Module 1-PSW Foundations

o Chapters 1 – 14; Pages 1-223

o Chapter 47; Pages 1075 – 1097
 Chapter 1 Chapter 1

The Role of the Support Worker

Support Worker- Person who assists clients

with personal care, family responsibilities,

social and recreational activities and

housekeeping or home management; provides

personal care and assistance with ADLs.

Support Worker Responsibilities

● Personal care
● Support for Nurses and Other
Health Care Providers
● Family Support
● Social Support
● Housekeeping or Home
Management
People Needing Support Services
● Older adults
● People with disabilities
● People with medical issues
● People having surgery
● People with mental health issues
● People needing Rehabilitation
● Children
● Mothers and newborns
● People requiring special care
The Health Care Team
Support worker is an important
member of the healthcare team.
Other members are:
Dietitian
Occupational Therapist
Physician
Pharmacist
Nurse Practitioner
Physiotherapist
Recreational Therapist
Registered Nurse
Registered Practical Nurse
Respiratory Therapist
Social Worker
Being A professional

● Positive attitude
● Sense of responsibility
● Professional Appearance
● Discretion about Client
information
● Confidentiality
● Lifelong Learning
● Advocating for the client
● Discretion about personal
matters
 The Goal of Support Worker
Compassionate care or caring means having
concern for the client. The Acronym DIPPS is a
reminder of the five principles of compassionate
care, which are-
Dignity- state of feeling worthy, valued and
respected.
Independence- clients need to do what they can do.
Preference- clients need to make their own choices.
Privacy- clients need to maintain their privacy.
Safety- clients need to live in safe environment.
 Chapter 2
Canada’s current healthcare system
Medicare- Canada’s national health insurance system is known as
[Link] uses provincial and territorial taxes and federal taxes
to pay for all Medically necessary Health services for all permanent
residents.
Principles of Medicare,as listed in Canada Health Act (1984)
● Comprehensiveness- The insurance plan must pay for all medically
necessary services.
● Universality-Every permanent resident is entitled to receive the
insured healthcare services provided by the plan.
● Portability-People can keep their healthcare coverage even if they
are unemployed, moving or change jobs.
● Accessibility-People can receive medical services regardless of
their age or gender, geographical area.
● Public Administration-The insurance plan must be run by a public
organization on a nonprofit basis.
 Levels of Health Care
Every province and
territory provides
primary, secondary and
tertiary health care.
 Health Care Challenges
The canadian Health care system has come under stress in recent [Link]
factors challenge the country’s ability to provide quality, Universal healthcare.
They include :
● Worker shortage- Many rural and remote areas face severe shortage of
physicians, nurses and other healthcare workers.
● Aging of baby boomer generation(those born between 1945 and 1964)-
For the older adult population to live safely and with dignity, the cost of our
healthcare system will rise.
● Aging of Health care workers- Health workers are also aging.
● Long waiting lists for surgeries, diagnostics and medical procedures-It
can lead to stress and possibly worsening of client’s condition.
● Long waiting times for admission to long- term care facilities- Clients
who are ill and waiting for long term care facilities, must stay in acute
care hospitals because it is unsafe for them to live at home.
● The steadily rising cost of care- Rising cost is the greatest [Link],
technology, labour and building costs are too high.
 Additional Services
Provinces and territories provide coverage to certain people (e.g., older adults,
children, and recipients of social assistance) for services that are not generally
covered under the publicly funded health care system. These supplementary
health benefits often include prescription drugs, dental care, vision care,
medical equipment and appliances (e.g., prostheses, wheelchairs),
independent-living assistance, and the services of other health care providers
such as chiropractors. The level of coverage varies across the
[Link] health insurance, sometimes referred to as benefits, covers
services that are not government funded, such as some of the costs of
rehabilitation and extended care services.
 Private Insurance
Those who do not qualify for supplementary benefits under government plans
pay for these services with individual, out-of- pocket payments or through
private health insurance plans. Many Canadians are covered by private health
insurance, paid for by their employers or themselves.
 Healthcare trends
To reduce some of the pressures placed on our health care system, new ways of providing care
have been introduced to Canadians, with the intent of providing quality care while avoiding
needless [Link] part of these reforms, provincial and territorial governments are now
focused on two areas:

[Link] promotion and disease prevention- Some sectors of government and industry have
policies to promote health and prevent illness by improving the quality of people's lives.
Examples of such policies include:
• Immunization programs
• Prenatal and parenting classes
• Information campaigns to reduce drinking during pregnancy, unsafe sex, and tobacco use
• Efforts to improve housing, decrease poverty, monitor drinking water.
Support workers contribute to health promotion and disease

[Link] care-Home care is health care and support services provided to people in their places
of residence, including private homes, licensed residential care facilities, and assisted-living
facilities.
 Categories of Home Care
[Link] Care services- These non medical services offered through home care,
often by support workers, include the following: Assisting with activities of daily living (ADLs—
e.g., bathing, feeding, mobility, and dressing), Providing comfort care to clients who are dying

2. Home support services. These services include the following: Assisting with
home management, Assisting with ADLs, Assisting with taking medications

3. Nursing and professional services. Therapies and treatments provided by the

relevant health care providers include the following: Nursing care, Physiotherapy,
Occupational therapy, Speech therapy, Nutrition counselling,Social work, Respiratory
therapy

4. Support for instrumental activities of daily living (IADLs). These services,

often provided by support workers, include the following: Shopping with a client,
Assisting a client with banking, Teaching a client how to follow a recipe.
 Chapter 3

Workplace settings and services provided

Support workers provide care in many settings.
● Acute Care-health care that is provided for a relatively short time (usually days to weeks).
● Subacute care (also known as convalescent care or complex continuing care)—health care or rehabilitation
for people recovering from surgery or injury or being stabilized after a serious illness or health challenge.
● Long-term care-health and support services provided over the course of months or years to people who
cannot care for themselves.
● Respite care- temporary care of a person who requires a high level of support, care, and supervision.
● Rehabilitation and restorative care services- therapies designed to restore or improve the client's
independence and functional abilities.
● Palliative care- care for clients with progressive, life-threatening illnesses. Also called end-of-life care,
palliative care includes services that aim to relieve or reduce uncomfortable symptoms, not to produce a
cure
● Hospice- an element of palliative care that provides home, residential, or inpatient care to a client who has
a terminal diagnosis and is no longer seeking life-prolonging care.
 Mental health care services (also known as psychiatric care services) —services for people with mental
health disorders (such as schizophrenia, bipolar disorder, and addictions)
.
Working in Community-Based Settings

Community-based settings are places within the community that provide health care
and support services. Examples of community- based settings include clients' homes,
group homes, and retirement homes in which clients live as independently as
possible. The most common community seing is the client's home.
Home Care
Home care is a vital part of Canada's
health care system. Support workers
have a central role within home
[Link] workers are responsible for
providing a range of home care services,
including assisting with personal care ,
ADLs, child care, transportation, and
home management.
Issues and challenges Associated with
working in homecare
● Working on your own.
● Taking direction from different health care providers.
● Maintaining professional boundaries.
● Providing for client safety.
● Providing for your personal safety.
 Working in facility based settings
Facility-based settings are workplaces that provide
clients with accommodations, health care, and support.
Examples include hospitals and long-term care
facilities.

Hospitals- A hospital is a facility for clients with acute

illnesses or injuries who require admission and care on
a relatively short-term basis

Long-term care facility- is home to people who are not

able to live independently or in their own homes and
who require the availability of 24-hour nursing services
to meet their personal care needs but do not need
hospital care.
 Residential Facilities
A residential facility is a facility that provides living accommodations, care, and
support services. People using residential facilities are called residents because they
reside, or live, in the facility. The facility is their temporary or permanent home.
Therefore, these facilities provide care in a comfortable, homelike atmosphere.
Clients need residential care when they require supervision and assistance with some
or all of their ADLs but do not need acute medical care or high-level nursing care.
Such clients include the following:
• Frail older adults
• Individuals of all ages who have physical disabilities, mental health challenges, or
both
• Individuals with substance addiction
 Assisted Living facilities
Also called supportive housing facilities, assisted-living facilities are residential
facilities where people live in their own apartments and receive support services.
Because they are located in the community, assisted-living facilities are
considered to be community-based services.
Residents usually receive the following support services:
• 24-hour supervision and emergency response services • Social and recreational
programs
• One or two daily meals
• Housekeeping and laundry services.
 Group Homes
A group home is a residential facility in which a
small number of people with physical or mental
disabilities live together and receive supervision,
care, and support services. Rather than having
their own apartments, residents share a house in a
residential neighbourhood.. Usually, residents
have their own bedrooms but share bathrooms and
living and dining areas. They receive 24-hour
supervision, meals, housekeeping and laundry
services, and assistance with personal care and
ADLs.
Retirement Residences
A retirement residence (or retirement home)
is a facility that provides accommodation and
supervision for older adults. Residents have
their own bedrooms and bathrooms but share
common living and dining [Link] may
need help with housekeeping but limited
supervision and lile to no assistance with
personal care. The goal of a retirement
residence is to allow older people to live as
independently as possible while providing
security, support services.
 Community Day programs
An adult community day program (also called adult day
centre or adult day program) is a daytime program for
people with physical or mental health issues or for older
adults who need assistance. These programs may be
held in hospitals, nursing homes, community and
recreational centres, adult day centres, church
basements, or other settings. In some provinces, support
workers are hired by school boards to assist with clients
who are attending school instead of a day [Link]
day programs offer recreational activities, such as arts
and crafts, social events, films, and board or card games.
Issues and Challenges
Associated With Working in a
Community Day Program
• Working closely with a team and a supervisor.
• Working in a structured environment
• Meeting multiple needs.
Working Directly for Clients

A support worker may be hired by, supervised by, and work directly for a
client or the client's family. Clients may hire their own support workers if they
need a service that is not provided by local agencies or if their province
provides funding assistance directly to them rather than to an agency for their
care.
Issues and Challenges Associated
With Working Directly for Clients

● Clarifying the terms of employment

● Establishing work limits
● Knowing scope-of-practice limits and your role and responsibilities.
● Needing to carry liability insurance
 Working in a facility
A health care facility is a building designed or established for the
delivery of specific care, treatment, and support services.
1. Hospitals and Other Medical Facilities- Clients in hospitals
usually have serious illnesses or injuries that require treatment in a
timely manner, skilled professional [Link] may be
employed in any unit in a hospital, including the critical care unit
(CCU) and the emergency department (ED). Their role may be to
provide basic care such as feeding, transporting people, taking
specimens to the lab, or measuring vital signs. In some hospitals,
they may assist nurses before, during, or after surgical or medical
procedures.
[Link]-term care facilities (also called nursing homes, homes for
the aged, long-term care homes, and special care homes) offer
higher levels of care than do retirement residences and assisted-
living facilities. They provide accommodations, 24-hour
professional nursing care, and support services to clients who
cannot care for themselves at home but Do not need hospital care.
Issues and Challenges Associated With
Working in a Facility
● Working in a structured team environment.
● Meeting multiple needs and demands.
● Doing many tasks within a short period.
● Respecting your role and scope of practice.
● Working in shifts.
 Chapter 4

Health and Wellness

According To World Health Organization (WHO), “
Health is a state of complete physical, mental and
social well-being and not merely the absence of
disease or infirmity.”
 Dimensions of Health
The five dimensions of health must be
considered in whole health. These are:
 Physical Health-is achieved when the body is
strong, fit and free from disease.
 Emotional Health-is not merely the absence
of negative emotions but the ability to function
well in and adapt appropriately to
circumstances.
 Social Health- is achieved through stable and
satisfying relationships.
 Spiritual Health- is achieved through belief in
a purpose greater than the self.
 Cognitive or Intellectual Health-is achieved
by keeping the mind active and creative
throughout life.
 Determinants of Health
The 12 key determinants of health are:
● Income and Social Status
● Social Support Networks
● Education and Literacy
● Employment and Working Conditions
● Social Supports
● Physical Environments
● Personal Health Practices and coping
skills
● Healthy Child Development
● Biology and Genetics
● Health Services
● Gender
● Culture
 Illness and Disability
Illnessis the loss of physical or mental health, whereas
disability is the loss of physical or mental function.
Illness or disability may limit a person's ability to
communicate, move, or perform ADLs without
assistance.
Common Reactions to Illness and
Disability
● Fear and Anxiety
● Sadness and Grief
● Depression
● Denial
● Anger
Factors affecting a client's experience
of illness and disability
• The nature of the illness or condition
• The client's age
• The client's level of physical fitness
• The amount and degree of pain and discomfort the client experiences
• The prognosis (the expected course of recovery based on the usual outcome
of the illness)
• The client's emotional, social, cognitive, and spiritual health
• The client's personality and ability to cope with difficulties
• The client's cultural background, which may influence how she views the
illness, seeks treatment, and interacts with caregivers and health care workers
• The presence of emotional, social, and financial support
 Communication

Interpersonal communication is the

exchange of information between two
people, usually face to face. A message is
sent by one person (the sender) and is
received and interpreted by another
person (the receiver). Often, the receiver
provides information in response to the
message (feedback).
Factors Influencing Communication
● Perceptions
● Experience and Confidence
● Physical and Mental Health
● Mood and Emotions
● Values
● Beliefs and Cultural Influences
● Gender
● Age
● Electronic Communication and Social Media
 Verbal Communication
In verbal communication, messages are sent through the spoken [Link]
effectively communicate you need the following:
● Choose your words carefully
● Be aware that emotions can affect your communication
● Use simple, everyday language
● Speak clearly and slowly
● Use visual cues
● Control the volume and tone of your voice
● Be brief and concise
● Present information in a logical manner
● Ask one question at a time
● Determine understanding
● Do not pretend to understand
Nonverbal Communication
In nonverbal communication, messages
are sent without words through body
language, touch, and the use of silence.
Body Language- includes the following:
Posture, Appearance, Facial expressions,
Body movements, Eye contact, Gestures.
Touch-Touch is a very important form of
nonverbal communication. It can convey
warmth, comfort, concern, affection, trust,
and reassurance
Silence- The use of silence can convey
messages of acceptance, rejection, fear, or
the need for quiet and time to think.
 Communication Methods
Certain communication skills help you share information more effectively with others and
result in better relationships with people.
● Active Listening - Face the Client,make eye contact, Lean toward the client, Respond to
your client, Avoid Communication barriers.
● Paraphrasing- Paraphrasing is restating another person's message in one's own words.
● Empathetic Listening- Empathetic listening requires being attentive to the speaker's
feelings. Empathy means being open to and trying to understand the experiences and
feelings of others.
● Asking Closed questions- Closed questions focus on specific information.
● Asking Open-Ended questions-Open-ended questions invite a person to share thoughts,
feelings, or ideas. Answers must be more than a yes or no.
● Clarifying-Clarifying helps you make sure that you have understood a person's message.
● Focusing- Focusing is limiting the conversation to a certain topic.
 Communication Barriers
Communication barriers prevent the sending and receiving of messages,
limiting communication or causing it to fail [Link] of them
are:
● Interrupting
● Answering your own questions
● Giving advice
● Minimizing problems
● Using patronizing language
● Failing to listen
 Communicating as a PSW
● Communicating Assertively- Assertiveness is a style of communication
in which thoughts and feelings are expressed positively and directly
without offending others.
● Communicating with angry people- Recognize client’s feelings and
treat them with respect and dignity.
● Communicating with clients with dementia- pay attention to your
verbal and nonverbal messages when communicating with people who
have dementia. As clients lose their language skills, they rely more
heavily on the nonverbal cues of others, especially their caregivers.
 Chapter 6

The Health Care Team

In most healthcare settings, support

workers work on a team. A team is a
group of people who work together
toward a common goal. The goal of a
healthcare team is to provide the client
with the best possible care and support.
When providing care, team members
must consider the whole client and
promote health in all five dimensions of
the client's life: physical, emotional,
social, cognitive, and spiritual.
Benefits of Working on a team
The many benefits of a team approach to care include the following

● Opportunities for collaboration

● Opportunities for communicating
● Opportunities for mentorship
● A wide range of abilities, skills and perspectives
● Better decision making and problem solving
● A positive, trusting atmosphere
● Recognizing role boundaries
● Being flexible
● Handling conflict
● Expressing your needs and views
 Teamwork in facilities
Teams in facilities vary as much as the settings themselves. For example, a
team at a retirement home functions differently from a team at a hospital,
and a hospital team functions differently from a team in a long-term care
facility.
● Hospitals- An interdisciplinary team (also called an interprofessional
healthcare team) includes health care providers from a variety of
backgrounds and specialties, as needed, who work together to meet the
client's needs.
● Long term care facilities- Teams in long-term care facilities include
physicians, nurses, social workers, support workers, therapists, the client,
and the client's family.
● Hospices and Palliative care unit-A health care team may consist of
nurses, support workers, physicians, social workers, volunteers, dietitians,
the client, and his or her family members.
● Assisted-living facilities- team usually include a supervisor and one or
two support workers.
Teamwork in Community Settings
Teams in community settings also vary in membership and
function.
● Home Care- The homecare team includes the client, family
members, the case manager, the family physician, nurses,
support workers and their supervisors.
● Community Day Programs- It includes supervisor(nurse or
other Health care provider), other professionals and support
workers.
Working Under Supervision
Support workers have a responsibility to their supervisor, client, and
co- workers. . In facilities and agencies, the supervisor is usually a
nurse. In some community care settings, the supervisor may be a nurse,
a social worker, or another health care provider. Supervising means
being responsible for monitoring and overseeing the activities of others
on the health care team.
• Supervision in a facility. In many facilities, the team leader (usually
a nurse) supervises the support workers. The team leader has overall
responsibility and accountability for the client's care and the work of
the other team members.
• Supervision in a community setting. In a community setting, the
support workers and supervisor work for an agency, which is
accountable for the actions of all employees.
 Assigning
Assigning means appointing someone to take on a task of providing
client care that is within that person's scope of practice..
for example, you may be assigned to assist with or perform the
following tasks:
• Activities of daily living (ADLs)—dressing, personal hygiene,
mobility, feeding, toileting
• Instrumental activities of daily living (IADLs)—handling finances,
managing medications, handling transportation, shopping, preparing
meals, using a telephone.
• Social and recreational activities
• Household management—housecleaning, meal preparation
• Basic support care tasks—measuring height, weight, and vital
signs
 Delegation

Delegation (also called transfer of function) is a process by

which a nurse authorizes another health care provider to
perform certain tasks. A controlled act procedure—normally
performed only by a regulated health care provider-may be
delegated to a member of the client's household, a family
member, a support worker, or another unregulated care
provider.
 Who Can Delegate ?
Depending on the legislation of each province and
territory, delegation to support workers is the responsibility
of a regulated health care provider, such as a registered
nurse (RN), registered practical nurse (RPN), or licensed
practical nurse (LPN). When making delegating decisions,
the regulated health care provider must always protect the
client's health and safety.
 The Delegation Process
Before delegating, the nurse must know:
● What tasks your province or territory allows support workers to
perform.
● The tasks included in your job description.
● What you were taught in your training program.
● What skills you have learned.
● Your work experience.

Continued…..
A nurse who delegates a task is required to:
● Have the knowledge, skills and judgement to perform the task.
● Have the knowledge to teach the task to others.
● Accept responsibility to teach the task to the support worker.
● Assess support worker’s performance.
● Determine if the task taught can be performed for more than one
client.
● Monitor you over time to ensure you remain able to perform the
task correctly.
The Five Rights of Delegation
The National Council of State Boards
of Nursing in the U.S identifies five
rights of delegation as:
1. The Right Task
2. The Right Circumstances
3. The Right Person
4. The Right Directions and
Communication
5. The Right supervision and
Evaluation
Factors Affecting Delegation
The support worker is responsible for taking the following into consideration:
◆ Is this task included in my job description?
◆ Is this task a part of the client's ADLs or IADLs?
◆ Am I aware of how the client responds when this task is performed?
◆ Is it appropriate for me to perform task considering the client's
condition?
◆ Am I aware of the risks associated with performing this task?
◆ Is the client able to direct his or her own care and allow me to perform
this task?
◆ Will I be adequately supervised in this seing to ensure that the task is
performed correctly and the client not harmed?
◆ Is an appropriate health care provider available to help me if the client's
condition changes or if problems arise?
◆ Do I remember all the steps necessary to safely perform this task now?
◆ Am I able to refuse this task if I feel I am not competent enough to
perform it.
Accepting or Refusing a task

When you agree to perform a task, you are accountable for

your own actions. You must complete the task safely.

You have the right to say no. If you have a good reason for not
doing a task, refusing to do it is your right and your duty. You
must not refuse a task simply because you do not like or want
to do the task.
 Chapter 7
Managing Stress, Time and Problems

Stress is the emotional, behavioural or physical response to an event or

situation.
Eustress is a type of stress that is healthy and gives one a feeling of
fulfillment.
Acute Stress is short in duration.
Chronic Stress is ongoing and can lead to burnout- a state of physical,
emotional and mental exhaustion.
Dimensions affected by Stress

Stress can affect all dimensions of health.

● Physical- Death by pneumonia, loss of breast because of breast
cancer
● Emotional- Fear of all men because of sexual assault by man.
● Intellectual( Cognitive)- Deciding not to study because of fear of
failure.
● Social- Withdrawal from family because of Alcoholism.
● Spiritual- Abandoned faith because of death of a family member.
Physical Signs and Symptoms of
Acute and Chronic Stress
Acute stress: Chronic Stress:
● Rapid pulse, respirations, ● Chronic headache
speech ● Mood swings
● Increased blood pressure ● Anxiety
● A lump in the throat ● Substance abuse
● Dry mouth, sweaty palms, ● Memory disturbances
perspiration ● Weakening of immune system
● Sore muscles in neck, arms ● Cardiovascular diseases
and back
● Bowel disorders
● Nausea, Diarrhea
● Decreased sexual drive
● Urinary frequency, urgency
● Sleeplessness
● Difficulty sleeping, change in
appetite and weight
Managing Stress in your Life
The following strategies can help in managing stress:
● Develop self- awareness
● Take care of your needs
● Think positively
● Assert yourself
● Ask others for help and support
● Practice calming exercises
● Learn to accept the things you cannot change
Managing Stress
Stress can be reduced by managing time and Setting SMART
goals.
Time Management- It is very essential reduce stress. To
manage your time you must identify your priorities. Doing so
helps you stay focussed on what is important to you.
Setting SMART Goals- Setting goals for yourself will help
you manage time and stress. Your goals should be SMART:
● Specific
● Measurable
● Achievable
● Realistic
● Timely
 Problem Solving
Problem solving is a process that Includes:
● Identify the problem- You must first determine if you have a
problem and what it is.
● Analyze the problem- Once you know you have a problem,
think about what kind of problem it is. Decide if it is one that
you can solve on your own.
● Find a solution- Think of as many solutions as you can.
● Devise a Plan- The planning part of the problem-solving process
may involve creativity. Do not be afraid to try a plan, as long as
it is safe.
 Managing Conflict
You may occasionally experience conflict with clients or their families or with your co-
workers or supervisors. In dealing with any conflict, remember that caring for the client's
needs is always your first priority. Ways to manage conflict:
● Approach the person with whom you have a conflict, and ask to talk with him
privately.
● Be polite and professional in your approach. Agree on a time and place to talk.
● Talk in a private setting . Others should not see or hear you.
● Explain the problem and what is bothering you.
● Listen to the person's response. Do not interrupt.
● Identify ways to resolve the problem.
● Schedule a date and a time to review the situation.
● Thank the person for meeting with you.
● Implement the solutions.
● Review the situation, as needed.
● If you are unable to resolve the conflict, ask your supervisor for some time to talk
privately.
 Chapter 8
Ethics
The term ethics refers to the rules of conduct that guide us when deciding
what is right and what is wrong (immoral).
Morals are the fundamental principles of behaviour each person believes
to be right or wrong for him- or herself without concern for legalities or
customs.
Values are what an individual considers to be worthwhile or desirable
qualities in a person.
A belief is a conviction that something is true.
Code of Ethics for Support Workers
● Support workers provide high-quality personal care and support services.
They work within their scope of practice.
● The support worker needs to be aware of the policies and procedures for
each area.
● Support workers provide compassionate care to all clients.
● Support workers value the dignity and worth of all clients.
● Support workers respect their clients' choices about how they receive or
participate in their care.
● Support workers respect their clients' right to privacy and confidentiality.
● Support workers do not misuse their position of trust.
● Support workers are reliable.
● Support workers promote and maintain their clients' safety.
The Principles of Health care Ethics
The four basic principles of health care
ethics are:
• Autonomy—respecting the client's right
to make choices for himself or herself
• Justice—being fair
• Beneficence—doing good
• Nonmaleficence—doing no harm
Ethical Dilemma and Dealing with it
An ethical dilemma is a situation in which there is an apparent conflict
between opposing moral choices, and choosing one would result in going
against another moral choice.
When making an ethical decision, carefully consider the four principles of
health care [Link] yourself these questions about each option:
• Does the option respect the client's wishes and preferences?
• Does the option treat the client justly and fairly?
• Does the option provide the client with a short-term benefit or a long- term
benefit?
• Could the option cause harm or increase the client's risk for harm?
• What are all of the possible consequences to the client, family, or others
with this option?
 Chapter 9
Understanding Rights

A Right is something to which a person is justly entitled. Some rights,

sometimes called moral rights, are based on a sense of fairness or ethics.
Rights that are formally recognized in law are legal rights based on rules
and principles outlined in the law and enforced by society.
Basic Human Rights In Canada
The Canadian Charter of Rights and Freedoms is federal
legislation that applies to all canadians regardless of where they live.
The Charter lists the basic rights and freedom as:
● Freedom of conscience and religion.
● Freedom of thought, belief, opinion and expression.
● Freedom of peaceful assembly and association.
● The right to vote.
● The right to enter, stay in or leave Canada.
● The right to life, liberty and security.
● The right to equality before and under the law, without
discrimination.
 Bill of Rights
There is no single list of rights afforded to all Canadians
receiving care in facilities and in the community. However,
Ontario has created a bill of rights for clients.
Ontario’s Residents’ Bill of Rights for long- term care clients.
Basic Rights of Clients
Generally , all clients have the
following rights;
○ The Right to be treated
with Dignity and Respect
○ The Right to Privacy and
Confidentiality
○ Electronic Privacy
○ The Right to Give or
Withhold Informed
Consent
○ The Right to Autonomy
 Informed Consent
All people have the right to decide for themselves whether or not
they agree to medical treatment, health care or personal care
services. Such agreement is called Consent. Informed Consent is
based on having accurate and complete information. Consent is
informed when the client clearly understands the following:
● The reason for the treatment or service
● What will be done
● How it will be done.
● Who will be doing it.
● The expected outcomes
● Potential risks and side effects of the treatment
● Other treatment options
● The likely consequences of not having the treatment
 Advance Directive
Advance directives (also known as advance care directives) are legal
documents that allow clients to convey their decisions about their own end-of-
life care.
Living Will- Some people who are still living in their own home will want
their family and friends to know whether or not they want care that is
intended to sustain their life, and some may write these thoughts down in
what is called a living will. In a living will, a person can state whether she
wishes to accept or refuse medical care under certain circumstances. A living
will can address such issues as the following:
• The use of dialysis and breathing machines
• Resuscitation if breathing or heartbeat stops
• Tube feeding
• Organ or tissue donation
A living will is not legally enforceable.
Substitute Decision Makers for
Personal Care or for Property
● Substitute Decision maker for Personal Care- In some situations, for example,
an unconscious client cannot give consent for a procedure. Such situations
require a substitute decision maker for health care. Depending on the province,
the title proxy or power of attorney for personal care may be used instead.

● Substitute Decision Maker for Property- The client may be unable to make
decisions regarding his belongings. In this case, the client's interests would be
represented by a substitute decision maker for property.
A generally accepted term in Canada for the person who acts on behalf of a
client in regard to property is an estate trustee (or guardian of property).

Most adults have a will—a legal document that states one's wishes about where (or to
whom) his or her property should go. It should be written while the client is
cognitively intact, witnessed by a lawyer, and kept in the lawyer's office.
 Understanding Legal issues
Client rights are based on laws. Like all health care team members, you, as the
support worker, must act in a legally appropriate manner. If you break the law or
violate someone's rights, you are legally responsible (liable) for your actions and
could be fined, sued, or even imprisoned.

Criminal laws are concerned with offences against the public and against society in
general. A violation of criminal law is called a crime—for example, theft, murder,
rape, or abuse—and a person found guilty of a crime is fined or sent to prison.

Civil laws deal with relationships between people. For example, laws relating to
business disputes, divorce, or adoption are civil laws.
 Tort
A tort is a wrongful act committed by an individual against another person or the person's
[Link] may be intentional or unintentional.
 Negligence- Negligence occurs when a person fails to act in a careful or competent manner and
thereby harms the client or damages property.
 Assault and Battery- Assault can be defined as intentionally attempting or threatening to touch
a client's body without the client's consent, causing the client to fear bodily harm. Battery is the
actual intentional touching of a client's body without the client's consent.
 False imprisonment - is the unlawful restraint or restrictions on a person's freedom of
movement.
 Invasion of Privacy- Every client has the right not to have her name, photograph, private
affairs, health information, or any personal information made public without having given
consent. Violating this right is an invasion of privacy.
 Defamation of Character- Defamation is injuring the name and reputation of a person by
making false statements to a third person. Libel is a criminal offense when it is knowingly
making false statements that harm a person's reputation in print, writing, or through pictures or
drawings. Slander is making harmful false statements orally.
 Chapter 10
Caring about Culture and Diversity
Diversity is the state of different individuals and cultures coexisting.
Racism results when people have feelings of intolerance or prejudice
toward a person or group of people because of their racial or ethnic
backgrounds.
Ethnicity refers to the sharing of common history, language, geography,
national origin, religion pr identity.
Culture refers to the characteristics of a group of people- the language,
values, belief, habits, ways of life, implied rules for behaviour, music and
traditions.
 Cultural Conflict
Cultural Conflict occurs when a person tries to dictate to
another person what his culture should be.

Cultural Competence is the ability of a person to interact

effectively with people from different cultures or
socioeconomic backgrounds.
 The Effect Of Culture
Culture affects a person’s beliefs and behaviours as :

❖ The Effect of Culture on the Family- Culture affects family structure, as

well as the roles and responsibilities of family ,members. Types of families:
● Nuclear family- Consists of a mother, father and children
● Single- parent family- in this the adult head of the household does not have a
partner who shares the home.
● Blended family- Consists of a couple with two or more children, at least one
of whom is the natural child of both members of the couple and at least one is
the stepchild of one of the partners.
● Same-sex family, is one in which both partners living together in a loving,
intimate relationship are of the same gender.

Continued…...
 The Effect Of Culture
❖ The Effect of Culture on Religion- People from different
culture rely on religion for support and comfort during illness.
❖ The Effect of Culture on Perceptions of Healthcare and
Illness- Culture greatly affects how people view health care and
illness and how they cope with the symptoms and stresses of
being ill.
❖ The Effect of Culture on communication-Communication
across cultures present many challenges.
● The Use of Translators and Interpreters
● Body Language
● Touch
● Personal Space
● Eye Contact
● Facial Expressions
● Silence
Providing Culturally Sensitive Care and
Support
Providing culturally sensitive care is important in support work. Do not
stereotype a person based on ethnicity, religion or any other factor.

Caring for clients in a Non judgemental way- As a support worker you do not
have to agree with the client’s beliefs and practices, however, you must be tolerant
and not make judgements. To accept people of different cultures:
● You need to learn about them from them.
● Communicate with them, listen to them attentively.
● Learn as much as possible about their thoughts, beliefs and values.
● Respect and show interest in their traditions, foods, dress and customs.
Your clients will feel valued and respected.
Maintaining a Professional Relationship
With the Client

A relationship is the connection between two or more people, and it is shaped by

the roles, feelings, and interactions of those [Link] relationship with your
clients is a professional helping relationship that is established to benefit the client.
Professional Boundaries
As a support worker, you must remember that you are a professional and must
maintain professional boundaries. Professional boundaries are appropriate
limitations on behaviour, meant to protect the vulnerable client from the caregiver
who has access to private knowledge about him or her.
Working with clients and their families
When working with clients and their families, demonstrate the following:
● Respect- Respect is showing acceptance and regard for another person.
Accept your client's values, feelings, lifestyle, and decisions.
● Compassion- Compassion is characterized by a person's awareness of the
misfortune and suffering of another and the desire to take action to reduce or
eliminate the problem.
● Empathy-Empathy is the ability to recognize and understand another's
emotions
● Sympathy- Sympathy differs from empathy and compassion. Whereas
compassion involves listening and understanding, sympathy involves
reacting.
● Competence- Competence is the ability to do a job well. In support work,
you must perform your tasks safely and skillfully; must be well- organized,
punctual, and reliable; and must know your scope of practice and personal
limits.
● Self-awareness- Self-awareness is an understanding of one's own feelings,
moods, attitudes, preferences, biases, qualities, and limitations.
Pain and Its Impact on A Client's
Well-Being
To have discomfort or pain means to ache, hurt, or be sore. You cannot see, hear, touch, or smell
a client's discomfort or pain. You must rely on what the client and the client's body language tell
you. Report complaints and observations to your supervisor.
Types of Pain:
● Acute pain is felt suddenly from injury, disease, trauma, or surgery, when tissue is
damaged; it usually lasts less than 6 months and decreases with healing.
● Persistent pain lasts longer than 6 months. Pain is constant or occurs off and on. Arthritis
and cancer are common causes of persistent pain.
● Radiating pain is felt not just at the site of tissue damage but extends to nearby areas as
well. Pain from a heart attack is often felt on the left side of the chest, left jaw, left
shoulder, and left arm.
● Referred pain is pain felt in a part of the body separate from the source of the pain (e.g.,
a kidney stone may produce pain in the groin).
● Phantom limb pain is felt in a body part that is no longer there. A client who has had a
leg amputated may still feel leg pain.
 Factors Affecting Pain
Pain does not affect all clients the
same way. Many factors affect
reactions to pain.
● Past experience
● Anxiety
● Rest and sleep
● Attention
● The meaning of pain
● Support from others
● Culture
● Age
Sign and Symptoms of Pain
Record and report following to your supervisor;
❖ Location of Pain
❖ Onset and Duration
❖ Intensity and Description
❖ Factors causing pain
❖ Vital signs
❖ Other signs and symptoms like:
Body responses- Increased Pulse, respirations and blood pressure
Nausea and vomiting, pale skin, sweating
Behaviours- Changes in speech, crying, grimacing, groaning
Grunting, Holding the affected body part, Irritability
Moaning, being quiet, being restless, rubbing, screaming
Rocking back and forth, maintaining one position
Words used to Describe Pain
Words Used to Describe Pain
● Aching
● Burning
● Cramping
● Crushing
● Dull
● Gnawing
● Knifelike
● Piercing
● Pressing
● Sharp
● Sore
● Squeezing
● Stabbing
● Throbbing
● Viselike
 Pain Scales
1. Colour Visual Analogue Scale
 Measures to Relieve Pain
● Wait 30 minutes after administration of pain medication before giving care.
● Position the client in good body alignment. Use pillows for support.
● Keep bed linens tight and [Link] blankets for warmth and to
prevent chilling.
● Make sure the client is not lying on drainage tubes. Assist with elimination needs.
● Use correct lifting, moving, and turning procedures.
● Provide extra support for painful areas during movement.
● Use your hands or a [Link] a back massage. Use touch to provide comfort.
● Provide soft music to distract the [Link] family and friends to visit, if
requested by the client.
● Avoid sudden or jarring movements. Handle the client gently.
● Practise these safety measures if the client is receiving strong pain medication or
sedatives:
• If the client is in a hospital bed, keep the bed in the lowest position.
• Follow the care plan for bed rail use.
• Check the client every 10 to 15 [Link] assistance when the client is up.
• Provide heat or cold applications, as [Link] a calm, quiet, darkened
environment.
 Other Measures to Relieve Pain
Measures other than medications that control pain include:
● Distraction involves a change in a client's focus of attention by
conversation, music, television, games, and needlepoint.

● Relaxation means absence of mental or physical stress.

● Guided imagery involves creating an image in the mind and focusing

on it. The client is asked to think of a pleasant scene—for example, a
warm, sunny beach. The nurse uses a calm, soft voice when helping the
client focus on the mental picture of the scene.
 Rest and Sleep
To be rested means to be calm, at ease,
relaxed and free from anxiety and stress.
Several factors affect the amount of sleep a
person needs. These are:
● Illness
● Nutrition
● Exercise
● Environment
● Medications
● Alcohol
● Change and stress
● Emotional problems
● Nocturia
 Sleep Disorders
Sleep disorders are persistent problems that affect the amount and quality of
sleep and can cause fatigue, irritability, poor judgement, and other problems.
Some common are:

Insomnia- Insomnia is a persistent condition in which the person affected

cannot go to sleep or stay asleep throughout the night.

Sleep Deprivation- In sleep-deprived people, the amount and quality of sleep

decline. Illness and hospital care are common causes of sleep deprivation in
clients.

Sleepwalking- Sleepwalkers walk about while they are sleeping, often for
several minutes. They are not aware that they are sleepwalking and have no
memory of doing so on awakening.
Signs and Symptoms of Sleep Disorders
• Hand tremors
• Slowed response to questions, conversations, or situations
• Difficulty finding the right word
• Decreased attention
• Decreased reasoning and judgement
• Irregular pulse
• Red, puffy eyes with dark circles
• Moodiness; mood swings
• Disorientation
• Fatigue, sleepiness, or both
• Restlessness, agitation, or both
• Irritability
• Hallucinations
• Coordination problems
• Slurred speech
 Measures to Promote Sleep
● Organize care to allow for uninterrupted rest. Encourage the client to avoid
physical activity before bedtime.
● Discourage the client from tending to business or family matters before
bedtime.
● Allow flexible bedtimes. Bedtime is whenever the client is ready to sleep.
● Ensure a comfortable room temperature. Help the client take a warm bath.
● Provide a bedtime snack, if [Link] the client avoid caffeine and alcohol.
● Have the client void before going to bed. Make sure clients are clean and dry.
● Follow the client's bedtime [Link] sure the client wears loose-fitting
nightwear.
● Provide for [Link] sure linens are clean, dry, and wrinkle-free.
● Allow the client to read, listen to music, or watch television if he so desires.
● Stay and talk with the [Link] noise.
● Darken the room: close shades, blinds, and curtains. Shut off or dim the lights
in the room and hallway.
● Position the client in good body alignment. Support body parts, as ordered.
● Implement measures to relieve [Link] a back massage, if [Link]
with relaxation exercises, as ordered.
 Chapter 13

Medical Terminology
Word Elements- Like all words, medical terms are made up of parts or
word elements. Important word elements are:
● Prefixes- A prefix is a word element placed at the beginning of a
word that changes the meaning of the word.
● Root- The root contains the basic meaning of the word.
● Suffixes- A suffix is placed at the end of a root to change the
meaning of the word.
Do not use abbreviations list
Some of the common abbreviations that should never used in
Canada are given in link.

[Link]
[Link]/download/ISMPCanadaListOfDangerousAbbreviatio
[Link]
Common Prefix, Root and Suffix

Common Prefixes, Roots and Suffixes in Medical Terminology

 Abdominal Regions
Abdominal Regions
The abdomen is divided into regions
to help describe the location of body
structures, pain, or discomfort. The
regions are as follows:
• Right upper quadrant (RUQ)
• Left upper quadrant (LUQ)
• Right lower quadrant (RLQ)
• Left lower quadrant (LLQ)
 Directional Terms
Certain terms describe the position of one body part in relation to another. These
terms indicate the direction of the body part when a person is standing and facing
forward. These are:
• Anterior (ventral)—located at or toward the front of the body or body part
• Distal—the part farthest from the centre or from the point of attachment; for
example, the foot is distal to the knee
• Lateral—the farthest away from the midline of the body
• Medial—the closest to the midline of the body
• Posterior (dorsal)—the back surface of the body—often used to indicate the
position of one structure to another
• Proximal—nearest to the trunk of the body or the point of origin
Common abbreviations

MEDICAL TERMINOLOGY ABBREVIATIONS

 Describing Your Observations
Your observations are critical to the care-planning process since nurses
and case managers use them for the assessment and evaluation steps.
Remember these points when describing your observations:

• Be precise and accurate. Provide details of what you actually see, hear,
touch, and smell. Measurements, calculations, and times must be accurate.
When describing subjective data, report or record the client's exact words.

• Do not interpret or make assumptions. In most cases, your

observations are sufficient, and you do not need to interpret them. Do not
make assumptions. An assumption is a guess, usually based on insufficient
evidence. When you make assumptions, you may be making a wrong or
hasty conclusion.
 Verbal Reporting
A verbal report is the spoken account of care provided and observations made.

Verbal Reporting in a Facility- In a facility, support workers report actions and

observations to the charge nurse or to the supervisor. Reports must be prompt, thorough,
and accurate.
• Always include the client's name, the room and bed number, and the time you made the
observation or gave the care.
• Report only what you observed or performed.
• Prioritize items—start your report with the most important points.
• Give reports as often as the client's condition requires or requested by the nurse.
• Immediately report any changes in the client's previously reported condition.

Verbal Reporting in a Community Setting- Employers have their own policies for
verbal reports. Most employers in the community do not require support workers to make
daily verbal reports. However, call your supervisor immediately if something unexpected
happens.
 Documentation

Documentation (also called charting) is a record of the care you

have given the client and the observations you have made during
care. Documentation is a legal requirement for health care
[Link] recording, focus on the following:
• What you observed, including symptoms the client reported to you
• What you did
• When you did it
• The client's response
Electronic Documentation
Both written reports and electronic reports have advantages as well as
disadvantages. Written reports provide a permanent record, but they are
time-consuming and can be difficult to read if the handwriting is not clear.
Electronic reports are fast and efficient, but confidentiality can be more
difficult to maintain because of the risk for data being accessed by
unauthorized [Link], long-term care facilities, and community
agencies are increasingly using electronic charting.
 Documentation Guidelines
For Documentation in writing;
• Always use ink. Follow employer policy in regard to the colour of ink to be used.
• Make sure that your writing is legible and neat.
• Include the date and the time whenever a recording is made. Use conventional time (a.m. or p.m.)
or 24-hour clock time.
• Never erase or use correction fluid if you make an error. Draw a single line through the error. Write
“error” or “mistaken entry” above it, and sign your initials.
• Sign all entries, and include your title, as required by your employer's [Link] not skip lines.
• Make sure each form is stamped with the client's name and other identifying information.

For All Documentation:

• Use only employer-approved [Link] correct spelling, grammar, and punctuation.
• Record only what you observed and [Link] chart a procedure or treatment until after its
[Link] accurate, concise, and factual. Do not record assumptions or opinions.
• Record in a logical manner..Be descriptive. Avoid terms with more than one meaning.
• Use the client's exact words. Use quotation marks to show that the statement is a direct quote.
• Report any changes in the client's previously reported condition. Do not omit any information.
• Record all safety measures used, such as assisting a client when she is up or reminding a client not
to get out of bed. This documentation will help protect you from legal action if the client has a fall.
 Recording Time
The 24-hour clock is used to document
care. It uses a four-digit number for time.
The first two digits are for the hour:
0100 = 1:00 a.m.; 1300 = 1:00 p.m. The
last two digits are for minutes: 0110 =
1:10 a.m. The abbreviations “a.m.” and
“p.m.” are not used, but sometimes the
abbreviation h or hr is used.