a variety of situations.
Recognized HCA Program educators are asked to build specific learning opportunities into their programs and confirm students complete the Provincial Violence Prevention e-modules prior to the start of their practice education placements. The curriculum was developed to fill a need for effective, recommended, and provincially recognized violence prevention training. After completing this curriculum, HCA students will have received education and tools to prevent, defuse, and/or deal with potentially violent situations. Given the provincial commitment to health and safety of workers and reducing the risk of violence, an active partnership with health program educators is essential.
The Provincial Violence Prevention curriculum is available online at LearningHub.
A quiz is embedded at the end of each module and students are then able to print their results to provide proof of completion.
The curriculum consists of eight e-learning modules and takes approximately 3.5 to 4 hours to complete. Modules include:
Good communication skills are invaluable to the effective HCA and these skills need to be practised. Below are several approaches that are aimed at giving students opportunities to practise effective communication.
Invite students to select partners to practise non-verbal listening skills. While one partner assumes the role of speaker, the other is the listener. The speaker can talk about anything, but a topic that elicits opinions or feelings is best. While the speaker is talking, the listener will practise excellent listening. For example:
After 5 or 10 minutes, the interaction stops and the partners change roles. Once both participants have had a chance at both roles, discussion should take place guided by the following:
Invite students to get into groups of three for a short discussion period. Each member of the group will take on one of these roles:
The speaker can talk about anything, but may be helped by some suggested topics such as those below:
The process for each group will be as follows:
Following this practice, invite the groups to discuss the difficulties they experienced trying to understand the other person and trying to be understood. Students should identify what they learned from this exercise about speaking and listening.
Invite students to practise empathic responding in two real-life situations. Ask them to pick one person they don’t know well (e.g., a sales person in a store, a new client in the practice setting) and one person they do know well (e.g., a close friend or relative). Instruct the student to initiate a conversation with each person and attempt to tune in to what the other person is saying and what they seem to be feeling. Ask the student to attempt to respond empathically.
At the next class, discuss the following questions:
Ask students to work with a partner and use the scenarios on the STUDENT HANDOUT below to practise assertive communication skills.
STUDENT HANDOUT
Practising Assertive Communication
DIRECTIONS: With a partner, practise using assertive communication. Alternate so each student has an opportunity to practise in the HCA role. Debrief after each scenario.
Student 1 (Team leader):
“Hi . I’m going on my lunch break now. Janice will cover this team as team leader while I’m on my break, but she is really busy, so you can go ahead and change Mr. Grey’s IV bag when it’s empty. The new one is on the bedside table all ready to go.”
Student 2 (HCA):
You know this is not in your defined role as an HCA. What will you say to the team leader?
Student 1 (Client’s daughter):
“We are so appreciative of what you do for our father. Please accept this bottle of wine as a thank you from our family.”
Student 2 (HCA):
You know you are not allowed to accept gifts from clients. What will you say?
Student 1 (HCA student on clinical in a complex care facility):
“Excuse me, could you help me to transfer Mrs. Jones? I know that the policy is to always have two people when using the ceiling lift.”
Student 2 (HCA at a complex care facility – acting as a mentor):
“Just do it on your own. We don’t have time to have two of us use the lifts. This is the real world.”
Student 1 (HCA student on clinical in a complex care facility):
How would you respond?
Debrief Questions
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Practising Assertive Communication [PDF].
Students will apply effective communication strategies using the scenarios provided below. If available, students may enjoy completing this activity in the lab, with measures taken to simulate a real-life setting. The role play should be used towards the end of the course, as a consolidation activity.
STUDENT HANDOUT
Scenarios: Practising Effective Communication Skills
DIRECTIONS: Read the scenarios you have been assigned. The student taking the role of the HCA should first take a few minutes to identify three communication skills that they will apply to the scenario. The students should then act out the scenario, with the student in the role of the HCA using the communication skills they selected. The student acting as the observer should make notes about the perceived effectiveness of the communication skills that were used during the interaction. After each role play, take a few minutes to complete the debrief discussion questions.
You are an HCA working for a home support agency. You have been asked to visit James Smith, a 72-year-old client with diabetes. When you arrive at his home, you notice that he has several candy wrappers at his bedside. You understand that you are required to report this to your supervisor and when you mention this, Mr. Smith becomes upset and shakes his cane at you.
You are an HCA working in a residential care home and have been assigned to care for Mrs. Chan, a 90-year-old lady who has just moved into the care home. Mrs. Chan emigrated from China and has been living in Canada for 10 years. When you enter her room, she is crying because she misses her daughter who is no longer able to care for her at home.
You are an HCA working in acute care. Today has been a challenging day for you; you are nearing the end of your shift and are feeling tired and impatient. Before you leave, the team leader asks you to check on Amit Singh. When you enter the client’s room, his daughter starts to complain about the care Mr. Singh has received from you that day.
You have recently been hired as an HCA in assisted living. Lately, you have noticed that one of the staff members, Jan, seems to be avoiding eye contact with you. One afternoon, when you greet her, Jan does not respond and walks away. A week later, another staff member tells you that Jan has been talking about you in the break room. How should you approach Jan about this situation?
You are an HCA student who has recently started your practicum placement in assisted living. It is flu season and two of the staff members have called in sick. You are helping Mr. Soong get ready for bed, and while he is in the bathroom, the LPN enters the room. “I’m swamped!” she says, setting down Mr. Soong’s medication. “Can you come and report back to me after Mr. Soong takes this Tylenol?” How will you respond to the LPN?
Today is the first day of your clinical placement in multi-level/complex care and you are assigned to shadow Ray, one of the HCAs. While you are assisting with Mr. Alveraz’s morning routine, Ray asks you to help him with the mechanical lift. You politely explain to Ray that you are not permitted to assist with lifts until your instructor has signed you off. Ray sighs loudly, and says, “Oh, brother. I’ve worked with your instructor before. Whenever she brings students here, everything takes twice as long!”
Debrief Discussion (after each role play):
After each role play has been completed, the group should discuss the following:
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Scenarios: Practising Effective Communication Skills [PDF].
The course learning outcomes may be assessed by the following tasks:
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British Columbia College of Nurses and Midwives. (n.d.). Taking pictures of clients: Is it ever OK? https://www.bccnm.ca/LPN/learning/confidentiality/Pages/photos_clients.aspx
Pappas, C. (2015, June 6). 10 netiquette tips for online discussions. eLearning Industry. https://elearningindustry.com/10-netiquette-tips-online-discussions
Arnold, R. (2015, February 23). A world of gestures. Culture and nonverbal communication [Video]. YouTube. https://www.youtube.com/watch?v=GRo0gLWqKxI
Academic Skills, The University of Melbourne. (2017, April 5). Giving and receiving effective feedback [Video]. YouTube. https://www.youtube.com/watch?v=zSEGZaI3fIY
Academy of Social Competency. (2018, April 10). Communication skills: Empathetic listening [Video]. YouTube. https://www.youtube.com/watch?v=t685WM5R6aM
Ballerz Mixtape. (2020, January 10). Non-verbal communication – the documentary [Video]. YouTube. https://www.youtube.com/watch?v=Ym081ObRtPcClassic
Conversation Sparks. (2017, September 12). How to be a better listener: Paraphrasing [Video]. YouTube. https://www.youtube.com/watch?v=BjUCF_Z146c
Cuddy, A. (2012, June). Your body language may shape who you are [Video]. TED Global. https://www.ted.com/talks/amy_cuddy_your_body_language_may_shape_who_you_are/up-next?language=en
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EIRMC (Eastern Idaho Regional Medical Center). (2013, November 25). Say this, not that: Patient experience video [Video]. YouTube. https://www.youtube.com/watch?v=r842Ylpa-nQ&t=267s
Fact and Figures. (2017, January 25). How to show respect in a conversation [Video]. YouTube. https://www.youtube.com/watch?v=1wVw4D5KvVM
GavProVideo. (2013, September 9). Communicate! – Paraphrasing with Denise Besson-Silva [Video]. YouTube. https://www.youtube.com/watch?v=5JL2iizK2c0
Happify. (2016, January 19). How mindfulness empowers us: An animation narrated by Sharon Salzberg [Video]. YouTube. https://www.youtube.com/watch?v=vzKryaN44ss
Headly, J. (2013, May 22). It’s not about the nail [Video]. YouTube. https://www.youtube.com/watch?v=-4EDhdAHrOg
Health Chronicle. (2017, November 8). How laughter affects our health (and why it’s the best medicine) [Video]. YouTube. https://www.youtube.com/watch?v=DB_cSy0IIOg
Izzo, J. (2014). 5 words that will improve your ability to receive feedback [Video]. YouTube. https://www.youtube.com/watch?v=4BpPtjKpJZM
Kiawans, K. (2013, December 12).The importance of non-verbal cues as told by “Friends.” [Video]. YouTube. https://www.youtube.com/watch?v=OvEci5Bjgd4
Kurtzberg, T. (2016, May 26). The unintended consequences of electronic communication [Video]. YouTube. https://www.youtube.com/watch?v=rH6dMhf_P-w
Lyon, A. (2019, June 11). Communicate with empathy [Video]. YouTube. https://www.youtube.com/watch?v=8tyFJTtzYtY
McAdam, E. (2017, November 2). Empathetic listening: “The hairy eyebrow” and other essential communication skills [Video]. YouTube. https://www.youtube.com/watch?v=MGdgUP8XLwc
MindToolsVideos. (2014, August 19). The Johari window [Video]. YouTube. https://www.youtube.com/watch?v=skKBI8wcMaA&feature=emb_logo
Richards, L. (2016, October 29). Conflict resolution techniques. A brief overview [Video]. YouTube. Teamworks. https://www.youtube.com/watch?v=NJH0XV9jGIE
RSA. (2013, December 10). Brené Brown on empathy [Video]. YouTube. https://www.youtube.com/watch?v=1Evwgu369Jw&list=PLoLnm0ZhSqhCsQmLI6U4zzDQBleEeyH0t
Santilli, B. (2016, November 6). 5 ways to improve nonverbal communication/body language skills [Video]. YouTube. https://www.youtube.com/watch?v=oQh7t4WRHOk
Sesame Street. (2007, April 20). Ernie and Bert can’t communicate [Video]. YouTube. http://www.youtube.com/watch?v=kjF4rKCR81o&feature=related
Sesame Street. (2007, September 29). Ernie and Bert “very important note” [Video]. YouTube. http://www.youtube.com/watch?v=RLgJtxCzDmM&feature=related
TEDx Talks. (2015, May 7). Interpersonal communication in the future world with Celine Fitzgerald [Video]. YouTube. https://www.youtube.com/watch?v=KlI2qDO0J6s
TEDx. Talks. (2015). Sheila Heen: How to use others’ feedback to learn and grow [Video]. YouTube. https://www.youtube.com/watch?v=FQNbaKkYk_Q
Van Edwards, V. (2020, January 14). Self-worth: 20 ideas to build your self-esteem [Video]. YouTube. https://www.youtube.com/watch?v=iDqik1-U3is
Winch, G. (2014, November). Why we all need to practice emotional first aid [Video]. TEDxLinnaeusUniversity. https://www.ted.com/talks/guy_winch_why_we_all_need_to_practice_emotional_first_aid/up-next
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
LearningHub. Provincial Violence Prevention Curriculum [E-learning modules]. https://learninghub.phsa.ca/Courses/7558/provincial-violence-prevention-for-medium-and-high-risk-departments-8-modules
Social Care Institute for Excellence. (2014). Dignity in care: Communication [Video]. http://www.scie.org.uk/socialcaretv/video-player.asp?v=communication
6
Invite students, as a whole class or in small groups, to discuss the following questions:
Caring always presupposes a person-centred approach to all caregiving practice. In order to fully understand the uniqueness of each client, students need to grasp how changes in one dimension of health affect and are affected by all the other dimensions. The following exercise helps to portray this interaction:
Begin by drawing a health wheel which identifies the five components or dimensions of health. Encourage students to suggest indicators or signs of health in each of the five components. See diagram below with some suggestions for indicators of health. Another resource is the First Nations Health Authority’s Health Wheel.
In order to assist students to see the intimate interconnectedness of the five components or dimensions of health, guide the students through the following exercise:
As a homework assignment, have students review their client portfolio for Peter Schultz and the Health Wheel: Indicators of Health. They could also use the First Nations Health Authority’s Health Wheel for this assignment.
Components of Health | Symptoms | Causes | Approaches |
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Physical |
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Cognitive |
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Social |
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Emotional |
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Spiritual |
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Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined; one group will take a pro position towards the topic and the other group will take a con position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate topics for Health 2: Lifestyle and Choices:
Have students work in small groups. Each group chooses, or is assigned, two to three determinants of health. The groups develop and write down scenarios to illustrate how the multiple determinants of health interrelate and influence health. The groups then share their scenarios with the rest of the class.
Health literacy is described by the Canadian Public Health Association as “the ability to access, understand, evaluate, and communicate information as a way to
promote, maintain, and improve health in a variety of settings across the life-course.”Canadian Public Health Association. (2017). A Vision for a Health Literate Canada: Report of the Expert Panel of Health Literacy. p. 11. https://www.cpha.ca/vision-health-literate-canada-report-expert-panel-health-literacy
This activity could be completed as part of a related assignment, such as the Lifestyle Change Project (Learning Strategy 4) below.
STUDENT HANDOUT
Evaluating Health Information Online: A Checklist
When seeking health information online, it is important to keep in mind that the Internet is not regulated and anyone can set up a website. The criteria presented here will help to decide whether information found online is credible.
Note: The material used to create this checklist has been obtained from the following sources:
Download Student Handout: Evaluating Health Information Online: A Checklist [PDF].
Invite students to undertake a Lifestyle Change Project, which may be a marked assignment for the course. This assignment will encourage students to actively use an informed problem-solving process to make positive changes in their lives. If possible, have students carry out the change for a period of three to four weeks. This allows time for them to understand the difficulty in sustaining the change, especially during the time of other changes in their lives (e.g., being a student). Students may enjoy using technology to monitor their progress. See Online Learning Tools and Apps at the end of this chapter.
Students may be invited to form small groups to share their change projects and what was learned.
See the STUDENT HANDOUT to guide this Lifestyle Change Project.
For an alternate assignment, you could use the Planning Your Journey to Wellness: A Road Map from the First Nations Health Authority.
STUDENT HANDOUT
Lifestyle Change Project
The purpose of this project is to provide you with an opportunity to apply knowledge learned in Health 1: Lifestyle and Choices to the development and implementation of a personal lifestyle change process.
Remember: Even if you aren’t completely successful in meeting your original goal, you will be successful in learning something about yourself and your needs that can be very useful to you in the future as you strive to make health-enhancing lifestyle choices.
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Lifestyle Change Project [PDF].
Invite students, working in small groups, to review the following scenarios and determine to what degree the HCA is behaving in a professional manner. Have students discuss how self-care relates to professional practice.
Sharon Sandhu is an experienced HCA working for a home support agency. Sharon has struggled with her weight for many years, knowing that the extra 30 pounds she carries could be increasing her chances for high blood pressure, diabetes, and cancer.
One of her elderly clients, Mable Chung, is an outspoken, sometimes brutally honest, 90-year-old who regularly advises Sharon that “there is no excuse for being fat.” One day, after hearing Mable’s comments many times, Sharon responds sharply, “Oh, for goodness sake Mable, get off it. I’m sick of hearing your nagging.”
Marg Thompson is an HCA who works in a special care unit with clients who have dementia. She loves her work but often feels tired and lacking in energy. She knows she would feel better if she could cut back on her smoking and exercise more. She tells herself that she will start exercising next month, or when the weather improves, but somehow she never actually gets started. She also promises to stop smoking every New Year’s but so far, she hasn’t. One day Marg’s supervisor mentions to her that he has noticed her lack of energy, which can seem like apathy. He has also noticed that Marg has had more illness (mainly colds) in the past year than anyone else on the unit. He wonders if she is unhappy with her job and, possibly, should consider working elsewhere.
James Ahmed is an HCA on a surgical unit in an acute care hospital. He works steady afternoon (1500–2300) shifts. This works well for him, as his wife works day shifts, so he can take his children to school and they only need a couple of hours of after-school child care per day. They are saving to buy a house and every penny counts!
This evening, one of the clients who had surgery today is very confused and agitated. The nurse assigns James to do 1:1 observation with the client. James keeps the client safe and reports his observations to the nurse. At the end of the shift, the nurse asks James if he can “do a double” (work until 0700) as the night HCA who was booked for 1:1 phoned in sick. James really needs the money, so decides to accept the shift, even though he only slept a few hours the night before and this is the third double shift he has done this month. James leaves the hospital at 0710 to drive home – a 35-minute drive. He really has trouble keeping his eyes open on the way home.
The course learning outcomes may be assessed by the following tasks:
Bergland, C. (2014, March 12). Eight habits that improve cognitive function. Psychology Today. https://www.psychologytoday.com/ca/blog/the-athletes-way/201403/eight-habits-improve-cognitive-function
Brown University, Health and Wellness. (2015). Alcohol and your body. https://www.brown.edu/campus-life/health/services/promotion/alcohol-other-drugs-alcohol/alcohol-and-your-body
Canadian Institute for Substance Use Research. (2013). Understanding substance use: A health promotion perspective. Here to Help. https://www.heretohelp.bc.ca/infosheet/understanding-substance-use-a-health-promotion-perspective
Care for Caregivers. (n.d.). Healthcare worker resources. https://www.careforcaregivers.ca/
Emerald Works Mind Tools. (n.d.). Stress management: Manage stress. Be happy and effective at work. https://www.mindtools.com/pages/main/newMN_TCS.htm
First Nations Health Authority (n.d.) First Nations perspective on health and wellness. https://www.fnha.ca/wellness/wellness-for-first-nations/first-nations-perspective-on-health-and-wellness
First Nations Health Authority (n.d.) Wellness streams. https://www.fnha.ca/wellness/wellness-for-first-nations/wellness-streams
First Nations Health Authority (n.d.) Wellness roadmap. https://www.fnha.ca/Documents/FNHA-wellness-roadmap.pdf
Government of British Columbia. (2014). Elder abuse reduction curricular resource. BCcampus. http://solr.bccampus.ca:8001/bcc/items/8d5b3363-396e-4749-bf18-0590a75c9e6b/1/
Government of British Columbia, Ministry of Health. (2005). Healthy aging through healthy living: Towards a comprehensive policy and planning framework for seniors in B.C. http://www.health.gov.bc.ca/library/publications/year/2005/healthy_aging.pdf
Government of Canada, Health Canada. (2016). Eating well with Canada’s food guide. http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index_e.html
Government of Canada, Health Canada. (2012). Environmental and workplace health. http://www.hc-sc.gc.ca/ewh-semt/index-eng.php
Government of Canada, Health Canada. (2015). Food and nutrition. http://www.hc-sc.gc.ca/fn-an/index-eng.php
Government of Canada, Public Health Agency of Canada. (n.d.). Social determinants of health and health inequalities. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
HealthLinkBC. (2015). Making a change that matters. https://www.healthlinkbc.ca/health-topics/abp2710
HealthLinkBC. (2015). Spirituality and your health. https://www.healthlinkbc.ca/health-topics/abq0372
HealthLinkBC. (2019). Stress management. https://www.healthlinkbc.ca/health-topics/rlxsk#hw153409
Lewis, C. (2019). Why is the wellness wheel important? [Blog post]. https://www.1and1life.com/blog/wellness-wheel/
National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Changing your habits for better health. https://www.niddk.nih.gov/health-information/diet-nutrition/changing-habits-better-health
New York State Department of Health Bureau of Injury Prevention. (2009). Check for safety: A home fall prevention checklist for older adults [Brochure]. https://www.health.ny.gov/publications/0641.pdf
Proactive Mindfulness. (n.d.). Proactive stress management. https://www.proactivemindfulness.com/category/stress/
Simon Fraser University (2014). The 7 dimensions of wellness. http://www.sfu.ca/students/health/resources/wellness/wheel.html
World Health Organization. (n.d.). Health topics. https://www.who.int/health-topics/
WorkSafeBC. (2014, December). Back talk: An owner’s manual for backs. https://www.worksafebc.com/en/resources/health-safety/books-guides/back-talk-an-owners-manual-for-backs
AsapScience. (2014, December 14). Are you sitting too much? [Video]. YouTube. https://youtu.be/uiKg6JfS658
Alcohol and Drug Foundation. (2014, October 26). Alcohol and your body [Video]. YouTube. https://www.youtube.com/watch?v=I_OoW_w-uM8
Australian Lions Drug Awareness Foundation, Inc. (2010, August 26). Alcohol and your brain [Video]. YouTube.https://youtu.be/zXjANz9r5F0
Boroson, M. (2011, March 2). One-moment meditation: “How to meditate in a moment” [Video]. YouTube. https://youtu.be/F6eFFCi12v8
Braive. (2017, December 10) Stress bucket [Video]. YouTube. https://youtu.be/1KYC5SsJjx8
Braive. (2016, March 31). The fight flight freeze response [Video]. YouTube. https://youtu.be/jEHwB1PG_-Q
Buettner, D. (2009, September). How to live to be 100+ [Video]. TEDxTC. https://www.ted.com/talks/dan_buettner_how_to_live_to_be_100/up-next?language=en
Government of British Columbia. (n.d.). Move for life DVD [Videos]. https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health-safety/active-aging/move-for-life-dvd
Maudsley Learning. (2016, July 1). What is mental health? [Video]. YouTube. https://youtu.be/G0zJGDokyWQ
McGonigal, K. (2013, June 13). How to make stress your friend [Video]. TEDGlobal. https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend/up-next
MHLiteracy. (2020, May 1). Stress (le stress) [Video]. YouTube. https://youtu.be/jHjkEfwfECo
Motivation Thrive. (2021, January 19). I can’t say no! – Don’t be emotionally triggered: Dr.Gabor Maté [Video]. YouTube. https://youtu.be/JKbZbiXzvDg
PE Buddy. (2020, May 10). Learn the 5 dimensions of health! PE Buddy [Video]. https://www.youtube.com/watch?v=ijpvLaArBBI&t=11s
PsycheTruth. (2011, August 8). Self-esteem, confidence, how to love yourself, human needs and humanistic psychology [Video]. YouTube. https://youtu.be/hplaY196ARw
TED. (2020, September 2). A walk through the stages of sleep: Sleeping with science, a TED series [Video]. YouTube. https://youtu.be/eM2VWspRpfk
Youngster. (2019, November 6). Top 3 benefits of physical activity: Dr. Greg Wells [Video]. YouTube. https://youtu.be/5-SgF18bCHQ
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
DocMikeEvans. (2011, December 2). 23 and 1/2 hours. What is the single best thing we can do for our health? https://www.youtube.com/watch?v=aUaInS6HIGo&list=PL4TcyUrQ3YhJ4X5kajWc
Government of Manitoba. (n.d.). Physical education/health education. Module B: Fitness management, lesson 2: Changing physical activity behaviour. https://www.edu.gov.mb.ca/k12/cur/physhlth/frame_found_gr11/rm/module_b_lesson_2.pdf
Here to Help. (2016). Wellness modules. http://www.heretohelp.bc.ca/wellness-modules
Anxiety Canada. (n.d.). MindShift CBT [Mobile app]. https://www.anxietycanada.com/resources/mindshift-cbt/
Canadian Mental Health Association. (n.d.). Mental health meter [Mobile app]. http://www.cmha.ca/mental_health/mental-health-meter/
Healthwise. (2015). Interactive tools. https://www.healthlinkbc.ca/health-topics/tu6657
Optimity. (2016). My optimity [Mobile app]. https://www.myoptimity.com/
7
Using the health wheel from Health 2: Lifestyle and Choices as a guide, invite students, working in small groups, to discuss how common health challenges might affect all areas of health and healing.
Each group may be assigned a specific health challenge and given the task of identifying the primary components of the health challenge (e.g., pain, loss of function, immobility, fatigue, confusion, stress, etc.).
With this information, the group will identify how these changes might affect all other aspects of the person’s health (e.g., how fatigue might affect social, cognitive, emotional, and spiritual health).
The group will then discuss how changes in each dimension of health might positively contribute to healing. Each group will report back to the whole class.
The above process could be undertaken using scenarios of real or fictitious individuals who are struggling with one or more of the common health challenges studied in this course. Students, in small groups, will discuss how the changes in health brought about by the health challenge(s) are affecting all dimensions of the person’s health and healing and how each level of needs (as described by Maslow) is affected. The group will then discuss how changes in each dimension of health might positively contribute to healing. Each group will report back to the whole class.
As a homework assignment, ask students to review relevant textbook, online or other course materials describing cerebral vascular accidents (CVAs).
Note: Students could be instructed to add the scenario and session materials to their client portfolio for Peter Schultz.
STUDENT HANDOUT
Unfolding Case Study: Caring for Peter Schultz
Cerebral Vascular Accidents (CVAs)
DIRECTIONS: Read the following account describing the CVA experienced by Peter Schultz. Working in small groups, apply your knowledge about CVAs to the scenario below by responding to the following discussion questions:
What I thought was the beginning happened March 3, 1995, when Peter was 77 [years old]. I awoke in the night to hear Peter in the bathroom coughing and hacking as though to rip his throat out. He finally stumbled back to bed and went to sleep. I arose fairly early to prepare breakfast for his sister and her husband who had been visiting us and were leaving that morning for Alberta. We three were sitting at the table waiting for Peter who was slow making an appearance. When he did, we couldn’t understand a word he said as his speech was so confused. He didn’t seem to realize there was anything wrong. We struggled through breakfast trying to persuade him to see a doctor, but he insisted he simply had a little sore throat, so finally our guests left and we began our day.
Peter lay down on the couch and slept. Something was wrong, but I didn’t know what. Later I went to my daughter’s house to give the kids a piano lesson. When I told them what had happened, my son-in-law immediately phoned the doctor who said I must bring Peter into the office. I went home and did that.
“His blood pressure is out of sight,” the doctor said. “He’s had a stroke. I’ll arrange for a brain scan and we’ll see what the damage is.”
The scan showed that he had had several prior strokes that hadn’t been obvious. Medication for high blood pressure was prescribed and I made sure Peter took his pills each day. I had no experience looking after someone who was sick, but Peter didn’t seem sick anyway, just a bit confused sometimes. However, as time went on I began to notice some personality changes. He was often rude to me in front of friends, cried easily, and clung to me almost obsessively; table manners seemed to slip away and he was sometimes extremely impolite.
Metzger, Z.B. (2010). The Last Lap of the Long Run, Addendum to “On the Long Run”: An Account of our Travels with Dementia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Cerebral Vascular Accidents (CVAs) [PDF].
The following case study is used with permission of Island Health.Island Health (2012).
A 61-year-old male is being admitted to the unit by stretcher from Emergency. He was receiving palliative end-of-life care at home, but has been admitted due to a pain crisis. You enter the room with the RN from your unit, and under the direction of the RN, you assist in moving the patient from stretcher to bed. With a gentle touch and a caring smile, you introduce yourself.
As the RN gets the report, you continue to help position the patient. You go for more pillows to help with positioning, get a warm blanket, and retrieve other care items. You ask the RN how you can help (for example, find an IV pole, collect mouth wash supplies, or get ice water.)
Once the patient is settled, you turn your attention to the family. You consider how many chairs they will need in the room and ask if you can get them something to drink. You also show them where the washroom, ice machine, and public telephone are located.
Remember to consider the family in planning the care of your patient. The death of a loved one is an experience that stays with most people forever. It is our job to be supportive during this time. The RN will need to pay attention to eliminating the pain crisis and attend to the other needs while you help to create a caring environment.
Questions for Discussion:
Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined; one group will take a pro position towards the topic and the other group will take a con position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate topics for Healing 1: Caring for Individuals Experiencing Common Health Challenges.
Invite students, working alone or in small groups, to develop a tool (for example, a checklist of best practices) that would aid them when they are supporting a client who is dying.
Based on what they have learned about end-of-life care, what regular observations should be made:
After developing the tool, students will discuss how the information will influence choices they will make about caregiving practice and how they will evaluate the care they provide.
STUDENT HANDOUT
Common Patterns of Dying
Video Discussion Questions:
Consider these questions while watching Unprecedented – Common Patterns of Dying instructional video available on the Life and Death Matters website.
Small Group Questions:
Read the case scenario below, describing the pattern of stuttering decline (“Stuttering Decline – The Roller Coaster”)
As a Class:
Stuttering Decline – The Roller Coaster
My name is Sarah. I am Tom’s wife and caregiver. Tom has chronic obstructive pulmonary disease, and although we have been dealing with it for over 15 years, the last eight years have been the hardest, with repeat hospital admissions, decreased abilities, and increased needs. I have heard it said that the typical patient with this disease goes to death’s door a number of times before dying. At least five times the children have gathered to say goodbye.
June 9: Last week the doctor came in and, squatting to make eye contact with Tom, asked us what we wanted. Tom said that he was tired – tired of hospitals, emergencies, tests, and more treatments. I very carefully suggested hospice. Tom and the doctor agreed.
June 15: We came home by transport ambulance. All the kids came home to help. In the middle of the night, I wept. I am exhausted. I wonder if he will die soon. I hope he will. I hope he won’t.
July 15: How long will this go on? It has already been eight years! The HCAs come five times a week now. I willingly let them help. Tom seems to enjoy them.
July 18: My, oh my, what a journey! This man of mine has always had a huge appetite. Now he is eating so little. It is hard for him to eat and digest and breathe at the same time. I try to feed him but even with all my effort, he eats very little.
August 9: Tom has been restless for the last three nights. He sits on the edge of the bed, tries to get up, then sits down. Then he wants up. We need to be with him because he is unsafe. He has more difficulty breathing. He is confused, sometimes talking to people who aren’t there. The other day he dreamt of his mom who died several years ago. His sentences are not making sense, his words jumbled. He was like this last year when he was really sick. He recovered then. I don’t think he will recover this time.
August 17: We celebrated our 60th anniversary two months early.
August 19: Tom is very weak, can manage sips of water. He is confused again.
August 20: It is with a sad heart that I tell you my Tom died this morning. He has been sick for 15 years.
Copyright © 2017, Life and Death Matters. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Common Patterns of Dying [PDF].
Students will use knowledge about communication, common health challenges, and observing and reporting to identify and respond to a variety of health-related situations.
Scenarios are provided below. Included for each scenario are a HCA Role Card, a Client Role Card, and a Client Profile. The Client Profile should be used to inform client care; alternately, it could be used to populate preferred templates in use by the program (e.g., bedside care plan or assignment sheets). The material provided for this activity has been formatted in a way that will facilitate its direct use in the educational setting.
Students may enjoy practising this activity in the lab, with measures taken to simulate a real-life setting. This critical thinking activity could also be adapted for use during the Healing 3: Personal Care and Assistance course.
Depending on program sequencing, scenarios and client profiles could be further adapted to increase the complexity of this activity. This could be accomplished by incorporating additional props and/or equipment or by adding information to the client profile (e.g., medication information).
While not directly indicated, the health-related situations are listed below for instructor reference. Students in the HCA role should be able to identify these situations (using observation and reporting) through the role play and when documenting. The instructor will highlight these during the debrief.
Setting Up the Activity
A. Role Play
Have students work in pairs, with one acting as the client and the other as the HCA. Provide role play cards in such a way that students do not see the card for the alternate role. The student acting as the client will read the Client Role Card and follow the directions provided. The student acting as the HCA will read the HCA Role Card and then use critical thinking skills to respond to the situation they are presented with. The Client Profile for each role play can be provided to both students and/or given to them to share.
Students playing the HCA role should be reminded to respond to the scenario based on their observations, communication with the client, and accompanying client profile (or assignment sheet and/or bedside care plan).
Students should be instructed to report any emergencies to the instructor, who could take on the role of the team leader.
Students should be directed to alternate roles after each role play and get new role cards from the instructor after completing required documentation (see B).
B. Documentation Exercise
After each role play is complete, the two students will prepare a written report describing the situation. If desired, the instructor could request that a specific documentation format is followed, such as the one to be used in the practice education setting. At a minimum, the following should be documented:
C. Debrief
After students have completed this activity, convene as a class to review the common health challenges presented. Discuss appropriate response(s) and reporting for each scenario, highlighting which situations would require immediate reporting to the team leader.
ROLE PLAY CARDS
ROLE PLAY 1: HCA ROLE CARD
You are working for a home support agency. Today you are visiting Jenny Smith for the first time. Enter the home, greet your new client and introduce yourself. Respond to the situation you are presented with.
ROLE PLAY 1: CLIENT ROLE CARD
Your name is Jenny Smith and you are 72 years old. After the HCA greets you, tell them you feel dizzy and sweaty and that you are hungry because you skipped breakfast today.
ROLE PLAY 2: HCA ROLE CARD
You are working in an assisted living residence. Today you will be escorting Mrs. Kaur to the dining room for lunch. Enter her room, greet her, and introduce yourself. Respond to the situation you are presented with.
ROLE PLAY 2: CLIENT ROLE CARD
Your name is Mrs. Kaur, and you are 88 years old. After the HCA provides introductions and checks your bedside care plan, they will ask you to walk to the dining room. As you get up from your chair, act dizzy. Sit down again and tell the HCA you feel dizzy.
ROLE PLAY 3: HCA ROLE CARD
You are working in a group home setting. Today you will be assisting Alicia Smith who has ataxic cerebral palsy. Enter her room, greet her, and introduce yourself. Respond to the situation you are presented with.
ROLE PLAY 3: CLIENT ROLE CARD
Your name is Alicia Smith, and you are 42 years old. You have ataxic cerebral palsy and are unable to speak. When the HCA arrives, use gestures to indicate that you are hungry.
ROLE PLAY 4: HCA ROLE CARD
You are working in an acute care setting. Today you will be providing care to Mr. Dhaliwal who has had hip replacement surgery. Enter his room, greet him, and introduce yourself. Respond to the situation you are presented with.
ROLE PLAY 4: CLIENT ROLE CARD
Your name is Mr. Dhaliwal. When the HCA enters your room, start coughing. Tell the HCA that you have chest pain and are feeling cold.
ROLE PLAY 5: HCA ROLE CARD
You are working in a residential care home. Today you will be assisting Rosa Martinez with her breakfast. Enter her room and greet her. Respond to the situation you are presented with.
ROLE PLAY 5: CLIENT ROLE CARD
Your name is Rosa Martinez. After the HCA greets you, act as if you are confused. Indicate that you have pain in your lower abdomen.
ROLE PLAY 6: HCA ROLE CARD
You are working in a residential care home. Today you will be assisting Julie Bates with her breakfast set up. Enter her room, greet her, and let her know that it’s time for breakfast. Respond to the situation you are presented with.
ROLE PLAY 6: CLIENT ROLE CARD
Your name is Julie Bates. After the HCA lets you know that it’s time for breakfast, tell her you don’t feel hungry. When the HCA follows up, tell her that you have a stomach ache.
CLIENT PROFILES
ROLE PLAY 1: CLIENT PROFILE
Jenny Smith is a 76-year-old female who lives alone.
Health Challenges/Diagnosis: Diabetes, neuropathy, significant visual impairment, history of falls, history of depression
ADLs: Partial assist with personal care
Mobility: One person assist with walker, unsteady on feet, history of falls
Nutrition: Diabetic diet, receives Meals on Wheels, family sometimes brings food (sweets), Jenny occasionally skips meals
Communication: English
ROLE PLAY 2: CLIENT PROFILE
Harpreet Kaur is a 92-year-old female living in an assisted living residence.
Health Challenges/Diagnosis: Parkinson’s disease with history of falls, arteriosclerotic heart disease, orthostatic hypotension
ADLs: Supervision in bathroom, requires cueing, appropriate cultural attire, raised toilet seat, meal set up
Mobility: Uses four-wheeled walker
Nutrition: Soft diet with fluids, plate protector, adaptive utensils, cup with lid
Communication: Speaks Punjabi and English
Cultural: Attends temple every Sunday
ROLE PLAY 3: CLIENT PROFILE
Alicia Smith is a 42-year-old female client who lives in a group home.
Health Challenges/Diagnosis: Ataxic cerebral palsy, expressive aphasia
ADLs: Full assist with personal care
Mobility: Risk of falls, assist with range of motion exercises
Nutrition: Soft diet, encourage small snacks throughout the day
Communication: Understands English, uses gestures to communicate when hungry
ROLE PLAY 4: CLIENT PROFILE
Jagdish Dhaliwal is a 73-year-old male in hospital following hip replacement surgery.
Health Challenges/ Diagnosis: Osteoarthritis, history of falls, CVA at age 68, dysphagia
ADLs: Assist client to sit (dangle) at side of bed (Q.I.D), one-person assist for dressing, assist with mouth care, commode for toileting, and deep breathing and coughing exercises
Mobility: Two-person assist to dangle and commode
Nutrition: Thickened fluids, dysphagia diet, cultural food preferences
Communication: Speaks Punjabi and English
ROLE PLAY 5: CLIENT PROFILE
Rosa Martinez is a 79-year-old female who lives in an assisted living residence.
Health Challenges/Diagnosis: Blind due to glaucoma, history of urinary tract infections
ADLs: Requires partial assistance with personal hygiene
Mobility: Uses white cane, assist with walking
Nutrition: Assist with meal set up/eating, record fluid intake, cranberry juice with meals
Communication: Speaks Spanish and English
ROLE PLAY 6: CLIENT PROFILE
Julie Bates is an 88-year-old female who lives in residential care.
Health Challenges/Diagnosis: Arthritis, esophageal reflux, constipation, hemorrhoids
ADLs: Partial bath, set up with meals, assist with hearing aid and glasses
Mobility: Uses four-wheeled walker, assist with mobility
Nutrition: Low fibre diet, small appetite, encourage to drink fluids
Communication: Speaks English, shy and doesn’t like to bother staff
Other: Last recorded bowel movement was four days ago
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download: Role Play Cards [PDF].
The following case study is used with permission of Island Health.
It is not unusual for client status to change quickly in acute care settings; HCAs need to be aware of how to most effectively communicate changes in client conditions in order to ensure their safety and well-being.
For the past few months, Greg, an HCA, has been working full time on a surgical unit. He is getting to know the team members and enjoys the opportunity to work in partnership with the health care team.
For the past few shifts, Greg has been supporting care for Mr. Stark. Mr. Stark is 67 years old and is a retired teacher. He had surgery six days ago to remove a tumour in his small intestine and now has a colostomy bag. He has been progressing well after the surgery and is looking forward to returning home to his wife. Mr. Stark plans to independently manage his colostomy care with assistance from community based nursing as required.
Greg is stopped by Mr. Stark while doing his hourly care rounds. Mr. Stark indicates that he is feeling like he is going to vomit and needs help. Mr. Stark’s RN, Jane, is currently in a family meeting with another patient.
Ask students to consider the “who, what, when, where, why and how” for this situation.
Who to communicate with. It is important to get the assistance of nursing staff with this as there may be a variety of factors contributing to the nausea. If unable to interrupt Jane, contact the RN covering for Jane, or the team leader.
What to communicate. Tell the RN what you saw (observations), when you saw it and what Mr. Stark reported to you regarding his nausea. Determine if the RN wants you to record this on any special forms. Be prepared to answer some questions from the RN.
When. This nausea is a change for Mr. Stark. Because of this, it is important that you verbally communicate this information immediately.
Where. It may be that you are asked to record this information on a special form or chart. Depending on the outcome, this may be a topic that is addressed in a team huddle as well. Collaborate with the RN to determine who will report this information and where. Ensure patient confidentiality and privacy is respected during verbal communication.
Why. It is critical that this information is shared in a timely way as Mr. Stark will require the assessment of his condition and possible treatment. Timely communication will also reassure Mr. Stark that his care needs are being addressed.
How. You may be able to use the nurse call bell system, pager, or voice-activated devices to alert team members that you require assistance.
Consider what forms and meetings you can use to share information once immediate needs are addressed.
Maintaining professional boundaries when caring for a dying person can sometimes be particularly challenging. Elizabeth Causton, in her writings on the “The Dance” (See STUDENT HANDOUT), provides caregivers with a metaphor that may be helpful as they work closely with clients and families.
Have students read the description of “The Dance” and ask them to discuss the following:
STUDENT HANDOUT
The Dance by Elizabeth Causton
When we work with a conscious awareness of where we stand in relationship to patients and families, respecting their unique “dance” in response to grief and loss, we are less likely to become over involved or to get lost in our work.
The idea of a family dance is not new, but it works particularly well as an image that reminds us of the importance of paying attention to boundaries as we work with people who are “vulnerable and broken.” The image can also be used to describe the sense of continuity of the family dance, which has evolved over generations. It reminds us that every family dance has its own history and that every step taken on the family dance floor has a reason in the context of that shared history.
So, when one member of the family either sits down or lies down on the dance floor because of terminal illness, the dance may look quite clumsy as the family tries to modify their routine to accommodate the changes, but the new steps are not random. They, too, have meaning in the context of what has gone on before.
Still, as we watch families struggle with a difficult dance, to music that always gets faster and louder in a crisis, we may be tempted to get onto their dance floor to try and teach them a new dance, with steps from the dance that we are most familiar with – our own. Of course, this rarely works, for the obvious reason that our dance steps do not have a history or a reason in the context of another family’s particular dance. Our valuable and unique perspective is lost the moment we step out onto someone else’s dance floor. Regardless of our good intentions, we truly become lost in our work.
The greater value of our role is to stay on the edge of the dance floor and from that vantage point, to observe, comment on, and normalize the process that the family is going through. We may suggest options, new dance steps that the family hasn’t thought of, but we do so with the recognition that they can only consider new ideas in the context of their own history. This is what it means to work from a “therapeutic distance,” to work with an awareness of where we stand in relation to the people with whom we are working.
However, whereas working with this kind of clarity and respect for boundaries may be our goal, experience tells us that it is not easy to achieve. The edge of the family dance floor is often, in fact, a fluid border as difficult to define as it is to say exactly where the sea meets the sand. In addition, each of us has “hooks” – people or situations that may touch us in some deep, unconscious place. Because we have an obligation to do this work with awareness, it is important that we do our “homework”, seeking to identify our “hooks” and paying attention to signs that we may have stepped over the line.
The signs that we are losing our perspective are: 1) experiencing an extreme emotional reaction to a person or situation that (perhaps without our knowing it) resonates with an unresolved issue or a difficult relationship on our own dance floor; 2) feeling a sense of ownership as reflected in language such as “my patients” or “my families,” or difficulty in letting go or sharing individuals with other team members; and/or 3) experiencing a need to influence or control patients and families by directing their options and choices or by making ourselves indispensable to them.
Despite having identified signs of over-involvement, it is also important to understand the challenges inherent in our work and be gentle with ourselves as we strive to be “good enough.” We need to remember that maintaining a therapeutic distance does not preclude strong emotions and deep caring. Two of the great advantages of knowing where we stand and being clear about what we bring to our work are being able both to feel deeply and to act wisely.
Reprinted with permission of the author
Elizabeth Causton
elizabeth@caustonsonbeach.ca
Causton, Elizabeth. (2003). The Dance. In M. Cairns; M. Thompson; W. Wainwright (Eds.), Transitions in Dying and Bereavement: A Psychosocial Guide for Hospice and Palliative Care. (p. 202–203) Baltimore, MD: Health Professions Press.
Download Student Handout: The Dance by Elizabeth Causton [PDF].
The course learning outcomes may be assessed by the following tasks:
Each student should reflect on their strengths as a caregiver as these relate to end-of-life care and identify areas of personal or professional development that would assist them to become more effective or confident in providing end-of-life care (Learning Outcomes #4 and #5).
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MS Society. https://mssociety.ca/
Muscular Dystrophy Association. https://www.mda.org/
Osteoporosis Canada. https://osteoporosis.ca/
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Parkinson Society British Columbia. https://www.parkinson.bc.ca/
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BioDigital, Inc. (2008, October 14). 3D medical animation – What is cancer? [Video]. YouTube. http://youtu.be/LEpTTolebqo
Brown, G. (2009, July 15). Jenny’s Huntington’s story [Video]. YouTube. https://www.youtube.com/watch?v=rleVDQ-4MsY
CTE Skills.com. (2015, November 31). The urinary system in 7 minutes [Video]. YouTube. https://www.youtube.com/watch?v=CkGqp5tr-Qk
Diabetes UK. (2013, September 3). Diabetes and the body: Diabetes UK [Video]. YouTube. https://youtu.be/X9ivR4y03DE
Diseases Simplified. (2020, January 16). Must know causes of edema/swelling [Video]. YouTube. https://www.youtube.com/watch?v=jyoaxSbwFTM
DocMikeEvans. (2014, March 13). Failing kidneys and different treatment options [Video]. YouTube. https://youtu.be/mi34xCfmLhw
DrDrewLCTV. (2011, October 31). What alcohol can do to your liver [Video]. YouTube. https://www.youtube.com/watch?v=l-SBR7p7K-M
End of Life Project. (2012, November 29). Completing the circle: End of life care with Aboriginal families [Video]. YouTube. https://www.youtube.com/watch?v=XbUGMIKId0c
FilmSpawn. (2012, June 12). World elder abuse awareness day [Video]. YouTube. https://www.youtube.com/watch?v=mSFnDe6A2Ww
Geriatric Dietitian. (2019, July 20). Embracing hospice end of life nutrition [Video]. YouTube. https://www.youtube.com/watch?v=suj_EXYHhGI
Gilbert, D. (2014, February 18). Loss of independence within the elderly [Video]. YouTube. https://www.youtube.com/watch?v=up7rGG0ytoE
Halton Healthcare. (2020, February 20). Pressure injury prevention 2020 [Video]. YouTube. https://www.youtube.com/watch?v=qcyhJuNhPG4
Healthguru. (2008, February 8). Understanding epilepsy. (Epilepsy #1) [Video]. YouTube. https://www.youtube.com/watch?v=MNQlq004FkE
Heat Inc., Health Education and Training. (2017, September 11). The nursing assistant: pressure ulcer prevention [Video]. YouTube. https://www.youtube.com/watch?v=6OGSkxlr9-c
HeistheStud. (2014, December 14). Emphysema & bronchitis [Video]. YouTube. https://www.youtube.com/watch?v=S-tryBgTBBk
Human Biology Explained. (2014, March 8). Anatomical terms – drawn and defined (updated) [Video]. YouTube. https://www.youtube.com/watch?v=kvHWnJwBkmo&app=desktop
Innovative Hearing Solutions, Inc. (2015, July 14). Inserting and removing RIC’s, CIC’s and BTE’s hearing aids [Video]. YouTube. https://www.youtube.com/watch?v=K4BK-ohwhoI
Janux. (2015, January 10). Human physiology – Introduction to the immune system [Video]. YouTube. https://youtu.be/CG931UYMbN0
Los Angeles Times. (2013, July 3). The singing nurse at Valencia hospital soothes the suffering [Video]. YouTube. https://www.youtube.com/watch?v=ODok6eNtA9c
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Life and Death Matters. (2015, March 21). My tribute to PSWs [Video]. YouTube. https://www.youtube.com/watch?v=7nvHOawDX8M
Life Before Death. (2013, December 7). Life before death – Roger’s story [Video]. YouTube. https://www.youtube.com/watch?v=eQRHrgCiEzI
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TED-Ed. (2017, December 14). How your digestive system works – Emma Bryce [Video]. YouTube. https://www.youtube.com/watch?v=Og5xAdC8EUI
TED-Ed. (2018, March 12). The science of skin – Emma Bryce [Video]. YouTube. https://youtu.be/OxPlCkTKhzY
Teepa Snow’s Positive Approach to Care. (2017, December 21). How dementia affects language skills [Video]. YouTube. https://www.youtube.com/watch?v=0BlZF_4EKp4
ThePenguinProf. (2011, July 29). Medical terminology [Video]. YouTube. https://www.youtube.com/watch?v=3fiEszFPRE8
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USMLE pass. (2019, November 18). Sounds of breathing patterns (Cheyne-Stokes, Kussmauls, Biots) [Video]. YouTube. https://www.youtube.com/watch?v=ViGjOiPE2mY
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YourRenalCare. (2011, December 15). Kidney stones [Video]. YouTube. https://www.youtube.com/watch?v=LngbrHJkXoE
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
SuperTeacherTools: https://www.superteachertools.us/#.
Canadian Virtual Hospice. (2016). Livingmyculture.ca. http://livingmyculture.ca/culture/
Joyce, S. & Grainger, J. (2021). NHA-CL-Palliative care awareness. LearningHub. https://learninghub.phsa.ca/Courses/7491/nha-cl-palliative-care-awareness
Life and Death Matters. (2015). Boundaries and self-care in hospice palliative care. https://www.youtube.com/watch?v=wSb_O6_E7_A&feature=em-share_video_user
8
The main focus of this course (at least 70%) should be on:
A maximum of 30% of course hours should be dedicated to:
Invite students to imagine what it is like to suffer from a cognitive health challenge, particularly dementia. Have students sit comfortably, close their eyes, and take several deep breaths.
Speaking softly, lead them through the following scenario:
Imagine yourself walking alone through a forest. It’s a lovely warm spring day. The sights and sounds and smells of the forest are refreshing and you are enjoying your walk.
As the afternoon progresses, you realize you aren’t sure which direction you should take to get back to your friends and family. As you look around, you realize that you are lost.
As you realize your situation, you experience a twinge of fear.
You decide to keep walking in hopes of seeing something familiar, but find that the further you go, the more lost you become. Time passes and your fear is verging on panic. As evening draws closer, you realize that you may have to spend the night alone in the forest.
Invite students at this point to open their eyes and discuss their bodily experiences, feelings, and thoughts. Invite them to discuss how this is similar to what some cognitively challenged individuals might experience.
The client with cognitive changes may constantly feel lost. No matter what they do or where they go, they can find nothing that is familiar.
What feelings, therefore, would this person be likely to have? How is this related to some of the behaviours we might see in a cognitively challenged person?
Invite students to close their eyes once again and visualize themselves back in the forest. Continue the scenario as follows:
You are back in the forest, still feeling lost and fearful. As dusk begins to settle, you notice that there is a strange man who seems to be following or observing you.
Can you see him? He is about 30 feet away. When you attempt to speak to him, he answers in a language you don’t understand.
Invite students to open their eyes and describe their responses to the stranger. What feelings were stimulated? How does this relate to how a cognitively challenged individual might experience the people in their environment (even family members)? How might this help us understand some of the responses of clients?
Using the health wheel from Health 2: Lifestyle and Choices as a guide, invite students to work in small groups to discuss how cognitive health challenges might affect all areas of health and healing (physical, cognitive, emotional, social, and spiritual). Then ask the groups to discuss how changes in each dimension of health might positively contribute to improved quality of life for the affected individual. Invite each group to report back to the whole class.
The above process could be undertaken using scenarios of real or fictitious individuals who are experiencing a cognitive health challenge. Invite students, in small groups, to discuss how the changes in cognitive ability and perceptions affect all dimensions of the person’s health and lifestyle. Ask the groups to discuss how changes in each dimension of health might positively contribute to healing. Discussion should also focus on how this understanding might influence caregiver practice. Invite each group to report back to the whole class.
An alternative to the above could involve using scenarios of a real or fictitious individual who is supporting a family member experiencing a cognitive health challenge. The focus should be on a family member (wife, husband, daughter, son, etc.) and how the cognitive health challenge of a family member is impacting them. Invite students, in small groups, to discuss how the cognitive and perceptual changes in a family member affect other members of the family. Students should consider all dimensions of the health wheel. Discussion should also focus on how this understanding might influence caregiver practice. Invite each group to report back to the whole class.
As a homework assignment, ask students to review relevant textbook, online course, or other course material related to communicating with clients with dementia.The following resource could also be referenced: Alzheimer Society of B.C. (n.d.). Communicating with people living with dementia. http://www.alzheimer.ca/en/bc/Living-with-dementia/Ways-to-communicate
Whole Class or Small Group Activity
In class, briefly review the challenges to communication experienced by clients with dementia. Following this, create a table with three columns on the whiteboard (or use the STUDENT HANDOUT) below.
Throughout the activity and/or during the debrief, highlight further communications challenges and strategies that were not listed.
STUDENT HANDOUT
Communication Challenges and Impact: Supporting Clients with Dementia
Communication Challenges – Peter Schultz | Impact on the Client and/or Family | HCA Strategies |
---|---|---|
Difficulty initiating or following conversations. | ||
Difficulty following instructions or rules related to a game or activity. | ||
Difficulty understanding written material or communicating in writing. | ||
Expressing confusion and/or the inability to understand what is being said. | ||
Expressing resistance when directed to complete tasks related to personal care and hygiene. | ||
Expressing anger and frustration related to the loss of ability to complete formerly known or routine activities (e.g., household repairs and maintenance). |
Metzger, Z.B. (2010). The Last Lap of the Long Run, Addendum to “On the Long Run”: An Account of our Travels with Dementia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Communication Challenges and Impact: Supporting Clients with Dementia [PDF].
Using the document, Ambiguous Loss and Grief: A resource for health-care providers as reference, introduce the concept of ambiguous loss and grief to the class.
Explain that this document is intended to help health care providers, Alzheimer Society staff, and volunteers gain a better understanding of how loss and grief affect people with dementia and their family caregivers. It provides useful strategies to assist families with their multiple losses and grief and to help caregivers stay connected with the person with dementia, while building strength and resilience as the disease progresses.
Using the DISCUSSION GUIDE below, explore the following questions with the students:
Invite students to share their response to the questions listed above. As ideas are forthcoming, write them on the whiteboard or flip chart. Use the discussion guide to highlight any items that were not considered.
Note: To promote discussion, you may wish to prepare a few copies of the document to share with the class. Students could also be asked to review the document as a homework assignment prior to the class discussion. To support a professional approach to practice, students could be provided with a link to the document for reference during their clinical placement and after completion of the program.
DISCUSSION GUIDE
Ambiguous Loss and Grief
What is ambiguous loss and grief?
Why is ambiguous loss and grief different from other types of grief?
How can HCAs provide support to individuals and families experiencing ambiguous loss and grief?
Download Discussion Guide: Ambiguous Loss and Grief [PDF].
Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined; one group will take a pro position towards the topic and the other group will take a con position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate topics for Healing 2: Caring for Individuals Experiencing Cognitive or Mental Health Challenges.
As a homework assignment, have students read relevant course or online materials describing challenges that may be experienced by people with dementia and their families and the role of the HCA in responding with appropriate care and support.
STUDENT HANDOUT
Scenarios: Supporting Clients with Dementia
DIRECTIONS: Identify key information and observations from the scenario and list in the first column. Next, identify important considerations that could provide context for the situation and list them in the second column. Finally, consider how to best respond to the situation.
Example, Scenario 1
It is 1:00 p.m. – time for Jean’s scheduled bath. Although she willingly goes to the bathing room with her regular HCA, she pulls away and cries out when the HCA starts to remove her clothing. She becomes extremely agitated and the HCA is unable to calm her and continue with the bathing process. For the third week in a row, Jean returns to her room without bathing.
Key Information | Considerations | HCA Responses |
---|---|---|
|
|
|
Scenario 2
Mary usually goes to bed around 8:00 p.m. but always gets up at 2:00 a.m. and wanders the halls. When staff take her back to bed, she gets up again, saying she has to take care of the baby.
Key Information | Considerations | HCA Responses |
---|---|---|
Scenario 3
Fiona has lived at a care home for the past two years. She has Alzheimer’s disease and now requires full assistance with personal care and dressing. She used to be a very classy lady – everything matching, makeup always impeccable. Her daughter, Marjorie, is having a hard time adjusting to her mother’s changing abilities.
Today the HCA, Maria, came in to help Fiona get ready for the day and Fiona was already dressed. Maria noticed that the buttons of her blouse were done up incorrectly and her clothing neither matched, nor was particularly clean. She had brushed her hair, leaving a large piece sticking up at the back. Maria was thrilled that Fiona had dressed and groomed independently and chose to leave Fiona’s hair and clothing as it was, saying, “Fiona, you look nice today. I like the blouse you’ve chosen!” Later in the day when Marjorie visited, she was furious that staff had not “corrected” her mother’s outfit and hair.
Key Information | Considerations | HCA Responses |
---|---|---|
Scenario 4
Albert is a newly graduated HCA. He feels fortunate to have secured full-time employment at a fairly new long-term care facility. During his HCA program, Albert took pride in taking the time to apply a person-centred approach with each of the clients he supported.
Despite his training and a sincere desire to help, he quickly feels discouraged and overwhelmed by the large workload and the attitudes of his colleagues, who Albert considers to be too “task focused.” He does not feel that he is able to use anything he learned, since every minute of his day is spent racing through a series of tasks.
Key Information | Considerations | HCA Responses |
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Copyright © 2017, Alzheimer Society of B.C. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Scenarios: Supporting Clients with Dementia [PDF].
DISCUSSION GUIDE:
Supporting Clients with Dementia
Key Information | Considerations and Potential Responses |
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Scenario 1
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Scenario 2
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Scenario 3
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Scenario 4
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Copyright © 2017, Alzheimer Society of B.C. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Discussion Guide: Supporting Clients with Dementia [PDF].
Using the document, Guidelines for Care: Person-centred care of people with dementia living in care homes framework as reference, explore the role of the HCA in providing person-centred care to clients with dementia.
STUDENT HANDOUT
Scenario: Person-Centred Care in Practice
DIRECTIONS: Read the scenario and respond to discussion questions provided. While completing this activity, you may wish to refer to Guidelines for care: Person-centred care of people with dementia living in care homes framework.
Mr. Peterson has moderate dementia and has particular difficulty with his language. He never participates in any of the activities that the facility organizes. Today he walked over to the activity room and sat down at a table by himself. The recreation therapist, Dawn, asked one of the HCAs to take him back to his room. “He never participates anyway, so he probably just got lost,” she tells the HCA.
Small Group Discussion Questions:
Copyright © 2017, Alzheimer Society of B.C. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Scenario: Person-Centred Care in Practice [PDF].
DISCUSSION GUIDE
Person-Centred Care in Practice
Person-Centred Care
How can HCAs provide person-centred care for people with dementia?
What does it mean to understand another person’s reality?
How can you involve and support family and friends?
“Come on, sweetie. Let me help you get dressed.” Is there anything wrong with this statement?
Would you say Dawn is providing person-centred care? Please explain why you answered the way you did.
How can you provide choices to the person who appears unable to choose? Why is this important?
Download Discussion Guide: Person-Centred Care in Practice [PDF].
Invite students, individually, to reflect on the following questions:
Invite students to form small discussion groups to discuss how the caregiver role, whether in the community or a facility, would be different when the client is experiencing a mental health disorder as opposed to a physical health challenge.
What personal and professional caregiver characteristics would be most valuable when working with individuals with mental illness? Encourage them to consider characteristics related to:
What legal and ethical issues would be particularly important to be aware of when working with clients experiencing mental illness?
As a homework assignment, have students review relevant textbook, online material,Alzheimer Society of Canada (2017). Person-centred language guidelines. https://alzheimer.ca/sites/default/files/documents/culture_exec_summary_e.pdfHeretohelp (2014). Stigma and discrimination around mental health and substance use problems. http://www.heretohelp.bc.ca/factsheet/stigma-and-discrimination-around-mental-health-and-substance-use- problems or other course information describing myth and stigma associated with dementia and mental health.
STUDENT HANDOUT
Scenarios: Addressing Myths and Stigmas – Promoting Person-Centred Language
DIRECTIONS: Working in partners, read the scenarios and consider the following questions. Prepare to share your answers with the larger group:
You are an HCA working in an acute care setting. Mr. Edwards, a 72-year-old man diagnosed with Alzheimer’s disease, has been admitted to the unit following a hip fracture. One of your colleagues has limited experience working with people who have dementia; you notice he tends to talk “over” Mr. Edwards instead of including him in conversations. He also uses terms such as “senile” and “demented” when referring to Mr. Edwards.
You are an HCA program graduate who has recently been hired at a residential care facility. When working with your new colleague, Sharon, you notice that she refers to the number of “feeders” that she will be assisting during lunch.
You are an HCA working in an assisted living home. You have been assigned to mentor John, who is an HCA student from a local college. One day while working with John, he refers to Betsy Smith, a client who is living with schizophrenia, as “the schizophrenic.”
You are an HCA student working at your first clinical placement. One day, while working with a staff member, you refer to the client you are working with as a past “user.” The staff member looks alarmed and rebukes you quite sharply for using this term.
Download Student Handout: Scenarios: Addressing Myths and Stigmas – Promoting Person-Centred Language [PDF].
The course learning outcomes may be assessed by the following tasks:
STUDENT HANDOUT
Responding to an Individual Experiencing Cognitive Challenges
PURPOSE
DIRECTIONS
Choose two separate interactions you have had with individuals experiencing cognitive challenges. Briefly document each interaction, what happened, and how you responded. You may use a table like the one below to document your two interactions.
For each interaction that you document, write your reflections on the incident using a format that’s similar to the outline below and identify what you have learned. This will assist you in future to increase your effectiveness with individuals experiencing cognitive challenges.
Situation | My response | Consequences of my actions | Effectiveness of my actions | What the client’s behaviour may have been communicating |
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Mrs. S. kept asking me over and over where she was and when her husband would be coming to get her. | I told her I had already answered her question three times in the past half hour and the answer was still the same. I also reminded her that her husband had died several years ago. | Mrs. S. looked distraught and anxious, wringing her hands and pacing about the hallway. | Not very because Mrs. S. seemed even more anxious and confused. She kept asking the same question to whomever she encountered. | I’m feeling lost. I want to see someone I recognize who will care for me. |
Mr. T. kept wiping the kitchen counter over and over again, and it didn’t seem like he was going to stop. |
I asked Mr. T. why he kept wiping the counter. | Mr. T. looked confused and troubled and continued to wipe the counter for several more minutes. | Not very since he kept wiping the counter and seemed even more agitated. | Need to expend nervous energy. Unable to stop the behaviour on his own. |
For each interaction identify:
Download Student Handout: Responding to an Individual Experiencing Cognitive Challenges [PDF].
Alzheimer’s Association. (2021). Aggression and anger. https://www.alz.org/help-support/caregiving/stages-behaviors/agression-anger
Alzheimer’s Association. (2021). How the brain works: A tour of how the mind works. https://www.alz.org/alzheimers-dementia/what-is-alzheimers/brain_tour
Alzheimer Society. (2019). Ambiguous loss and grief in dementia: A resource for individuals and families. https://alzheimer.ca/sites/default/files/documents/ambiguous-loss-and-grief_for-individuals-and-families.pdf
Alzheimer Society. (n.d.). Communicating with people living with dementia. https://alzheimer.ca/en/help-support/i-have-friend-or-family-member-who-lives-dementia/communicating-people-living-dementia
Alzheimer Society. (n.d.) Communication challenges and helpful strategies. https://alzheimer.ca/en/help-support/im-living-dementia/managing-changes-your-abilities/communication-challenges-helpful
Alzheimer Society. (2011). Guidelines for care: Person-centred care of people living with dementia in care homes. https://alzheimer.ca/sites/default/files/files/national/culture-change/culture_change_framework_e.pdf
Alzheimer Society. (2017). Person-centred language guidelines. https://alzheimer.ca/sites/default/files/documents/Person-centred-language-guidelines_Alzheimer-Society.pdf
Alzheimer Society. (2017). Providing person-centred care. https://alzheimer.ca/en/help-support/im-healthcare-provider/providing-person-centred-care
Alzheimer’s Society. (n.d.). Restlessness or “sundowning.” http://www.alzheimer.ca/en/bc/Living-with-dementia/Caring-for-someone/Understanding-symptoms/Sundowning
Alzheimer Society. (2019). Supporting clients through ambiguous loss and grief. Strategies for healthcare providers. https://alzheimer.ca/sites/default/files/documents/Ambiguous%20Loss%20Health%20Provider%20En-20-FINAL-MD_1.pdf
Alzheimer Society. (2018). Understanding genetics and Alzheimer’s disease. https://alzheimer.ca/sites/default/files/documents/research_understanding-genetics-and-alzheimers-disease.pdf
Alzheimer Society. (2017). Using person-centred language. https://alzheimer.ca/en/take-action/become-dementia-friendly/using-person-centred-language
Alzheimer Society British Columbia. https://alzheimer.ca/bc/en
Alzheimer Society Canada. https://alzheimer.ca/en
B.C. Mental Health and Substance Use Services. (2020). Trauma-informed practice. http://www.bcmhsus.ca/health-professionals/clinical-professional-resources/trauma-informed-practice
B.C. Provincial Mental Health and Substance Use Planning Council. (2013, May). Trauma-informed practice guide. https://bccewh.bc.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf
B.C. Schizophrenia Society. https://www.bcss.org/
Beattle, E. (2015). BCcampus leads the collaborative development of new and open elder abuse prevention, detection and response resources. https://bccampus.ca/2015/10/20/bccampus-leads-the-collaborative-development-of-new-and-open-elder-abuse-resources/
Canadian Alliance on Mental Illness and Mental Health. https://www.camimh.ca/
Canadian Association for Suicide Prevention. http://suicideprevention.ca/
Canadian Coalition for Senior’s Mental Health. https://ccsmh.ca/
Canadian Mental Health Association. http://www.cmha.ca/
Canadian Mental Health Association: Here to help. (2014). Learn about Alzheimer’s disease [Information sheet]. https://www.heretohelp.bc.ca/sites/default/files/alzheimers-disease.pdf
Canadian Mental Health Association. (2016). Myths about mental illness. http://www.cmha.ca/mental_health/myths-about-mental-illness/
Carreiro, D. (2013, October 15). Suicide rates climb among elderly in Canada. CBC News. https://www.cbc.ca/news/canada/manitoba/suicide-rates-climb-among-elderly-in-canada-1.2054402
Centre for Addiction and Mental Health. (2020). Trauma. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/trauma
Chan, P. (2011). Clarifying the confusion about confusion: Current practices in managing geriatric delirium. BCMJ, 53(8). https://bcmj.org/articles/clarifying-confusion-about-confusion-current-practices-managing-geriatric-delirium
Dementia.org. (2016). Dementia grief – Part 3: The three stages. https://www.dementia.org/dementia-grief-3-stages
Government of British Columbia. (n.d.). Protection from elder abuse and neglect. http://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health-safety/protection-from-elder-abuse-and-neglect
Government of British Columbia, Ministry of Health. (2012, October 25). Best practice guideline for accommodating and managing behavioural and psychological symptoms of dementia in residential care. A person-centered interdisciplinary approach. https://www.health.gov.bc.ca/library/publications/year/2012/bpsd-guideline.pdf
HealthLinkBC. (2019). Dementia, British Columbia specific information. https://www.healthlinkbc.ca/health-topics/uf4984
HealthLinkBC. (2019). Dementia: Helping a person avoid confusion. http://www.healthlinkbc.ca/healthtopics/content.asp?hwid=hw135788
HealthLinkBC. (2019). Elder abuse, British Columbia specific information. http://www.healthlinkbc.ca/healthtopics/content.asp?hwid=aa60933spec
HealthLinkBC. (2018). Preventing abuse and neglect of older adults. https://www.healthlinkbc.ca/healthlinkbc-files/prevent-abuse-older-adults
Here to Help. (2019). Resource library. http://www.heretohelp.bc.ca/self-help-resources
Island Health. (2021). Mental health and substance use resources and education. https://www.islandhealth.ca/learn-about-health/mental-health/mental-health-substance-use-resources-education
Lidhran, G. (2016). OP-ED: Exploring dementia villages and other care models in Canada. SafeCare B.C. http://safecarebc.ca/op-ed-exploring-dementia-villages-and-other-care-models-in-canada
MedicineNet. (2016). What are phobias? Agoraphobia, social anxiety disorder, other fears. https://www.medicinenet.com/phobias_picture_slideshow/article.htm
Mental Health ., RSBC 1996, c 288. http://www.bclaws.ca/civix/document/id/complete/statreg/96288_01
Mental Health Commission of Canada. http://www.mentalhealthcommission.ca/
Mood Disorders Society of Canada. https://mdsc.ca/
National Institute on Aging. (2019). Assessing risk for Alzheimer’s disease. https://www.nia.nih.gov/health/assessing-risk-alzheimers-disease
Office of the Seniors Advocate British Columbia. (2016, June). Resident to resident aggression in B.C. care homes. https://www.seniorsadvocatebc.ca/app/uploads/sites/4/2016/06/SA-ResidentToResidentAggressionReview-2016.pdf
PIECES. (n.d.). PIECES. Learning and development model. http://www.piecescanada.com/index.php?option=com_content&view=article&id=1&Itemid=3
Schizophrenia Society of Canada. http://www.schizophrenia.ca
Seniors First B.C. http://seniorsfirstbc.ca/
(Formerly the B.C. Centre for Elder Advocacy & Support)
Simon Fraser University, Centre for Applied Research in Mental Health and Addiction. http://www.sfu.ca/content/sfu/carmha.html
Smith, M. (2020). Caregiver stress and burnout. HelpGuide. https://www.helpguide.org/articles/stress/caregiver-stress-and-burnout.htm
STA Health Care Communications. (n.d.). Canadian Review of Alzheimer’s Disease and Other Dementias. http://www.stacommunications.com/adreview.html
University of Waterloo, Murray Alzheimer Research and Education Program. https://uwaterloo.ca/murray-alzheimer-research-and-education-program/
Vancouver Coastal Health. (2020). First Nations ReAct. http://www.vch.ca/Pages/First-Nations-ReAct0131-6129.aspx?res_id=1238
Validation Training Institute Inc. (n.d.). Getting started: Validation to suit your needs. https://vfvalidation.org/get-started/validation-to-suit-your-needs/#ui00c2e24|tab2
Wincer. P. (2020, November 26). What caring for my mum taught me about caring for my son. BBC News. https://www.bbc.com/news/stories-55057440
Wong, S., Gilmour, H. & Ramage-Morin, P. L. (2016). Alzheimer’s disease and other dementias in Canada. Health Reports, 27(5), 11–16. Statistics Canada. http://www.statcan.gc.ca/pub/82-003-x/2016005/article/14613-eng.pdf
WorkSafeBC. (2010). Dementia: Understanding risks and preventing violence. https://www.worksafebc.com/en/resources/health-safety/books-guides/dementia-understanding-risks-and-preventing-violence?lang=en
WorkSafeBC. (n.d.) Working with people with dementia. https://www.worksafebc.com/en/health-safety/industries/health-care-social-services/topics/working-with-people-with-dementia
AboutAlzOrg. (2010, October 26). What is Alzheimer’s disease [Video]. YouTube. https://www.youtube.com/watch?v=7_kO6c2NfmE
Alila Medical Media. (2014, September 10). Neuroscience basics: Human brain anatomy and lateralization of brain function, 3D animation [Video]. YouTube. https://youtu.be/owFnH01SD-s
Alzheimer’s Australia VIC. (2015, June 1). Purposeful activities for dementia: Alzheimer’s Australia VIC [Video]. YouTube. https://www.youtube.com/watch?v=9Y6LCpL8HUU
Animated Alzheimer’s Patient. (2021, January 27). Understanding Alzheimer’s disease [Video]. YouTube. https://www.youtube.com/watch?v=lFBTlHfV8Iw
Applewhite, A. (2017, April).Let’s end ageism [Video]. TED2017. https://www.ted.com/talks/ashton_applewhite_let_s_end_ageism
Bartlet, S. & LeRose, M. (2007). Beyond memory: A documentary about dementia [Film]. National Film Board of Canada. https://www.nfb.ca/film/beyond-memory-a-documentary-about-dementia/
Caregiver Stress. (2013, May 17). Family caregiver stress relief [Video]. YouTube. https://www.youtube.com/watch?v=XaonoH1XqNI
CBC News: The National. (2015, October 11). Home recreates past for dementia patients [Video]. YouTube. https://www.youtube.com/watch?v=9rOYmxIWzJI
CBC News: The National. (2015, August 4). Seniors home brings young and old together [Video]. YouTube. https://www.youtube.com/watch?v=3LGSfgOi9UU
CNN. (2014, June 9). Anderson Cooper tries a schizophrenic simulator [Video]. YouTube. https://www.youtube.com/watch?v=yL9UJVtgPZY
Creative Connections. (2016, May 17). Delirium awareness video [Video]. YouTube. https://www.youtube.com/watch?v=BPfZgBmcQB8
Crime Beat TV. (2012, August 23). 16×9. The real truth: Senior’s home abuse caught on camera [Video]. YouTube. https://www.youtube.com/watch?v=qIAiMylHT-k
Crime Beat TV. (2014, April 28). Full story: Dementia – The unspooling mind [Video]. YouTube. https://www.youtube.com/watch?v=kkvIZaSfUxc
Dementia Careblazers. (2018, February 4). 5 surprising facts about dementia you may not know [Video]. YouTube. https://www.youtube.com/watch?v=qwtMU5mwGJ4
Dementia Careblazers. (2018, January 28). What are the different stages of dementia? The 3 stage and the 7 stage models explained [Video]. YouTube. https://youtu.be/sGjuX8WHJLk
Education for Rural and Underserved Communities. (2016, April 8). Persons with dementia: Skills for addressing challenging behaviors [Video]. YouTube. https://www.youtube.com/watch?v=hgVMKEnkvHo
havethattalk. (2017, May 3). Reducing stigma [Video]. YouTube. https://www.youtube.com/watch?v=eio-I8PbdDk
Kujath, J. (2017, November 16). Understanding cycles of abuse [Video]. YouTube. https://youtu.be/0Q0-Eps1ThE
Martin, G. (2015, June 22). How to approach residents with behaviors [Video]. YouTube. https://www.youtube.com/watch?v=xylQt7TxDwo
Memorybridge. (2009, May 26). Gladys Wilson and Naomi Feil [Video]. YouTube. https://www.youtube.com/watch?v=CrZXz10FcVM
Mental Health at Work. (2016, July 1). What is mental health? [Video]. YouTube. https://www.youtube.com/watch?v=G0zJGDokyWQ4
Miller, B. (2015, March). What really matters at the end of life [Video]. TED2015. https://www.ted.com/talks/bj_miller_what_really_matters_at_the_end_of_life
Mmlearn. (2018, September 28). How to talk to someone with dementia: Diane Waugh [Video]. YouTube. https://www.youtube.com/watch?v=ilickabmjww
Music and Memory. (2011, November 18). Man in nursing home reacts to music from his era [Video]. YouTube. https://youtu.be/fyZQf0p73QM
My Alzheimer’s Story. (2015, August 15). 10 ways to de-escalate a crisis with Teepa Snow [Video]. YouTube. https://www.youtube.com/watch?v=xNznZ2MnV3I
Programs for Elderly. (n.d.). Documentary library [Documentary films available as videos]. http://www.programsforelderly.com/index-documentaries-subpage.php
SafeCare B.C. (2019, February 5). Dementia care teams: Families and continuing care providers working together [Video]. YouTube. https://www.youtube.com/watch?app=desktop&v=VxDopCVswmg
Saks, E. (2012, June). A tale of mental illness from the inside [Video]. TEDGlobal2012. https://www.ted.com/talks/elyn_saks_seeing_mental_illness
Senior Helper National. (2013, July 23). Teepa Snow discusses the ten early signs of dementia [Video]. YouTube. https://www.youtube.com/watch?v=pqmqC-702Yg
Seniors First B.C. (n.d.). Finding a future for Ellen [Video]. http://seniorsfirstbc.ca/resources/video/finding-a-future-for-ellen/
Social Care Institute for Excellence (SCIE). (2011, May 13). Dementia: End of life care [Video]. YouTube. https://www.youtube.com/watch?v=bQXtC3HdCIc
TED. (2017, May 19). What can you do to prevent Alzheimer’s disease: Lisa Genova [Video]. YouTube. https://www.youtube.com/watch?v=twG4mr6Jov0
TED-Ed. (2016, June 9). Why do our bodies age? Monica Menesini [Video]. YouTube. https://www.youtube.com/watch?v=GASaqPv0t0g
TEDx Talks. (2012, October 9). The power of addiction and the addiction of power: Gabor Maté at TEDxRio=20 [Video]. YouTube. https://www.youtube.com/watch?v=66cYcSak6nE
TEDx Talks. (2017, March 27). I am not a monster: Schizophrenia – Cecilia McGough. TEDxPSU [Video]. YouTube. https://www.youtube.com/watch?v=xbagFzcyNiM
Teepa Snow’s Positive Approach to Care. (2017, April 29). Challenging behavior [Video]. YouTube. https://www.youtube.com/watch?v=ZpXeefZ2jAM
Teepa Snow’s Positive Approach to Care. (2019, May 15). Dementia dare – How to redirect hallucinations with Teepa Snow of Positive Approach to Care [Video]. YouTube. https://www.youtube.com/watch?v=3s0ktYUIn0Y
Therapist Aid. (2014, September 19). How to do deep breathing [Video]. YouTube. https://youtu.be/EYQsRBNYdPk
University of Derby Online Learning. (2015, July 10). Creating a culture of compassion for dementia patients in our society [Video]. YouTube. https://www.youtube.com/watch?v=QIYY4nNHkXo
Validation Theory Institute. (2017, March 13). What is validation – Interview by Naomi Feil [Video]. YouTube. https://www.youtube.com/watch?v=ejVqVKWnDOE
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
Alzheimer’s Society. (n.d.). Video resources. https://alzheimer.ca/en/help-support/dementia-resources/video-resources#The_Alzheimer_Journey
Canadian Mental Health Association. (n.d.). Myths about mental illness. http://www.cmha.ca/mental_health/myths-about-mental-illness/
Canadian Virtual Hospice. (n.d.). My grief.ca: Because losing someone is hard…. https://www.mygrief.ca/
Home Instead Senior Care. (2017). Alzheimer’s disease or other dementias CARE: Changing aging through research and education. http://www.helpforalzheimersfamilies.com/alzheimers-dementia-education/
Island Health. (n.d.). Dementia video series: Practical advice from caregivers, for caregivers. https://www.islandhealth.ca/learn-about-health/seniors/dementia-video-series
Province of British Columbia. (2015). Elder abuse reduction curricular resource. BCcampus. http://solr.bccampus.ca:8001/bcc/items/8d5b3363-396e-4749-bf18-0590a75c9e6b/1/
PsychHub. (2021). Videos. https://psychhub.com/videos/
Rossato-Bennett, M., McDougald, A., Scully, R. K., Cohen, D., Sacks, O., McFerrin, B., Shur, I. (2014). Alive inside: A story of music and memory. MVD Visual (Film). Available on Netflix.
Web Services. (2012). Delirium Videos [Videos]. https://www.bing.com/videos/search?q=delirium&&view=detail&mid=26A860D4F26C551495B226A860D4F26C551495B2&FORM=VRDGAR
WorkSafeBC. (2013). Two-person care needs a planned approach [Video]. https://www.worksafebc.com/en/resources/health-safety/videos/two-person-care-needs-a-planned-approach
WorkSafeBC. (2009). Working with dementia: Safe work practices for caregivers [Videos]. https://www.worksafebc.com/en/resources/health-safety/videos/working-with-dementia-safe-work-practices-for-caregivers/introduction?lang=en
9
A minimum of 65% of this course should consist of the supervised application of hands-on skills to ensure students are deemed safe and competent in performing personal care.
Use the following questions and statements to elicit discussion about caring:
Use scenarios from clinical situations to help students contextualize the caregiving practices they are learning in this course. With only preliminary information about the client who is the recipient of care, ask students to consider the following:
Once the student has collected information and assessed the (simulated) client, they will progress with the provision of care or assistance. During this process, the student should be observed to assure that:
Following the provision of care or assistance, the student will be invited to reflect on the process using the points above and to discuss their experience with those who observed the process.
As a homework assignment, have students review their client portfolio for Peter Schultz.
STUDENT HANDOUT
Unfolding Case Study: Caring for Peter Schultz
Changing Client Health Status and Response to Care
DIRECTIONS: Read the following scenario. Then populate the table with observations based on the situation provided. For each observation, list possible responses that fall within the parameters of the HCA role.
You are an HCA who has been working at the same residential care home for the past five years. Today is your first day back after a two-month absence, and you are assigned to care for Peter Schultz. As you carry out the plan of care, you observe changes in Peter’s health status and response to care.
You have always enjoyed providing care for Peter. When he first moved to the care home four years ago, you used several strategies to include him in the morning care routine. He especially enjoyed singing old tunes and reciting poems while you were helping him to get ready for the day. He enjoyed his meals and was a regular participant in the music and exercise programs and daily social hour. You always appreciated Peter’s smile and hearing him laugh.
Since Peter has moved to the care home, he has been diagnosed with Alzheimer’s disease, in addition to the diagnosis of vascular dementia following a CVA. He now requires full assistance with his activities of daily living and is on a regular toileting schedule. Over the past year, Peter’s legs have gotten weaker and he is no longer able to bear weight. He is on medication for blood pressure and bowel control.
Over the past year, Peter has become progressively less responsive during the morning care routine. He says very little and usually just listens as you sing his favourite songs. You have also observed that he smiles less often. Usually, when you try to involve him in simple care- related activities, such as washing his face or combing his hair, he will reach out for the face cloth or hair brush that you offer him, but will not use them unless you guide his hands for him. This morning when you offer him the face cloth, he does not reach out his hand to take it.
Since losing his ability to walk, Peter has used a wheelchair to ambulate. The foot pedals on his chair are removed and he uses his feet or the side rail to move himself up and down the hallway. Today when you look for Peter to bring him to the lunch room, you notice that he has not moved from the place where he was one hour ago. When you assist Peter with his lunch, he doesn’t try to hold his cup as he used to. He eats very slowly and clears his throat often. You observe that he finishes half of his mashed potatoes, but coughs when you offer him small pieces of minced chicken. He eats all of his chocolate pudding. It takes Peter 55 minutes to eat his lunch.
This afternoon, Eve comes to attend a special music program with Peter. When you walk with her to his room, you find that he has fallen asleep in his chair. Eve tells you that Peter has fallen asleep every day after lunch for the past two weeks. Eve has a difficult time waking Peter up to listen to the guest musicians. It takes an hour for Peter to drink a cup of thickened coffee and when Eve gives him a cookie, it drops out of his hand.
Observation | HCA Response |
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Peter did not reach out to take the face cloth when it was offered to him. | Continue to offer the face cloth to Peter. If he does not reach out for it, place it in his hand and guide him in washing his face. Minimize distractions during this care activity. Continue to monitor Peter’s response to this approach. |
Metzger, Z.B. (2010). The Last Lap of the Long Run, Addendum to “On the Long Run”: An Account of our Travels with Dementia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Changing Client Health Status and Response to Care [PDF].
Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined; one group will take a pro position towards the topic and the other group will take a con position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate topics for Healing 3: Personal Care and Assistance.
After students have learned about body mechanics and asepsis, and have mastered basic transfer, bathing, and toileting techniques, present them with scenarios that simulate various practice environments, such as community (homelike) settings and acute care. Working in small groups of two or three, students should use critical thinking, problem-solving, and decision-making skills to consider how they will apply the skills in settings that are different from the standard lab setting or in changing situations.
Situations may include:
The following case study is used with permission of Island HealthIsland Health. (2012). Changes have been made to the case scenarios and learning activities contained within the original source document (p. 87): Health Care Assistant Program Provincial Curriculum (2015) Supplement by the B.C. Ministry Of Advanced Education, licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License (CC BY-SA 3.0).
The case study, provided as a STUDENT HANDOUT below, could be used as a “pen and paper” exercise, either individually or with the students in small groups, or it could be set up as a practice scenario. There is also a DISCUSSION GUIDE below on putting safety into practice.
Note the use of the four-step process to help ensure patient safety:
STUDENT HANDOUT
Putting Safety into PracticeIsland Health (2012).
DIRECTIONS: Read the scenario and make notes to consider how to best provide safe care using the four-step process to ensure patient safety.
Mary is a new HCA working on a general medicine unit.
She is about to go into Mr. Lee’s room to assist him to the bathroom for morning care. Mr. Lee shares his hospital room with one other gentleman.
Mary confirms instructions for morning care with the RN and finds out from his chart that Mr. Lee requires stand by assistance with his mobility and wears a gait beltA gait belt may also be called a walking, ambulation, or transfer belt, depending on the setting. HCA instructors may wish to lead a discussion about related equipment used by HCAs and other health care professionals in their local health authorities. while he is walking. Mary confirms that she will observe and supervise while Mr. Lee moves from a sitting to standing position and while he walks from his bed to the bathroom.
Mary begins to set up the space. She gathers towels, a change of hospital gown, and toiletries. She looks for his gait belt but cannot find one next to his bed. She notes there is one hanging by his roommate’s closet door.
Keeping in mind a standard process, Mary considers the “Prevent, Check, Respond, and Report” steps.
Download Student Handout: Putting Safety into Practice [PDF].
DISCUSSION GUIDE
Putting Safety into Practice
Download Discussion Guide: Putting Safety into Practice [PDF]
Invite students, working in small groups, to discuss scenarios in which, as HCAs, they are faced with being asked to undertake questionable activities. For each one, have them identify an appropriate response and explain their response. Suggest that they refer to the Assigned/Delegated Task Decision Tree for support during this activity.
Here are some examples:
As an HCA, you are providing care and service for an elderly gentleman, Mr. Syms, who requires help with his meals and his bath. One day, when you arrive at Mr. Syms’ house, you find that a doctor is visiting him. Apparently, Mr. Syms’ daughter, who lives across town, called the doctor when her father complained of chest pain. The doctor says to you, “Well, he seems to be fine now. Maybe it was only indigestion.” As he is leaving, he says to you, “Mr. Syms was telling me that his back is bothering him. I’ve left some Tylenol with codeine. Give him two of those whenever he needs them.”
How might you handle this situation?
As an HCA, you have been visiting Mr. and Mrs. Sihota for several months. Mrs. Sihota is a woman of 78 years who is physically frail and experiencing some cognitive decline. Two days ago, she had day surgery to correct a cataract in her left eye. Mr. Sihota is almost 10 years older than his wife and suffers from arthritis and heart problems.
When you come to their house, Mr. Sihota greets you at the door saying, “Thank goodness you are here. Now you can give my wife her eye drops. I’m no good at that sort of thing and she’ll be happier to have you do it.”
How might you handle this situation?
You are working on an acute care orthopaedic ward. When you walk into the room of a client you have not met before, he says, “Oh, there you are, nurse. Can you please hand me the magazine that’s on the chair?”
The following video scenarios have been developed for students to self-assess their learning prior to their practice experience. Instructors should provide the links for these videos to their students near the end of the Healing 3: Personal Care and Assistance course so students can complete each scenario and be better prepared for their practice experiences. Instructors should review these videos before assigning them to students.
Instructors can request or require that students submit a reflective journal for each video scenario. Another option is to have a class or small group discussion after all students have completed the video(s). A Self-Assessment Video Reflective Journal Sheet [PDF] sample is available.
There are also some practices and procedures that are worthy of follow-up discussion. For example:
The course learning outcomes may be assessed by the following tasks:
Testing can be accomplished through performance of a scenario simulating the practice environment and may include an opportunity for problem-solving. The specific skills tested and expected level of competency may vary, depending upon when the first clinical experience occurs within the program. At a minimum, students should perform safely prior to entering the clinical setting. Students should be evaluated using clear and consistent criteria; an evaluation rubric may be used (Learning Outcomes #1, #2, #3, and #4). Refer to Section 5: Sample Evaluation Tools.
STUDENT HANDOUT
Home Safety Assessment Guide
DIRECTIONS: In addition to conducting the assessment (indicating with a checkmark where met), make comments on safety issues identified (items unmet) and suggest ways that the environment could be made safer for the client/family and members of the health care team.
General Assessment
|
Comments: |
Living Room
|
Comments: |
Kitchen
|
Comments: |
Bathroom
|
Comments: |
Bedroom
|
Comments: |
© Province of British Columbia. This material is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
Download Student Handout: Home Safety Assessment Guide [PDF].
B.C. Centre for Disease Control. http://www.bccdc.ca/
B.C. Centre for Disease Control. (2017). Harm reduction guidelines. http://www.bccdc.ca/health-professionals/clinical-resources/harm-reduction
B.C. Centre for Disease Control & Government of British Columbia, Ministry of Health. (2020, August 31). Infection prevention and control requirements for COVID-19 in long-term care and seniors’ assisted living. http://www.bccdc.ca/Health-Info-Site/Documents/COVID19_LongTermCareAssistedLiving.pdf
B.C. Public Service Agency and B.C. Government & Services Employees Union (2007). Guide to Prevention and Control of Infectious Diseases in the Workplace. https://www2.gov.bc.ca/assets/gov/careers/managers-supervisors/managing-occupational-health-safety/infectious_disease_guide.pdf
Doyle, G. R. & McCutCheon, J. A. (n.d.). Ostomy care. In Clinical procedures for safer clinical care. BCcampus. https://opentextbc.ca/clinicalskills/chapter/10-6-ostomies/
Fortis B.C. (2017). Gas leaks and odours. https://www.fortisbc.com/safety-outages/natural-gas-safety/gas-leaks-and-odour
Government of British Columbia. (n.d.). Safety at home. https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health-safety/safety-at-home
Government of British Columbia, Ministry of Health Services. (2008). Personal assistance guidelines. https://www.health.gov.bc.ca/library/publications/year/2008/Personal_Assistance_Guidelines.pdf
Interior Health. (2017). Safe patient handling videos. https://www.interiorhealth.ca/sites/Partners/WHSresources/Pages/SafePatientHandling.Aspx
Provincial Infection Control Network of British Columbia. https://www.picnet.ca/
Provincial Residential Care Musculoskeletal Injury Prevention Team (2011). Provincial safe resident handling standards for musculoskeletal injury prevention in British Columbia. https://www.safecarebc.ca/wp-content/uploads/2020/10/Provincial-Safe-Resident-Handling-Standard-2011.pdf
SafeCareBC. (n.d.). Point of care risk assessment. http://safecarebc.ca/wp-content/uploads/Point-of-Care-Risk-Assessment-SCBC-Version1.pdf
Tiner, S. (2020, April 1). Your new super power: Hand-washing. Mayo Clinic. https://discoverysedge.mayo.edu/2020/04/01/your-new-super-power-hand-washing/?_ga=2.139963571.1440117354.1590880017-2090357955.1590880017
WorkSafeBC. (2014). Back talk: An owner’s manual for backs. https://www.worksafebc.com/en/resources/health-safety/books-guides/back-talk-an-owners-manual-for-backs?lang=en
WorkSafeBC. (2009). Controlling exposure: Protecting workers from infectious disease. https://www.worksafebc.com/en/resources/health-safety/books-guides/controlling-exposure-protecting-workers-from-infectious-disease?lang=en
WorkSafeBC. (n.d.). Health care and social services. https://www.worksafebc.com/en/health-safety/industries/health-care-social-services
WorkSafeBC. (2006). Home and community health worker handbook. https://www.worksafebc.com/en/resources/health-safety/books-guides/home-and-community-health-worker-handbook
WorkSafeBC. (2020). Patient handling: Overhead lifts vs floor lifts – what’s the difference? https://www.worksafebc.com/en/resources/health-safety/hazard-alerts/patient-handling-overhead-lifts-vs-floor-lifts?lang=en
WorkSafeBC. (2014). Patient handling. https://www.worksafebc.com/en/health-safety/industries/health-care-social-services/topics/patient-handling
WorkSafeBC. (2020). Patient handling: Soaker pads. https://www.worksafebc.com/en/resources/health-safety/hazard-alerts/patient-handling-soaker-pads?lang=en
WorkSafeBC. (2013). WorkSafeBC occupational health and safety regulations.
Ergonomics (MSI) requirements. https://www.worksafebc.com/en/law-policy/occupational-health-safety/searchable-ohs-regulation/ohs-regulation/part-04-general-conditions
Biological agents. https://www.worksafebc.com/en/law-policy/occupational-health-safety/searchable-ohs-regulation/ohs-regulation/part-06-substance-specific-requirements
WorkSafeBC. (2013). Two person care needs a planned approach. https://www.worksafebc.com/en/resources/health-safety/videos/two person-care-needs-a-planned-approach?lang=en
WorkSafeBC. (2019). WHMIS (Workplace hazardous materials information system). https://www.worksafebc.com/en/health-safety/hazards-exposures/whmis
Align Home Health. (2015, November 17). Glove removal [Video]. YouTube. https://youtu.be/wZO9O9iGlKs
All N One Home Health. (2015, November 12). How to help someone who uses a wheelchair including walkers, crutches and canes [Video]. YouTube. https://www.youtube.com/watch?v=EZestPFcvP0
American College of Surgeons. (2015, September 8). Feeding tube skills: What is an enteral feeding tube? [Video]. YouTube. https://www.youtube.com/watch?v=1Gd_LSR9VIA
Coughsafevideos. (2012, March 7). Why don’t we do it in our sleeves [Video]. YouTube. https://www.youtube.com/watch?v=CtnEwvUWDo0
Dynamis. (n.d.). Bathing without a battle [Video]. Vimeo. https://vimeo.com/121147508
Eaton, C. (2014, August 29). Bed bath and occupied bed making video part 1 [Video]. YouTube. https://www.youtube.com/watch?v=75O-MWF8K6w
Eaton, C. (2014, August 29). Bed bath and occupied bed making video part 2 [Video]. YouTube. https://www.youtube.com/watch?v=zjPu4EbbGNE
FunctionFocusedCare. (2013, June 26). Function focused care for assisted living residents: Dressing [Video]. YouTube. https://www.youtube.com/watch?v=4qTVkBn2i-A
FunctionFocusedCare. (2013, June 26). Function focused care for assisted living residents: Toileting [Video]. YouTube. https://www.youtube.com/watch?v=tNDGfuUtcFo
Globalhygienecouncil. (2012, September 20). Bacteria on your hands [Video]. YouTube. https://www.youtube.com/watch?v=YfzgWpG4H5c
Handicare. (n.d.). Handicare band sling [Video]. Vimeo. https://vimeo.com/269759430
Handicare. (n.d.). Handicare positioning sling [Video]. Vimeo. https://vimeo.com/274733472
Handicare. (n.d.). Handicare TriTurner sling [Video]. Vimeo. https://vimeo.com/269767001
Handicare. (n.d.). Handicare universal sling [Video]. Vimeo. https://vimeo.com/274735676
Handicare North America. (2018, June 29). Handicare slings: ComfortCare [Video]. YouTube. https://youtu.be/NxpHCFBGNuE
Handicare North America. (2018, June 29). Handicare slings: Deluxe hammock [Video]. YouTube. https://www.youtube.com/watch?v=qrcl6TzSM4o
Healthy Canadians. (2020, June 2). COVID-19: How to wear a non-medical mask or face covering properly [Video]. YouTube. https://youtu.be/gvLA–hGU70
Kozak, J. (2012, May 20). How may I help you? – A guide to assisting the visually impaired [Video]. YouTube. https://youtu.be/YS8aaPmZeUI
Lippincott, Williams and Wilkins. (2013, March 25). Positioning and lifting patients and residents [Video]. YouTube. https://www.youtube.com/watch?v=H68Sa04s_1s
Lortie, C. & Fontaine, N. (2022). AM Skills Care [Video]. Selkirk College and College of the Rockies. https://video.bccampus.ca/playlist/dedicated/26132/0_gmt3777b/0_1m7lxqfz
Marwaha, S. (2011, September 30). Wash your hands – it just makes sense [Video]. YouTube. https://www.youtube.com/watch?app=desktop&v=M8AKTACyiB0
Ostomystory. (2012, February 11). How to change your ostomy bag [Video]. YouTube. https://www.youtube.com/watch?v=l9PYMfqNGm0
Provincial Health Services Authority. (n.d.). Patient handling videos [Videos]. http://learn.phsa.ca/phsa/patienthandling/
World Health Organization. (2014, July 2). WHO: SAVE LIVES – Clean your hands – No action today; no cure tomorrow [Video]. YouTube. https://youtu.be/kOKeFv5VvY4
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
Provincial Infection Control Network of B.C. (2017). Infection prevention and control practices modules. https://www.picnet.ca/education/education-modules/infection-control-module/
Social Care Institute for Excellence. (2014). Personal hygiene: Dignity in care [Video]. http://www.scie.org.uk/socialcaretv/video-player.asp?v=personal-hygiene
WorkSafeBC. (2008). Assess every time [Video]. https://www.worksafebc.com/en/resources/health-safety/videos/assess-every-time?lang=en
WorkSafeBC. (2013). Ceiling lifts. Why aren’t they being used? [Video]. https://www.worksafebc.com/en/resources/health-safety/videos/ceiling-lifts
WorkSafeBC. Home care visits. Find the hazards in this staged photo [Photo collection].
WorkSafeBC. (2008). Leave when it’s unsafe [Video]. https://www.worksafebc.com/en/resources/health-safety/videos/leave-when-its-unsafe
WorkSafeBC. (2014). Make your home safer for care workers [Information sheet]. www.worksafebc.com/en/resources/health-safety/books-guides/make-your-home-safer-for-care-workers?lang=en
WorkSafeBC. (2009). Working with dementia: Safe work practices for caregivers [Videos]. https://www.worksafebc.com/en/forms-resources#q=Working%20with%20Dementia&sort=relevancy&f:content-type-facet=[Videos%20%26%20slide%20shows]&f:language-facet=[English]
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The following learning strategies can be applied within a variety of contexts, depending on the parameters of the clinical placement and the preferences of the instructor.
Early in the clinical placement, ask students to gather information about a client for whom they are providing care. Potential sources of information include the client, family, friends, staff, the chart, and other client-specific documents. Ask students to describe what they learned about the client and how the information has influenced how they provide care to them (Learning Outcomes #1, #2, #3, #4, #6, and #7).
Have the students write person-centred goals for the care of their client(s). This will help them become more focused on the client(s), ensuring their best care, rather than placing focus on other areas (e.g., their time schedule).
Have students gather with the clinical instructor topics and issues to discuss related to their clinical placement.
Topics to support pre- or post-conference discussions or journal writing are outlined below.
Ask students to identify a scenario where they faced a challenge related to communication with a client, family member, or staff member. Have the students use the problem-solving/decision-making process to analyze the problem, identify what they learned through the situation, and describe how it has impacted their approach to future communication in this context (Learning Outcomes #2, #6, and #8).
Invite students to use their clinical practice to learn the importance of observation to person-centred care. Students, working individually or in small groups, will choose a client experiencing cognitive challenges and observe this individual closely for at least two days, being particularly aware of the person’s behaviours and what aspects of the environment and of the client’s needs seem to be related to the behaviours. Students are also encouraged to talk with other members of the health care team who know this client and, if possible, research the client’s background.
Students will review the information and discuss what environmental factors seem to be contributing to the client’s behaviours, both positively and negatively. This should include the social environment as well (e.g., the actions of staff and other residents). Students should also observe for unmet needs of the client which may be causing responsive behaviours.
This information can be brought back to post-conference for wider discussion of possible causes of responsive behaviours and determination of how the information might help to guide caregiving practices.
Provide orientation activities where students become familiarized with the clinical setting and routines, staff, and the clients. As an orientation activity, invite students to engage in a “search and find activity” for important items and information at the clinical site. Include a list of staff members for students to meet and introduce themselves to.
Invite members of the team at the clinical site to talk with students about their role or profession. As part of these sessions, have the team member and students identify how the role of the HCA interacts with the specific discipline and how the two parties can work most effectively together (Learning Outcomes #5 and #9).
Provide reflective learning activities where students record observations, challenges, and other information. This will help students to synthesize their learning.
Assist students to obtain the HCA job description for their practice education site and to assess what, if any, additional skills they would need to acquire to be employable in that setting (Learning Outcome #8).
The course learning outcomes may be assessed by the following tasks:
B.C. Academic Health Council. (n.d.). B.C. preceptor development initiative: Supporting health preceptors in practice, modules 1–8. http://www.practiceeducation.ca/modules.html
B.C. Care Aide and Community Health Worker Registry. (2014). B.C. health care assistants core competency profile. https://www.cachwr.bc.ca/getattachment/About-the-Registry/Resources/HCA-Core-Competency-Profile_March2014-(2).pdf.aspx
Gibbs, G. (2013). Learning by doing: A guide to teaching and learning methods. Oxford Brooks University. https://thoughtsmostlyaboutlearning.files.wordpress.com/2015/12/learning-by-doing-graham-gibbs.pdf
Hampe, Narelle. (2013). Reflective practice and writing: A guide to getting started. Australian Library and Information Association. https://www.betterevaluation.org/en/resources/guide/reflective_practice_and_writing
Melrose, S. Park, C. & Perry, B. (2015). Creative clinical teaching in the health professions. Athabasca University. http://solr.bccampus.ca:8001/bcc/file/c6d0e9bd-ba6b-4548-82d6-afbd0f166b65/1/CREATIVE-CLINICAL-TEACHING-IN-THE-HEALTH-PROFESSIONS.pdf
Phaneuf, M. (n.d.). Learning and teaching in clinical settings. http://www.prendresoin.org/wp-content/uploads/2014/05/LEARNING-AND-TEACHING-IN-CLINICAL-SETTINGS.pdf
Practice Education Guidelines for B.C. (2021). https://hspcanada.net/pegs/
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Have the student identify a challenge they faced in providing personal care and assistance to a client with complex health needs. Ask the student to describe the assistance provided, how they adapted the care to accommodate the challenge, and the action(s) they took following the encounter (Learning Outcomes #1, #2, #3, #5, and #7).
Have the students write person-centred goals for the care of their client(s). This is particularly important in community settings, where students should be encouraged to consider ways to promote and further client independence, with an orientation to “help with,” rather than to “do for.”
Set up meetings with the site supervisor/mentor and/or course instructor to give students the opportunity to discuss topics and issues related to their community placement.
Ask students to complete a home safety assessment of the residence for one of the clients they are working with in their community placement (see instructions in the DISCUSSION GUIDE: Putting Safety into Practice). Have the student report their findings to the site team and/or supervisor at a daily meeting. If possible, the student could compare their assessment to the one completed by the employer and discuss the effectiveness of the strategies used to enhance safety in that setting (Learning Outcomes #2, #7 and #8).
If this is the final placement, bring students together back at the college for a final debrief. This could provide rich learning opportunities for students to share what they have learned, gain insight from the learning of others, and consider further areas for their continued professional growth and development.
Reflective learning activities where students record observations, challenges, and other information can be used to synthesize their learning.
In the community setting, students will likely practise as part of the team, under the supervision of site staff. During the first week of placement, ask students to identify a minimum of two areas where they would like to enhance their own learning. They should discuss these areas with their site supervisor and/or course instructor and identify potential opportunities for learning. Ask the student to record the conversation outcome and report to the instructor at the end of the community placement (Learning Outcomes #5 and #8).
The course learning outcomes may be assessed by the following tasks:
Refer to Resources for Practice Experience in Practice Experience in Multi-Level and/or Complex Care.
II
Computer skills are one of the key essential skills for success in the workplace, and upon completion of the HCA program, graduates should be prepared to use current computer technology in accordance with workplace standards.
While the specific technology used by HCAs will be dependent on their place of employment, baseline knowledge of computers and technology will help to prepare them to assume their workplace role.
Fundamental computer skills include basic knowledge of computers, word processing, and electronic communication using the internet and email; additional computer-related concepts applicable to HCAs are respectful and appropriate use of digital communication and technology in the workplace. While it is not within the scope of every HCA program to include computer skills training, it is possible to ensure that HCA students possess baseline computer skills upon graduation. The following table outlines suggested learning activities for incorporating these skills into existing HCA Curriculum. A Computer Skills Self-Assessment and a targeted resources list are also provided to support students’ self-development in this key employment skills domain.
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Computer Skills | Suggested Learning Activities |
---|---|
1. Basic Knowledge of Computers |
|
2. Word Processing |
|
3. Electric Communication
a. Internet
|
|
b. Online Forms/Applications |
|
c. Email
|
|
d. E-Communication and Netiquette |
|
e. Professional Use of Technology |
|
Student Name: Date:
I can identify the basic parts of a computer system | Yes □ No/Not Sure □ |
I can properly start and shut down a computer system | Yes □ No/Not Sure □ |
I can start and close a computer program | Yes □ No/Not Sure □ |
I can describe some common uses of computers in society | Yes □ No/Not Sure □ |
I can use a mouse/pointing device | Yes □ No/Not Sure □ |
I can operate a printer (turn power on, put online/offline, load paper) | Yes □ No/Not Sure □ |
I can create a new word processing document | Yes □ No/Not Sure □ |
I can edit a document | Yes □ No/Not Sure □ |
I can save a document to the storage drive | Yes □ No/Not Sure □ |
I can print a document | Yes □ No/Not Sure □ |
I can retrieve a document | Yes □ No/Not Sure □ |
I can use tools such as spell check or thesaurus | Yes □ No/Not Sure □ |
I can search online | Yes □ No/Not Sure □ |
I can complete an online form | Yes □ No/Not Sure □ |
I can add to favourites/bookmark bar | Yes □ No/Not Sure □ |
I can send and receive email, including attachments | Yes □ No/Not Sure □ |
Note: This tool has been adapted from the “Generic topic outlines, computer studies: fundamental level, adult basic education: A guide to upgrading in British Columbia’s public post-secondary institutions” (2014), produced by the Post-Secondary Programs Branch, Ministry of Advanced Education, Province of British Columbia.
Download Computer Skills Self-Assessment [PDF].
If you answered No/Not Sure to one or more of the questions in the Computer Skills Self-Assessment, you can use the following strategies to help you to complete computer-related assignments throughout the HCA program.
Ask a friend or family member to demonstrate the basic skills of using a computer, including identifying its main parts, turning it on/off, starting and shutting down a computer program, and using a printer.
If you do not have an email account, you can set one up by accessing one of the following:
*Basic tasks and functions of your email, including attaching files, will depend on your account.
Government of British Columbia, Ministry of Advanced Education. (2014). Adult basic education in British Columbia’s public post-secondary institutions: An articulation handbook.
Government of British Columbia, Ministry of Health. (2014). B.C. health care assistants core competency profile. https://www.health.gov.bc.ca/library/publications/year/2014/HCA-Core-Competency-Profile_March2014.pdf
Human Resources and Skills Development Canada. Literacy and essential skills, skills definitions and complexity. http://www.esdc.gc.ca/eng/jobs/les/definitions/inde.g.,shtml
III
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The addition of acute care content in the current Health Care Assistant Program Curriculum Guide (2015) is at the level of introducing students to the acute care context only, and only in theory and lab courses. Practice experiences in acute care are not part of the 2015 Guide.
With a goal of minimizing disruption to the 2008 curriculum (to not require a change in hours or a shift in existing content from one course to another), the following table indicates where acute care content could fit into existing courses with associated outcomes/content and align with the HCA Program Curriculum Guide (2015). Time estimates for the added content are also given.
The acute care content provided in this section is based on materials developed by Island HealthIsland Health Authority, the B.C. Health Education Foundation and the Ministry of Health Services are acknowledged for granting permission to adapt material from the Island Health Transitional Learning Continuum, Health Care Assistant in Acute Care Curriculum (2012). (formerly Vancouver Island Health Authority, VIHA). Instructors are encouraged to adapt and integrate this content into their instructional activities (e.g., PowerPoint slide, student handouts, course manuals, etc.).
Content Added | Courses and Strategies | Time Added |
---|---|---|
1. The supervision structures in acute care that support HCA practice | Health Care Assistant: Introduction to Practice | 30 minutes |
2. Similarities and differences between clients in acute care settings and clients in residential or community settings | Healing 1: Caring for Individuals Experiencing Common Health Challenges | 1 hour 30 minutes |
3. Specific elements of the acute care environment | Healing 1: Caring for Individuals Experiencing Common Health Challenges
Healing 3: Personal Care and Assistance |
No additional time |
4. How the role of the HCA may change in the acute care setting, depending on client acuity and intensity | Healing 1: Caring for Individuals Experiencing Common Health Challenges | 1 hour |
Health Care Assistant: Introduction to Practice course | 15 minutes | |
Health and Healing: Concepts for Practice | 30 minutes | |
5. Key considerations for providing holistic, person-centred care for acute care clients with IV lines, tubes, wounds, and surgical incisions | Healing 3: Personal Care and Assistance | 2 hours theory/lab |
6. Strategies for prioritizing tasks, demonstrating flexibility in work assignments, problem-solving and decision-making regarding care provision | Health and Healing: Concepts for Practice
Healing 1: Caring for Individuals Experiencing Common Health Challenges Healing 3: Personal Care and Assistance |
1 hour theory/lab |
7. Interprofessional collaborative practice in acute care settings | Health Care Assistant: Introduction to Practice | No additional time |
8. The importance of knowing when and how often to communicate with the client and health care team | Healing 1: Caring for Individuals Experiencing Common Health Challenges (specific examples related to acute care)
Healing 3: Personal Care and Assistance (specific examples/applications related to acute care) Health Care Assistant: Introduction to Practice (concepts related to supervision) |
30 minutes |
9. The role of the HCA in responding to emergency codes | Health and Healing: Concepts for Practice
Healing 3: Personal Care and Assistance (apply to lab scenarios) |
30 minutes |
10. Other acute care revisions | Healing 2: Caring for Individuals Experiencing Cognitive or Mental Challenges | 15 minutes |
Course: Health Care Assistant Introduction to Practice
Estimated additional time: 30 minutes
Examples of content based upon Island Health materials
Course: Healing 1: Caring for Individuals Experiencing Common Health Challenges, specifically within Learning Outcome #4: Ways to organize, administer and evaluate person-centred care. The content could be addressed with case studies or other activities already being delivered in teaching the course by basing some of these in acute care to emphasize differences.
Estimated additional time: 1 hour 30 minutes
Examples of content based on Island Health materials
Course: Healing 1: Caring for Individuals Experiencing Common Health Challenges; applied aspects in Healing 3: Personal Care and Assistance
Estimated additional time: covered in #2 and #5
Examples of content
Examples of environmental aspects more often encountered in the acute care setting may include:
Course: Healing 1: Caring for Individual Experiencing Common Health Challenges; may be addressed through specific examples while teaching about specific health challenges. Acute care information should also be added to Learning Outcome #1: “Display an understanding of the roles…” in the Introduction to Practice course
Estimated additional time: 1 hour in Common Health Challenges, 15 minutes in Introduction to Practice, and 30 minutes in Concepts for Practice (recording/reporting)
Examples of content based on Island Health materials
Course: Healing 3: Personal Care and Assistance
Estimated additional time: 2 hours theory/lab
Examples of content based on Island Health materials
Emphasize: When providing care, be sure to look at the client and to look at the site of the surgical or medical line. Seek assistance if there are any concerns or questions before proceeding with care and care-related activities.
IV lines
Ask: “What is an IV?”
Answer: An intravenous catheter is a small plastic cannula that is inserted in the vein with the use of a needle. After the plastic cannula is secure within the vein, the needle is removed. They are most commonly inserted in the hand or forearm but can be located in other areas such as the foot. Intravenous catheters are used to supply a client with additional fluids or medications.
Ask: “What does an HCA need to do when providing care to a client with an IV?”
Answer: When providing care to a client with an IV, the HCA should:
Oxygen tubing
Ask: “What does an HCA need to know about providing care to a client with oxygen tubing?”
Explain: Clients may require oxygen therapy as either a short-term intervention (clients with pneumonia, for example) or for long-term use (such as COPD clients). How much oxygen therapy is required and what method of delivery is used will depend on the client’s condition and may change as the client improves or deteriorates. Chronic conditions, such as COPD, will require consistent oxygen therapy at all times.
Describe: Different methods of delivering oxygen, such as nasal prongs or facial masks.
Ask: “What does an HCA need to do when providing care to a client on oxygen?”
Answer: When providing care to a client on oxygen, the HCA should:
Surgical drains
Ask: “What is a surgical drain?”
Answer: Surgical drains are:
Ask: “What does an HCA need to do when providing care to a client with a surgical drain?”
Answer: When providing care to a client with a surgical drain, the HCA should:
Chest tubes
Ask: “What does an HCA need to know about providing care to a client with a chest tube?”
Answer: HCAs need to know that:
Ask: “What does an HCA need to do when providing care to a client with a chest tube?”
Answer: When providing care to a client with a chest tube, the HCA should:
Catheters
Ask: “What does an HCA need to know about providing care to a client with a catheter?”
Answer: HCAs need to know that:
Ask: “What does an HCA need to do when providing care to a client with a catheter?”
Answer: When providing care to a client with a catheter, the HCA should:
Surgical incisions
Ask: “What types of surgical incisions would you expect to see in acute care?”
Answer: In acute care, you may encounter a wide variety of incisions. Incisions are generally covered with a dressing/bandage.
Common surgical incisions include:
Ask: “What does an HCA need to do when providing care to a client with a surgical incision?”
Answer: When providing care to a client with a surgical incision, the HCA should:
Course: Health and Healing: Concepts for Practice; Healing 1: Caring for Individuals Experiencing Common Health Challenges; applied aspects in Healing 3: Personal Care and Assistance
Estimated additional time: 1 hour for theory/lab
Examples of content based on Island Health materials
Ask: “What does an HCA need to know to prioritize tasks when providing care in acute care settings?”
Answer: When providing care in acute settings, HCAs need to know that:
The health care team needs to respond to these changes by managing their priorities.
Ask: “What does an HCA need to do to prioritize tasks when providing care in acute care settings?”
Answer: When providing care in acute care settings, HCAs need to:
Emphasize that although HCAs may not be assigned to specific client assignments or teams, they may be required to support specific aspects of daily care under the direction of another health care team member. This will require a level of flexibility and adaptability of the HCA to meet the client care needs in the rapidly changing environment in acute care.
Problem-solving and decision-making regarding care provision
Case studies or lab scenarios could be used to give students an opportunity to apply critical thinking and problem-solving skills to acute care settings, or to compare and contrast acute care and other settings.
Course: Health Care Assistant Introduction to Practice
Estimated additional time: not applicable, as already covered in program
Interprofessional collaborative practice is important because it meets the following needs in providing client care:
Describe: When teams work interprofessionally:
Highlight: The outcomes of interprofessional collaboration.
Clients and families have:
Health care providers:
The health care system:
Reference: Barrett, J., Curran, V., Glynn, L., & Godwin, M. (2007). CHSRF synthesis: interprofessional collaboration and quality primary healthcare. Canadian Health Services Research Foundation.
Course: Healing 1: Caring for Individual Experiencing Common Health Challenges; applied aspects in Healing 3: Personal Care and Assistance. This also relates to supervision in Introduction to Practice. Specific examples related to acute care could be included in Healing 1 and Healing 3
Estimated additional time: 30 minutes
Examples of content based on Island Health materials
Communication principles in acute care for HCAs:
Reinforce the importance of frequent communication in acute care settings.
Emphasize that the other members of the health care team will base their analysis, synthesis, and evaluation of client care on their observations and information (such as care planning or physician’s orders).
Explain that other members of the hospital team will base their client access and flow decisions on the most recent client information (such as who can be discharged or who can be admitted to a room and when).
Identify any specific protocols or site-specific processes that HCAs may encounter that will highlight the need for urgent and frequent communication processes (such as reduced staffing levels and high client acuity levels). Explain what the HCA role and responsibilities will be within these processes (such as re-prioritizing care and care activities to attend to different unit requirements).
Reinforce that HCAs should:
Emergent or emergency events may occur with a client or with a member of the health care team.
Acknowledge that sometimes communication processes do not go well. Explain the reporting structure that HCAs may use as a guide to facilitate difficult communication processes. Highlight any specific protocols, policies, or procedures that may be used at this site to address ongoing or unresolved communication difficulties (such as respectful workplace policies).
There are several YouTube videos that reinforce the concept of communication
Therapeutic communication for nurses (from a client’s perspective)
Classic Sesame Street – Ernie and Bert can’t communicate
Sesame Street – Ernie and Bert “Very Important Note”
Poor communication (health care assessment – context of care)
“See Me, Nurse” – video clips to the poem about nursing
Course: Coverage recommended in the Health and Healing: Concepts for Practice course. A lab scenario could also be added into the Healing 3: Personal Care and Assistance course
Estimated additional time: 30 minutes
Review the role of the HCA in assisting with emergencies
The following lists are examples of what may be expected of HCAs for the three top codes at one particular site:
Code Blue:
Explain the site policy and protocol for both witnessed and unwitnessed cardiac arrests.
Code White:
A call for help due to a potentially violent situation, or a violent or escalating incident.
Question: What are the differences between a code white response in a hospital, residential care home, and in a community setting?
Code Yellow:
Content is covered by online orientation for students doing placements at health region sites.
Code Red:
Content is covered in the online orientation for students doing placements at health region sites.
Standardized codes in B.C.
The following codes have been standardized for B.C. Not all codes will be used by all health regions or all sites.
Refer to the following document for further information:
Ministry of Health Services Policy Communiqué: Standardized Hospital Codes
Course: Healing 2: Caring for Individuals Experiencing Cognitive or Mental Challenges
Estimated additional time: 15 minutes
Examples of content based on Island Health materials
Explain: There are specific criteria and processes for people who are admitted involuntarily into acute care.
An involuntary admission is guided by criteria that are outlined in the Mental Health Act of British Columbia.Mental Health Act [RSBC 1998] Chapter 288, Section 22. http://www.bclaws.ca/civix/document/id/complete/statreg/96288_01#section22 Generally, the client has been examined by a physician who is of the opinion and provides reporting supporting the opinion that the client:
a. Has a mental health disorder.
b. Requires treatment in or through a designated facility.
a. Requires care, supervision, and control in or through a designated facility to prevent the person’s or patient’s substantial mental or physical deterioration or for the protection of the person or patient or the protection of others.
b. Cannot suitably be admitted as a voluntary patient.
Reinforce that depending on specific client care needs, there may be unique forms that are being used by the health care team. An example of client needs is substance withdrawal – CIWA protocol.
British Columbia Hospitals Emergency Colour Codes
IV
14
The Clinical Instructor Orientation supports clinical instructors in Health Care Assistant programs. It includes information on the role and expectations for both instructors and students; suggestions for instruction, reflection, and assessment; information on how to set students up for success; tips on giving and receiving feedback; and resources for more information. It also includes several sample evaluation tools.
The Clinical Instructor Orientation is available as a downloadable Word or PDF file for instructors. You can modify the file to reflect the specific background and requirements of the Health Care Assistant program at your institution.
Download Clinical Instructor Orientation [Word doc].
Download Clinical Instructor Orientation [PDF].
15
The Preceptor Orientation provides information to support Health Care Assistant preceptors who are working with students completing the course Practice Experience in Multi-Level and/or Complex Care. The orientation guide includes information on the role and expectations for both preceptors and students, tips on giving and receiving feedback, and resources for more information. It also includes a preceptor checklist, a student information form, and a practice education evaluation.
The Preceptor Orientation is available as a downloadable Word or PDF file. You can modify the file to reflect the specific background and requirements of the Health Care Assistant program at your institution.
Download Preceptor Orientation [Word doc].
Download Preceptor Orientation [PDF].
V
Based on the request for evaluation tools that are ready for use, the following section contains sample tools that could be applied to theory, lab, and practice education courses. As noted for each, the tools in this section align with suggested course assessments.
The following assessment tools are included in this section:
Assignment: HCA Workplace Settings
Assignment: Supporting Clients with Dementia or a Mental Health Disorder
Scenario-Based Lab Skills Assessment
Health Care Assistant Program Learning Outcomes Verification
Professional Behaviour Development Rubric
16
The purpose of this assignment is for students to explore workplace settings that are compatible with your values, beliefs, interests, and career goals as a Health Care Assistant (HCA).
Using the internet, students will research potential employers and settings of employment in their communities. After completing the research, students will prepare a written report of 500–750 words that addresses the follow components:
You will be marked using the following criteria:
Criteria | Exceeds Expectations | Meets Expectations | Partially Meets Expectations | Does Not Meet Expectations |
---|---|---|---|---|
1. Required Components
Possible marks: 10/10 |
Required components are thoroughly and thoughtfully addressed | Required components are adequately addressed | Required components are partially addressed | Required components are minimally, inadequately and/or not addressed |
Describes the work setting, two rewards and two challenges of working in the chosen work setting | The work setting is fully described and clear, detailed examples of two rewards and two challenges of working in the chosen setting are provided | The work setting is described and examples of two rewards and two challenges of working in the chosen setting are provided | The work setting is minimally described and/or examples of one or two rewards and one or two challenges of working in the chosen setting are provided | A description of the work setting and appropriate examples of rewards and challenges are minimally or not provided |
5 | 4 | 2-3 | 0-1 | |
The mission/value statement of the employer has been submitted with the assignment and is appropriately referencedFor any assignment requiring referencing of resources, it would be expected that the program would indicate the referencing style (e.g., APA) to be used and provide the necessary instruction and supporting materials for students to be successful in this criterion of the assignment. It would also be expected that referencing resources would be included as a criteria in the marking rubric, with placement depending on the parameters of the assignment. | The mission/value statement of the employer has been submitted with the assignment and is appropriately referenced | The mission/value statement of the employer has been submitted with the assignment and is appropriately referenced | The information submitted as the employer mission/value statement is not a mission/value statement and is appropriately referenced | An employer mission/value statement has not been submitted OR is not appropriately referenced |
1 | 1 | 0.5 | 0 | |
A personal mission statement related to the values, beliefs, interests and career goals has been developed | The personal mission statement is well prepared. It clearly addresses the beliefs, values, interests, and short- and long-term career goals of the student | The personal mission statement adequately addresses the beliefs, values, interests, and short- and long-term career goals of the student | The personal mission statement partially addresses the beliefs, values, interests, and short- and long-term career goals of the student | A personal mission statement minimally or does not address the beliefs, values, interests, and short- and long-term career goals of the student |
4 | 3 | 2 | 0-1 | |
2. Reflection
Reflect on how the mission/value statement of the employer aligns/does not align with your own beliefs, values, goals, and interests Possible Marks: 5/5 |
Response demonstrates an in- depth reflection on how the mission/value statement of the employer aligns with each of the following: personal beliefs, values, goals, and interests | Response demonstrates an adequate reflection on how the mission/value statement of the employer aligns with the personal beliefs, values, goals, and interests | Response demonstrates a partial reflection on how the mission/value statement of the employer aligns with the personal beliefs, values, goals, and interests | Response demonstrates minimal or no reflection on how the mission/value statement of the employer aligns with the personal beliefs, values, goals, and interests |
5 | 4 | 2-3 | 0-1 | |
3. Writing Mechanics
Possible Marks: 5/5 Writing and Sentence Structure |
Writing style is clear and concise, with excellent sentence/paragraph construction | Writing style is mostly clear and concise, with adequate sentence/paragraph construction | Writing style is partially clear, with a few errors in sentence/paragraph construction | Writing is unclear and disorganized with errors in sentence/paragraph construction |
2 | 1-1.5 | 0.5-1 | 0-0.5 | |
Format and Presentation | Content is presented in an organized and logical manner with appropriate headings and formatting | Content is presented in a logical and organized manner | Content is partially expressed in a logical manner | Content is minimally or not presented in a clear and logical manner |
2 | 1-1.5 | 0.5-1 | 0-0.5 | |
Spelling and Grammar | There are no more than three errors in spelling or grammar | There are no more than five errors in spelling or grammar | There are more than five errors in spelling or grammar | There are many more than five errors in spelling or grammar |
1 | 0.5 | 0-0.5 | 0 | |
Total Possible Marks:
20/20 |
Download Rubric: HCA Workplace Settings Assignment [PDF].
Note: This tool has been adapted from the Reflection Evaluation Criteria (the rubric). Retrieved on August 26, 2016.
Note: This sample tool has been included to align with Suggested Course Assessment 4 for the Health Care Assistant Introduction to Practice course.
17
The purpose of this assignment is to explore best practices for communicating with clients with dementia or mental health disorders.
Working in small groups, students will research a cognitive or mental health disorder of their choice. After completing the research, the groups will prepare an 8–10 minute presentation, with visual materials (e.g., a PowerPoint presentation or poster) and a short written handout to give to the class, addressing the following components:
You will be marked using the following criteria:
Criteria | Exceeds Expectations | Meets Expectations | Partially Meets Expectations | Does Not Meet Expectations |
---|---|---|---|---|
1. Required Components
Possible Marks: 15/15 |
Required components are thoroughly and thoughtfully addressed | Required components are adequately addressed | Required components are partially addressed | Required components are minimally, inadequately and/or not addressed |
Briefly describe the type of dementia or mental health disorder | The type of dementia or mental health disorder (causes, signs, and symptoms) are accurately and thoroughly described | The type of dementia or mental health disorder is described, with some consideration of the causes, signs, and/or symptoms | The type of dementia or mental health disorder is partially described. There may be important elements missing and/or some information may not be accurate | The type of dementia or mental health disorder is minimally or not described and/or Information is not accurate |
5 | 4 | 2-3 | 0-1 | |
Describe how the diagnosis or symptoms may impact communication between the client and HCA | How the diagnosis or symptoms may impact the ability to communicate is thoroughly described. The basic elements of interpersonal communication (sender, receiver, message, feedback) are considered | How the diagnosis or symptoms may impact the ability to is described, with some consideration for the basic elements of interpersonal communication | There is a partial description of how the diagnosis or symptoms may impact the ability of the client to communicate and/or the basic elements of interpersonal communication | How the diagnosis or symptoms may impact communication and the basic elements of communication are minimally or not addressed |
5 | 4 | 2-3 | 0-1 | |
Describe and/or demonstrate a minimum of three communication techniques (verbal and non-verbal) that could be used by an HCA to communicate with the client | A minimum of three appropriate communication techniques are fully demonstrated and/or described. Both verbal and non-verbal techniques are included. The value of each approach for the current context is fully explored | Two to three communication techniques are described and/or demonstrated. Verbal and/or non-verbal techniques are considered | There is a partial description of one to three communication techniques that may or may not be appropriate for the context | There is minimal coverage of communication techniques and/or suggestions are not appropriate |
5 | 4 | 2-3 | 0-1 | |
2. Presentation
Possible Marks: 15/15 Delivery *Individual mark
|
The presentation is delivered in an engaging manner. The speaker uses appropriate eye contact, appears relaxed and confident and speaks with appropriate volume and tone. There is a clear understanding of the subject matter, as evidenced by responses to questions from the audience | The presentation is presented in a somewhat engaging manner. Eye contact, body language, tone and volume is satisfactory. Some reference may be made to notes. There is a good understanding of the subject matter | The speaker sometimes demonstrates eye contact with the audience, speaks in an uneven or low tone and mostly reads from their notes. Audience engagement is minimal | The presentation is delivered in a manner that does not interest or engage the audience or is inappropriate |
5 | 4 | 2-3 | 0-1 | |
3. Teamwork and Organization | The group works well together to prepare and deliver the presentation.
Tasks are appropriately Components of the |
The group works together to prepare and/or deliver the presentation.
The division of tasks is satisfactory and there is evidence of adequate collaboration between group members. Components of the presentation are delivered in a logical sequence and/or within the time frame allotted. |
The team partially works together to prepare and/or deliver the presentation.
The division of tasks is not balanced and there is a low level of collaboration between group members. Components of the presentation may not be delivered in a logical sequence and/or not delivered within the time frame allotted. |
There is minimal to no evidence that the team has worked together to prepare or deliver the presentation.
The division of tasks is not balanced and there appears to be a low level of collaboration between group members. The presentation is not delivered in a logical sequence or within the time frame allotted. |
5 | 4 | 2-3 | 0-1 | |
4. Visual Materials and Student Handout | Visual materials and student handout are attractive and organized, with appropriate headings and formatting. There are minimal mistakes in spelling/grammar.
Resources used are identified and appropriately referenced.For any assignment requiring referencing of resources, it would be expected that the program would indicate the referencing style (e.g., APA) to be used and provide the necessary instruction and supporting materials for students to be successful in this criterion of the assignment. It would also be expected that referencing resources would be included as a criteria in the marking rubric, with placement depending on the parameters of the assignment. criteria of the assignment. It would also be expected that referencing resources would be included as a criteria in the marking rubric, with placement depending on the parameters of the assignment. |
Visual materials and student handout are presented in organized manner with appropriate headings. There may be a few mistakes in spelling/grammar.
Resources used are identified and appropriately referenced. |
Visual materials and/or student handout are not clearly tied to the presentation. There may be mistakes in spelling/grammar.
Resources used are identified and appropriately referenced. |
Visual materials are minimally or not adequate or resources are not appropriately referenced. |
5 | 4 | 2-3 | 0-1 | |
Total Possible Marks:
30/30 |
Note: This sample tool has been included to align with Suggested Course Assessment 3 for the Healing 2: Caring for Individuals Experiencing Cognitive or Mental Challenges.
Download Rubric: Supporting Clients with Dementia or a Mental Health Disorder [PDF].
18
To support program consistency, recognized B.C. HCA programs are expected to use case scenario testing to confirm that students are safe and competent before they go into the clinical setting.
As noted in the suggested course assessment for the Personal Care and Assistance course, skills testing could be accomplished through performance of a scenario simulating the practice environment and may include an opportunity for problem-solving. The specific skills tested and expected level of competency may vary depending upon when the first clinical experience occurs within the program. To support student success, it may be helpful to implement a mid-course assessment and/or pre-testing practice session.
For scenario-based or case study type assessment, it is typical to have at least four client scenarios for skills testing that students could receive in advance for preparation purposes. On testing day, a scenario will be randomly chosen for each student to perform. The student will have a set amount of time (e.g., 45 minutes per student) to complete the scenario. Students will work in pairs with one acting as the client and the other being the HCA.The program may choose to have an instructor or a standardized patient (actor) in the role of the client. It is important that the student acting as the client play the role seriously. Prompting or cueing by the client is not allowed. With some scenarios, it may be necessary for the HCA to obtain a partner who will be designated the “helper.” Some components of care may be provided on a mannequin or using simulation aids (e.g., torso with a penis or torso with a vulva).
A care plan is often provided for each scenario for the purpose of student testing.
HCA programs may already have skills testing assessment criteria in place. At a minimum, students should demonstrate their ability to:
Evaluation is typically conducted on a satisfactory/unsatisfactory or a pass/fail basis. Programs implementing a mid-course skills assessment may add a “needs improvement” designation, which, if assigned, is followed up with a learning contract.
To ensure fair and reliable student practical skills assessment, there should be established criteria regarding what would constitute unsatisfactory performance. This could include the designation and number of minor infractions that may result in a cumulative fail, or major infractions that may result in an immediate fail.
Elements that may be considered include:
There should also be details set out in regards to requirements for retesting.
See sample case scenarios and rubrics below.
You are an HCA working in a residential care home. Today you are assigned to provide morning care for Edith Blaise, a 92-year-old woman who has recently fractured her left foot. This morning when you enter Ms. Blaise’s room, she asks you to assist her with a bedpan. Following this, you will assist Ms. Blaise with a partial bed bath, assist her with dressing, and transfer her to her wheelchair using a full mechanical lift.
Depending on the case scenario, each required skill could be evaluated as follows:
Skill performed | Unsatisfactory (Indicate where applicable with a check mark) |
Satisfactory (Indicate where applicable with a check mark) |
P=PASS F=FAIL R=Redo |
---|---|---|---|
Assists with a bedpan | □ Ineffective organization and prioritization (did not gather required supplies and managed time improperly) | □ Effective organization and prioritization (gathered required supplies and managed time properly) | |
□ Did not perform skill following correct lab procedures | □ Performed skill following correct lab procedures | ||
□ Performance of skill was unsafe | □ Safe performance of skill | ||
□ Improper medical asepsis | □ Proper medical asepsis | ||
□ Incorrect body mechanics | □ Correct body mechanics | ||
□ Inadequate communication with client | □ Adequate communication with client | ||
□ Does not attend to client comfort and/or support dignity | □ Attends to client comfort and supports dignity | ||
Instructor Comments | |||
Partial bed bath | □ Ineffective organization and prioritization (did not gather required supplies and managed time improperly) | □ Effective organization and prioritization (gathered required supplies and managed time properly) | |
□ Did not perform skill following correct lab procedures | □ Performed skill following correct lab procedures | ||
□ Performance of skill was unsafe. | □ Safe performance of skill | ||
□ Improper medical asepsis | □ Proper medical asepsis | ||
□ Incorrect body mechanics | □ Correct body mechanics | ||
□ Inadequate communication with client | □ Adequate communication with client | ||
□ Does not attend to client comfort and/or support dignity | □ Attends to client comfort and supports dignity | ||
Instructor Comments | |||
Assists with dressing | □ Ineffective organization and prioritization (did not gather required supplies and managed time improperly) | □ Effective organization and prioritization (gathered required supplies and managed time properly) | |
□ Did not perform skill following correct lab procedures | □ Performed skill following correct lab procedures | ||
□ Performance of skill was unsafe | □ Safe performance of skill | ||
□ Improper medical asepsis | □ Proper medical asepsis | ||
□ Incorrect body mechanics | □ Correct body mechanics | ||
□ Inadequate communication with client | □ Adequate communication with client | ||
□ Does not attend to client comfort and/or support dignity | □ Attends to client comfort and supports dignity | ||
Instructor Comments | |||
(sample skill)
Transfer from bed to wheelchair |
□ Ineffective organization and prioritization (did not gather required supplies and managed time improperly) | □ Effective organization and prioritization (gathered required supplies and managed time properly) | |
□ Did not perform skill following correct lab procedures | □ Performed skill following correct lab procedures | ||
□ Performance of skill was unsafe | □ Safe performance of skill | ||
□ Improper medical asepsis | □ Proper medical asepsis | ||
□ Incorrect body mechanics | □ Correct body mechanics | ||
□ Inadequate communication with client | □ Adequate communication with client | ||
□ Does not attend to client comfort and/or support dignity | □ Attends to client comfort and supports dignity | ||
Instructor Comments |
Download Rubric 1: Scenario-Based Lab Skills Assessment [PDF]
Note: This sample tool has been included to align with Suggested Course Assessment 3 in the Healing 3: Personal Care and Assistance Course.
You are an HCA working in a residential care home. Today you are assigned to provide morning care for Edith Blaise, a 92-year-old woman who has recently fractured her left foot. This morning when you enter Ms. Blaise’s room, she asks you to assist her with a bedpan. Following this, you will assist Ms. Blaise with a partial bed bath, assist her with dressing and transfer her to her wheelchair using a full mechanical lift.
Depending on the scenario, and the using following criteria (NI = Needs improvement [may be used for mid-point testing], NS = Not Satisfactory, S = Satisfactory) the rubric could be used as follows:
1. Maintains the comfort and dignity of the client | NI | NS | S |
Examples and comments
|
|||
2. Maintains the safety of the client, self, and other members of the health care team | NI | NS | S |
Examples and comments
|
|||
3. Communicates effectively with the client and other members of the health care team, where appropriate | NI | NS | S |
Examples and comments
|
|||
4. Provides care in an organized manner, gathers supplies, and manages time appropriately | NI | NS | S |
Examples and comments
|
|||
5. Maintains medical asepsis and infection control throughout the scenario | NI | NS | S |
Examples and comments
|
|||
6. Uses proper body mechanics throughout the scenario | NI | NS | S |
Examples and comments
|
|||
7. Performs personal care and assistance skills competently (scenario specific) | NI | NS | S |
Examples and comments
|
|||
i. Assist with bedpan (performed according to correct lab procedures) |
NI | NS | S |
Examples and comments
|
|||
ii. Partial bed bath (performed according to correct lab procedures) |
NI | NS | S |
Examples and comments
|
|||
iii. Transfer from bed to chair using full mechanical lift (performed according to correct lab procedures) |
NI | NS | S |
Examples and comments
|
Instructor Name Instructor Signature Date
Student Name Student Signature Date
Download Rubric 2: Scenario-Based Lab Skills Assessment [PDF].
Note: This sample tool has been included to align with Suggested Course Assessment 3 included in the Healing 3: Personal Care and Assistance Course.
19
The following summary list could be used as an organizational tool to identify learning needs and record practise of HCA skills in the lab and clinical settings. It is not intended to replace scenario-based lab skills testing or assessment of meeting program learning outcomes for practice education placements.
This is a summary list only. It is expected that additional procedure criteria for each skill would be provided by the program in a lab skills manual. The program may wish to indicate skills with additional safety-related considerations (e.g., instructor is present for the first time demonstration of a skill in the clinical setting, two person mechanical lift policy, etc.).
Student Name: has demonstrated completion of the following personal care and assistance skills.
HCA Skills Summary List | Peer Review (in Lab) | Instructor Review (in Lab) | Instructor Review (in Clinical) |
---|---|---|---|
Prevents Infection | |||
Handwashing | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Gloving | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Donning and removing gloves | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Donning and removing gloves | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Donning and removing mask | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Other, e.g., double bagging | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Promotes Personal Hygiene | |||
Oral hygiene | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Denture care | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Partial bath | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Complete bed bath | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Perineal care | □ Perineal care of the penis
Reviewed by: Date: □ Perineal care of the vulva Reviewed by: Date: |
□ Perineal care of the penis
Reviewed by: Date: □ Perineal care of the vulva Reviewed by: Date: |
□ Perineal care of the penis
Reviewed by: Date: □ Perineal care of the vulva Reviewed by: Date: |
Grooming | □ Male
Reviewed by: Date: □ Female Reviewed by: Date: |
□ Male
Reviewed by: Date: □ Female Reviewed by: Date: |
□ Male
Reviewed by: Date: □ Female Reviewed by: Date: |
Dressing and undressing | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Applying compressing stockings | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Skin care | □
Reviewed by: Date: |
□
Reviewed by: Date: |
□
Reviewed by: Date: |
Relieving pressure | □
Reviewed by: Date: |
□
Reviewed by: Date: |
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Reviewed by: Date: |
Assists with Movement | |||
Body mechanics | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Moving a client | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Positioning a client in chair | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Positioning a client in bed – supine | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Positioning a client in bed – lateral | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Positioning a client in bed – Sims | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Positioning a client in bed – Fowlers | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Transferring a client; one-person transfer | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Transferring a client; hemi transfer | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Use of a sit-to-stand lift | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Use of a full lift | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Use of a ceiling lift | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Promotes Exercise and Activity | |||
Assisting with walking devices | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Assisting with wheelchairs | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Preventing falls | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Responding to falls | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Assisting with range of motion exercises | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Provides Elimination Assistance | |||
Application of continence products (1 piece/2 piece) | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Assisting with bedpans | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Assisting with urinals | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Assisting with commodes | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Enema administration | □
Reviewed by: Date: |
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Reviewed by: Date: |
Ostomy care | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Care of indwelling urinary catheter | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Applying a condom catheter | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Collecting specimens | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Promotes Client Well-Being | |||
Supporting transitions | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Supporting comfort | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Supporting rest | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Changes Bed Linens | |||
Occupied bed | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Unoccupied bed | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Promotes Healthy Nutrition and Fluid Intake | |||
Assisting a client with eating/fluid intake | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Feeding a client | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Measuring and recording intake | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Measures Vital Signs | |||
Height | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Weight | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Pulse | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Respiration | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Temperature | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Reporting and recording | □
Reviewed by: Date: |
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Reviewed by: Date: |
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Reviewed by: Date: |
Instructor Name Instructor Signature Date
Student Name Student Signature Date
Note: This sample tool has been included to align with Suggested Course Assessment 2 included in the Healing 3: Personal Care and Assistance course and Suggested Course Assessment 1 included in the Practice Experience in Multi-Level and/or Complex Care course.
Download HCA Skills Summary Checklist [PDF].
20
This form confirms that the student identified below has completed the required practice education placements and placement hours for the HCA Practice Education program segment and has been deemed by their instructor as having met the required program learning outcomes outlined in the HCA Program Provincial Curriculum Guide 2015, p. 18.
Student Name: (please print)
Multi-level/complex care placement site name(s):
Date(s): Number of hours completed:
Name of instructor(s):
Assisted living/home support/group home placement site name(s):
Date(s): Number of hours completed:
Name of instructor(s):
Directions: Please indicate whether or not the student has met (been able to demonstrate) the following learning outcomes in the clinical setting and sign and date the bottom of the form.
1. Provide person-centred care and assistance that recognizes and respects the uniqueness of each individual client. | Met | Not Met |
Examples and comments:
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2. Use an informed, problem-solving approach to provide care and assistance that promotes the physical, psychological, social, cognitive, and/or spiritual well-being of clients and families. |
Met | Not Met |
Examples and comments:
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3. Provide care and assistance for clients experiencing complex health challenges. | Met | Not Met |
Examples and comments:
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4. Provide care and assistance for clients experiencing cognitive and/or mental health challenges. | Met | Not Met |
Examples and comments:
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5. Interact with other members of the health care team in ways that contribute to effective working relationships and the achievement of goals. | Met | Not Met |
Examples and comments:
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6. Communicates clearly, accurately, and in sensitive ways with clients and families within a variety of contexts. | Met | Not Met |
Examples and comments:
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7. Provides personal care and assistance in a safe, organized, and competent manner. | Met | Not Met |
Examples and comments:
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8. Recognizes and responds to own self-development, learning, and health enhancement needs. | Met | Not Met |
Examples and comments:
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9. Performs the care provider role in a reflective, responsible, accountable, and professional and ethical manner. | Met | Not Met |
Examples and comments:
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Instructor Name Instructor Signature Date
Instructor Name Instructor Signature Date
Student Name Student Signature Date
Download Health Care Assistant Program Learning Outcomes Verification [PDF].
Note: This sample tool has been included to align with Suggested Course Assessments 3 and 5 included in the Practice Experience in Multi-Level and/or Complex Care course and Suggested Course Assessment 2 included in the Practice Experience in Home Support, Assisted Living, and/or Group Home course. It could be further adapted for use as a self-assessment by the student.
21
The Professional Behaviour Development RubricNote: The Registry would like to acknowledge the Continuing Care Assistant Program in Nova Scotia, www.novascotiacca.ca, for developing the original version of this resource, which has been adapted for use in the B.C. Health Care Assistant Program. © Continuing Care Assistant Program. (2013). Professional Behaviour Development Rubric. Nova Scotia. sets out expectations for student conduct within the Health Care Assistant program with a view to effectively preparing graduates for success in today’s health care workforce. This rubric is intended to positively reinforce and support the development and application of professional behaviour. It responds to feedback from HCA educators and employers alike that HCA program students and graduates could gain from additional strategies to support their success in the program and allow for more productive employee integration and retention.
Given the associated learning outcomes and course content, it is suggested that this tool be introduced for learning and discussion during the HCA Introduction to Practice course. It could be used as a formative evaluation tool (either graded or non-graded) during both the HCA Introduction to Practice course and the Healing 3: Personal Care and Assistance course. Constructive feedback gained throughout the program could then guide further development and application when used as a final evaluation tool (graded) during practice education coursework. The behaviours addressed within this tool align with the learning outcomes for both the Practice Experience in Multi-Level/Complex Care course and the Practice Experience in Home Support, Assisted Living and/or Group Home course. Competent performance (in all areas) could be required for successful completion of practice education coursework.
There are four sections to the rubric:
A variety of approaches are encouraged to address the development of professionalism throughout the HCA program. By taking an ongoing, integrated approach, students can be supported in behaving in a way that will most greatly support their success when they move into their practice education experiences and into the workforce. When using this tool, it will be important for instructors (as well as practice education site mentors) to provide ongoing input,
informing and enabling students to reach a “competent” level for each of the behaviours by the end of the practice education placement. When assessing behaviours, specific examples and suggestions for development should be provided.
Measurement | Definition |
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Developing | The student is in the process of learning and applying the behaviour. |
Competent | The student meets expectations for the behaviour. |
Exemplary | The student exceeds expectations of the desired behaviour. |
Student Name Date
1. Appropriate Behaviour | Developing | Competent | Exemplary |
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Attitude: The attitude of the student is positive, friendly, helpful, courteous, person-centred, optimistic, and team oriented. | |||
Appearance: The appearance of the student is appropriate: hair and body are clean; no noticeable body odour and scent free; clothes are clean, wrinkle free, and appropriate; wears name tag; appropriate footwear and minimal jewellery and nails are clean, short, and polish-free. | |||
Integrity: The student interacts with people in a respectful manner: their manner is honest, ethical, sincere, reliable, empathic, and committed. | |||
Technology: The student uses technology (e.g., mobile phone, including photo and video recording features; computer; social media) in alignment with established policies and procedures. Does not use personal communication or media devices inappropriately. | |||
Comments (examples and suggestions):
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2. Respect for Self and Others | Developing | Competent | Exemplary |
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Communication (verbal and non-verbal): The student communicates in an appropriate manner, verbally and non- verbally. Verbal communication is appropriate: able to speak in turn without interrupting others, takes into consideration tone and volume, does not speak too quickly or unclearly, avoids use of profanity and slang, appropriate self-disclosure. Is considerate of non-verbal communication (e.g., posture, facial expressions, and other body language). | |||
Communication (written): The student communicates in an appropriate manner in written communication. Written documentation is legible, with correct spelling and grammar, objective (fact-based), and uses appropriate terms and abbreviations. E-communication, such as text messages and emails, are written in a suitable manner, taking into consideration the relationship with the recipient. For example, informal “SMS language” such as common texting abbreviations are avoided when communicating with the instructor or practice education site personnel. | |||
Nonjudgemental: The student demonstrates a nonjudgmental attitude in all settings: respecting diversity, differing opinions, and beliefs. Displays a positive approach to differences. | |||
Caring: The student displays a caring attitude with clients/team in all settings. Actively listens, and is kind, respectful, gentle, thoughtful, considerate, compassionate, sincere, person-centred, concerned, team oriented. | |||
Team player: The student demonstrates they are a positive team player. Contributes to the group, committed to team goals, shares the workload, participates in tasks, accountable for actions, takes a multi-disciplinary approach. | |||
Comments (examples and suggestions):
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3. Commitment | Developing | Competent | Exemplary |
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Time management: The student manages their time effectively. Student is punctual, prepared, and efficient. Student can effectively prioritize and multitask and is dependable. | |||
Adaptability: The student displays a positive attitude when adapting to changes such as shifts in team/group members or shifts in environment such as increased workload, changes in client assignment, and practising in diverse settings. | |||
Stress management: The student manages their stress appropriately by demonstrating: awareness of and management of triggers (precipitating factors), able to accept when situations cannot be changed, utilizes and continues to develop individual coping skills, maintains professional boundaries effectively (leaves personal life at home), prioritizes appropriately. | |||
Comments (examples and suggestions):
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4. Competence | Developing | Competent | Exemplary |
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Accountability: The student demonstrates accountability through appropriate application of skills and knowledge, staying informed of learning goals and requirements, asking questions and seeking guidance, recognizing client status, reporting issues and changes, and advocating for the client. | |||
Continuous learning: The student demonstrates continuous learning by openly offering, receiving, and applying feedback; seeking out learning opportunities; attending available in-services and workshops; and focusing on personal and professional development. | |||
Problem-solving: The student demonstrates problem-solving skills: uses critical thinking skills, follows policies and procedures, understands chain of command, maintains calm and competent presence in unforeseen situations/circumstances. | |||
Comments (examples and suggestions):
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1
This page provides a record of edits and changes made to this book since its initial publication. Whenever edits or updates are made in the text, we provide a record and description of those changes here. If the change is minor, the version number increases by 0.01. If the edits involve substantial updates, the version number increases to the next full number.
The files posted by this book always reflect the most recent version. If you find an error in this book, please fill out the Report an Error form.
Version | Date | Change | Details |
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1.00 | February 1, 2022 | Book published. | |
1.01 | April 29, 2022 | Add link to resource. | Add link to “AM Skills Care” videos in Healing 3: Personal Care and Assistance. |