CSC Disability Care Trainer Guide

CHC08 Disability Care Skill Set Trainer
Guide
1 | Page TRAINER GUIDE
Contents
Purpose of the Trainers Guide
Learning principles
How to use the Trainers Guide
Key learning points
Relevant topic points
Presentation
Training delivery
Workbook exercises
Suggested training videos, you tubes and DVDs resource list
Training preparation
Evaluation form

PURPOSE OF THE TRAINERS GUIDE
The package has been designed to be a comprehensive training resource for

support workers involved in the delivery of services for people with disabilities in
the disability care environment. Specifically, the package aims to:
facilitate a sound understanding of client-directed care
support and empower clients with disability in the area of choice and control
develop support workers self- awareness and skills related to
communication, negotiation, advocacy, management of risk duty of care
and client choice
LEARNING PRINCIPLES
Experiential learning is the most effective way for adults to learn. It is actively
encouraged throughout this trainers guide by providing opportunities for learning
by thinking, doing and reflecting. Active participation does not just happen. It
needs to be supported by creating a relaxed learning environment.
Ground rules for participation include:

make sure the activities involve no risk or
embarrassment
provide clear, simple instructions
ensure all physical material are
available
encourage participants to have fun
The trainers guide is designed to provide information and knowledge required to

adequately understand the relevance of client directed care. It also allows the
opportunity to explore values and attitudes, communication and practise
skills required to implement client-directed care in order to deliver a quality
service.
Examples are included for comparison and discussion. Practical activities, role-
plays, problem solving activities and case scenarios are all used to support the
learning outcomes.
HOW TO USE THE TRAINERS GUIDE

The trainers guide is designed to be accompanied by the workbook that contains
only key information, practical exercises and case scenarios.
Each section in the trainers guide relates directly to a powerpoint
slide/s.
KEY LEARNING POINTS

Key learning points have been identified at the beginning of each section to
highlight the main messages to be covered.
RELEVANT TOPIC POINTS

Each of the main points on the powerpoint slide corresponds directly to the
headings used within the relevant section. Each point will include presentation
material and supporting information if relevant.
PRESENTATION
This is the material to be used for the actual presentation by the trainer.

TRAINING DELIVERY
The training package comprises Trainer Guide, a Participant Workbook and a
series of PowerPoint slides for use during training. The training has been
designed so that it can be delivered by individuals who have experience in
training delivery, as well as knowledge and experience of the standards
monitoring and/or self-assessment processes. Accordingly, it is expected that
the training package could be delivered by Programme Supervisors,
Coordinators and Managers.
Key to the delivery of this training is the involvement of people

with disabilities in the training sessions.
It is important to identify various people with disability who would be suitable to

participate in these training sessions in your regions. There are various points
within each section where a client with disability can help present or participate
in the experiential learning activities and provide a real and nuanced response to
aspects of support and care. Having clients involved in training teams, panels, as
guest speakers or interviewees, or even using a pre-recorded DVD with client
stories can be a great way of enhancing the support workers learning experience.
This will also facilitate a greater understanding of how disability is lived for each
individual client and why good communication, self-awareness, advocacy and
empowerment are necessary skills and traits for an effective support worker in a
client-directed environment. To be truly client-directed, the voice, insight and
real life experiences of clients with disability should be present in these training
sessions.
Guest speakers and accompanying resources can be sourced from organizations

including MS, Paraquad and Dementia Australia.
The involvement of effective and experienced disability support workers is also

important to enhance the learning experience of the class. Relating the
conceptual aspects of this learning package to the real life experiences and
challenges in the practical environment, is likely to enhance the understanding
and practical implications of client-directed care to the learners. There are
various opportunities within this learning package to invite disability support
workers to participate and encourage questions from the learners.
The package has been designed with a view to flexible delivery, for
example:
as a complete package, which will involve a minimum of 120
hours delivery
in smaller instalments comprising 2 hour sessions over a series of
weeks
as a self-paced training resource, where staff read and work through the
material at their own pace with access to the support of a trainer at key
points to review and discuss progress
It is suggested that the training material be presented as four key components

as follows:
Introduction to disability support work and an overview of individual
abilities and disabilities Section 1 and 2.
Effective communication, conflict resolution and negotiation Section 3.
Client-directed care and community access and social inclusion - Sections
4 and 5.

You and The disability care environment Section 6.
Workbook Exercises
Each section contains a number of Workbook Exercises to ensure that
participants have the opportunity to actively participate in the discussion and
application of the material. All of the exercises should to be completed.
Furthermore, the scenarios used in the workbook exercises may be modified and
adapted to ensure relevance to the participants, answers have been provided in
red text. All the exercises are also contained in the accompanying participants
workbook.
SUGGESTED TRAINER RESOURCE LIST

Websites suggested websites are also contained within the workbook
Hand Hygiene Australia www.hha.org.au/

What is hand hygiene
Online learning hand hygiene
Hand care issue
Scope Victoria http://www.scopevic.org.au/

Access and inclusion
Aids and equipment
Behaviours of concern/challenging behaviour
Communication
Disability awareness and rights
Health and well-being
Links
Research reports
Sensory participation
Transportation
People with disability - http://www.pwd.org.au/

Human Rights
The social model of disability
Advocacy
Legislation
Education and training
ParaQuad - http://paraquad.org.au/
Spinal cord injuries
Holidays
Aids and equipment

DVDS, VIDEOS AND YOU TUBE CLIPS
Training DVDs
Reading, Reporting Recording
Just Like You Communication Resources
Ideas that Work
Manual Handling
Duty of Care Series
Hazards and Risks
Communicate and Connect
Respite helps you find balance
Time for you
Balance the Care
Videos and DVDs

The Intouchables
The Black Balloon
Never Tell Me Never
The Sessions Helen Hunt
Temple Grandin Claire Danes
Mask
The Elephant Man
You Tube
Disability Care coming to Australia
Disability Overlooked
Building Australias Workforce Success stories: Employees with disabilities
No Arms No Legs No Worries !! Nick Vujicic
Disability Dating
Making Sex work legal
What people with disability can do
Books
Looking in the eye
Be different
Freeks
Geeks and Asperger Syndrome John Elder Robisen
The Disability Support Worker - Geoff Arnott
Caring in the Community Helen Croft
Golden Girl - Betty Cuthburt
Never tell me never
PREPARATION FOR TRAINING

The success of this workshop relies on the trainer having excellent training
skills and thorough knowledge of workplace health and safety issues in the
community sector. Prior to the training, familiarise yourself with the
participant workbook (a copy is in the guide) and the powerpoints relating to
each topic.
Room Layout
Ensure that you organise for the room to be set up as tables of small groups to
encourage discussion and problem-solving. All training venues are non-smoking
and must be left in a clean and organised manner.
Audiovisual requirements

The trainer will require a laptop computer, DVD, data projector, screen and
whiteboard.
Training materials
The participant workbooks, pens, pencils and white board markers.
Participant guidelines while training

Setting a few ground rules at the start of a training session can make the day go
more smoothly.
Please sign attendance sheet each day.
Explain there is no need to rush or interrupt everyone will have a turn to
speak.
Use each other's first names, not "he" or "she."
If something is not working for you, speak up.
Please keep mobile phones on silent.
Be on time every time!
Respect others cultural and religious traditions, beliefs, values and
languages.
Breaks will be after every two hours or as the trainer sees necessary.
This is a non-smoking environment.
Please remove all your rubbish.
Complete the evaluation form at the end of the training session, your
feedback is valuable
TRAINING EVALUATION FORM TEMPLATE

1. What sections of the day were useful to you?
Excelle Good Fair Poor Uncerta

Sections 1 & 2: nt in
Introduction to disability
support work and an
overview of individual
abilities and disabilities
Section 3:
Effective communication,
conflict resolution and
negotiation
Sections 4 & 5:
Client-directed care and
community access and
social inclusion
Section 6:
You and the disability care
environment
Video clips, pictures, photographs and powerpoint.
2. Did you find the DVD clips helpful in illustrating the issues?

3. Did you find the photographs helpful in illustrating the issues?
4. Did you find the powerpoint/s helpful in illustrating the issues?
5. Please rate the effectiveness of the trainer
Excellent Good Fair Poor Uncertai

n
Preparation &
organisation
Knowledge of topic
Trainer was
engaging
6. Did you find the facilities and training room appropriate.
7. Comments for improvement or addition
Thankyou

ATTENDANCE RECORD TEMPLATE
DATE NAME TIME TIME SIGNATURE

IN OUT
10 | P a g e TRAINER GUIDE
Time Topic
Session 1
MORNING TEA
LUNCH BREAK
AFTERNOON TEA BREAK
SUMMARISE THE DAY
Evaluation & close

GENERIC LESSON PLAN TEMPLATE
INTRODUCTION TO TRAINING
Welcome the participants to the training and ask participants to introduce
themselves, their organisation, their main work and their experience in the
community services sector.
Discuss with participants the following:

the learning outcomes for the training
the program for the day
make participants aware of the toilets, breaks and emergency
arrangements
ground rules for the training room
refer the participants to the Resources. Briefly describe the
resources and what they cover. Ensure that participants know how to
obtain the resources mentioned.
Getting to know you ask each participant to complete the follow and
openly discuss each question. You can print this out if easier.
What is Where What do What do What do

your do you you like you love you want
name? work? about about to change
your job? your about your
job? job?
Note - this part of the exercise may be omitted for groups who
already know each other.
Learning Outcomes for the Training Package

Now we have some information about each other and what you would like to get
out of this training package, lets look more closely at the overall learning
outcomes.
When you have completed this training package, you will have:
Greater understanding and skills in the areas of:
o client directed-care
o support and empowerment of clients with disability in the area of
choice and control
o your own self-awareness and skills related to communication,
conflict resolution, advocacy, negotiation and client choice
Section 1: Welcome to Disability

Support Work - Empowering
Clients with Disability
Welcome to the Disability Care Skill Set Learning Package and Participant
Workbook! This is an exciting part of a journey that will introduce you to some of
the opportunities and challenges of working in this growing sector. Our aim is to
help improve your knowledge, skills and understanding to enable you to support
client choice and empowerment in the area of disability care.
This training package has been created in conjunction with clients with disability.
Those with disability who will be most impacted upon by this new environment
guided us with their views, experiences and opinions. Throughout this training
package you will see comments from people with disability to give a greater
sense of connection and understanding of their situations. This connectedness
with those who are have disabilities as well as the people who support and
enable them in their homes and communities is vital for real choice and
empowerment to occur.
Lets look at some startling facts to get us started:
Facts:
One in five Australians has a disability.

Every week, five more Australians sustain a spinal cord injury and 10 to 15
sustain a severe traumatic brain injury.
Every two hours, an Australian child will be diagnosed with an intellectual
disability.
Today, over three million Australians are living with some form of disability.
People with disabilities come from all sectors of the community. They have the
same hopes and dreams as everyone, and the same rights to live their daily life
in a welcoming community.
People with disabilities are rarely portrayed as living an average daily life. Yet
they remain people first, and just want to be treated as equals in a welcoming
and inclusive community. Actions and words have the ability to enhance or
corrupt the way in which members of the community treat or view people with a
disability
So, you want to contribute to someones life by enabling them in their

homes and communities, read on.
Do you have the attributes and personality we are looking for in a good
disability support worker?
Do you want to:
contribute to someones life and enable choice and empowerment?
put your life experience to good use?
feel valued and good about yourself?
make a difference to someones day?
support a person achieve to their goals?
want flexible working hours?
Do you have:
good communication skills?
a genuine interest in people?
a positive outlook on life?
respect for differences?
pleasant personality?
a sense of humour?
a good sense of reliability?
A sense of honesty?
a sense of responsibility?
If you answered yes to all of these questions then you could be a great disability
support worker!
What will you do as a disability support worker?
It is a brilliant job and I love it but Id say to people get real and be
prepared to get your hands dirty.
Anonymous
I dont expect to move jobs after this as I really enjoy what I do. For me,
the next stop will be retirement!
Anonymous
Nothing pleases me more than to see my clients happy and

comfortable ... On some occasions Ive had the honour of accompanying
them to special family functions where Im treated with such high respect
and regard. This has to be one of the great highlights of my job.
Anonymous
The best aspects about my job are being able to help people and have a
positive influence on their lives. I enjoy meeting lots of different people
and it is really rewarding when somebody manages to turn their life
around. Anonymous
The main role of a disability support worker is to enable a person with a disability
to live as independently as possible with as much choice and control over their
current and future decisions. A large part of this role is to assist the person with
disability in some aspect of their daily life, including home, work and/or their
social life.
Some people with disabilities need assistance with everyday daily living tasks.
Others need assistance with accessing recreation and leisure and others with
finding and maintaining employment. The great diversity of jobs within the
disability sector allows you to utilise your skills in a variety of settings with a
variety of people.
Working in the disability sector is an enjoyable and satisfying career. Just like all
of us, each person with a disability is different, with their own personalities,
dreams, aspirations and abilities. People with a disability may require assistance
in one or more areas of their life to enable them to maximise their full potential.
Working to assist people in their daily lives also means that your working hours
can be flexible and may cover a 24 hour period. Depending on your chosen area
of employment, you are able to work around your own life, including family and
study.
Part of being a disability support worker is being able to relate to different people
in different stages of their lives and disabilities. People with disabilities come
from different cultures, faith traditions and lifestyle preferences. We need to
respect their choices with regards to these areas. Our attitudes towards these
differences and our own personal values will impact upon how the client feels
empowered and valued.
When you hold a particular attitude towards a person this is often reflected in the
way you behave in toward that person. As human beings, we all have our own
values, beliefs and attitudes that we have developed throughout the course of
our lives. The attitudes that we feel very strongly about are usually called values.
Sometimes our own attitudes can make us blind to other peoples values,
opinions and needs. Values can influence many of the judgments we make as
well as have an impact on the support we give clients. It is important that we do
not influence clients decisions based on our values. We should always work from
the basis of supporting the clients values.
Our family, friends, community and the experiences we have all contribute to our
sense of who we are and how we view the world. As support workers, we are
often working with people who are vulnerable and/or who may live a lifestyle that
mainstream society views as being different. If, as support workers, we are to
provide a service that meets the needs of our target groups and help them to feel
empowered, we need to be aware of our own personal values, beliefs and
attitudes and be prepared to adopt the professional values of our industry. We will
discuss this a little later in the training package.
Values are closely related to attitudes
Requirements and checks for becoming a disability
support worker
We want to make sure the environment is as safe as possible for both support
workers and clients with disabilities. Part of this is ensuring our potential SWs
have the necessary checks that the legislative environment requires. These may
include the following:
a satisfactory national criminal history check
an Australian motor vehicle drivers licence
a current First Aid certificate or the willingness to attain one
Benefits of working as a disability support worker

Besides having that sense of purpose or feeling that you are making a difference
to many in our community, other benefits occur in the following areas:
Working hours
Disability work offers flexibility. Hours of work may include weekdays, evenings,
overnights and weekends, or a combination of these. The duration of work time
can vary from a few hours up to 24 hours. Work can also be Monday to Friday
during office hours. The options of work include full time, part time and casual
work.
Salary and wages

Salary and wage rates and levels vary across agencies and depending on the
nature/level of work you are engaged in. Attractive salary sacrificing options are
possible with most agencies.
Other Conditions and Benefits

On the job induction and training
High level of job satisfaction
Training in Certificate III and IV in Disability Work can be offered.
Qualifications
The qualification required depends on what type of work you are doing. Past
experience and relevant qualifications will be considered relating to the job you
want. The entry level qualification for a disability services support worker is
generally the Certificate III in Disability Work or similar qualification or working
towards a qualification.
What are my career
prospects?
You will develop a strong foundation from which to develop a career in disability
services. Some of the career pathways for disability support workers after gaining
experience and/or qualifications include senior disability support worker roles,
Team Leader roles, Coordination and or Workplace Trainer.
Helpful links which may provide you with background information helpful for a
career in Disability Support work.
1. Disability Service Standards- The nine standards have a primary focus of

ensuring results for consumers of Disability Services that are consistent with the
principles and objectives of the State legislation. The emphasis is on using the
standards to encourage continuous improvement of services. Click on this link to
find out more about the standards. Disability Service Standards Booklet
2. Duty of Care- A duty of care is a duty to take reasonable care of a person. A

disability support worker has a duty of care to anyone who is reasonably likely to
be affected by their work activities. These are likely to include the person with a
disability that they are the support worker for, the families and carers of clients
other support workers and the general community when working within a
community environment. Click on this link for further information.
http://www.qla.org.au/PDFforms/Procedures/Duty%20of%20Care%20Procedure
%20Mar07.pdf
3. Understanding Disability- It is helpful to understand disability and how it

affects people. There are many different types of disabilities such as intellectual
disability, cerebral palsy and autism. Click on this link for further information.
http://www.adcet.edu.au/Cats/Understanding_Disability.chpx
Section 2: Individual Abilities
and Disabilities
Disability is not a brave struggle or courage in the face of adversity.
Disability is an art. Its an ingenious way to live. Neil Marcus
A disability may be visible or hidden, permanent or temporary, and may have a

minimal or substantial impact upon a persons abilities. Focusing on the ability of
the individual person, who may be constrained at times by their physical, social,
and psychological disability, is an important way forward to help enable them to
be meaningful participants in the wider society. As support workers we are there
to enable them and support the client in areas in which their disability exists, but
need to be aware that many of clients with disabilities possess strong abilities in
other areas which are less visible. This is part of enabling choice and control and
giving our clients the capabilities and support needed to fulfil their potential.
Sometimes they just see the wheelchair and dont realise that you
may not have been in it all your life ... you might be a lawyer,
engineer, paramedic or pharmacist.
I want to be treated as an individual, not just one of many or a thing

to be processed.
1 in 5 Australians has one or more disabilities and this proportion is increasing

with the ageing of the population. This means that sometime in our life we are all
likely to have a disability and/or have a friend, family member, class mate and/or
work mate with a disability.
The term disability also refers to people who have a mental illness or medical
condition, such as diabetes, epilepsy or HIV/AIDS. Furthermore, 88% of
disabilities are invisible. There is a tremendous variety of specific causes, as well
as combinations and severity of disabilities.
IN THIS SECTION WE WILL LOOK AT:
Defining a disability
o Developmental disability
o Acquired disability
Looking at the various types of disability
o Chronic medical conditions
o Intellectual disabilities
o Learning disabilities
o Mental health issues
o Neurological conditions
o Physical disabilities
o Hearing impairment
o Vision impairment
Resources for further research
There are a number of key issues that people with disabilities are faced with on a
daily basis. These include legal, social, philosophical and legislative issues that
guide and affect the provision of services to the disabled.
People with disabilities require a range of supports and the ability to access
mainstream community services and facilities in order to have a full life in the
community. This should be underpinned by individual planning and support, with
the ability for the person to be as self-directed as possible and have the
availability of facilitation and co-ordination where required.
Human rights for people with disabilities have been incorporated into Australian
law in several ways. The Commonwealth Disability Services Act 1986 gave the
Commonwealth the power to disburse money for services for people with
disabilities and to provide grants to the states and territories for the provision of
services. It also enables the Commonwealth to make regulations that specify the
aims and principles when providing these services. All states and territories
receiving money under this act are required to pass complementary legislation
confirming the aims and principles of the Commonwealth law. The objective of
this was to unify the intent of all the disability services in Australia so as to keep
its international treaty obligations.
To say that people with disabilities are individuals may seem obvious but for a
very long time they have been regarded as part of a group and not as an
individual. This has led to stereotyping and large numbers of people being
categorized and cared for in the same way with no focus on individual needs and
expectations. People with disabilities are entitled to be treated with dignity and
respect. They have their own likes and dislikes, feelings, attitudes, interests and
talents. Like every human being a person with a disability means being a unique
individual who has more in common with a non-disabled people than he or she
has different.
Disabled people have legal rights and human rights and there should be no
differentiation between their rights and the rights enjoyed by the rest of the
population of Australia. Disabled people have the right to:
the fullest possible development
be treated just like able bodied members of society
a reasonable quality of life
participate in decisions affecting the person
pursue grievances
People with disabilities are mothers, fathers, friends, neighbours, employees,
bosses, customers, and community leaders. They are just like you and expect
to be treated just as you would like to be treated. One of the ways that you can
contribute to helping the disabled achieve this is through effective
communication. Some of the ways that this can be achieved are:
ensuring people with a disability have equal access to information

about services, activities, events, and issues affecting their lives
interacting with people with a disability in such a way that shows
that we value their contribution and respect their rights
using appropriate language when speaking and writing about people
with a disability
Research undertaken in Australia has identified the following issues of people

with a disability:
Accessibility to their community and surroundings. This relates to

facilities and services, information, infrastructure, transport and
opportunities for raising awareness with local businesses and
organisations.
Accommodation and housing :

people with disabilities have the right to the same range of housing
choices as the rest of the community. There are barriers however
that limit the extent to which this right can be achieved. Availability
of accessible, affordable housing and transition and supported
accommodation are areas that are developed and planned for by
local councils in consultation with all members in the community.
A sense of belonging in the community which goes beyond having a

home in a street with other people . It is about rights and
opportunities, employment opportunities, participation in volunteer
activities, programs which address social isolation, accessibility for
participation in local cultural and festival events. These all assist the
disabled person to feel as though they are part of the community.
Provision of services such as a service provider network, providing

such services as respite care, vacation care programs (for children
with a disability) and adequate and accessible health care providers.
Culturally specific and linguistic issues.
Financial vulnerability.
Carer/family burnout.
Financial support for carers e.g. income support from Centrelink,

carers allowances.
Freedom from discrimination: discrimination occurs when people with

a disability are treated less fairly than people without a disability.
Peer support for carers.
Mutual support and self-help groups.
There are a number of misconceptions in our society in respect to people with

disabilities. These ultimately impact on the disabled person and how they feel
about themselves and their place in society. When the community in which you
live brands you as a menace to society or sees you as an object of dread and
pity the effect that this can have on an individual can be extremely detrimental.
Some of the most common failings that are felt by people with disabilities are:
being seen as having little or no worth in society
being the object of pity and charity
fear of rejection on all levels- personal , social and employment
being seen as a burden on society
being isolated and segregated form society
having their life wasted
social relationship discontinuity
loss of control over ones life
being seen as belonging to a group and not as an individual
being unable to support oneself financially
Many people with disabilities spend their whole lives being told that they are not
like other people or in the extreme that they are worthless. The result of this
constant berating is that a great percentage of disabled people have low self-
esteem and feel that they are a source of anguish to those around them.
Societys values and attitudes towards disabled people are changing and through
the implementation of government regulations/acts and education to the rest of
the community on disabled people there will be even more changes and
improvements.
What is disability?
You only live with my disability for 1 hour I live with it 24 hours a
day.
Understand my needs that are individual to me. Do treat me as a

person with needs. Im no different to you. Its just that my body
doesnt work as well as yours.
A disability is an impairment that may be physical, cognitive, mental, sensory,
emotional, developmental, or some combination of these. A disability may be
present from birth, or occur during a person's lifetime.
World Health Organisation define disabilities as an umbrella term, covering

impairments, activity
limitations, and participation restrictions.
An impairment is a problem in body function or structure.
An activity limitation is a difficulty encountered by an individual in

executing a task or action.
A participation restriction is a problem experienced by an individual in

involvement in life situations.
A disability may be physical, cognitive, mental, sensory, emotional, and

developmental or some combination of these. A disability may be present from
birth, or occur during a person's lifetime, while the degree of disability may range
from mild to moderate, severe, or profound. A person may also have multiple
disabilities.
DISABILITY CAN BE DEVELOPMENTAL OR ACQUIRED.
Developmental disability:
Developmental disability is a term that refers to a permanent impairment usually
occurring early in life. Mostly result from damage caused;
before birth (prenatal stage) by factors including genetics, developmental
malformation and diseases
around birth (peri natal stage) by factors including low weight,
prematurity and obstetric complications
after birth (neonatal and postnatal stages) by factors including infections,
diseases,
malnutrition and environmental factors
Acquired disability:
Acquired disability or acquired brain injury - or ABI- refers to any damage to the
brain that occurs after birth. That damage can be caused by an accident or
trauma, by a stroke, a brain infection, by alcohol or other drugs or by diseases of
the brain like Parkinson's disease.
Under the Disability Discrimination Act (1992) examples of conditions that may
be considered disability include:
chronic medical conditions - (asthma, diabetes, cancer, crohns disease,
arthritis)
intellectual disabilities - (down syndrome, fragile X syndrome, foetal
alcohol syndrome)
learning disabilities - (dyslexia, dysgraphia, scotopic sensitivity)
mental health conditions - (depression, anxiety disorders, schizophrenia,
bipolar disorder)
neurological conditions - (multiple sclerosis, epilepsy, aspergers)
physical disabilities - (spinal cord injury, cerebral palsy)
sensory disabilities - (hearing, vision)
What are chronic medical conditions and some associated facts.
Chronic medical conditions are health condition that have been or likely to
have been present for at least 6 months.
Leading causes of death and disability in Australia.
Require high use of health services, contributing to health funding

pressures.
Increasing prevalence in Australia, often linked to lifestyle.
Complex and varied in terms of their nature and impact.
Increasing ageing of population played a key role in rise in prevalence.
2010 leading cause of death in Australia
o Asthma
o Cancer
o Diabetes mellitus
o Cardiovascular disease
o Arthritis
What is an intellectual disability and some associated facts.

An intellectual disability is a disability affecting cognition.
People with intellectual disability may have difficulties with learning,
communication, daily living skills, information processing, social
functioning and problem solving.
Around 3% of Australians have an intellectual disability.
Approximately 1.8% of Australians have an intellectual disability which
leads to severe or profound activity limitations.
Intellectual disabilities are life-long, and must be identified before the age
of 18.
Examples of intellectual disabilities include Down syndrome, Fragile X
Syndrome, Prader-Willi Syndrome, and Angelman Syndrome.
What is learning disability and some associated facts.

A learning disability refers to a varied group of conditions which impact on
the development and use of listening, spelling, reading, writing, reasoning
or mathematical skills.
Has a significant effect on learning but is NOT an indicator of intelligence.
Learning disabilities include:

o Dyslexia difficulty with language processing
o Dyspraxia difficulty with fine motor skills or coordination
o Dysgraphia difficulty with writing, spelling or composition
o Visual processing disorder, e.g. Scotopic sensitivity
o Auditory processing disorder
What is mental illness and some associated facts.

Mental illnesses are a varied group of conditions that significantly affect
how a person feels, thinks, behaves, and interacts with other people.
Close to 1 in 5 Australians will have a mental illness in any year.
Mental illnesses are diagnosed according to standardised criteria.
They are different from temporary mental health problems that may be
experienced following stressful life events.
Some major types of mental illness include:
o anxiety disorders most common at 9.7% of Australian adults in any
year
post traumatic stress disorder (3.3%)
generalised anxiety disorder (3.1%)
social phobia (2.7%)
obsessive compulsive disorder (0.4%)
o substance use disorders 7.7% of Australian adults in any year
dependence on alcohol or a drug, leading to problems at work
or home, and/or causing damage to health
o depression 5.8% of Australian adults in any year
o psychotic disorders, including schizophrenia and bipolar disorder
(much less common at 0.4-0.7%)
What is a neurological condition and some associated facts.
Neurological conditions are disorders of the brain, spine and the nerves
that connect them.
The associated structural, biochemical or electrical abnormalities can
result in a range of symptoms.
Interventions may include preventative, lifestyle changes, physiotherapies
or other therapies, rehabilitation, pain management, medications or
surgery.
Causes vary but may be genetic, congenital abnormalities, infections,
lifestyle, and environmental health issues.
There are more than 600 diseases of the nervous system.
Some common neurological disorders include:
o brain tumours
o Parkinsons disease
o epilepsy
o stroke
o multiple Sclerosis
o Alzheimers disease
What is a physical disability and some associated facts.

Physical disabilities affect a person's physical functioning, mobility,
dexterity or stamina.
A person may be born with a physical disability, or acquire it later in life.
Examples include:
o cerebral palsy
o spinal cord injury
o amputation
o spina bifida
o musculoskeletal injuries (e.g. back injury)
What is a hearing impairment and some associated facts.

Hearing impairments range from mild hearing loss to profound deafness.
Can be caused by a genetic condition, illness, trauma, or natural aging.
People with hearing impairment may use hearing aids, lip-reading, Auslan
(Australian sign language) or a combination to assist with communication.
What is a vision impairment and some associated facts.

Vision impairment refers to some degree of sight loss.
A person is considered legally blind if:
o they cannot see at six metres what someone with normal vision can
see at 60 metres, or
o their field of vision is less than 20 degrees in diameter (normal
vision 180 degrees)
A person may be born with a vision impairment, or acquire it through an
accident, disease or the aging process.
Examples include:
o cataracts clouding of the clear lens in the eye
o glaucoma damage to the optic nerve associated with pressure in
the eye
o macular degeneration deterioration of central vision
o retinitis pigmentosa genetic condition causing retina to
progressively degenerate
CHRONIC MEDICAL CONDITIONS

Asthma
Asthma is a chronic lung disease that inflames and narrows airways.

Causes recurring periods of wheezing, chest tightness, shortness of breath
and coughing.
Affects people of all ages, mostly starts in childhood.
Pollen, cigarette smoke, colds and flu can cause an asthma attack. One in
ten Australians has asthma.
Asthma cannot be cured, requires good management which enables
people to lead normal lives.
Treatment includes relievers (act quickly and relax muscles around
airways) taken when having an attack.
Preventers make airways less sensitive to triggers and reduce
inflammation.
Symptom controllers slowly relax muscles around airways, taken with a
preventer.
Combinations of the above in one inhaler.
An asthma attack can be life threatening. If you are not sure what to do, call
an ambulance
Diabetes
Diabetes is a chronic condition where the levels of glucose (sugar) in the

blood are too high.
Blood glucose levels are normally regulated by insulin (a hormone) made

by the pancreas.
In people with diabetes the pancreas does not make enough insulin.
Two main types of diabetes Type 1 & Type 2.
About 7.4.% of Australians aged 25 years or older have diabetes.
Risk increases with age.
There is no cure for diabetes.
Aboriginal people have one of the highest rates of type 2 diabetes in the
world.
Type 1 Diabetes
Auto immune destruction of insulin making cells in the pancreas, insulin is

no longer made.
One of most common chronic childhood illness.
Most common in under 30 years of age.
Was called insulin dependent diabetes. This term is no longer used.
Type 2 Diabetes
Inadequate levels of insulin or failure of body cells to respond properly to

insulin.
Most common over 40 years of age.
Known to have been diagnosed in overweight children and teenagers.
May be brought on by unhealthy diet or lack of exercise.
More common where close relatives and certain ethnic groups have
diabetes.
Was called non-insulin dependent diabetes. This term is no longer used
Treatment
Type 1
insulin injections
balanced healthy diet
monitoring blood glucose
physical activity
regular check ups
Type 2
healthy eating
physical activity
medications and (perhaps) insulin
weight management
monitoring blood glucose
cease smoking
regular check ups
Untreated diabetes
kidney damage
eye damage
nerve damage to feet and other parts of body
heart disease, stroke and circulation problems
sexual problems
foot ulcers or infections, due to circulation and nerve problems
Cardiovascular Disease - Leading cause of death in Australia
heart, stroke and blood vessel disease
kills one Australian every 12 minutes
affects one in six Australians
31.7% of deaths (45,500) in 2010 deaths that can largely be prevented
high prevalence and hospitalisation in lower socio economic groups,

Aboriginal and Torres Strait Islanders people and those living in remote
areas
Coronary heart disease or heart disease
affects 1.4 million Australians
15.1.% ( 21,700) of deaths in 2010
kills 59 Australians each day
Heart Attack
estimate over 380,000 Australians have had a heart attack at some stage
about 55,000 Australians each year suffer a heart attack
average 27 Australians die each day
Risk Factors
high blood pressure
high cholesterol
overweight and obesity
physical inactivity
poor diet
alcohol
smoking
nine out of ten Australians have at least one risk factor
one in four (25%) have three or more risk factors
Warning signs
Vary from person to person may not always be sudden or severe.
Chest pain/discomfort most common sign not all people have pain.
Symptoms may be pain, pressure, tightness in the upper body including
chest, neck, jaw, arms, and shoulders or back in combination with nausea,
shortness of breath, dizziness or a cold sweat.
Quick response and calling triple 000 can reduce damage to the heart and
increase survival.
Arthritis
General term describing pain, stiffness and inflammation (heat and
swelling) in the joints.
Group of conditions affecting joints.
Over 100 types of arthritis and there is no cure.
Most common osteoarthritis, rheumatoid arthritis, gout and ankylosing
spondylitis.
Arthritis affects people of all ages, lifestyles and backgrounds.
No cure for arthritis.
Medication, physiotherapy and exercise are used in treatment.
Symptoms include;
pain, swelling in joints
redness and warmth in joints
stiffness or reduced movement of a joint
general symptoms such as fatigue and feeling unwell
Osteoarthritis
Osteoarthritis is a disease of the joints.
The two bones of a joint are normally protected by smooth, cushioning
material called cartilage.
In osteoarthritis, cartilage breaks down, causing pain and stiffness in the
joint.
Osteoarthritis is one of the most common forms of arthritis.
A joint is the meeting point of two bones to allow movement.
Symptoms:
The symptoms vary from one person to the next. More common symptoms
include:
stiffness
joint pain
muscle weakness
Common sites
The most common joints that develop osteoarthritis include:
hands usually the end finger joints
spine in the neck or lower back
hips older people are most at risk
knees might be caused by an old injury
Risk factors
The cause of is unclear risk factors for its development have been identified.
These include:
family history of osteoarthritis
previous injury or overuse of the joint
being overweight
Managing osteoarthritis
Education Arthritis Australia can provide you with information and self-
management courses that support you with your management.
Weight management controlling weight is important for those who are
overweight and have osteoarthritis affecting the weight-bearing joints.
Medication pain-relieving and anti-inflammatory medications.
Relaxation techniques for example muscle relaxation, meditation or
visualisation.
Support A support or self-help group may be another option contact
Arthritis Victoria for details of support groups.
Surgery to replace hip and knee joints, in cases of advanced
osteoarthritis.
Equipment that promotes independence there are many specially
designed aids and types of equipment available to assist people with
painful joints.
Rheumatoid Arthritis
Autoimmune disease causes pain & inflammation of joints.
Other body parts may be affected.
Stiffness in the joints is common, especially in the morning.
The inflammation caused by rheumatoid arthritis can result in damage to
the joints.
Usually starts in middle life, with onset generally occurring between the
ages of 35 to 64, and affects 1 per cent of Australias population.
Estimated 57 per cent of people with rheumatoid arthritis are women.
Symptoms
The most common symptoms include;
swelling, pain and heat in the joints

stiffness in the joints, especially in the morning
persistent fatigue
sleeping difficulties because of the pain
weak muscles
the same joints on both sides of the body are usually affected
Cause
The cause or causes of rheumatoid arthritis are not yet fully understood.
Rheumatoid arthritis is an autoimmune disease, when a person has an
autoimmune disease, the immune system starts attacking the bodys
healthy tissues.
The immune system targets the lining of the joints, causing inflammation
and joint damage.
Some people may be more at risk of developing rheumatoid arthritis due
to heredity factors.
There is no cure for rheumatoid arthritis.
Management
Medication Non-steroidal anti-inflammatory drugs (NSAIDs) are
commonly prescribed to reduce pain and inflammation. The disease-
modifying anti-rheumatic drugs (DMARDs) are a special group of
medications used to treat inflammatory arthritis. Biological DMARDs are
the newest class of arthritis medication and work to stop the disease
progressing and causing structural damage to joints.
Aids and equipment supports such as walking aids and specialised
cooking utensils reduce joint strain.
Relaxation techniques muscle relaxation, distraction, guided imagery and
other techniques can help manage pain and anxiety.
Exercise some physical activity helps maintain muscle strength and joint
flexibility and assist in managing pain. Exercising in warm water, strength
training and Tai chi may help.
Rest rest can help manage fatigue and is important when joints are
swollen.
Nutrition healthy, balanced diet to maintain general health and prevent
other medical problems.
Support Contact Arthritis Victoria for more information.
Complementary therapies such as massage or acupuncture may be
helpful.
Joint surgery may be necessary in some cases.
ACTIVITY
WHAT IS IT? ANSWER
This can be found in the hands, hips

and knees
This arthritis is an autoimmune disease
55,000 Australians suffer with this each

year
Kidney damage, Eye damage, Heart

disease, stroke and circulation
problems, Sexual problems
Foot ulcers or infections are signs of

what untreated disease
This is the leading cause of death in

Australia
This condition cannot be cured and

requires good management which
enables people to lead normal lives
Aboriginal people have one of the

highest rates of this disease in the
world
Swelling, pain and heat in the joints are

symptoms of what disease
There are over 100 types of this
condition and there is no cure
INTELLECTUAL DISABILITY
A person with an intellectual disability may have difficulty learning and managing
daily living skills. This is because their cognitive (thought-related) processing is
impaired. Children and young people have different abilities and develop at
different rates.
A person is said to have an intellectual disability if they have both the following
before they are 18 years of age:
an IQ below 70 (average IQ is 100)
significant difficulty with daily living skills including looking after
themselves, communicating and taking part in activities with others
Approximately two to three per cent of the population have an intellectual
disability.
Common characteristics
Generally speaking, a person with an intellectual disability:
learns and processes information more slowly than people without an
intellectual disability
has difficulty with abstract concepts, such as money and time
has difficulty understanding the subtleties of interpersonal interaction.
Needs depend on individual factors

Categories of mild, moderate, severe and profound levels of intellectual disability
are defined on the basis of IQ scores. These levels give some guide to the level of
support someone might need, but the way the person functions in their life also
depends on other factors including:
personality and coping skills
other disabilities for example, physical, social or sensory
the amount of support offered by family, friends and the community
what is demanded of them in different situations for example, home or
work
People with a mild intellectual disability

A mild intellectual disability is defined as an IQ between 50 and 70. A person with
a mild intellectual disability;
can participate in and contribute to their families and their communities
will have important relationships in their lives
may find the subtleties of interpersonal relationships and social rules
difficult to fully understand. They may sometimes behave awkwardly or
inappropriately in social situations
may marry and raise children with the support of family, friends and
support services
may have a job, in either open or supported employment
may live and travel independently but may need support and help to
handle money and to plan and organise their daily life
may learn to read and write with appropriate teaching
People with a moderate intellectual disability
A moderate intellectual disability is defined as an IQ between 35 and 50. A
person with a moderate intellectual disability:
will have important relationships in their life and will probably form valued
and lasting friendships
will enjoy a range of activities with their families, friends and
acquaintances
may be able to learn to travel on regular public transport routes with
specific training, but will have difficulty planning trips and handling money.
They may have great difficulty problem solving when unexpected events
occur
may learn to recognise some words in context, such as common signs
including Ladies, Gents and Exit
will be able to make choices and understand daily schedules or future
events if provided with visual prompts such as daily timetables and
pictures of planned events
will need lifelong support in the planning and organisation of their lives and
activities
may develop independence in personal care, such as toilet hygiene,
dressing and bathing -
independence in these tasks will depend on opportunities to learn and
practise these tasks, and whether or not the person has other disabilities,
such as cerebral palsy
People with a severe or profound intellectual disability

A severe intellectual disability is defined as an IQ between 20 and 35. A profound
intellectual disability is defined as an IQ below 20. A person with a severe or
profound intellectual disability:
will usually recognise familiar people and may have strong relationships
with key people in their lives
is likely to have little or no speech and will rely on gestures, facial
expression and body language to communicate needs or feelings.
Communication systems for people with this level of disability generally
rely on photographs or objects to support understanding. For example, a
cup or a photograph of a cup may be used with the spoken question:
Would you like a drink?
will require lifelong help with personal care tasks, communication and
accessing and participating in community facilities, services and activities
ACTIVITY
What is the average IQ for the following levels of an intellectual

disability?
Mild
Moderate
Severe
DOWN SYNDROME
Down syndrome (also known as trisomy 21) is a genetic condition in which
the person has an extra copy of chromosome 21.
This results in a number of physical and developmental characteristics and
some level of intellectual disability.
Down syndrome and the extra chromosome

Chromosomes are the blueprint for the bodys development.
They determine our physical and mental characteristics.
The usual number of chromosomes is 46 (arranged in 23 matched pairs).
People with Down syndrome have an extra chromosome 21.
Down syndrome is the most common chromosome disorder and occurs in
all races and cultures at around the same rate.
Some level of intellectual disability is the only feature common to all,

although a range of other features are also associated with the condition.
These include characteristic physical features and a number of health and
developmental indications.
Common physical characteristics

There are a number of physical characteristics associated with Down syndrome.
The most common physical characteristics include:
Eyes nearly all people with Down syndrome have a slight upward slant of
the eyes. There can also be a small fold of skin on the inside of the eye
(epicanthic fold) and small white patches on the edge of the iris of the eye
(Brushfield spots).
Face this is often rounded and tends to have a flat profile.
Stature babies with Down syndrome are usually smaller and weigh less
at birth than others. Children tend to grow more slowly and are commonly
smaller than other children their age. Adults with Down syndrome are
commonly smaller than in the general population.
Delayed development
Babies reach the same developmental milestones (such as smiling, sitting
up, crawling, walking, talking and toileting) as all babies, but with some
degree of delay.
Speech and language development is often the area of greatest delay.
Everyone with Down syndrome will experience some delay in their
development and some level of learning disability, but the extent and
specific areas of delay vary from one individual to another.
Generally need more support than most other people in order to achieve
their potential some will need very little support, while others may
require a high level of support.
Capabilities and potential
Down syndrome affects, but does not determine, development and
achievement in a person.
People demonstrate a wide range of capabilities.
What happens after birth will be far more important in shaping the outlook
for a person than the occurrence of the extra chromosome at conception.
These days, children with Down syndrome attend childcare settings, pre-
schools and primary and high schools alongside other children of their age.
Adults with Down syndrome attend post-school training, participate in the
workforce and lead full lives as productive and valued members of their
communities.
An increasing number are achieving independent living, with some level of
support, within the community.
People with Down syndrome often have their abilities and potential
underestimated.
A person with this condition will achieve in many areas when offered the
opportunity and encouraged to do so.
Diagnosis of Down Syndrome

Down syndrome is usually recognisable at birth and confirmed by a blood test.
Prenatal tests that can help to detect Down syndrome in a foetus include:
ultrasound scans
maternal serum screening
amniocentesis
chorionic villi sampling
FRAGILE X SYNDROME
Fragile X syndrome is an inherited condition causing various degrees of
intellectual disability.
It affects males more than females and is the most common known cause
of inherited intellectual disability.
Fragile X syndrome is a genetic disorder caused by an alteration in the X
chromosome (that is, a change in the DNA structure.)
It results in a wide range of developmental, physical and behavioural
problems.
Prevalence estimates for Fragile X syndrome vary the best estimate is
that about one in 4,000 males have this syndrome.
Fragile X syndrome presentation

The most significant effects of Fragile X syndrome are:
developmental delay
intellectual disability - can vary from mild learning difficulties through to
severe intellectual impairment
behavioural problems present in some Fragile X individuals
mimicking
tend to be more severe in males than in females
Characteristics of Fragile X syndrome
Some children with Fragile X syndrome will display behaviours similar to those of
children with autism, including:
hand flapping
repeating of words and sentences.
Fragile X males may have certain physical features, including:

large, prominent ears
enlarged testes
flexible joints
not all of these characteristics are seen in every person with fragile X
syndrome
Chromosomes
Chromosomes are located in the cells of the human body and contain all
our genetic information.
In every cell, there are 23 pairs of chromosomes, one pair of which
determines the sex of a person.
A male has an X and a Y, a female has two X chromosomes.
A child will receive one of their sex chromosomes from the fathers sperm
(X or Y) and one from the mothers egg (X).
Fragile X syndrome is inherited

The Fragile X syndrome is inherited in a way known as X-linked.
The altered gene is on the X chromosome.
On the X chromosome, there is a gene called FMR1, which produces a
protein that helps the brain to function normally.
If this gene is altered, it cannot produce its normal protein.
Our genes often contain regions that are repeated.
In the normal form of the gene, there will be between five and 55
repeated copies of a small section of the gene.
In a person with Fragile X syndrome, this copy number is increased to more
than 200 repeats (called a full mutation).
When there are more than 200 repeats, the gene is switched off, leading to
the symptoms seen in Fragile X syndrome.
A repeat number of between 55 and 200 is classed as a pre-mutation.
The number of repeats may increase when the mother passes on her X
chromosome to her child.
Therefore, an apparently unaffected woman with fewer than 200 repeats
may have an affected son or daughter with greater than 200 repeats.
PRADER-WILLI SYNDROME
Prader-Willi syndrome is a rare genetic disorder that affects development and
growth.
Estimates of its incidence vary; around one in 10,000 to 20,000 children are born
with the syndrome, with females slightly more prone than males.
There is no cure for the condition; health care from a range of specialists can
improve the childs quality of life.
Symptoms of Prader-Willi syndrome

The affected child is unusually floppy at birth and has feeding difficulties
and a weak cry.
Males frequently have undescended testes and may have underdeveloped
genitalia
Around half of all children will have fair skin, blonde hair and blue eyes.
The child is delayed in all aspects of development, reaching developmental
milestones such as sitting, crawling and walking later than other
children.
The average IQ is around 70, but the degree of intellectual disability will
differ for each child
By five years of age, a feature is the childs excessive appetite, which often
leads to obesity if not managed carefully with dietary and behavioural
control.
Causes
Humans have 23 pairs of chromosomes, with one set inherited from each parent.
Research indicates that missing genes on chromosome 15, contributed by the
father, cause Prader-Willi syndrome.
The loss can happen in four ways, including:

The fathers chromosome 15 is altered usually, genes are deleted. This is
the most common cause, accounting for between 60 and 70 per cent of
cases.
The baby inherits two of the chromosomes from the mother, and none
from the father. This happens in about 25 to 30 per cent of cases.
A translocation occurs, which means some of the genes on chromosome
15 get shuffled around or swapped with genes from other chromosomes.
The fathers chromosome 15 is intact, but the genes in the Prader-Willi
region do not work properly.
Obesity and Prader-Willi syndrome

At birth, the child has poor sucking ability and may not grow at the
expected rate.
This changes remarkably by the time the child is one to four years of age.
Prader-Willi syndrome is associated with an excessive appetite, which
means that the child is prone to obesity.
Challenge for the child with Prader-Willi syndrome and their family, but it
can be managed by dietary and behavioural measures.
Problems associated with Prader-Willi syndrome
A child with Prader-Willi syndrome is prone to a range of associated health and
behavioural problems as they get older. Some of these problems may include:
obsessive and compulsive behaviours, such as picking at the skin
eye problems, such as near sightedness
short stature, often due to growth hormone deficiency
delayed onset of puberty
scoliosis (sideways curves in the spine)
kyphosis (exaggerated hump in the spine)
delayed or absent menstrual periods in girls
abnormally small penis in boys
diabetes, triggered by obesity
osteoporosis (weakened bones that are prone to fracturing)
teeth problems, including soft enamel and tooth grinding
sleep apnoea (periods of breathing cessation during sleep)
problems with short term memory
temper tantrums
Diagnosis of Prader-Willi syndrome

Prader-Willi syndrome is diagnosed by physical examination and blood tests to
check for problems with chromosome 15.
Treatment for Prader-Willi syndrome

There is no cure for Prader-Willi syndrome and no means of prevention. Treatment
aims to ease some of the associated problems.
Some of the treatment options may include:
Strict supervision of diet. Currently, there are no medical means of curbing
appetite.
Plenty of physical activity to help maintain the childs body weight within
the normal range.
Growth hormone treatment to overcome the hormone deficiency that
contributes to the childs short stature.
Hormone therapy to increase muscle mass.
Hormone therapy to boost inadequate sex hormone levels.
Medications to help control any obsessive and compulsive behaviours.
Orthopaedic treatment for scoliosis or kyphosis.
Appropriate prescription eye glasses.
Specialist care from a range of health care professionals.
Specialist care
Health professionals often include:
general practitioner
paediatrician
dietician
physiotherapist
speech therapist
dentist
optician
behavioural psychologist
ANGELMAN SYNDROME
Angelman syndrome is a genetic condition that is present at birth (congenital). It
causes intellectual disability, distinctive facial features, mental retardation,
speech problems and hyperactive behaviour.
In most cases, the cause is a missing section (deletion) on the mothers copy of
chromosome 15. The syndrome was known as happy puppet syndrome because
of the childs sunny outlook and jerky movements. Most diagnoses are made
between the ages of three and seven years of age and are thought to affect one
child in every 10,000 to 25,000.
Symptoms of Angelman syndrome

Characteristic symptoms usually present include:
delayed motor development, such as delay in sitting, crawling and walking
speech problems
jerky, puppet-type movements
stiff-legged walking style
hand flapping
Hyperactive behaviour
loving, happy and social demeanour
a child easily moved to laughter
intellectual disability a child will have delayed development in all areas
and disability is severe in most cases
Characteristic symptoms include:

small head
characteristic EEG (brainwave) abnormalities
epilepsy (occurs in 80 per cent of cases)
Physical characteristics
The characteristic physical features are not always obvious at birth, but evolve
during childhood. Characteristic physical features include:
flattened back of the head
deep-set eyes
wide, ever-smiling mouth
prominent jaw and widely spaced teeth
lightly pigmented hair, skin and eyes
Behaviour problems
Some common problems include:
feeding difficulties
disturbed sleep
delayed toilet training (about 80 per cent of adults are dry during the day)
Chromosome disorder
Angelman syndrome occurs in the following scenarios:
A section of genetic material is missing from the copy of chromosome 15
inherited from the mother. This is the most common scenario. Note that
the mothers chromosome 15 is normal, and the genetic material is lost
during the development of the egg.
The child inherits two copies of chromosome 15 from its father and none
from its mother. This happens occasionally.
The child may inherit one chromosome 15 from each parent, but the
chromosome from the mother works in the same way as the chromosome
from the father.
In 2030 per cent of cases, there is no cause found. Some of these patients
have a fault (mutation) in a gene called UBE3A on chromosome 15.
Diagnosis
Diagnosis methods include checking for the clinical features and
performing DNA tests.
May be mistaken for autism because of similar symptoms including
hyperactive behaviour, speech problems and hand flapping.
A child with Angelman syndrome is highly sociable, unlike a child with
autism.
It is important that the child is carefully diagnosed. Sometimes Angelman
syndrome and autism are both present.
Other conditions that share some common characteristics with Angelman
syndrome include Rett syndrome, Lennox-Gastaut syndrome and non-
specific cerebral palsy.
Treatment
There is no cure, but the child can benefit from a range of treatments for some
symptoms including:
speech therapy
behaviour modification
communication therapy
occupational therapy
physical therapy
special education
social skills training
anti-epileptic medication
Angelman syndrome is not a degenerative disease. Children can

expect a normal lifespan.
LEARNING DISABILITY
DYSLEXIA
Dyslexia is a type of specific learning difficulty (SLD) in which the person has
difficulties with language and words. The term dyslexia, although still used by
some, is generally felt to be too narrow and SLD is often used to describe these
learning difficulties.
Most children with SLD also have difficulty with spelling.

The most common characteristic is that people have difficulty reading and
spelling for no apparent reason. The person may be intelligent, able to
achieve well in other areas and exposed to the same education as others,
but is unable to read at the expected level.
Common problem areas include spelling, comprehension, reading and
identification of words.
Up to five per cent of the population are thought to have dyslexia.
Cause remains unknown.

Most people affected eventually learn to read, they may have severe
spelling problems unless they get support and specialised education.
Dyslexia isnt a symptom of low intelligence.
Symptoms in pre-schoolers
Some of the symptoms of dyslexia or SLD in a pre-schooler could include:
delayed speech
problems with pronunciation
problems with rhyming words and learning rhymes
difficulty with learning shapes, colours and how to write their own name
difficulty with retelling a story in the right order of events
Symptoms in primary school children

Some of the symptoms in a primary school age child could include:
problems with reading a single word
regularly confuses certain letters when writing, such as d and b or m
and w
regularly writes words backwards, such as writing pit when the word tip
was intended
problems with grammar, such as learning prefixes or suffixes
tries to avoid reading aloud in class
doesnt like reading books
reads below their expected level
Symptoms in high school children

Some of the symptoms in a high school student could include:
poor reading
bad spelling, including different misspellings of the same word in one
writing assignment
difficulties with writing summaries
problems with learning a foreign language
Symptoms in adults
Some of the symptoms in an adult could include:
reading and spelling problems
doesnt like reading books
avoids tasks that involve writing, or else gets someone else to do the
writing for them.
better than average memory
Often, a greater than average spatial ability - the person may be talented
in art, design, and mathematics or engineering.
Theories
The exact causes of dyslexia remain unknown, but theories include:
problems with phonological awareness (distinguishing the meaning of
contrasting speech sounds)
a person with poor phonological awareness has trouble with their short-
term memory for spoken words, which means they tend to forget
instructions or word lists
problems with the visual, auditory, linguistic or neurological processes that
are involved with recognising the written word
reading difficulties tend to run in families which suggests a genetic link
Diagnosis methods
Dyslexia or SLD can be hard to diagnose unless the problem is severe.
Evaluation may include testing a range of factors including:
cognitive (thinking) skills and memory
vocabulary
literacy skills
intellectual ability
information processing
psycholinguistic processing
Contributing factors
Not everyone who has trouble with reading and writing is dyslexic.
Some of the reading and writing difficulties of someone with dyslexia may be
caused or worsened by other factors. Some contributing factors to be considered
include:
Health - the person may have health issues that have interfered with their
language development and writing ability, such as deafness or visual
problems.
Language - a child from a non-English speaking background usually takes
longer to master speech, reading and writing in both languages.
Education - the person may have missed out on educational
opportunities; for example, a chronic illness may have kept them out of
school for long periods of time.
Behavioural or developmental disorders - the person may have
attention deficit hyperactivity disorder (ADHD), which can cause learning
problems.
Treatment options
There is no cure for dyslexia, support provided could include:
one-to-one tutoring from a specialist educator
a phonics-based reading program that teaches the link between spoken
and written sounds
a multi-sensory approach to learning, using as many different senses as
possible such as seeing, listening, doing and speaking
arrangements with the childs school - for example, for them to take oral
instead of written tests
learning via audiotape or videotape
DYSPRAXIA
Dyspraxia is a neurologically developmental disability which is present
from birth
Dyspraxia is a motor planning disorder, not a muscular deficit. A child
knows what they want their body to do but can't get their body to do it.
There are three (3) types of Developmental Dyspraxia - Oral, Verbal and
Motor.
A child with Dyspraxia can have one or a combination of all three types of
Dyspraxia and in varying degrees of severity.
Dyspraxia is a hidden handicap. Children with this disability appear the
same as any other child. It is only when a skill is performed that the
disability is noticeable.
Dyspraxia is believed to be an immaturity of parts of the motor cortex
(area of the brain) that prevents messages from being properly
transmitted to the body.
Dyspraxia affects up to 10% of the population with approximately 70% of
those affected being boys.
Dyspraxia does not impact on intelligence, children with Dyspraxia have
average or above average intelligence.
Dyspraxia can impact on behaviour and social skills.
Dyspraxia is a specific learning disability.
Oral Dyspraxia
Oral dyspraxia is a difficulty with planning and executing non-speech
sounds, such as blowing, sucking or individual tongue/lip movements.
May indirectly affect speech and/or swallowing skills.
A child with Oral Dyspraxia may dribble profusely, have difficulty licking an
ice-cream and may have a preference for either soft or hard textured
foods.
Verbal Dyspraxia
Verbal Dyspraxia is a speech disorder that affects the programming, sequencing
and initiating of movements required to make speech sounds.
Children with Verbal Dyspraxia may:
display highly unintelligible speech
simplify words e.g. bur for burger
have inconsistent speech patterns
move sounds in a word e.g. to be for boat
exhibit lost or searching movements of the tongue and lips as they
endeavour to find the position to make a sound
have delayed expressive language
adopt a complex gesture system to aid communication skills
have difficulty with sequencing words, and sounds in words
Motor Dyspraxia
Motor Dyspraxia is a difficulty in planning, sequencing and then executing the
correct movement to perform age appropriate skills in a smooth and coordinated
manner at will or on command.
Children with Motor Dyspraxia may have difficulty with:

learning a new skill
coordinated movement
handwriting
consistent performance
age appropriate skills
generalising learnt skills
timing and rhythm
learning rules
responding quickly
spatial organisation
problem solving
using appropriate cues
analysing what is needed for task performance
preparing for the next stage in task performance
(Ref Australia Dyspraxia Association)
DYSGRAPHIA
Dysgraphia is a specific learning disability that affects written expression.
Can appear as difficulties with spelling, poor handwriting and trouble
putting thoughts on paper.
Can be a language based, and/or non-language based disorder.
A neurological disorder that generally appears when children are first
learning to write.
Experts are not sure what the causes are, early treatment can help prevent
or reduce problems.
Writing requires a complex set of motor and information processing skills.
Not only does it require the ability to organize and express ideas in the
mind. It also requires the ability to get the muscles in the hands and
fingers to form those ideas, letter by letter, on paper.
Dysgraphia that is caused by a language disorder may be characterised by
the person having difficulty converting the sounds of language into written
form (phonemes into graphemes), or knowing which alternate spelling to
use for each sound.
A person with dysgraphia may write their letters in reverse, have trouble
recalling how letters are formed, or when to use lower or upper case
letters.
A person with dysgraphia may struggle to form written sentences with
correct grammar and punctuation, with common problems including
omitting words, words ordered incorrectly, incorrect verb and pronoun
usage and word ending errors.
People may speak more easily and fluently than they write.
Non-language based dysgraphias are those caused by difficulties
performing the controlled fine motor skills required to write. The generic
term apraxia refers to a wide variety of motor skill deficits in which the
voluntary execution of a skilled motor movement is impaired.
Apraxia can involve a single controlled movement, or a sequence of
movements, such as writing a single letter or entire words.
Signs of Dysgraphia
generally illegible writing
inconsistencies in writing, e.g. mixtures of printing and cursive writing,
upper and lower case, or irregular sizes, shapes, or slant of letters
unfinished words or letters, omitted words
inconsistent position of letters on the page with respect to lines and
margins
inconsistent spaces between words and letters
cramped or unusual grip of the writing instrument, especially
o holding the writing instrument very close to the paper, or
o holding thumb over two fingers and writing from the wrist
strange wrist, body, or paper position
talking to self-whilst writing, or carefully watching the hand that is writing
slow or laboured copying or writing
large gap between written ideas and understanding demonstrated through
speech.
difficulty organising thoughts on paper
Supporting people with dysgraphia

There are many ways to help a person with dysgraphia achieve success.
Generally strategies fall into three categories:
accommodations: providing alternatives to written expression, such as
adjusting assessments (oral)
modifications: changing expectations or tasks to minimize or avoid the
area of weakness
remediation: providing instruction for improving handwriting and writing
skills
ACTIVITY
Match the condition in the left column with the correct signs in the right
column.
Dysgraphia This is a hidden disability,
there are three types of
this condition
Dyslexia Illegible Writing,

unfinished words,
difficulty organising
thoughts on paper
Dyspraxia Doesnt like reading

books.
Avoids tasks that involve
writing, or else gets
someone else to do the
writing for them.
Better than average
memory.
VISUAL PROCESSING DISORDER
A Visual Processing Disorder is the inability for an individual to make proper

sense of information taken in through the eyes. This disorder has nothing to do
with one's vision or the sharpness of it, but it is the difficulties experienced with
how visual information is processed by the sufferer's brain. The individual may
have 20/20 vision but may have problems in figuring out background from
foreground, size, forms and positions in space.
There are five main regions affected by Visual Processing Disorder. They are
object recognition, spatial relations, visual closure, visual discrimination and
whole/part relationships.
Object Recognition - Here the individual finds it difficult to recognize familiar

objects. One reason is because they are unable to put the whole image into
place. They see it in parts and not as a whole object. For some others it could be
a visual memory problem, where, even if the object is recognized as a familiar
object, they may not be able to recollect from memory an object which is similar
or are unable to make a connection between the object before them and the
remembered object.
Difficulties in object recollection and recognition can often be frustrating when it

comes to learning numbers, letter, words, pictures and symbols. What could be
even more frustrating is the fact that something learned today may not be able
to be recalled the next day.
Spatial Relations - This has reference to objects in space and their position and
also the ability to perceive objects in space in relation to other objects.
Mathematics and reading are two subjects that deal with numbers, letter,
symbols and where the understanding of spatial relationships and accurate
perception are rather important. A person with this condition, therefore, generally
finds it difficult to figure out the difference between p and q and b and d.
Visual Closure - The individual finds it difficult to figure out an object only if part
of it is visible. For example he/she will find it difficult to figure out a word if a
letter is missing from that word, or perhaps will be unable to recognize a car if
the wheels are missing or difficulty in recognizing a face if the nose or mouth or
eye does not complete the picture.
Visual discrimination - Here the individual, by sense of sight is unable to tell

the difference between two similar objects, or two similar shapes or even two
similar letters. He/she is also unable to tell or notice the differences and
similarities between a particular colour, patterns and shapes.
Whole/part relationships - Here the individual finds it difficult to recognize an

object. For example, either he/she sees the whole object or he/she sees only
parts of the object. A typical example would be an individual may see the tree
but not the forest or may see the forest and not the tree.
AUDITORY PROCESSING DISORDER (APD)
Also known as central auditory processing disorder (CAPD) is an umbrella
term for a variety of disorders that affect the way the brain processes auditory
information. Individuals with APD usually have normal structure and function of
the outer, middle and inner ear (peripheral hearing). However, they cannot
process the information they hear in the same way as others do, which leads to
difficulties in recognizing and interpreting sounds, especially the sounds
composing speech. It is thought that these difficulties arise from dysfunction in
the central nervous system (i.e., brain). APD has been referred to as dyslexia for
the ears.
APD can affect both children and adults, although the actual prevalence is
currently unknown. It has been suggested that males are twice as likely to be
affected by the disorder as females
Characteristics
have trouble paying attention to and remembering information presented
orally, and may cope better with visually acquired information
have problems carrying out multi-step directions given orally; need to hear
only one direction at a time
have poor listening skills
need more time to process information
have low academic performance
have behaviour problems
have language difficulties (e.g., they confuse syllable sequences and have
problems developing vocabulary and understanding language)
have difficulty with reading, comprehension, spelling, and vocabulary
APD can manifest as problems determining the direction of sounds, difficulty

perceiving differences between speech sounds and the sequencing of these
sounds into meaningful words, confusing similar sounds such as hat with bat,
there with where.
MENTAL HEALTH
POST TRAUMATIC STRESS DISORDER (PTSD)

A set of mental health reactions that can develop in people who have
experienced or witnessed an event that threatens their life or safety (or
others around them) and leads to feelings of intense fear, helplessness or
horror.
This could be a car or other serious accident, physical or sexual assault,
war-related events or torture, or a natural disaster such as bushfire or
flood.
Other life-changing situations such as being retrenched, getting divorced
or the expected death of an ill family member are very distressing, and
may cause mental health problems, but are not considered events that can
cause PTSD.
Anyone can develop PTSD following a traumatic event but people are at greater
risk if:
the event involved physical or sexual assault
they have had repeated traumatic experiences such as sexual abuse or
living in a war zone
they have suffered from PTSD in the past
Signs and symptoms

People with PTSD often experience feelings of panic or extreme fear, which may
resemble what, was felt during the traumatic event. A person with PTSD has
three main types of difficulties:
Reliving the traumatic event through unwanted and recurring

memories and vivid nightmares. There may be intense emotional or
physical reactions when reminded of the event. These can include
sweating, heart palpitations or panic.
Being overly alert or wound up sleeping difficulties, irritability, lack
of concentration, becoming easily startled and constantly being on the
lookout for signs of danger.
Avoiding reminders of the event and feeling emotionally numb
deliberately avoiding activities, places, people, thoughts or feelings
associated with the event. People may lose interest in day-to-day
activities, feel cut off and detached from friends and family, or feel flat and
numb.
People with PTSD can also have what are termed dissociative experiences,
which are frequently described as follows:
It was as though I wasnt even there.
Time was standing still.
I felt like I was watching things happen from above.
I cant remember most of what happened.
A health practitioner may diagnose PTSD if a person has a number of symptoms

in each of the three areas for a month or more, which:
lead to significant distress, or
impact on their ability to work and study, their relationships and day-to-
day life
It is not unusual for people with PTSD to experience other mental health
problems at the same time.
Up to 80 per cent of people who have long-standing PTSD develop additional
problems; most commonly depression, anxiety and alcohol or other substance
misuse. These may have developed directly in response to the traumatic event or
have developed sometime later after the onset of PTSD.
Impact of PTSD
PTSD can affect a persons ability to work, perform day-to-day activities or
relate to their family and friends. A person with PTSD can often seem
disinterested or distant as they try not to think or feel in order to block out
painful memories.
They may stop participating in family life, ignore offers of help or become
irritable. This can lead to loved ones feeling shut out.
People with PTSD need the support of family and friends but may not know
that they need help.
Alcohol and drug use

People commonly use alcohol or other drugs to blunt the emotional pain
that they are experiencing.
Alcohol and drugs may help block out painful memories in the short term,
but they can get in the way of a successful recovery.
When to get help

A person who has experienced a traumatic event should seek professional help if
they:
dont feel any better after two weeks
feel highly anxious or distressed
have reactions to the traumatic event that are interfering with home, work
and relationships
are thinking of harming themselves or someone else
Some of the signs that a problem may be developing are:

being constantly on edge or irritable
having difficulty performing tasks at home or at work
being unable to respond emotionally to others
being unusually busy to avoid issues
using alcohol, drugs or gambling to cope
having severe sleeping difficulties
Support is important for recovery

Many people experience some of the symptoms of PTSD in the first couple of
weeks after a traumatic event, but most recover on their own or with the help of
family and friends. For this reason, formal treatment for PTSD does not usually
start for at least two weeks following a traumatic experience.
A range of treatments
If problems persist after two weeks, a doctor or a mental health
professional may discuss starting treatment. Effective treatments are
available. Most involve psychological treatment but medication can also be
prescribed.
Generally, its best to start with psychological treatment rather than use
medication as the first and only solution to the problem.
The cornerstone of treatment for PTSD involves confronting the traumatic
memory and working through thoughts and beliefs associated with the
experience.
Trauma-focussed treatments can:

reduce PTSD symptoms
lessen anxiety and depression
improve a persons quality of life
be effective for people who have experienced prolonged or repeated
traumatic events
ANXIETY DISORDERS
Anxiety disorders are a group of mental health problems.
They include generalised anxiety disorders, social phobias, specific
phobias (for example, agoraphobia and claustrophobia), panic disorders,
obsessive compulsive disorder (OCD) and post-traumatic stress disorder.
Untreated, anxiety disorders can lead to depression.
Anxiety disorders are common mental health problems that affect many
people.
Approximately 25 per cent of the population have an anxiety disorder that
warrants treatment at some time in their life and up to another 25 per cent
have less severe anxieties such as fears of spider and snakes.
Not all anxiety is a disorder

Everyone experiences anxiety and fear at times; they are normal and
helpful human emotions that help us deal with danger.
However, some people experience excessive and irrational anxiety, and
worries that become ongoing and distressing and that interfere with their
daily lives. This may indicate an anxiety disorder.
Often there appears to be no obvious or logical reason for the way the
person feels.
This may make an anxiety disorder even more worrying to the sufferer.
Symptoms of anxiety disorders

The main features of an anxiety disorder are fears or thoughts that are chronic
(constant) and distressing and that interfere with daily living. Other symptoms of
an anxiety disorder may include:
panic or anxiety attacks or a fear of these attacks
physical anxiety reactions for example trembling, sweating, faintness,
rapid heartbeat, difficulties breathing or nausea
avoidance behaviour a person may go to extreme lengths to avoid a
situation that they think could bring on anxiety or panic
Panic attacks are a common symptom

A panic attack is a sudden feeling of intense terror that may occur in
certain situations or for no apparent reason.
A panic attack does not mean a person is necessarily suffering an anxiety
disorder.
A panic attack is a common feature of each type of anxiety disorder.
Symptoms of a panic attack may include:

shortness of breath
dizziness
rapid heartbeat
choking
nausea
The cause of panic attacks is unknown but they may be related to a chemical
response in the brain, caused by actual threatening or stressful events or by
thinking about stressful events. The brain response leads to physiological
changes in the body, such as shallow breathing and rapid heartbeat.
Panic attacks can be frightening. Some people say they feel like they are going
to die or go crazy.
People affected by panic attacks may avoid situations in which they think attacks
might occur. In some cases, this may lead to the development of other anxiety
disorders including agoraphobia.
Types of anxiety disorders

Anxiety becomes a disorder when it is irrational, excessive, too persistent and
attached to situations that do not warrant it and when it interferes with the
persons daily life.
Anxiety disorders include:
generalised anxiety disorder
social phobias fear of social situations
specific phobias for example a fear of open spaces (agoraphobia) or
enclosed spaces (claustrophobia)
panic disorders frequent and debilitating panic attacks
obsessive compulsive disorder
post-traumatic stress disorder
Generalised anxiety disorder

Generalised anxiety is excessive anxiety and worry about common issues. The
focus of the anxiety might be family or friends, health, work, money or forgetting
important appointments.
A person may be diagnosed with a generalised anxiety disorder if:

the anxiety and worry has been present most days over a six-month period
the person finds it difficult to control their anxiety
SOCIAL PHOBIAS
People with social phobia are afraid of being negatively judged or
evaluated by others.
This leads to fear of doing something that may humiliate them in public
for example public speaking, using public toilets, eating and drinking in
public, writing in public, or any social encounters such as parties or
workplaces.
Some social phobia sufferers may only fear one type of situation.
Others may be concerned about several types of situations. This can lead
them to avoid the feared situations, which can lead to severe isolation.
SPECIFIC PHOBIAS
A person with a specific phobia has a persistent and irrational fear of a
particular object or situation.
They may fear animals, places or people. Fear of the object or situation is
so severe that a person may experience physical symptoms and panic
attacks.
Fears may include dogs, blood, storms, spiders or other objects or
situations but, in all cases, the anxiety is both excessive and interfering.
The adult phobia sufferer usually knows that their fear is excessive or
unreasonable However, their need to avoid the object, place or person can
significantly restrict their life.
PANIC DISORDERS
Panic or anxiety attacks are common.
Panic disorders are less common; they affect about two per cent of the
population.
For a person to be diagnosed with a panic disorder, they would usually
have had at least four panic attacks each month over an extended period
of time.
Often panic attacks may not be related to a situation but come on
spontaneously.
Panic disorder may be diagnosed if panic attacks are frequent and if there
is a strong and persistent fear of another attack occurring.
OBSESSIVE COMPULSIVE DISORDER
People with obsessive compulsive disorder (OCD) have intrusive, unwanted
and involuntary thoughts or impulses (obsessions.)
They also feel compelled to perform behavioural and mental rituals
(compulsions) such as excessive hand washing, showering or checking.
They are usually aware of the irrational and excessive nature of their
behaviour
Anxiety disorders can have serious effects

An anxiety disorder may lead to social isolation and clinical depression,
and can impair a persons ability to work, study and do routine activities.
It may also hurt relationships with friends, family and colleagues.
Depression can be a serious illness with a high risk of self-harm and
suicide.
Recovery is possible with treatment

Recovery from an anxiety disorder is possible with the right treatment and
support. Effective treatments for anxiety disorders may include:
Cognitive behavioural therapy aims to change patterns of thinking,
beliefs and behaviours that may trigger anxiety. Part of the therapy may
involve gradually exposing a person to situations that trigger anxiety: this
is called desensitisation.
Anxiety management and relaxation techniques for example
hypnotherapy, meditation, breathing exercises and counselling.
Medication this may include antidepressants and tranquillisers.
Drug & Alcohol Dependency

There are a number of services available to help a person with drug
dependency.
The best treatment depends on the needs of each person.
Different treatments aim for different outcomes, whether its total
abstinence or reduction of drug use to a safer and less harmful level.
Options include individual counselling, group therapy and medications to
ease the symptoms of withdrawal. Not everyone completes a treatment
program the first or even second time, but this does not mean a person
cannot seek help again.
Some people find they need to explore a number of different treatment
options before they find what works for them.
Assessment
A person with a drug dependency is normally assessed at a treatment
centre or health agency to find out which forms of treatment might work
best for them.
Face-to-face interviews and questionnaires help to pinpoint key areas of
the persons drug use in relation to their history, lifestyle and personality.
The issues discussed may include:

the type of drug used
how much is used
the regularity of the drug use
the level of drug dependency or severity of addiction
any previous dependency problems with other drugs
the persons motivation for change regarding their drug use
lifestyle issues such as housing, employment and relationships
Following assessment, a treatment plan can be developed. Treatment plans
are a common part of many drug and alcohol interventions.
Brief intervention for drug dependency
Brief intervention means attempting to treat a person in the earlier stages
of their drug use before they develop serious drug-related problems.
It is based on the theory that a person can manage their own drug use and
associated issues if they are provided with the appropriate information or
other intervention at the right time.
These intervention sessions may include an assessment of the persons
drug use and provide a self-help manual or other information.
Brief intervention has been used successfully with cigarette smokers and
heavy alcohol drinkers.
Counselling options for drug dependency

A person can receive individual or group counselling as an outpatient or as part
of their inpatient treatment. The different models of counselling may include:
The Egan model the person decides which issues are important and the
best ways to address them, with the counsellor as a sounding board.
Motivational interviewing the person is encouraged to reduce their level
of drug use by exploring the consequences of their addiction and the
benefits of behavioural change. Taking responsibility for their behaviour
and decision-making helps the person to see their ability to make changes
in their life.
Cognitive behavioural therapy (CBT) the person is helped to overcome
irrational thoughts. The theory aims to change the way people think about
their own behaviour.
The systems theory a form of counselling that places a person in the
context of family, social, cultural and other environments in which they
live. The theory proposes that change in one area creates change in other
areas.
Detoxification is withdrawal from the drug

Detoxification (detox), or withdrawal, is a program to rid the persons
body of toxic drug levels.
A person who is dependent on a drug may suffer from withdrawal
symptoms when they stop using the drug.
Withdrawal from certain drugs such as alcohol and minor tranquillisers
(benzodiazepines) can be life-threatening in extreme circumstances.
Therefore, a medical assessment should be considered before a person
withdraws from a drug.
Medical withdrawal means using other medications to ease the symptoms
of withdrawal. This can be carried out either in hospital or through a drug
withdrawal service.
Typical withdrawal symptoms can include:

insomnia
nausea
shaking
sweating
coma or death, in very rare cases
Harm reduction when breaking drug dependency
Harm reduction recognises that most people regularly use drugs of some
type, such as alcohol.
The concept of harm reduction centres on reducing drug use or changing
drug use behaviour so it is less harmful to the drug user.
An example is the needle exchange program, which is designed to reduce
the incidence of HIV and other blood borne diseases that are spread
through sharing needles.
For many people, reducing drug use is a more realistic goal than quitting
altogether
Pharmacotherapy and medication to treat drug dependency
Sometimes a prescribed medication is used to replace the drug a person is trying

to stop using. This is call substitution pharmacotherapy e.g. Methadone, instead
of heroin.
Methadone is a synthetic drug that is taken in place of heroin. While it doesnt

provide the same high as heroin, it eases the withdrawal symptoms.
Methadone works for longer than heroin, so it only needs to be taken once daily
instead of every few hours.
Substitution pharmacotherapy has a number of benefits. Depending on the drug

a person is using, some of these benefits can include:
An easing of withdrawal symptoms, which allows the person to function in
day-to-day life.
The person is no longer taking a drug that is manufactured in a backyard
lab with no quality control or knowledge of its purity.
The person is no longer using a drug in harmful amounts or using a
potentially dangerous method, such as injecting.
Providing a person with the chance to address their life issues without
having to worry about finding enough money each day, getting the drug,
using it and so on.
Examples of pharmacotherapies for different drugs include:
alcohol acamprosate (campral), disulfiram (antabuse), naltrexone (revia)
opioids (such as heroin) buprenorphine (subutex, suboxone),
methadone, naltrexone (revia)
tobacco nicotine replacement therapies (NRT) such as patches, gum and
inhalers, bupropion (zyban), clonidine, nortriptyline.
Relapse prevention during drug dependency treatment

A person undergoing treatment for drug dependency needs considerable
support to make a successful transition to a drug-free lifestyle.
There are various support programs available for example, to help the
person find employment or housing.
Other drug dependency treatments
A person with a drug problem can gain insights into their drug use by
talking to others who have been in a similar situation. Many of these
groups can also offer support services.
Also, there are therapeutic communities, the aim of which is personal
growth, aided by the understanding and care of others in the community. A
person may join a therapeutic community for months or years.
Because women are less likely to seek help for drug use than men, several
treatment options have been established specifically for women for
example, group counselling sessions that are for women only, with
childcare available if required.
DEPRESSION
Different types of depression exist, with symptoms ranging from relatively

minor (but disabling) to very severe.
Risk factors for depression include stressful life events, personal factors
such as family history and personality, serious medical illness, and drug
and alcohol use.
Early detection of depression is important, as untreated depression can
lead to suicide. Treatment is widely available and effective.
Different types of depression often have slightly different symptoms and
may require different treatments. Several mental health disorders have
depression as a key feature, including major depressive disorder, bipolar
disorder, dysthymic disorder, cyclothymic disorders and seasonal affective
disorder.
While the exact cause of depression isnt known, multiple factors can be
associated with its development, including life events, personal factors
such as family history and personality, serious medical illness, and drug
and alcohol use.
Generally, depression does not result from a single event, but from a mix
of recent events and other longer-term or personal factors.
Depression is not just feeling sad

While we all feel sad, moody or low from time to time, some people
experience these feelings intensely for long periods of time (weeks,
months or even years) and sometimes without any apparent reason.
Depression is more than just a low mood its a serious illness that has an
impact on both physical and mental health.
On average, one in six people one in five women and one in eight men
will experience depression at some stage of their lives.
Symptoms of depression
A person may be depressed if, for more than two weeks, feelings of sadness,
down or miserable most of the time, lost interest or pleasure in usual activities,
and experienced several of the signs and symptoms across at least three of the
groupings below.
Its important to note that everyone experiences some of these symptoms from
time to time it may not necessarily depression. Not every person who is
experiencing depression will have all of these symptoms.
Behaviour
A person with depression may:
have stopped going out
not be getting things done at work or school
be withdrawing from close family and friends
be relying on alcohol and sedatives
have stopped their usual enjoyable activities
be unable to concentrate
Thoughts
A person with depression may have thoughts such as:
Im a failure
Its my fault
Nothing good ever happens to me
Im worthless
Lifes not worth living
People would be better off without me.
Feelings
A person with depression may feel:
overwhelmed
guilty
irritable
frustrated
unconfident
unhappy
indecisive
disappointed
miserable
sad
Physical symptoms
A person with depression may experience:
fatigue
feeling sick and run down
headaches and muscle pains
churning gut
sleep problems
loss or change of appetite
significant weight loss or gain
Risk factors for depression

While the exact cause of depression isnt known, many things can be
associated with its development, including life events, family history,
personality, illness, drug or alcohol misuse, or brain changes.
Everyone is different and often a combination of factors can contribute to
developing depression. Its important to note that the cause of depression
cannot always be identified. The most important thing is to recognise the
signs and symptoms and seek help.
Life events
Research suggests that continuing difficulties such as long-term
unemployment, living in an abusive or uncaring relationship, long-term
isolation or loneliness, or prolonged exposure to stress at work are more
likely to cause depression than recent life stresses.
However, recent events (such as losing a job) or a combination of events
can trigger depression in people who are already at risk because of past
bad experiences or personal factors.
Family history
Depression can run in families, so some people are at increased genetic
risk.
This doesnt mean that a person will automatically experience depression
if a parent or close relative has had the illness.
Life circumstances and other personal factors are still likely to have an
important influence.
Personality
Some people may be more at risk of depression because of their
personality, particularly if they have a tendency to worry a lot, have low
self-esteem, are perfectionists, are sensitive to personal criticism, or are
self-critical and negative.
Serious medical illness

Having a medical illness can trigger depression in two ways. Serious
illnesses can bring about depression directly or can contribute to
depression through the associated stress and worry, especially if it
involves long-term management of the illness or chronic pain.
Drug and alcohol use
Drug and alcohol use can both lead to and result from depression.
Many people with depression also have drug and alcohol problems.
Changes in the brain

What happens in the brain to cause depression is not fully understood.
Depression may be related to changes in the levels or activity of certain
chemicals that carry messages within the brain particularly serotonin,
norepinephrine and dopamine, the three main chemicals related to mood
and motivation.
Changes to stress hormone levels have also been found in people with
depression.
Research suggests that behaviour can affect brain chemistry for
example, long-term stress may cause changes in the brain that can lead to
depression.
Changes in brain chemistry have been more commonly associated with
severe depression rather than mild or moderate depression.
1
Different types of depression
Different types of depression often have slightly different symptoms and may
require different treatments. The five main types of depression are:
major depressive disorder
bipolar disorder (which used to be called manic depressive illness)
cyclothymic disorder
dysthymia
seasonal affective disorder (SAD)
Major depression
Sometimes this is called major depressive disorder, clinical depression,
unipolar depression or simply depression.
It involves low moods, and loss of interest and pleasure in usual activities,
as well as other more common symptoms.
The symptoms of major depression are experienced most days, nearly
every day and last for at least two weeks.
The symptoms interfere with all areas of a persons life, including work and
social relationships.
Depression can be described as mild, moderate or severe, melancholic or
psychotic.
Melancholia
Melancholia is a term used to describe a severe form of depression in
which many of the physical symptoms of depression are present e.g. one
of the major changes is that the person moves more slowly.
The person is also more likely to have depressed mood characterised by
complete loss of pleasure in everything or almost everything.
Psychotic depression
Sometimes people with a depressive disorder can lose touch with reality.
Experiencing psychosis can involve hallucinations (seeing or hearing things
that are not there) or delusions (false beliefs that are not shared by
others.)
People with this type of severe depression may believe they are bad or
evil, being watched or followed, or feel as though everyone is against them
(paranoia), or that they are the cause of illness or bad events occurring
around them.
Antenatal and postnatal depression

Women are at increased risk of depression during pregnancy (known as the
antenatal or prenatal period) and in the year following childbirth (known as
the postnatal period).
The causes of depression at this time can be complex.
Many women experience the baby blues a common condition related to
hormonal changes affecting up to 80 per cent of women.
The baby blues, or general stress adjusting to pregnancy or a new baby,
are common experiences, but are different from depression.
Depression is longer-lasting and can affect not only the mother, but her
relationship with her baby, the childs development, the mothers
relationship with her partner and other members of the family.
Almost 10 per cent of women will experience depression during pregnancy
and 16 per cent in the first three months after having a baby.
PSYCHOTIC DISORDERS
Are a group of serious illnesses that affect the mind.
These illnesses alter a person's ability to think clearly, make good
judgments, respond emotionally, communicate effectively, understand
reality, and behave appropriately.
When symptoms are severe, people with psychotic disorders have difficulty
staying in touch with reality and often are unable to meet the ordinary
demands of daily life.
Even the most severe psychotic disorders usually are treatable.
ACTIVITY
List the five types of depression.
Define the following words.
WORD DEFINITION
Melancholia
Depression
Methadone
Detoxification
Obsessive
Compulsive Disorder
Brief Intervention
SCHIZOPHRENIA
Schizoaffective Disorder: People with this illness have symptoms of both
schizophrenia and a mood disorder e.g.: depression or bipolar disorder.
Schizophreniform disorder: People with this illness have symptoms of

schizophrenia, but the symptoms last between one and six months.
Brief Psychotic Disorder: People with this illness have sudden, short periods of
psychotic behaviour, often in response to a very stressful event, such as a death
in the family. Recovery is often quick - usually less than a month.
Delusional disorder: People with this illness have delusions involving real-life
situations that could be true, such as being followed, being conspired against, or
having a disease. These delusions persist for at least one month.
Shared psychotic disorder: Occurs when a person develops delusions in the

context of a relationship with another person who already has his or her own
delusion(s).
Substance-induced psychotic disorder: Caused by the use of or withdrawal

from substances, such as alcohol and crack cocaine, may cause hallucinations,
delusions, or confused speech.
Psychotic disorder due to a medical condition: Hallucinations, delusions, or

other symptoms may be the result of another illness that affects brain function
e.g. head injury or brain tumour.
Paraphrenia: This is a type of schizophrenia that starts late in life and occurs in
the elderly population.
What Are the Symptoms of a Psychotic Disorder?

Symptoms of a psychotic disorder vary from person to person and may
change over time.
The major symptoms are hallucinations and delusions.
Hallucinations are unusual sensory experiences or perceptions of things
that aren't actually present, such as seeing things that aren't there,
hearing voices, smelling odours, having a funny taste in your mouth, and
feeling sensations on your skin even though nothing is touching your body.
Delusions are false beliefs that are persistent and organized, and that do
not go away after receiving logical or accurate information. For example, a
person who is certain his or her food is poisoned, even if it has been
proven that the food is fine, is suffering from a delusion.
Other possible symptoms of psychotic illnesses include:

disorganized or incoherent speech
confused thinking
strange, possibly dangerous behaviour
slowed or unusual movements
loss of interest in personal hygiene
loss of interest in activities
problems at school or work and with relationships
cold, detached manner with the inability to express emotion
mood swings or other mood symptoms, such as depression or mania
Causes
The exact cause is not known, but researchers believe that many factors
may play a role.
Some psychotic disorders tend to run in families, suggesting that the
tendency, or likelihood, to develop the disorder may be inherited.
Environmental factors may also play a role in their development, including
major life changes, stress, and drug abuse.
In addition, people with certain psychotic disorders may have an
imbalance of certain chemicals in the brain. They may be either very
sensitive to or produce too much of a chemical called dopamine.
Dopamine is a neurotransmitter, a substance that helps nerve cells in the
brain send messages to each other.
An imbalance of dopamine affects the way the brain reacts to certain
stimuli, such as sounds, smells, and sights, and can lead to hallucinations
and delusions.
Schizophrenia
Schizophrenia is a complex brain disorder, which affects about one in a
100 Australians.
The illness is characterised by disruptions to thinking and emotions, and a
distorted perception of reality.
It usually begins in late adolescence or early adulthood and does not spare
any race, culture, class or sex. About 20 to 30 per cent of people with
schizophrenia experience only a few brief episodes. For others, it is a
chronic condition.
Ten per cent of people with schizophrenia commit suicide.
Symptoms of schizophrenia
Symptoms include:
hallucinations
delusions
thought disorder
social withdrawal
lack of motivation
blunted emotions
inappropriate responses
impaired thinking and memory
lack of insight
Not all people affected by schizophrenia have all these symptoms. Some
symptoms appear only for short periods or episodes.
Hallucinations, delusions and thought disorder

Hallucinations and delusions are psychotic symptoms.
Hallucinations can involve hearing, seeing, tasting, feeling or smelling
something that does not exist, but which the sufferer believes is real.
Delusions are unfounded beliefs, for example, of persecution, guilt or
grandeur that seem utterly real to the person experiencing them.
Thought disorder manifests as disconnected, illogical speech.
Social isolation a major problem
While these psychotic symptoms are more alarming, other symptoms reinforce
the alienation of people with schizophrenia. They are often unable to participate
in normal social events or conversations, and lack sufficient motivation for simple
activities like bathing or cooking.
Sufferers lack the insight to recognise how their inappropriate behaviour appears
to others.
Schizophrenia is not a split personality

There are many myths. Sufferers do not have split personalities and are not
intellectually disabled.
Aggression may occur among a minority of patients during an untreated acute
episode, it is uncommon and not like that portrayed in the media of serial killers
or psychopaths.
Current treatments
Medication, hospital care and rehabilitation are the best forms of
treatment.
Admission to hospital is only necessary during crises; normal living can
resume once symptoms subside. Effective antipsychotic medications
enable many people with schizophrenia to lead full and productive lives.
Antipsychotic drugs help stabilise some symptoms, but do not cure the
disease and are frequently associated with side effects.
Most people need to stay on medication to prevent relapse.
Current research
Schizophrenia is highly complex. The exact cause of the illness is not yet known,
although research to date has yielded several valuable leads. Several lines of
research are currently being pursued at the Mental Health Research Institute.
Some of these include:
Molecular research aims to develop new antipsychotic medications.
A protein that appears altered in people with schizophrenia has been
identified this may be relevant to the development of future drug
treatments.
Structural changes have been found in the hippocampus (a brain region
involved in memory and thinking) after the onset of psychotic symptoms.
This suggests that brain changes are actively occurring during the period
of transition to illness.
Research looking at the protective effect of oestrogen in schizophrenia
may help with delaying the onset of illness and treating negative
symptoms.
Information about the behavioural, thought, hearing and structural brain
abnormalities related to auditory hallucinations, or hearing voices, has
provided new insights into the nature of auditory hallucinations.
Clinical research has led to the development of resources for professionals
to support families where children are living with mentally ill parents.
Clinical researchers are collecting data as part of an international study of
families in which there is a clearly inherited pattern of the illness. This may
help them to learn more about genetic links in the illness.
BIPOLAR DISORDER
Bipolar disorder, or bipolar mood disorder, used to be called manic
depression.
It is a psychiatric illness characterised by extreme mood swings.
A person may feel euphoric and extremely energetic, only to drop into a
period of paralysing depression.
The exact cause is unknown and a number of factors may be involved, a
genetic predisposition has been clearly established.
Around one in 50 Australians develops this illness, which affects men and
women equally.
Most of those affected are aged in their 20s when first diagnosed.
Bipolar disorder typically involves extreme moods of mania and depression
each lasting days, weeks or even months.
The severity of the mood swings and the symptoms vary from person to
person.
The person may be affected so much that they experience the symptoms
of psychosis and are unable to distinguish reality from fantasy.
Bipolar disorder and mania

Common symptoms include:
feeling extremely euphoric (high) or energetic
going without sleep
thinking and speaking quickly
delusions of importance
reckless behaviour, such as overspending
unsafe sexual activity
aggression
irritability
grandiose, unrealistic plans
Bipolar disorder and depression

Common symptoms include:
withdrawal from people and activities
overpowering feelings of sadness and hopelessness
lack of appetite and weight loss
feeling anxious or guilty without reason
difficulty concentrating
suicidal thoughts and behaviour
Contributing factors
The underlying mechanisms of bipolar disorder are not fully understood.
A strong genetic predisposition has been established.
One theory is that the illness might be linked to particular brain chemicals
(neurotransmitters) called serotonin and norepinephrine that help regulate
mood.
In a person with bipolar disorder, it is thought that these chemicals are
easily thrown out of balance.
Other contributing factors may include stressors in life that can trigger
episodes of illness.
Treatment for acute episodes of bipolar disorder
When people experience an acute episode of mania or depression, they often
require immediate care and treatment. These episodes can often be prevented
by regular medication.
Help for bipolar disorder

Treatment depends on the severity of the condition, but may include:
mood-stabilising medications such as lithium
antidepressants for depression
a range of medications for mania, such as sedatives or tranquillisers
counselling and education to help the person understand and manage
their condition
community support programs, which provide rehabilitation,
accommodation and employment support
self-help groups for emotional support and understanding
NEUROLOGICAL CONDITIONS
EPILEPSY
Involves recurring seizures partial or generalized.
Brain controls the bodys actions, sensations through nerve cells
(neurones) that carry messages from the brain to the body. Messages are
transmitted through electrical impulses. Seizures occur when sudden burst
of electrical activity in the brain disrupts the pattern.
Up to 10% of people may have an isolated seizure and a third of that group
will go on to have a recurrence and may be diagnosed with epilepsy.
Approximately 2 % of people have epilepsy.
Seizures can involve loss of consciousness, unusual movements, odd
feelings or sensations or changed behaviours.
Types of seizures
Generalised
Tonic clonic muscles stiffen, person may fall, jerking may follow, person
may bite their tongue, become incontinent. May be confused afterwards.
Absence seizure occur mostly in children. Person may go blank where
they stare/eyelids flicker. May not be noticed by others.
Tonic body stiffens, person may fall. Recovery usually quick.
Atonic sudden loss of muscle tone causes person to fall, recovery usually
rapid.
Myoclonoc brief, shock like jerks of muscle or muscle group, usually in
upper body.
Partial Seizures
Simple partial
person remains conscious, may have unusual sensations, pins & needles,
unpleasant smell/taste, feel nauseous or have a dj vu experience
Complex Partial
may be preceded by a partial seizure
persons conscious state is altered, may appear confused and dazed and
may do strange and repetitive actions e.g. fiddling with clothes, unusual
sounds
maybe trance like or robot like, usually last one to two minutes, but person
maybe confused and drowsy for some time and have no memory of the
seizure
Causes
Causes of seizures are not always known, some causes include:
brain injury
stroke
brain infection
structural abnormalities of the brain
genetic factors
Treatment
Medication is the main treatment, where people are considered at risk of having
further seizures.
Surgery may be an option where medication has not been effective in controlling
seizures.
MULTIPLE SCLEROSIS (MS)
Most common chronic disease of the central nervous system among young
Australians. Victoria has more people with MS than any other state.
MS is not contagious, but progress is progressive and unpredictable.
Cause is unknown and there is no cure, treatment can ease symptoms and
slow the progress of the disease.
MS occurs when the protective sheath (myelin) around the nerve fibres in
the brain and spinal cord is damaged, causing random patches called
plaques or lesions. These patches interrupt and distort the messages sent
along the nerves.
Sclerosis means scar and the disease is called multiple, because damage
occurs in a number of areas.
The health effects of this disease are varied and no people will share the
same symptoms.
Symptoms
blurred or double vision
numbness, pins & needles
weakness in arms and legs
loss of balance
tendency to drag one foot
fatigue
loss of coordination
continence problems
hand tremors
loss of mobility
problems or changes in memory function
speech difficulties or slurring
Types of MS
Relapsing remitting MS 85 % of people with MS start with this disease
course. Acute episodes occur, which may last for days, weeks, months before
completely or partially resolving. Intervals between attacks vary, but on average
occur every one to two years.
Primary progressive MS affects about 10 % of people with MS. Experience no

relapses, but have gradual onset of disability, which does not recover or reverse.
Secondary relapsing- remitting MS occurs in people who started with

relapsing remitting, but relapses diminish or cease altogether, though disability
continues to increase. About 60% of people who start with relapsing remitting
MS develop secondary progressive MS after 15 years.
Relapsing progressive MS occurs about 5%of people from the outset, with
relapses occurring and disability accumulating between relapses.
BRAIN & SPINAL TUMOURS
Brain cancer affects adults of all ages and is one of the few cancers that
occur in children.
Most brain tumours are gliomas, which develop from glial cells.
Symptoms and treatment depend on which part of the brain is affected.
The brain and spinal cord make up the central nervous system.
Brain and spinal cord tumours can be either malignant (cancerous) or
benign (not cancerous).
The brain controls thoughts, intelligence, memory and emotions.
It coordinates body functions (such as movement, blood circulation and
production of hormones.)
Interprets information from our senses (sight, hearing, smell, touch and
taste.)
It weighs about one and a half kilograms and is made up of nerve cells
(neurones.)
Nerve fibres run out of the brain and join together to make the spinal cord.
The brain and spinal cord form the central nervous system, which helps all
the different parts of the body to communicate with each other
There are over 100 different types of brain tumours. Tumours that begin in the
brain are known as primary brain tumours.
Some types of brain tumours are malignant (cancerous) and others are benign
(non-cancerous). Differences include:
Benign brain tumours are often slow growing and are unlikely to
spread, but they can press on and damage the surrounding brain tissue.
Usually, this type of tumour can be successfully removed with surgery.
Malignant brain tumours vary in how they grow and respond to
treatment. Some are contained inside a capsule and are easy to remove,
while others have thin filaments spreading through the brain making them
very difficult to take out.
The causes of primary brain tumours are not fully understood.
Symptoms
Depends on which part of the brain is affected.
Generally, a growing tumour and swelling brain tissue presses on the brain
causing symptoms including:
headaches this is the most common symptom and may be severe and
persistent, or come and go
seizures (fits)
nausea and vomiting
difficulty speaking or thinking of words
disturbed vision, hearing, smell or taste
weakness or paralysis in parts of the body
loss of balance
irritability, drowsiness or personality changes
loss of consciousness
Treatment
Aims to remove the tumour or at least slow its growth and relieve the symptoms.
Treatment may include:
Surgery some tumours can be completely removed. If it has spread
throughout the brain, it may be more difficult to remove.
Radiotherapy using x-rays to kill cancer cells. In children, low doses are
used because the x-rays can slow a childs development and growth.
Chemotherapy using anti-cancer drugs to stop the cancer cells from

multiplying. Chemotherapy is rarely used for adults, but often used for
children because of the possible side effects of radiotherapy.
Steroid therapy drugs to reduce the swelling around the tumour. These
do not treat the tumour itself but they do help to relieve the swelling and
pressure.
Complementary and alternative therapies when used alongside

conventional cancer treatment, some of these therapies can improve
quality of life. Others may not be so helpful and in some cases may be
harmful.
Secondary Brain Tumours

Many malignant brain tumours are secondary cancers. This means they
developed from a cancer that began elsewhere in the body.
Cancers of the lung, breast, kidney, stomach, bowel (colon), and skin
(melanoma) can all spread to the brain.
The symptoms of secondary brain tumours are similar to those of a
primary tumour, but they are treated differently.
PARKINSONS DISEASE
Affects one in 100 people over the age of 60.
Symptoms range from tremor, rigidity and slow movements to lethargy,
masked face and sleep disturbance. Cause is unknown, treatments include
medication, surgery and multidisciplinary therapy.
Progressive, degenerative neurological condition that affects the control of
body movements
Symptoms result from the progressive degeneration of nerve cells in the
middle area of the brain. Causing a deficiency in the availability of
dopamine, a chemical messenger necessary for smooth, controlled
movements.
Symptoms appear when about 70 per cent of the dopamine producing cells
cease to function normally.
It is estimated that approximately four people per 1,000 have Parkinsons
in Australia, incidence increasing to one in 100 over the age of 60.
In Australia there are approximately 80,000 people living with Parkinsons.
Physical symptoms
The type, number, severity and progression of symptoms varies greatly between
individuals. Some of the main symptoms are:
tremor (shaking)
rigidity (muscle stiffness)
bradykinesia (slowness of movement)
freezing
stooped posture
shuffling gait
micrographia (small handwriting)
lethargy
At present there is no known cause. Research worldwide is investigating possible

causes including:
pesticides, toxins, chemicals
genetic factors
head trauma
Management of Parkinsons
Parkinsons is managed by:
medication
neurosurgery
multidisciplinary therapy (physiotherapists,
dieticians, counsellors)
STROKE

Stroke is often referred to as a cerebrovascular accident.
The underlying conditions of a stroke (or cerebrovascular disease) are
usually present for years before a stroke occurs, although the symptoms of
a stroke may occur suddenly.
Transient ischaemic attacks (TIAs) are an important warning sign that a
stroke may occur in the future.
There are sometimes quite specific warning signs of an impending stroke.
Symptoms of a stroke can include:
a numb or weak feeling in the face, arm or leg
trouble speaking or understanding
unexplained dizziness
blurred or poor vision in one or both eyes
loss of balance or an unexplained fall
difficulty swallowing
headache (usually severe or of abrupt onset) or unexplained change in the
pattern of headaches
confusion

TRANS ISCHAEMIC ATTACKS (TIA)
Are caused by a temporary cut in blood supply to the brain, due to the
partial blockage of an artery by a blood clot or debris.
TIAs have the same symptoms as a stroke, but they are temporary and do
not usually cause long-term brain damage.
A TIA can appear hours, days, weeks or months before a full stroke but is
more common within days or a few weeks.
Just like full strokes, TIAs need emergency treatment and should not be
ignored.
A TIA, or mini-stroke, is a warning of an impending stroke.
A person who has had a TIA is at greater risk of having a stroke or heart
attack. Early identification of symptoms and early management greatly
reduces the chances of a major stroke.
A TIA is:
Transient symptoms last for less than 24 hours
Ischaemic failure of blood flow to part of the brain or eye
Attack sudden onset of symptoms, depending on which part of the brain
or eye is starved of blood
ALZHEIMERS DISEASE
Alzheimers disease is a progressive and eventually fatal disease of the
brain.
It impairs higher brain functions such as memory, thinking and personality.
Alzheimers disease is the most common form of dementia.
It affects one in 25 Australians aged 60 years and over.
There is no cure and no way yet proven to prevent the disease from
developing.
Early stage symptoms of Alzheimer's

Since Alzheimers disease is a progressive disease, the initial symptoms may be
too subtle to notice.
The symptoms differ from one person to the next, depending on the affected
brain areas, common early stage symptoms can include:
memory lapses
problems with thinking of the right word for common objects
difficulties with making decisions
confusion
personality changes, such as irritability
Late stage symptoms of Alzheimer's

The symptoms become more severe as time goes by and can include:
long term memory loss, including forgetting the names of family members
inability to manage responsibilities, such as work or running the house
inability to look after oneself; for example, help may be needed to go to
the toilet
severe personality changes
loss of social skills, such as the ability to hold a conversation
speech loss

In the later stages, the person is usually bed-ridden and needs full-time care.
Two types of Alzheimer's
Sporadic Alzheimers disease -

accounts for more than 90 per cent of cases
most cases occur in people over the age of 65 years
It can take up to 20 years for the disease to develop
Familial Alzheimers disease - this rare type is caused by a genetic mutation.

The age of onset is earlier than for sporadic Alzheimers disease, with symptoms
appearing at 40s or 50yrs
Protein build-up
Brain cells (neurones) talk to each other by means of connections called
synapses.
In Alzheimers disease, these connections are broken and ultimately
disappear entirely in the parts of the brain where thinking occurs.
Post mortems of the brains of people who have died from Alzheimers
disease reveal remnants of damaged cells called tangles as well as
amyloid plaques in the spaces between the cells.
These plaques are mostly made up of aggregates of a protein called A-
beta.
It is the build-up of this otherwise normal protein that is thought to cause
the damage.
Research has shown that, sometimes, the A-beta can convert oxygen into
hydrogen peroxide - a form of bleach - which then corrodes the grey
matter, particularly the parts of the brain concerned with memory and
reasoning.
Risk factors for Alzheimer's
Advancing age - the incidence of Alzheimers disease increases with age.
Some estimates suggest that about one quarter of people aged 85 years
and over have Alzheimers disease.
Down syndrome - a person with down syndrome has an increased risk
because they have an extra chromosome. This means they have an
additional copy of the gene for the amyloid precursor protein, the mother
molecule from which A-beta is made. This makes it more likely that this
protein will accumulate in their brains.
Family history - each child of a parent who carries the familial
Alzheimers gene has a 50 per cent chance of inheriting the disease.
Environmental factors - researchers are investigating possible
environmental causes, such as head injuries and other stresses.
Unknown - for most people who develop Alzheimers disease, no known
risk factors can be found.

Diagnosis of Alzheimer's
There is no definite test for the disease. Only a post mortem can establish
beyond doubt whether Alzheimers disease was present.
Diagnosis is about 90 per cent accurate. It is important to rule out the
presence of other conditions that can mimic the symptoms of Alzheimers
disease, such as brain tumours, depression or some types of malnutrition.
Diagnostic tests used may include:
medical history
physical examination
blood and urine tests (called a dementia screen)
urine tests
x-rays
imaging techniques, such as a CT scan
neurological examination
neuropsychological tests
intellectual function tests
psychiatric assessment
Treatment for Alzheimer's

There is no cure.
Treatment may include the use of drugs that boost the efficiency of
damaged neurones.
Drugs can also ease some of the secondary symptoms, such as
depression.
Second generation drugs, which are aimed at inhibiting the production or
toxic effects of the A-beta protein, are in development.
Professional associations, support groups and counselling can help the
affected person and their family come to terms with the diagnosis, and
plan ahead.
ACTIVITY - Place a tick in the correct box, either true or

false.

TRUE FALS
E
There is currently no cure for Alzheimers Disease
Alzheimers only affects one man in 25 Australians aged 60

years and over.
TIA stands for Trans Ischaemic Attack
A numb or weak feeling in the face, arm or leg is a sign of

stroke
Many malignant brain tumours are secondary cancers. This
means they developed from a cancer that began elsewhere in
the body.
TIA is another name for a stroke
PHYSICAL DISABILITIES
CEREBRAL PALSY
Describes a range of disabilities associated with movement and posture.
Cerebral refers to the brain and palsy means weakness or lack of muscle
control.
Cerebral palsy affects people in different ways some may have minor
motor skill problems, others may be totally physically dependent.
Cerebral palsy distorts messages from the brain, can cause increased
muscle tension or reduced muscle tension. The tension can fluctuate
becoming more or less obvious. Messages from the brain can be mistimed,
sent to the wrong area or not sent at all.
This causes the erratic movement of the muscles, the message path
between brain and muscles is affected.
Types of cerebral palsy

Spastic cerebral palsy most common type. Spasticity means stiffness or
tightening of muscles, most obvious when the person tries to move.
Athetoid cerebral palsy uncontrolled movements, which often lead to
erratic movements.
Ataxic cerebral palsy least common type. Ataxia means lack of balance
and coordination. Presents as unsteady, shaky movements called tremors.
Mixed type cerebral palsy may involve a combination of types.
Other disabilities sometimes occur with cerebral palsy hearing, sight and
speech, epilepsy or an intellectual disability
Causes
CP Is a condition, it is not contagious and not hereditary.
Usually result of changes or injury to the developing brain before or during
birth or early childhood.
Usually the result of reduced blood supply and lack of oxygen to areas of
the brain.

Maybe caused by illnesses e.g.: rubella during pregnancy, meningitis in
young children or accidental injury to the brain.
Extremely premature babies may also be at risk.
Implications
If speech is affected, the person may understand what is said to them but
may have difficulty responding.
Many people with CP may not be able to walk or require assistance.
CP can also lead to reduced control of facial muscles.
Many people with CP can and do live independently in the community.

SPINAL CORD INJURY
Spinal Cord Injury (SCI) is damage to the spinal cord that results in a loss of
function such as mobility and/or feeling.
In order for the loss of function to occur, the spinal cord does not have to be
completely severed. In most individuals with SCI, the spinal cord is intact, but it's
the damage to it that results in the loss of functioning. SCI is very different from
back injuries such as ruptured disks, spinal stenosis or pinched nerves.
Also, a person can break their back or neck yet not sustain a spinal cord injury if
only the bones around the spinal cord (the vertebrae) are damaged, not the
actual spinal cord. In these cases, the bones usually heal and the person does not
experience paralysis.
The majority of people who have a spinal cord injury are young males (they have
a greater tendency to indulge in risky behaviour). However, there are people from
both sexes and of all ages with spinal cord damage.
Frequent causes of spinal cord injury
The most common causes of damage to the spinal cord are traumas such as car
accidents, motor bike accidents, falls, diving mishaps (particularly diving into
shallow water), sports injuries and work accidents.
There are currently around 10,000 people living with a spinal cord injury in
Australia, with a further 300 400 new cases reported every year.
Around half of all new cases are people aged between 15 and 34 years old.
What are the effects of SCI
The effects of SCI depend on the type of injury and the level of the injury. SCI can
be divided into two types of injury - complete and incomplete. A complete injury
means that there is no function below the level of the injury; no sensation and no

voluntary movement. Both sides of the body are equally affected. An incomplete
injury means that there is some functioning below the primary level of the injury.
A person with an incomplete injury may be able to move one limb more than
another, may be able to feel parts of the body that cannot be moved, may have
more functioning on one side of the body than the other or may even be able to
walk. With the advances in acute treatment of SCI, incomplete injuries are
becoming more common.
The level of injury is very helpful in predicting what parts of the body might be
affected by paralysis and loss of function. Remember that in incomplete injuries
there will be some variation in these prognoses.
Cervical (neck) injuries usually result in quadriplegia.

C1 to C4 injuries may require a ventilator for the person to breathe.
C5 injuries often result in shoulder and bicep control, but no control at the
wrists or hands.
C6 injuries generally yield wrist control, but no hand function.
C7 and T1 injuries can straighten their arms but still may have dexterity
problems with the hand and fingers.
Thoracic level injuries and below result in paraplegia, with the hands not
affected.
T2 to T8 injuries have control of their hands, but poor trunk control as the
result of lack of abdominal muscle control.
T9 to T12 injuries allow good trunk control and good abdominal muscle
control. Sitting balance is very good.
Lumbar and Sacral injuries yield decreasing control of the hip flexors and
legs.

Besides a loss of sensation or motor functioning, individuals with SCI also
experience other changes. For example;
incontinence of the bowel and bladder

erectile dysfunction
fertility may be affected in SCI men
wide and rapid fluctuations in body temperature
inability to sweat below the level of injury
low blood pressure
chronic pain.
Very high injuries (C1, C2, C3) can result in a loss of many involuntary functions.
For example;
the ability to breathe (may require breathing aids such as mechanical

ventilators or diaphragmatic pacemakers)
inability to regulate blood pressure effectively
Some common health problems
Other problems which can arise for people with spinal cord injuries are:
frequent urinary tract infections

kidney stones
muscle spasm
pressure sores from sitting in one position for too long without a correct
pressure cushion;
Higher level injuries may develop a condition called autonomic hyper
reflexia, also known as autonomic dysreflexia. This condition can be
triggered by a variety of factors, including distended bladder, distended
bowel and skin or pressure sores. The symptoms of this condition include
raised body temperatures, profuse sweating, high blood pressure, slow
pulse rate and blackouts.
http://www.aqavic.org.au/sci_facts/whats_sci.html

MUSCULOSKELETAL INJURIES (EG BACK INJURY)
More than 6.1 million Australians are reported to have arthritis or a
musculoskeletal condition.
Most commonly reported conditions are back pain and various forms of
arthritis.
Almost 1.2 million of these are reported to have disability associated with
their condition.
Musculoskeletal disorder is an umbrella term for related injuries and disorders

including:
sprains and strains of muscles, ligaments and tendons
back injuries, including damage to the muscles, tendons, ligaments, spinal
discs, nerves, joints and bones
joint injuries or degeneration, including injuries to the shoulder, elbow,
wrist, hip, knee, ankle, hands and feet
bone and nerve injuries
soft tissue hernias
muscular and vascular disorders as a result of hand-arm vibration
SPINA BIFIDA
Spina bifida is a condition in which the bones of the spinal column do not close
completely around the developing nerves of the spinal cord. As a result, part of
the spinal cord may stick out through an opening in the spine, leading to
permanent nerve damage. Spina bifida results when a structure called the neural
tube fails to close completely during the first few weeks of embryonic
development.
The neural tube is a layer of cells that ultimately develops into the brain and
spinal cord. Because spina bifida is caused by abnormalities of the neural tube, it
is classified as a neural tube defect (NTD).
Children born with spina bifida often have a fluid-filled sac on their back covered
by skin. If the sac contains part of the spinal cord and its protective covering, the
abnormality is known as a myelomeningocele. If it does not, the abnormality is
known as a meningocele.

The signs and symptoms of these abnormalities range from mild to severe,
depending on where the opening in the spinal column is located and how much of
the spinal cord is affected. Related problems can include a loss of feeling below
the level of the opening, weakness or paralysis of the feet or legs, and problems
with bladder and bowel control. Some affected individuals have additional
complications, including a build up of excess fluid around the brain
(hydrocephalus) and learning problems. With surgery and other forms of
treatment, many people with spina bifida live into adulthood.
There is also a milder form of the condition called spina bifida occulta, in which
the spinal column is abnormal but the nerves of the spinal cord do not stick out
through an opening in the spine. Spina bifida occulta usually causes no health
problems, although rarely it can cause back pain or changes in bladder function.

How common is spina bifida?
Spina bifida is one of the most common types of neural tube defect, affecting an
estimated 1 in 2,500 newborns worldwide. The prevalence of spina bifida varies
among different geographic regions and ethnic groups.
How do people inherit spina bifida?
Most cases of spina bifida are sporadic, which means they occur in people with
no history of the disorder in their family. A small percentage of cases have been
reported to run in families; however, the condition does not have a clear pattern
of inheritance. First-degree relatives (such as siblings and children) of people with
spina bifida have an increased risk of the condition compared with people in the
general population.
AMPUTATION
Amputation is a surgery to remove a limb or part of a limb. Amputation can also
happen as an accident, which is called a traumatic amputation.
Who is a candidate for the procedure?

Amputation is most often used for one of four conditions:
gangrene, which is a severe limb infection with death of tissue
lack of enough blood flow through the arteries that supply blood and
oxygen to the affected limb

severe trauma or injury of a limb
cancer or a tumour involving a limb
Amputation has serious emotional and physical effects. For this reason, limb
removal is usually advised only when other options are not possible or have little
chance of success.
What happens later at home?

In many cases, a person will need a prosthesis, or artificial body part, after
surgery. The prosthesis can help a person continue to walk after limb removal.
The new body part often requires a custom fit. Physiotherapy to learn how to
use the new limb is usually given. The area of the incision should be watched
closely for signs of infection. These signs include increasing pain, warmth, or
redness. Any new or worsening symptoms should be reported to the doctor.

What are the potential complications of amputation?
The most common complications of amputation are:
phantom limb pain, a condition in which the person feels pain in the body
part that is missing
stump pain, due to abnormal nerve growth at the site of surgery
Medication, more surgery, or another type of therapy may be needed for these
types of pain.
Many of the people who need an amputation have poor circulation, diabetes, or
both. These conditions interfere with healing. If healing does not occur, more
surgery or other therapy may be needed in the future.
Musculoskeletal disorders can occur suddenly as a result of a single forceful

action or develop over long periods as symptoms associated with minor tissue
injuries are ignored, eventually resulting in a more serious injury. Many workers
performing repetitive tasks or work of a similar nature fall into the longer-term
category.
ACTIVITY

Question Answer
What is amputation?
What is phantom limb

pain?
Describe spina bifida.
List five musculoskeletal

injuries and or disorders.
List the four sections of
the spine
The spine consists of how

many vertebrae
What age are half of all

new spinal injury cases?
How common is spina

bifida worldwide?
What is the main reason

for amputation?
FURTHER INFORMATION CAN BE FOUND AT:
For more information about Chronic Medical Conditions:

Healthinsite
Department of Health
Aged Care Australia
Better Health
For more information about intellectual disability:

NSW Council for Intellectual Disability

Bruyere, S.M., & Golden, T.P. (2000). Working effectively with persons who
have cognitive disabilities. Employment and Disability Institute: Cornell
University.
For more information about learning disabilities:

Specific Learning Disabilities Association of NSW (SPELD)
For more information about mental health disabilities:

SANE Australia
Beyond Blue
Mancuso, L.L., & Bruyere, S.M. (2000). Employing and accommodating
workers with psychiatric disabilities. Employment and Disability Institute: Cornell
University.
Centre for Psychiatric Rehabilitation
For more information about Neurological Conditions

ehow.com
World Health Organisation
National institute of Neurological Disorders
Alzheimers Association
Epilepsy Foundation
Epilepsy Action Australia
Guillain Barr Syndrome Support Group
Australian Huntington's Disease Association
MS Australia
For more information about Physical Disabilities

The Cerebral Palsy Alliance
Paraplegic and Quadriplegic Association of NSW
Multiple Sclerosis Society of Australia
The Northcott Spina Bifida Group
For more information about hearing impairments:

Better Hearing Australia
National Relay Service
For more information about vision impairments:

Vision Australia
Dickson, M.B., Moore, E., & Bruyere, S.M. (2000). Working effectively with
people who are blind or visually impaired. Employment and Disability
Institute: Cornell University.

Section 3: Effective
Communication
Communicate! Understand that even though I am not physically able,
my mental faculties are still there.
Dont ignore me or talk about me as if Im not there.
Communication basically means meeting of the minds! I understand you and

you understand me. For communication to be successful you need a meeting of
the minds. This doesnt mean we need to agree: it does mean that we need to
be sure that we understand the message that the other is delivering and that we
clearly communicate our own message. We communicate and share information,
thoughts and feelings through speaking, writing or body language. While this
sounds simple and we think we are communicating clearly and understand a
message conveyed to us, our life experiences, habits, emotions and daily
pressures can sometimes block or cloud the real message. This can result in
miscommunication.
In this section, we will look at communication, especially in the setting of a

support worker and client with disability. Poor communication can result in
serious consequences for the support worker and clients and hamper our efforts
to support our clients journey for choice and independence.

The basic communication process
Barriers to effective communication
Strategies for communication
Communication with clients with specific disabilities
Augmentive and Alternative Communication
Effective Language
o Words to watch
o Acceptable Alternative
Conflict and Issue Resolution
o Identify conflict
o Levels of conflict
o Self-awareness in conflict situations
o Cross cultural conflict resolution
Negotiation The art of reaching a mutually satisfying agreement
Confidentiality and privacy

BASIC COMMUNICATION PROCESSES
The Communication Equation
What you hear: 40% of the message
Tone of voice
Vocal clarity
Verbal expressiveness
What you see or feel:

Facial expression 50% of the message
Dress and grooming

Posture
Eye contact
Touch
Gesture
WORDS: 10% of the message!
Channels of communication include:

Verbal channels include face-to-face meetings, telephone and
videoconferencing.
Non-verbal channels include sign languages, body language, gestures,
and facial expressions.
Written channels include letters, emails, memos and reports, signs and
symbols.
Different communication channels have different strengths and weaknesses; the

most important thing is that the receiver can access the message through that
channel. For example, if the intended receiver has a hearing disability and you do

not share a common non-verbal language; your message would be better
understood in written form.
In discussions, it is good to be mindful of non-verbal gestures that provide

information about how we are feeling and how the other person is coping. Pay
attention to things like eye contact, gestures, posture, body movements, and
tone of voice. All of these signals can convey important information that isn't put
into words. By paying closer attention to other people's nonverbal behaviours,
you will improve your own ability to communicate nonverbally.
Your tone of voice can convey a wealth of information, ranging from enthusiasm
to disinterest to anger. Start noticing how your tone of voice affects how others
respond to you and try using tone of voice to emphasise ideas that you want to
communicate.
If you are confused about another person's nonverbal signals, don't be afraid to
ask questions. A good idea is to repeat back your interpretation of what has been
said and ask for clarification. An example of this might be, So what you are
saying is that...

Communication problems occur when the sender and receiver do not share the
same understanding of the language used. For example, when young people use
the word 'whatever' in response to a question it is often unclear to parents
whether this signals agreement, disagreement or general apathy.
At any time in the communication process, a lack of response or an inappropriate

response would alert the sender to a problem with the communication. The
sender would then need to interpret the message differently or use a different
channel to ensure that the communication is received and understood.
Barriers to effective communication

A communication barrier is anything that prevents you from receiving and
understanding the messages others use to convey their information, ideas and
thoughts. These barriers may be related to the message, internal barriers related
to thoughts and feelings, or external barriers.
Barriers related to the message include:

lengthy or disorganised messages
complex or ambiguous language
inconsistent body language
disregard for specific need

Internal barriers include:
fatigue
disinterest
poor listening skills
past experiences with the client
home or work problems
poor listening skills
External barriers include:
noise and other distractions

unpleasant environment
problems with technology or equipment
These barriers keep the message from getting through. When you are
communicating, monitor the actions of the receiver by observing their body
language, response to the message, etc. To check that the message has been
received as it was intended, ask questions and listen to their response.
STRATEGIES FOR EFFECTIVE COMMUNICATION

As disability can affect people in different ways, communication is not always just
a matter of speaking and hearing. It can involve a range of methods by which
people choose to communicate (such as via sign language or communication
aids), depending upon the level of disability and the way it affects each
individual.
Interaction with people with disabilities is an unfamiliar and sometimes

threatening experience for many people. Avoidance behaviour can occur.
Interacting with people with disabilities requires common sense and simple
sensitivity. A few key points need to be stressed:

Good service behaviours such as active listening, a service orientation and
a results focus work equally well with people with disabilities as with all
other people.
Think of the person first and the disability second. Sensitive use of
language can help reinforce the person first attitude. Reference to people
with disabilities rather than to disabled people helps maintain this
stance.
Accept people with disabilities as individuals. People with disabilities may

have in common a disability, but the consequences of their disabilities will
vary considerably from person to person. Factors such as the degree of
impairment, duration, individual coping strategies and styles, support
structures available and a host of personality traits will all combine to
influence the nature of the individuals needs. Don't generalise about all
people with disabilities from your knowledge of a few.
Listen to what people say. Don't assume you know what they want or what
is best for them. People with disabilities are no less capable of thinking for
themselves than anyone else. There may be challenges in communicating
their needs, but assumptions that they cannot decide what they need are
also offensive.
Be yourself, be natural, don't force enthusiasm. Do not patronise or speak

down to people with a disability.
A disability is not necessarily an illness. Do not treat people with

disabilities as though they are sick. Treat them as healthy individuals.
Research indicates that people with disabilities take fewer sick days than
other employees. Their impairments cause inconvenience and disability in
particular areas of activity, but they are rarely dysfunctional.
Treat people in a manner that is appropriate to their age. It is not

appropriate to talk to people with disabilities as if they were children, or to
refer to them as children. Terms such as girlie or sonny are not
appropriate for adults with disabilities.
Speak directly to the person, not to their carer or other third party. People
with disabilities often have carers. However, the carers are there to assist
in specific ways. Do not assume that they are the mouthpiece or the

advocate for the person with a disability. It is insulting to talk in the third
person about a person who is present.
If the person with a disability has a communication problem they will

usually let you know and indicate a preferred method.
A disability is an inconvenience in certain situations, but it is not

necessarily a tragedy which dominates a person's life and makes fulfilment
impossible. Individuals find their own ways of adapting.
SPECIFIC DISABILITIES
People with vision impairment

Effective ways of providing information to people who are blind or have vision
impairment include:
Large Print
Text can be produced in a variety of sizes to meet individual needs. Printed
material should ideally be in a sans serif font and 16 point, with a minimum size
of 11 point. Use a text colour that contrasts with the background (avoid red type
as it has poor contrast and makes it difficult for people to read). Black type on
white or off-white background is optimal. Use style devices such as underlining,
italics and hyphenation sparingly.
Try your local library they generally have a wide selection of large
print books.
Information and Communication Technology

Providing information electronically, either on a website, through email or an
electronic file or document, can be a good option if the information is prepared in
an appropriate format. Unlike sighted people, most computer users who are blind
or vision impaired do not use a mouse. Many use a screen reader or, in some
cases, a Braille keyboard. A screen reader is software that works with a speech
synthesiser to read aloud everything on a computer screen, including icons,
menus, text, punctuation and control buttons. It reads across the screen from left
to right, one line at a time. This software will attempt to read any formatting
for example, instead of reading columns from top to bottom it will read the first
line of text in the first column and then jump across to read the first line of the
next column. For this reason, it is best to keep formatting (including tabs, tables
and columns) to an absolute minimum in your document.
Information provided as a PDF file should also be available electronically as an

RTF file. This will ensure it can be read by a screen reader and will also be able to
be enlarged by users to suit their needs.

Advice and guidelines for creating accessible websites are available
from the World Wide Web Consortium website (www.w3.org/WAI).
Audiotape/CD-ROM
Newsletters, books and reports can be produced on audiotape or CD-ROM. It is
best to use an organisation that specialises in the production of audio material
for people with a print disability, such as the Queensland Narrating Service. Costs
are minimal.
Radio
4RPH 1296AM is the Queensland radio station for the print handicapped. The
station airs a wide range of printed material, including newspapers, magazines,
books and journals to people who for reasons of age, disability or literacy
problems cannot handle or read information in a printed format.
Braille
Braille is used by a small proportion of people who are blind. Documents on
computer file can be converted into Braille using Braille conversion software and
printed out by a Braille embosser.
People with a hearing impairment

Effective ways of providing information to people who are deaf or have a hearing
impairment include:
Written/printed information

Printed information should be written in plain English and include cartoons,
diagrams, photographs and pictures to help communicate your message clearly.
Captioning
Captioning films, videos, television programs and advertisements assists viewers
who are deaf or hearing impaired to understand what they are not able to hear.
Telephone typewriter (TTY) and/or National Relay Service (NRS)

Organisations can communicate with people who are profoundly deaf through the
use of a TTY or the NRS.
Sign language
Skilled sign-language interpreters are available for seminars, meetings,
conferences and other community events. Qualified interpreters can be booked
through Auslan Services Australia wide or check the web for individual states
Deaf Interpreting Services.
http://auslanservices.com
Audio Loop
An audio loop in public meeting places such as halls, churches, seminar rooms,
lecture theatres and schools will allow people who use hearing aids to participate.
People with an intellectual disability

People with an intellectual disability may require information to be presented in a
brief and clear but not patronising or childlike manner. Written information may
need to be supported by symbols, pictures or photographs.
People with a physical disability

People with a mobility disability, including those with a temporary disability, may
find their access to mainstream information limited. They may be unable to travel
to libraries or meetings or may encounter difficulties with inaccessible buildings.
They too may prefer to receive information via the internet, email, radio, DVD or
disk. People with a manipulatory disability have difficulty holding and/or moving
objects as a result of nerve injuries, arthritis or amputation. They may find it

difficult to hold books or papers and turn pages. When providing information for
this audience, the formats to consider include the internet, disk, DVD and radio.
Many people with a disability have complex communication needs (CCN) which
cover a range of issues in the areas of speech, language, auditory and visual
processing. CCN considers receptive language skills (difficulties understanding
spoken language), expressive language skills (difficulties producing speech), or
both. Some general characteristics of CCN are:
the inability to follow instructions
incomprehensible speech
difficulty in identifying visual cues
overly slow speech
trouble with articulation, voice, and fluency
stuttering
difficulty in forming sentences (often saying words out of order)
People who have complex communication needs (CCN) are unable to

communicate effectively using speech alone. They and their communication
partners may benefit from using augmentative and alternative communication
(AAC) methods, either temporarily or permanently.
Augmentive and alternative Communication
Augment means to add to or to enhance. For example, we can augment speech

by using gestures, eye pointing and body language. Alternative means a choice
or a substitute. We can use alternative communication to speech by pointing to
symbols, signing or by spelling.
Communication means to send and receive messages with at least one other
person. Therefore AAC is the term used for all communication that is not speech,
but is used to enhance or to replace speech.

AAC covers a large number of ways of communicating. It can include one or more
of the following:
Natural communication methods, such as:
o pointing and gestures
o mime
o facial expressions
o body language
Methods that can be taught, such as:

Signing - this involves the use of a formal set of signs, or signs
which are particular to an individual. Signing is useful to help
children to understand language. The sign can be seen and held for
slightly longer if needed, whereas speech disappears as soon as it is
spoken. Signing can also be used as a means of expression with
other people who know signs.
Object symbols - these are objects such as small versions or parts of objects
which represent an activity, object or person (for example, a set of keys
represents that its time to go in the car)

Photos, drawings, symbols - these are used like object symbols to
represent words in a visual way.
Communication boards and displays - these are sets of photos, drawings,

symbols or words that are used by an individual for communication.
Speech generating devices - communication boards or displays on a machine

which speak a message when a particular button is pressed.
Spelling - using an alphabet board or typing device to spell out words

and messages
People with a disability should be portrayed as individuals first. Like everyone

else they have emotions, interests, problems, talents, frustrations and faults and
have a number of roles such as parent, friend, work colleague and club member.
As each person with a disability is an individual, the disability will affect his or her
life in different ways. You cannot assume that all people with a disability share
the same viewpoint, interests or outlook on life.
Using appropriate language emphasises this individuality, rather than the

disability that a person happens to have. This does not mean that the disability

should be hidden, ignored or deemed irrelevant but it should not be the focus of
a story except when the subject is disability.
Effective Language
In the general community, as well as in the disability community, there is
considerable debate about how people with a disability should be described.
Words and terms that are considered appropriate and acceptable change over
time. For example, once the word cripple was in common and respectable use.
Today its use to describe a person with a disability is considered offensive and
unacceptable. The same applies to words and expressions such as insane,
spastic and handicapped. Also unacceptable are words which imply a lack of
something or some kind of inferiority, such as invalid, infirm or incapacitated.
The following list of inappropriate terms and appropriate alternatives is a guide

only. When considering which terms are most appropriate to use in any situation
it is best to ask the person how he or she would like to be referred to.
WORDS TO WATCH ACCEPTABLE ALTERNATIVE
Abnormal, subnormal (negative terms Specify the disability

that imply failure to reach perfection)
Afflicted with (most people with Say the person has...(the

disabilities don't see themselves as disability)
afflicted)
Birth defect, also congenital defect, Say the person with a disability
deformity since birth, person with congenital
disability
Blind (the), visually impaired (the) Say person who is blind, person
with vision impairment
Confined to a wheelchair, wheelchair- Say has a physical or mobility
bound (a wheelchair provides mobility disability
not restriction)
Cripple, crippled (these terms Say has a physical or mobility

convey a negative image of a disability
twisted, ugly body.)
Deaf and dumb (the inability to hear Say hearing impaired; lack of
and speak does not imply intellectual speech usually results from impaired
disability.) hearing
Defective, deformed (degrading Specify the disability

terms.)
Deaf (the) Only appropriate when referring to

the Deaf community; say person who
is deaf

WORDS TO WATCH ACCEPTABLE ALTERNATIVE
Disabled (the) Say people with a disability; the

disability community
Epileptic Say person with epilepsy
Fit, attack, spell Say seizure
Handicapped (the) Say person with a disability unless

referring to an environmental or
attitudinal barrier, in such cases
person who is handicapped by a
disability is appropriate.
Insane (also lunatic, maniac, mental Say person with a mental health
patient, mentally diseased, neurotic disability or a specific condition.
psycho, psychotic, schizophrenic,
unsound mind and others are
derogatory terms.)
Invalid (the literal sense of the word Say person with a disability
is not valid.)
Mentally retarded (also defective, Say person with an intellectual

feeble minded, imbecile, moron and disability
retarded are offensive and
inaccurate terms.)
Mongol (out dated and Say has Down Syndrome.

derogatory)
Patient (only use in context of Say person with a disability.
doctor/patient relationship or in
hospital)
Physically/intellectually/vertically Say person with a disability

challenged, differently abled,
(ridiculous euphemisms for disability)
Spastic (usually refers to a person Say person with a disability.
with cerebral palsy or who has
uncontrollable spasms.
Derogatory, often term of abuse.
Suffers from, sufferer, stricken with Say person with a disability.

(Not all people with disabilities
actually suffer. Say person with a
mental health illness or disability or a
specific condition.
From A Way with Words (1995), Community Disability Alliance, Department of Families, Youth and Community
Care and Department of the Premier and Cabinet, Brisbane.

ACTIVITY
QUESTION ANSWER
What is an Alphabet Board used for?
What does speech generating devices

used for?
List three natural communication

methods.
What is the appropriate language for
Disabled?
Mongol?

Deaf?
Handicapped?
Define communication.
List six barriers to communication, these

can be internal or external.
Who would use Braille as a form of

communication?
What is signing?
What is CCN?

Insane?
List three forms of communication for

people with a hearing impairment.
List three form of communication for
people with vision impairment.
What is AAC?

CONFLICT AND ISSUE RESOLUTION
It is normal in life, especially a world in which different cultures, traditions and
belief systems operate, to encounter differences of opinions. We are human!
Sometimes, however, these differences can lead to conflict which can block our
ability to communicate effectively and provide support and a service to people in
our community. The potential for misunderstanding and tensions within the
worker-client relationship may be related to the following issues:
Support workers and the service support people not understanding the
complex challenges the clients and their families face every day due to the
disability.
Client and family frustrations with the care and support they receive from
support workers and organisations. Also, general frustration with the
overall system and compliance issues which impact upon the support
workers to deliver the type of support that the client and family would like.
General breakdown in communication between all parties involved in the
client care.
Clients experiencing major crises in their lives leading to a heightened
emotional state and frustrations.
You need to demonstrate patience, understanding, and respect for others'

cultural, religious or other preferences. In this way, you can minimise any barriers
arising from the clients' and co-workers' actions or beliefs, and ensure that they
do not contribute to breakdowns in communication, resulting in mistrust or
conflict.
The need for a support worker to demonstrate patience and understanding and a
commitment to avoiding unnecessary conflicts and tensions due to
miscommunication is essential.
Identify conflict
Conflict may be unavoidable, due to the nature and purpose of some
communications; however, by identifying early signs of conflict it is possible to
avoid communications becoming emotionally charged or destructive.
Signs of conflict can be verbal, non-verbal, or indicated through body language.

Verbal disagreement
This may include:
a raised voice
a sharp tone
snide remarks
asides (comments intended for one person to hear, but directed toward others)
direct explanation

Levels of conflict
The Levels of conflict diagram, describes the escalation of conflict from early
signs of discomfort through to incidents, misunderstandings, tension and crisis.

When a conflict is developing between yourself and a client or colleague, anger is
usually present. It is important to examine where that anger is coming from and
what needs are not being met both within yourself and within the client's
situation. This will be discussed later in the final section in more length.
You need to be very honest in acknowledging personal limitations and prejudices,

and avoid imposing your own personal values and beliefs on others. These could
include:
feeling threatened by the other person

commitment to personal values or beliefs
being unsure of your information
being unassertive, aggressive, talkative, or having low self-esteem.
being judgmental or having expectations
using inferences rather than facts or observations
Feelings can bubble up unexpectedly and you may not be prepared for their
intensity. This can exacerbate the potential for conflict developing with clients or
co-workers. It is important for you to be able to examine your responses to others
and to be constantly aware of what your feelings and perceptions tell you, about
your needs and those of your client, and whether these are being met.
People in conflict can approach the situation competitively or they can attempt to
cooperate, while still acknowledging the existence of a conflict. When people
compete in a conflict, they usually perceive that there will be an outcome in
which one side wins and the other loses. If people attempt to approach a conflict
cooperatively, they try to find a solution both parties can be satisfied with.
People's behaviour in conflict falls into five styles described below:
avoiding withdrawing from the conflict

smoothing finding common interests or areas of agreement
compromising bargaining so that each side gets a part of what they want
forcing one side causes the other side to change
problem-solving attempting to find a solution that meets both needs
Any conflict and also conflict in the workplace can be incredibly destructive to
good teamwork.
Managed in the wrong way, real and legitimate differences between people can
quickly spiral out of control, resulting in situations where co-operation breaks
down and the team's mission is threatened.

This is particularly the case where the wrong approaches to conflict resolution are
used. To calm these situations down, it helps to take a positive approach to
conflict resolution, where discussion is courteous and non-confrontational, and
the focus is on issues rather than on individuals. If this is done, then, as long as
people listen carefully and explore facts, issues and possible solutions properly,
conflict can often be resolved effectively.

Conflict resolution
Successful conflict resolution comprises three aspects:
1. Desire and necessity for the conflict to be resolved.
2. Understanding of possible barriers to the resolution of the conflict.
3. The choice of method of conflict resolution.
1. Desire and necessity for the conflict to be resolved

To resolve cross-cultural conflicts or misunderstandings, community service and
disability service workers need to be committed to resolving potential conflicts
and take responsibility for bridging the cultural gaps. They must:
have self-awareness of their own cultural practice, including prejudice,
stereotyping and bias
understand various cultural factors contributing to cultural differences
be sensitive and appreciate a migrants migration experience
have a good knowledge of, and skills in, communication
be able to work with interpreters
be willing to accept and appreciate other cultures (modified from
Lachowicz 1997)
2. Understanding of possible resistances

During the conflict resolution process, you might experience internal resistance
to recognition of problems or problem-solving.
This resistance may take the form of:
resistance to examining your own values
resistance to acknowledging your own cultural stereotyping or bias
denial of the existence of conflict
tendency to blame others for causing problems
looking for the right time to deal with conflicts
You must take prime responsibility for exploring the barriers and minimising this
resistance to conflict resolution.
3. Methods of conflict resolution

Different people might accept different conflict resolution methods, so it is
important to use methods or approaches that are suitable to all parties and enlist
the help of acceptable people in resolving cross-cultural conflicts.
To resolve conflicts arising from cultural differences, you need to:

identify the similarity and differences between your cultural practice and
those of the person in conflict with you
acknowledge the differences and attempt to balance the interests of both
parties
Build on common ground

Instead of focusing on the differences, you could look for common ground
between you and the other party, and build on it.
Break down power structure

The imbalance of power between community service and disability service
workers and clients or between co-workers can be an obstacle for conflict
resolution.
Clients may feel powerless: Such feelings may act as a force of resistance
in the conflict resolution process. One way to break the power structure is
to respect clients as experts in their own conditions.
Power differences also exist between workers, due to seniority: The focus
should be directed to the cause of conflict instead of seniority of the
position.
Use of mediation
Mediation means to have a middle person acting in the role as a go-between or
facilitator. The role of mediator is to provide both parties with opportunities to put
forward their views and assist in analysing the problem and looking for solutions.
Mediation with clients or their family

If you have conflict with a client or a clients family members, you could approach
your team leader to act as a mediator or you may seek external mediators from
multicultural organisations (with the clients or their family members consent).
Mediation with co-workers

When you have conflict with co-workers, you could use the conflict resolution
process or the grievance procedure used in your workplace.
Both of these processes would involve a mediator. The mediator could be:
a senior from your discipline area, if you and the co-worker are from the
same discipline
a team leader or other senior staff member
an independent person from human resources management
ACTIVITY: This activity will be discussed in a group situation.

Consider a situation in which a person was verbally or physically aggressive
towards you in a work context. If you cannot describe an incident that happened
to you in a work context, you can choose to describe an incident you witnessed
happening to a co-worker, or from your personal life.
Do not use names or any other identifying details.
1 Describe the situation briefly.

2 How did you feel at the time?
3 Describe your response to the aggression - how you may have looked, the
way you stood, your tone of voice, etc.
4 Which of the behaviours below describes your response? (Place a tick under
the response)

Avoiding Smoothing Compromisin Forcing Problem-
g solving

Negotiation the art of reaching a mutually satisfying agreement!
Its a two way interaction. Bouncing ideas

and ways of doing different things.
As we discussed earlier, the impact of life experiences, personalities and life in

general, will lead to differing opinions. We are all unique individuals and while
this adds richly to our culture and world, this uniqueness can also lead to outright
disagreements! The Disability Care environment which advocates greater choice
and control for our clients with disability is a great way forward. However, we are
more likely to see support workers engaging in conversations requiring effective
negotiation skills as we try to balance the areas of choice, control and risk.
We often find in 99% of cases, we do not need to say no, but rather present an
opinion in a more positive way.
A strategy for successful negotiations

Listen carefully to the requests or arguments of the other person and
assess the logic of their reasoning.
Clarify issues you are not clear about by asking how, why, where, when
and what questions.
List all the issues which are important to both sides and identify the key
issues.
Understand any outside forces that may be affecting the problem.
Keep calm and use assertive rather than aggressive behaviour. Use tact
and diplomacy to diffuse tensions.
Use both verbal and non-verbal persuasion skills. Use open, encouraging
body language such as mirroring, not defensive or closed.
Know when to compromise. Offer concessions where necessary, but minor
ones at first.
Distinguish between needs: important points on which you can't
compromise and interests where you can concede ground.
Allow the other party to save face if necessary via small concessions.
Make sure there is an agreed deadline for resolution of the negotiations
Decide on a course of action and come to an agreement.
The final agreement needs to be summarised and written down at the
conclusion of the negotiations.
Plan for alternative outcomes if you can't reach agreement.

CONFIDENTIALITY
Support workers should never discuss other clients as it creates insecurity

and distrust. When I hear what they say to me, I wonder what they are
saying about me to others.
All clients have a right to expect that information they give will be kept
confidential. This is part of your commitment to working legally and ethically.
You probably have heard some good stories from other workers about their
clients. It might be something funny or something that was really silly - however
you all have a good laugh! Just think about it. How would you like your service
provider talking about you to their colleagues? There may be some facts that are
distorted that make an innocent situation seem quite different. It is not a
pleasant thought is it?
Confidentiality is the protection of
personal information. Confidentiality means keeping a clients information

between you and the client, and not telling others including co-workers, friends,
family, etc.
Examples of maintaining confidentiality include:
individual files are locked and secured

support workers do not tell other people what is in a clients file unless
they have permission from the client
information about clients is not told to people who do not need to
know
clients medical details are not discussed without their consent
adult clients have the right to keep any information about themselves
confidential, which includes that information being kept from family
and friends
The types of information that is considered confidential can include:

name, date of birth, age, sex and address
current contact details of family, guardian etc.
bank details
medical history or records
personal care issues
service records and file progress notes
individual personal plans
assessments or reports
guardianship orders
incoming or outgoing personal correspondence
Other information relating to ethnic or racial origin, political opinions, religious or

philosophical beliefs, health or sexual lifestyle should also be considered
confidential. Adult clients have the right to determine what information they
consider personal and confidential.

There is, however, no such thing as absolute confidentiality in the community
services industry. Workers are required to keep notes on all interactions with
clients and often to keep statistics about who is seen and what issues are
addressed. As a worker, there will be times when you could be faced with some
personal difficulties regarding confidentiality. You need to give your client an
assurance that what is said will be in confidence (that it will stay secret between
you and the client) because, unless you are able to do that, the client is unlikely
to be open with you.
However, you also need to be aware of the limits to the confidentiality that you
are offering. There are several instances where total confidentiality is either
impossible, undesirable or illegal. These include:
cases where the law requires disclosure of information which will be

o if the health and/or welfare of a child or young person is at risk.
You are required to contact Department of Community Services
and notify them of your concerns
o if your client tells you he/she has committed a serious crime.
You are required to notify your supervisor or the police directly
o if a worker is subpoenaed to present information in a court of
law
when the client needs to be protected from harming themself (e.g. if
suicidal)
where others may need to be protected (if the client has threatened
to harm others or will do so inadvertently)
the need to keep records
when working in conjunction with other professionals in caring for a
client
the requirements of professional supervision, training, workshops or
seminars
It is always good practice to tell clients at the beginning of your contact with
them that whatever they tell you is confidential except in the above
circumstances. When writing up case notes you need to be careful about what
you include and how you write this information up. Always remember that clients
have the right to see files and read anything that has been written about them.
When working with other professionals it is good practice to obtain the written
consent of the client before exchanging information.

If you are going to be discussing a client and their situation in supervision, in a
training session or at a workshop, you can always change the name and any
information that may identify the client. Other workers in these situations are
also bound by the same ethical and legal requirements relating to confidentiality
that you are.
Confidentiality also extends to things like:
names and addresses of clients

phone numbers and addresses of staff and volunteers
names and personal details of people who donate money or time
details of funding agreements
information about strategic planning
Importance of confidentiality
Confidentiality is important for several reasons. One of the most important

elements of confidentiality is that it helps to build and develop trust. It potentially
allows for the free flow of information between the client and worker and
acknowledges that a clients personal life and all the issues and problems that
they have belong to them.
One of the major purposes for obtaining a clients consent before speaking to a
third party (such as another agency or a family member/carer) is to protect the
confidentiality and privacy of the client. Informed consent (obtaining personal
information with the formal permission of the client or a person who has the legal
authority to provide permission on behalf of the client) is considered essential in
maintaining the privacy of the client.
It is important to keep your clients business as just that; their business. You
should only discuss matters relating to your clients business with co-workers,
and then only what needs to be discussed.
Discussions should take place in the workplace and not be audible to other
members of staff or the general public. You should never discuss clients business
with family or friends.

Respect for client confidentiality and staff personal information should be a high
priority for all community services to comply with legislation that governs
disclosure of information. In this regard all organisations have policies and
procedures that provide guidelines for workers. Appropriate worker behaviour can
also be incorporated in a code of conduct.
To ensure confidentiality, workers should only access confidential information for

work that is covered by their job description and the policies and procedures of
the organisation. They should only disclose information to other parties where a
client (or co-worker in relation to their personal information) has consented to the
release of the information or where disclosure is required or mandated by
legislation due to indications of risk of harm. Further workers need to ensure that
any information that is collected is securely stored and disposed of.
Confidentiality agreement
All health services and or facilities take a very serious view of failure to observe
confidentiality as it constitutes a breach of the clients privacy. This places both
the service/facility and the individual concerned at risk of legal action and its
consequences and may constitute grounds for dismissal.
When you begin working in an organisation regardless of whether it is residential

or community based, you may be required to sign a confidentiality agreement.
This statement means that it is absolutely essential to treat any personal details
of medical, social or family history of a patient and any other information
pertaining to the aged care facility and its operation as strictly confidential.
Legislation governing confidentiality
All workers need to be aware that there are State and Federal laws that cover
confidentiality. The following Acts relate to privacy and confidentiality of clients:
Health Administration Act 1982
This Act covers any information that is provided or recorded within the health
system. Basically, information cannot be disclosed, without the consent of the

person to whom the information relates or for the purpose of legal proceedings,
such as a court order or subpoena that allows access to health information on a
client.
The Public Health Act 1999
This Act also relates to disclosure of information without consent. The most
important confidentiality provision of this Act is the part that deals specifically
with HIV/AIDS related information. Under this Act, this means two things:
the fact that a person has had or is going to have an antibody test
the fact that the person is HIV positive.
The Public Health Act allows for the disclosure of information relating to a
persons HIV status where the failure to provide the information could place the
health of the public at risk. This disclosure provision is limited and allows
notification to the Director-General of the Health Department. It does not
authorise disclosure to any other person.
Health Records and Information Privacy Act 2002
This Act is designed to protect the privacy of an individuals health information,

enable individuals to gain access to their health information and provide an
accessible framework for resolution of complaints regarding the handling of
health information.
Privacy and Personal Information Protection Act 1998 (NSW)

This Act consists of internationally accepted privacy principles dealing separately
with collection, storage, use and disclosure of personal information. One of the
key principles relates to accessibility of information, stipulating that agencies
must allow access to a clients personal information without reasonable delay and
expense, when it is requested.
Personal information includes information kept on the records of the clients,

personal details shared with you by the client and/or others, or medical
information if the client has been referred to your service by a doctor. There are
numerous sources of possible private information including written
communication coming from other agencies.
Crimes Act 1900 (NSW)
There is an obligation for people who have information about serious criminal
offences to notify the police. A serious criminal offence is an offence that attracts
a penalty of five years imprisonment or more. Support workers should be aware
that this covers offences such as drug trafficking, serious assaults, sexual
assaults, murder and manslaughter. It does not include minor possession
offences or any offences under public health legislation.
Exceptions to the general rule of confidentiality
There are few exceptions to the general rule of confidentiality, and they all have
legal bases. These include:
if the client tells you they have committed a serious crime

if the client is a child and is being abused or is at risk of abuse

if you are concerned that the client might harm themself or someone
else
if a child is under the age of 16 years, and especially under the age of
14, parents legally have the right to know what happens in
counselling.
making records available to the police if they have a warrant to
inspect documents
making information available in the case of suspected or confirmed
physical or sexual abuse
responding to a summons or subpoena
responding to a request under freedom of information legislation

In the case where legal obligations override a clients right to keep information
private and confidential, a community service organisation has the responsibility
to inform the client and explain in a way that they can understand, the limits of
confidentiality. Information may also be sought through a subpoena for court
proceedings.
Breaches of confidentiality
All community service organisations have a responsibility to keep client or

service-user information private and confidential. In some circumstances, clients
can take legal action against a worker or an organisation under the law of
negligence. We owe a duty of care to our clients to prevent any risk of harm.
If a worker breaks client confidentiality they are seen to have breached (If
something is breached it has been violated or broken) the policies of the
organisation and, as a result, he or she may be dismissed from their position
that is, sacked! This may also open the worker to legal action from a client.
If you, as a worker, notice that another worker seems to be breaching client

confidentiality you should:
1. See if they have the clients permission to share the information (you
can either ask the worker or check in the clients file).
2. Check to see what the service providers policy is regarding breaches
of confidentiality and follow the procedures outlined.
3. If there isnt a policy, and if you feel comfortable enough, approach
the worker and express your concern.
4. Talk with your supervisor and tell them what you have observed or
overheard and express your concerns.
5. Ask that all staff receive training in confidentiality, why it is important
and how to maintain it.
Confidentiality and duty of care
Confidentiality applies to all information that a client or colleague tells you

verbally or gives you in writing. It also applies to things that you learn through
observation. All information in a persons health care record is confidential and
may not be disclosed without permission from the client or their guardian.

Confidentiality is a critical aspect of your duty of care.
Remember that all clients have the same rights as everyone else in the
community, regardless of whether they have a drug and alcohol problem, a
mental illness, or a physical or intellectual disability. Their confidentiality must be
respected. This includes difficult clients and clients with dementia. Unless you
believe a client is at risk of serious harm, dont share the clients personal
information with others. Respect their right to privacy. Only the client has the
right to decide who to share their personal information with.
Every service organisation should have a confidentiality policy. This policy will
usually include an agreement, signed by workers and volunteers to uphold client
confidentiality, and an authority, signed by the client, allowing you to discuss
their personal information with specified others, but only in order to provide an
effective service.
Community Services need to have a range of policies and procedure in place to

ensure that workers comply with legislation and maintain a duty of care to not
place clients at risk of harm. These may include:
Recruitment policies that include police checks

Induction training of new workers and ongoing training of existing
workers that includes policies and procedures on confidentiality,
privacy and record keep
Policies on secure access of stored information, record collection and
disposal
Policies on how to deal with breaches
Confidentiality and privacy
What is the difference between confidentiality and privacy? Privacy is more often
taken to mean the right to be left alone. The term privacy usually attaches to
individuals. Confidentiality is a much broader concept. Information may be
confidential that is not personal.
Legally, organisations do not have privacy rights individuals do. In community

services personal information may become subject to confidentiality procedures
and policies but that will not affect the rights of the individual who is the owner of
that information. Information about an individual may be given to others for

legitimate purposes under ethical standards of confidentiality. Privacy is an
obligation to the individual who is the owner of the information and applies
regardless of who is providing the information.
Privacy principles
The NSW Privacy Committee Data Protection Principles outline the privacy
principles that all NSW community services organisations must follow. These
guidelines are to protect client rights and ensure that only essential information
about the client is collected.
1. Collect information directly from the client, except if:

a. the client agrees otherwise
b. the other information source also follows these principles.
2. Make sure the client knows whether it is compulsory or optional to
give the information.
3. Make sure the client knows the purpose for collecting the information.
4. Make sure the client knows who you usually pass information on to
(and who they usually pass it on to).
5. Make sure the client can look at and correct their information (unless
the law stops this), and the client knows this right.
6. Make sure the information is actually needed for your purpose.
7. Limit your use of the information to:
a. the purpose you collected it for
b. other purposes with the clients consent
c. preventing harm to the client or someone else
8. Make sure the information is accurate, up-to-date and complete.
9. Make sure the information is protected from unauthorised access.
10.Make sure the information is kept for no longer than necessary for the
purpose it was collected for.
11.Make sure that the information is only used or disclosed with the
freely given, clear written consent of the client if the information
concerns their:
a. ethnic or racial origin
b. political opinions
c. religious or philosophical beliefs
d. trade union membership
e. health and sexual life
Confidentiality and security
There is no such thing as absolute confidentiality in our industryespecially

when it comes to recording information about client contact or observations
about clients. We are required to keep notes of our interactions with clients and
often to keep statistics about who we see and what issues are addressed.
There may be people authorised in your organisation, or working in other

services that are authorised to see information about clients. As well, it is every
clients right to see the information recorded about them if they wish to do so. It
is not, however, any clients right to see information recorded about another
person.
Confidentiality also extends to things like names and addresses of clients,

consumers or residents, telephone numbers and addresses of staff and
volunteers, names and personal details of people who donate money or time,
details of funding agreements, and information about the organisations strategic
planning. Therefore, workers must not disclose any information about other
workers or people involved in the agency to anyone.
It follows that it is essential that all information and documents that are
confidential are kept secure. Upholding confidentiality and security involves
keeping information and documents in a place that cant be easily accessed by
non-authorised people.
Storage of records
All community service organisations need to ensure that all records are correctly
stored in line with legal requirements. Record storage must be secured in a place
where there is no possibility that they could be damaged. The storage system
must be easily accessed by authorised workers.
Secure spaces are:
rooms that are locked

filing cabinets that are locked
drawers that are locked
passwords on computers
Store case notes, case management plans and files in filing cabinets and
remember to lock filing cabinets when leaving the office. Ways of maintaining
confidentiality are to:
talk about clients in a private and soundproof place

not use clients names
only talk about clients to relevant people
keep communication books in a drawer or on a desk away from
visitors to the agency

keep staff files in a locked cabinet in the managers or coordinators
office
use case numbers when recording information about clients on a
database
remove identifying information when discussing cases for teaching
purposes
Destruction of records
Most records are kept for as long as they are in use by the organisation or for the
length of time that the client receives a service. In some cases legislation
requires the archiving of client files for 7 years and each organisation needs to be
familiar with the legislation as it applies to their service and client group. Any
confidential information must be shredded before it is sent for recycling.

ACTIVITY True or False

Statement TRUE FALSE
Confidentiality means not leaving your observation notes lying

around
If the police ask you, you must show them any records you
have?
You can store records in the drawer of your desk if the room is
locked at night.
Without privacy life could be hell
Family members have an automatic right to see the clients
records.
Privacy is different to confidentiality
In some cases legislation requires the archiving of client files for
7 years
Confidentiality is a critical aspect of your duty of care.
Respect for client confidentiality and staff personal information

should be a low priority
I discussed one of my clients condition with my husband last

night, I didnt mention their name so that is not a breach of
confidentiality?
Privacy can simply be defined as the right to be left alone.
The wrongful intrusion by individuals or the government into

private affairs with which the public has no concern could be
classed as a breach of privacy.
Under the privacy Acts, it is illegal for any of the information on

record to be disclosed even through an overheard conversation.
You are concerned that one of the newer members of your

workgroup who is a personal friend is openly discussing the
mental health records of the clients in a residential facility. This
is a breach of confidentiality.

Duty of Care and Ethical Conduct
We have a duty of care to our clients, and this duty is bound in legislation.
Ethical conduct is closely associated with duty of care and we want to do the
right thing by our clients and minimise any harms associated with doing or not
doing an act. The study of ethics was developed many years ago and attempts
were made to determine what is morally right and wrong and this was
translated into some rules to guide citizens behaviours in their communities.
From the perspective of a disability support worker, working ethically is based on
a clarification of what is good and bad practice. The aim is not to restrict you in
what you want to do, but to protect both you and the client from harms that
may result from your actions or inactions. Your organisation will have a code of
ethics that recognises and makes explicit the moral responsibility and
accountability of support workers.
In terms of duty of care, it is based on both the following:

the principle of doing good for clients by improving the quality of their lives
and helping in their self-determination
avoiding bad practice, which may lead to harm and injury to a client and
may further lead to a tort of negligence
The principle of duty of care will sometimes lead to an organisation adopting a

code of ethics as a guide to the professional behaviour it requires of its
employees. The code of ethics, comprising the standards of personal and
professional behaviour, is reflected by the mission statement, which sets out the
aspirations of the organisation in terms of meeting the needs of clients.
Organisations involved in devising a code of ethics include:

professional bodies
residential accommodation facilities-e.g. group home and independent
living accommodation venues
educational and training organisations - e.g. TAFE and community
education centres
foundations, charitable and religious organisations involved in disability
services e.g. Anglicare, Salvation Army
An examination of codes of ethical practice in all these organisations is useful in

deciding what would be included as ethical practice for your role as a disability

worker. The following aspects of working ethically should be included in forming
ethical principles and practices:
protecting the rights of the client
using effective problem-solving techniques with competing value systems
delivering service to clients regardless of personal values, beliefs and
attitudes
recognising and responding to potential ethical issues and dilemmas
working within boundaries applicable to your work role
demonstrating effective application of guidelines and legal application of
disclosure and
confidentiality
demonstrating awareness of your own personal values and attitudes
recognising, avoiding and/or addressing any conflict of interest
recognising and responding to the rights and interests of clients
recognising witnessed signs of financial, physical, emotional or sexual
abuse and neglect
of the client
recognising and responding to cultural/linguistic and religious diversity .
Source: The Disability Support worker. G
Arnott.
The law, ethics and morals are most important in your role. Ethics is concerned
with human character and conduct. It provides a system for morals and rules of
behaviour. Ethics identifies areas of desired behaviourthat is, the actions we
wish people to take, not the actions that are governed by law.
An ethical dilemma is a choice that must be made to reach a solution to a difficult

problem where there is no clear right or best answer. Ethical dilemmas that
could arise in your workplace could include issues such as mental competency,
confidentiality, the right to refuse healthcare, risk and death.
One of the most basic rules of healthcare ethics is that life is precious. It is not
always easy to keep this in mind, especially when a client is dying and or in pain.
Adherence to the ethical code ensures privacy, confidentiality and a respect for
personal and religious beliefs.
Review the latest nursing code of ethics at www.anmc.org.au

ACTIVITY Place a tick in the correct box, either yes or no.
Is this action ethical? YES NO
You call in sick to your supervisor because its a beautiful day

and you decide to go to the beach, or shopping, or
You work in a restaurant in which wait staff tips are shared

equally and you withhold a portion of your tips from the
common pot before the tips are divided.
You take office supplies from work to use at home because you
justify, you often engage in company work at home, or you
worked extra hours this week, and so on
Being honest with yourself and others about what you can do.
Show up on time or early, don't exceed break times, help

others when you can, don't take credit for other people's work,
give credit to others when you can.
You claim credit for the work of another employee, or you fail
to give public credit to a co-workers contribution, when you
share results, make a presentation, turn in a report or in any
other way appear to be the sole owner of a work product or
results.
Always have the best interests of the client in mind.
You overhear a piece of juicy gossip about another employee

and then repeat it to other co-workers. Whether the gossip is
true or false is not the issue.
Be loyal to your company, your boss and your coworkers, be

cheerful, don't cheat or steal, don't lie; leave your personal life
at home.
Some staff members treat women staff as sex objects and

making inappropriate remarks to them or touching them in a
sexual manner.
Always be professional and dress accordingly
As a support worker, you are expected to work to a certain

standard. You need to be able to do your job properly, behave
properly, and do the right thing at all times.
Many times people refuse to work well with others who are of
a different ethnic background or different sex.

FURTHER INFORMATION CAN BE FOUND AT:
Vision Australia http://www.visionaustralia.org/
The Royal Society for the Blind South Australia http://rsb.org.au/
Queensland Blind Association Inc. http://www.qba.asn.au/
Royal Blind Society of NSW http://www.rsb.org.au/
DeafBlind Association NSW. http://www.dbansw.org.au/
Canberra Blind Society Inc. http://users.tpg.com.au/canblind/
Australian DeafBlind Council http://deafblind.org.au/
Association of Blind Citizens of NSW Inc. http://www.asnblind-nsw.org.au/
Blind Welfare Association of South Australia. http://blindwelfare.org.au/
Blind Citizens Australia http://www.bca.org.au/
Royal Institute for Deaf and Blind Children http://www.ridbc.org.au/
Association for the Blind WA. http://www.health.wa.gov.au/services
Royal Victorian Institute for the Blind
http://www.vic.australis.com.au/pottaroo/blind.htm
NSW legislation is available at: http://www.legislation.nsw.gov.au/
Commonwealth legislation is available at: http://www.comlaw.gov.au/
Lawlink NSW: http://www.lawlink.nsw.gov.au/lawlink/privacynsw

Section 4: Choice and client-
directed care: The way forward...
The client knows themselves better than anybody else and we just have
to respect that .... Give me credit for having intelligence to make my own
decisions/mistakes .... (Client with disability)
Disability Care will give people with disability a right to realise their potential, and
to make choices and be in control of the decisions that affect their lives. It will
enable them to:
Have more choice and control over the type of support they receive
Have the right information and support to make decisions and take control
Have opportunities to be more independent and get the right type of
supports that allow them to reach their full potential
Be helped to stay connected to their communities of support, their
families, carers and friendship groups
Key words and concepts in this disability care environment are choice, control
and independence. This means also dealing with risk and client choice and
understanding the concept Dignity of Risk.

Why have a new disability care environment?
Choice: What does this mean?
Client-directed care: How does this work in the disability care
environment
Funding arrangements
Communication with clients and service providers in the CDC
environment
Comprehensive, holistic assessments in the CDC environment
Collaboration with other stakeholders
Client decision-making in the CDC environment
The support worker as advocate for client choice and client-directed
care
Challenges to client-directed care
Dignity of risk
Defining boundaries
Duty of care
Advocacy
Indicators of abuse or risk of harm
Workplace health and safety

Why have a new Disability Care environment?
The disability system, prior to the establishment of the Disability Care scheme
was reported by the Productivity Commission to be underfunded, unfair,
fragmented and inefficient. They recommended the establishment of a National
Disability Insurance Scheme (NDIS) or Disability Care as we now call it. The
Disability Care environment aims to achieve the following outcomes for eligible
people with disability:
People with disability will be supported to participate in and contribute to
social and economic life to the extent of their abilities.
People with disability and their carers will have certainty that people with
disability will receive the individualised care and support they need over
their lifetime.
People with disability will be able to exercise more choice and control in
their lives, through a person-centred, self-directed approach to service
delivery with individualised funding.
People with disability, their families and carers, service providers, the
public and governments will have greater transparency and certainty of
funding for disability care and support.
Disability care and support will be more accessible, meet nationally
consistent standards, sustainably resourced and will contribute to
governments commitments to closing the gap on Indigenous
disadvantage.
This will enable those with disabilities and their families to plan better for their
futures and realise their potential through greater choice and empowerment.
With the right type of support, people with disability are able to lead full and
independent lives go to school, gain employment, participate fully in their
communities, and live with friends, families or in their own homes. This means
that people with disability will have more opportunities to live the way they want
to and in the most independent way possible.
There are many terms used to describe the way that we want disability service
and support systems to operate so that a person living with disability has greater
control, such as 'individualised funding', 'self-managed care', 'direct payments'
and 'individualised budgets'. The key theme, or concept is the same that the
person living with disability is supported to be in control of their support services
and funding.
When support arrangements are intentionally developed around the

unique identity and needs of a person, it is much more likely that they will
get more of what they need and their needs will be better met.
Michael
Kendrick

Choice: What does this mean?
We often forget how important it is to have choice in our lives. There is something
powerful in the experience of choosing and taking responsibility for our own life.
It gives us direction over the way in which we live and the way in which we
interact with others. It gives us a sense of control and ensures that we have a
personal sanctuary.
Choice consists of the deciding or selecting between options. This generally

empowers individuals to make their own decisions. Most people regard having
choices as a good thing, though a severely limited or artificially restricted choice
can lead to discomfort with choosing and possibly, an unsatisfactory outcome. In
contrast, a choice with excessively numerous options may lead to confusion,
regret of the alternatives not taken, and indifference in an unstructured
existence.
However, choice should be informed choice. In other words, the person choosing
should have information about the different possible choices, so they can base
their decision on facts. Also, sometimes having a variety of options can seem
overwhelming and people will often go with what they know, rather than
something new and different, unless they understand this new and different
option.
We want to support the client making their own choice, but ensure they have
adequate information on which to base their choice.
ACTIVITY
You are a support worker working with Kevin who has an acquired brain injury.
Kevin has difficulty making decisions or initiating activities. You have three hours
each week for an activity for Kevin. You are aware he enjoys being outdoors and
science fiction. Give three examples of outdoor activities and two examples of
science fiction activities.

Client-directed care: How does this work in the Disability Care
environment?
Client-directed care allows people to have greater control over their own lives by
allowing them, to the extent that they are capable and wish so to do, to make
choices about the types of care services they access and the delivery of those
services, including who will deliver the services and when. Evaluations of existing
consumer directed care programs show this approach can lead to better
outcomes for care recipients in respect to their quality of life, independence and
satisfaction with care. Client-directed care allows community care clients to
actively choose the types of services they receive, and direct how, when and by
whom they are delivered.
People of all ages with disabilities and their carers, including dementia families,
generally benefit from participation in client-directed care. International studies
of these programs across a number of different countries with varying cultural
traditions and programs show that:
Program participants of all ages and their family carers have better
outcomes related to quality of life, independence, and satisfaction with
care than those who rely on home care agencies.
Quality of care is at least as good in client-directed care programs as it is in
traditional programs.
There is no systematic evidence of abuse or neglect of participants in
client-directed care programs.
Client-directed client also can enhance the quality of life for participants and their
family carers, who feel that they have more control over how things are done.
These benefits are accompanied by increased responsibilities, which may include
choosing services and managing, training, and paying workers, and assuring the
quality of services received.

Case Study
The example of Mrs. Bennett, a 58-year-old widow who lives with her daughter
illustrates how CDC can be helpful to dementia families. Mrs. Bennett has early
onset dementia, high blood pressure, and needs help with three daily activities
and walking. Mary, her daughter, is Mrs. Bennetts representative. Previously,
Mrs. Bennett received care from Mary and a home care agency. The agencys
hours were such that workers came at 8:00 am, even though Mrs. Bennett does
not get out of bed until 10:00 am and workers often changed daily and
sometimes did not even show up for work. With client-directed care, Mary was
able to hire one worker Sylviawho receives higher hourly pay and a more
convenient schedule than she had while working in an agency. Since Sylvia is
reliable and her schedule convenient Mary has been able to resume her in-home
accounting business. The relationship between Mrs. Bennett and Sylvia is a good
one and Mrs. Bennetts family appreciates Sylvias good work.
Client-directed care means the interventions, training, and skills by which clients
with a chronic condition, disability, or disease can effectively take care of
themselves and or learn how to do so.
Client-directed care helps people with physical disabilities to increase control
over their lives by helping them develop their own care plans and directly
arrange and administer their own support service needs. Funds will be provided
to eligible individuals so that they may directly employ care providers for the
purpose of meeting their approved service needs.
The self- manager (client) assumes full responsibility for the coordination and
management of the funded services. Self-directed funding is also known by a
range of terms, including 'individualised funding', 'self-managed care', 'direct
payments' and 'individualised budgets'. The key theme, or concept is the same
that the person living with disability is supported to be in control of their own
funding and the support it can create.
The term client-directed services describes a broad approach to developing

supports based on people having control over the planning and delivery of
services. This contrasts with the traditional service delivery model which fits
people into the services on offer.
Self-direction is about people being at the centre of determining what they need
and how services should work for them. It re-casts service users from passive
consumers or clients into active directors of their support arrangements.
Principles of Client-directed Care

Collaborative and active partnership between client and service provider

Shared responsibility for outcomes
Empowerment and enhanced capacity as goals of care
Care is lifelong
Lets take a look at the difference between the traditional care format and self-
directed support.
COLLABORATIVE AND ACTIVE PARTNERSHIP BETWEEN

CLIENT AND SERVICE PROVIDER
Expertise is shared between client
Service provider is expert and the
(expert on their life) and provider
client basically has little say.
(expert on needs and care).
CLIENT-CENTERED CARE
Care is disease and/or service Care is planned around the clients
centered and often standardised individualised circumstances, needs
or generic. and preference.
SHARED RESPONSIBILITY FOR OUTCOMES

A single service provider is the Responsibility for outcomes is shared
principle caregiver and therefore between the client and often multiple
responsible for outcomes. service providers.
EMPOWERMENT AND ENHANCED CAPACITY AS GOALS OF
CARE
The goal is compliance with
The goal is to empower the client and
funded packages and the
enhance their capacity to engage in
implementation of care along
activities that will improve their health
with the provision of information
and care.
and advice.
CARE IS LIFELONG
Immediate needs are addressed Long-term change and impacts are
and care is a one-time assessed addressed and care is a continual and
activity. self-corrective process.
There is no one size that fits all. Services need to be shaped to respond to each
person and communitys needs and aspirations.
Achieving client-directed care

As a concept, a self-managed approach places the individual at the centre of
decision making and treats family members as partners. The process focuses on
discovering the persons skills and capacities, and identifying the priorities of the
person in terms of their hopes, goals and lifestyle choices. The individual and
their family are then able to design the supports that will meet their own needs
and goals, rather than being limited to choosing only from a predetermined list of
service options.

What does it mean in practice?
A client-directed approach aims to give people with disability and their family (or
support network):
control over the what, when, where and by whom of support
assistance to plan, implement and change the nature of supports provided
by another person. The person providing the support remains accountable
to the person with disability
the option to delegate financial, legal and administrative responsibilities to
an intermediary service
the ability to build their knowledge and skills to direct their own support
Why is client choice and client-directed care important?

Research has found that people who manage their own supports are more
satisfied with their outcomes. They feel more in control of their lives and able to
change their supports when they want. According to one recent study: All
respondents said that individual funding had improved their control, choice,
independence and self-determination in their lives.
The main benefit is that by focusing on the person with disability, a self-directed
approach can deliver more flexible and appropriately targeted supports that
make a difference in the lives of people with disability and their families. At the
same time, it can lead to better utilisation and effectiveness of limited resources.
Funding arrangements
Who will make the decisions about a persons funding?
The freedom to make decisions about things which affect our lives is a right that
everyone should enjoy.
The person requiring the support will make the decisions about how they will use
their self-managed funding to meet their support needs and goals. For some
participants a guardian or carer may do this on their behalf. Some people may
want or need some support to make decisions and plan their support
arrangements.
A range of people will be able to help with decision making and planning,
including:
Parents and other family members
Carers
Friends and Circles of support
Guardians
Service providers
Facilitators will work with participants and their support network to develop a
personal plan which details how the funding will be used.

How will the funding be administered?
Some people will want to manage their self-managed funding independently.
Some people may need support to put in place their personal plan and manage
their support and funding arrangements. For this reason different mechanisms for
administering a persons self-managed funding will be made available.
These include direct payments to:

A person with a disability to enable them to arrange and purchase the
services they require.
A recognised carer or a legally nominated or recognised guardian,
administrator or attorney of a person with a disability. This person will act
on behalf of a person with a disability with respect to arranging and
purchasing services.
An organisation which will support a person with a disability to manage the
financial arrangements associated with self-managed funding.
An organisation which will support the person to put in place their personal
plan. This includes arranging services and managing the funds.
What can be purchased with self-managed funding?

Self-managed funding is provided to meet the disability support needs of a
person with a disability. Funds may be used to purchase services or items that
address these needs and assist with a persons goals, such as living
independently, improving skills or participating in the community. The person will
be encouraged to use their funding in innovative ways to meet their unique
needs and goals.
The funding cannot be used for anything that is against the

law or for gambling.
We have looked at details of self-managed support, now lets take a look at the
planning and decision making process.
How do we achieve this?

communicate and engage effectively with clients and service providers
conduct comprehensive, holistic assessments
plan and provide care collaboratively
support and empower clients
deliver care using a variety of approaches
possess care knowledge

use decision supports, information and communication management
systems effectively
identify and respond to clinical risks
engage in continuous quality improvement activities
Communicate and engage effectively with clients and service providers

Whether the clients with disability are doing the planning by themselves, with the
help of supporters or with a facilitator, there are a number of things to think
about. These begin with:
What are the goals?

How can the goals be achieved?
If the client is using a facilitator or disability service provider to help with

planning, they will be able to help the client work out what their current goals are
and tell them about the services in the area which will help them meet those
goals. The Local Area Coordinator or chosen facilitator may also advise the client
to talk to their family or friends and work out who will do what.
The following are a few key issues that the Local Area Coordinator or disability
service provider may say to the client with disability and/or advocate in regards
to comprehensive, holistic assessments.
Conduct Comprehensive, Holistic Assessments
What supports did you need?

Do you still need the same supports?
Has something changed in your life that means you might need different
supports?
What services do you need?

Do you know what is available or suitable for your needs?
Do you have some ideas, but want to talk them over with the facilitator or
disability service provider?
Are there people in your life that could provide some support without
charge?
Collaborating: Clients & service providers.......... to define problems, set

goals, actions, support and empower clients

Who will provide the services?
Do you know any service providers that you want to use?
Are there any service providers that have been recommended to you?
Are there any service providers you dont want to use?
What funding administration arrangement will be used?

What funding administration arrangement best fits the level of control and
responsibility you want for your supports?
What arrangement is the most efficient way of managing the package of
supports you have selected?
How will your plan work?
Who will make contact with the suppliers or service provider(s) to start the
service delivery?
Who will make sure the support happens when and how you want it to?
Who will follow up if something goes wrong?
How will payment for services happen?
How will the funding be monitored and accounted for?

Who is going to receive reports on how much funding has been spent on
your behalf or how much is left?
What will happen if you want your plan of supports reviewed?

Who do you need to ask?
Who will ask?
Deliver Care Using a Variety of Approaches
Registered disability service providers

Some organisations that provide disability services are registered by the
department under the Disability Act. To be registered, the service provider has to
show the department that they can provide a service for persons with a disability
and meet the requirements of the Disability Act.
The Disability Act says that registered service providers have to:
give people information about their services, including the cost have a
complaints process
meet the Standards for Disability Services in the relevant state
The Disability Act also enables people to make a complaint about a registered
disability service provider to the Disability Services Commissioner.
Registered providers may also be required to:
conduct pre-employment safety screening (police checks and Working with
Children checks where appropriate), comply with financial accountability
requirements
have processes in place to meet the obligations of the Workplace Health
and Safety Act 2012. Have a WorkCover policy
comply with the departmental incident reporting procedures
have appropriate insurance
Providers of personal support not registered

There are providers of personal support that are not registered under the Act. You
can choose one of these organisations but you need to know that:

they do not need to comply with the Disability Act, such as meeting the
disability standards
you cannot make a complaint to the Disability Services Commissioner
about their services
they are not monitored by the department
Providers of generic community services

Generic community services may be the most appropriate provider of the
supports you need. Generic community services include supports that many
community members use, such as dental services, therapy and recreation. These
services are not covered by the Disability Act.
You may want to visit some disability service providers and talk about what they
do and how much they will charge, and then make a choice.
Further information on service providers can be found on the

following web sites: http://www.adhc.nsw.gov.au
http://www.disability.vic.gov.au
http://www.disability.wa.gov.au
http://sa.gov.au
http://www.qld.gov.au
Client decision-making in the client-directed care environment

Decision-making is the act of expressing choice and preference and being able to
act upon that choice. For people with a disability this particularly relates to being
able to choose the supports they need to enable them to lead a lifestyle of their
choice. The types of choices people have are not limitless. A persons individual
circumstances will influence the choices open to them. This includes factors such
as the following:
Lifestyle and Recreation: family and friendships, relationships and sexuality,

involvement in cultural and religious events, keeping fit, shopping, using the
internet, smoking/drinking, going to the pub / club / cinema, holidays and days
out
Employment and Education: choosing a field of work, applying for jobs,

attending tertiary education, changing jobs/courses
Living Arrangements: who to live with and where, type of accommodation,

leaving home, moving home, decorating or making changes
Access to Services: choosing service providers, choosing day services and

times to attend, choosing support workers
Healthcare and Medical: routine medical and dental, emergency care, speech
therapy, physiotherapy, hospital visits and surgery, right to refuse care

Financial: banking, buying everyday items, paying for expensive items, getting
a loan, paying bills
Legal: signing contracts, providing consent, giving power of attorney, getting

married/divorced, wills and estate management
People should be provided with the opportunities required to address these
factors including information and appropriate supports. Sometimes people may
need additional assistance to understand and communicate their choices. This
might include information in different formats, communication aids, translators or
longer timeframes. The methods that people need to both understand and
communicate their decisions do not affect their right to make decisions. People
have the right to any information or supports they need to help them make and
express their decisions.
Authority, control and power: Person centred thinking shifts the power from
professionals to the person and their family. No organisation owns the persons
life the person and their family does.
NSW Department of Ageing, Disability and Home Care
(DADHC)
HOW CAN WE ASSIST?

Service providers can:
ensure their workers have ready access to the legislation and relevant policy
documents
discuss the legislation and policy at team meetings
consider including this topic in work plans and performance management
programs
engage staff and service users in discussions around a human rights
approach within the organisation

Support workers can:
remind people with a disability (and their supporters) that they have a right
to make decisions
remind co-workers that people with a disability have a right to make
decisions
help to set up situations where people have real choices
help people to get information as required to help them make decisions
refer a person to experts if they require specific help or assistance
allow time for people to explore their thoughts and feelings
understand that its difficult to make decisions about some issues, and that
its normal not to have an answer straight away
encourage people to make up their own mind about what they think
take the time to ask people their opinions and not assume what they want
speak up and take action if required where people are being denied the right
to make decisions
help people to lodge a complaint if they are denied the right to make
decisions
knowledge of the range of services and treatments available
knowledge of the range of self-management support tools available to clients
knowledge of the range of support networks available to clients
knowledge of evidence-based guidelines for care
understand the roles of other members of the health care team
maintain carer professional development, implement knowledge into practice
Supporters can:
remind people that they have a right to make decisions, even if other people
say otherwise
actively encourage people to decide for themselves as often as possible
help to set up situations where people with a disability can make decisions
help people to get information that will help them make their decision
take the time to ask people their opinion and not assume what they might
want
provide people with opportunities to discuss choices in an informal way
Source:Department of Human Services Victoria
The support that a person needs to make a decision will vary depending on a
wide range of issues. The need for support may decrease over time as people
gain experience and/or confidence. It may increase as the type of decisions
become more important.
Its like a jigsaw puzzleputting all the pieces together.

CHAL
LENGES TO CLIENT DIRECTED CARE
As with everything new there will be teething problems, barriers and or issues
that will need to be addressed. Issues that may arise could be:
concern about managing direct payments from service users and support
workers
difficulties getting personal assistant staff
lack of demand from service users and carers
inadequate training for front line staff
measuring and maintaining standards
ongoing service viability
complexity of the system
dealing with crisis or unforeseen situations
the management of financial risk for service users
accountability for spending of funds
having self-directed care does not necessarily mean better supports
support worker to complete service administration tasks
need to view client-directed care as means to a better life not the final goal
Some of the most difficult barriers people with disabilities face are the
negative attitudes and perceptions of other people. However, the intent of
this approach is to develop a viable service that will enable real choice and
flexibility and to assist the realisation of peoples aspirations. One area
which has been highlighted by clients with disabilities and organisations
working in this area is getting the balance right between choice, risk and
duty of care. We will now explore these areas.
Dignity of Risk
Anyone who leads a life of dignity and meaning takes risks. Each of us, in the
pursuit of jobs, our personal and romantic relationships, our leisure activities, and
our adventure has stepped into the unknown and risked failure, rejection, and
even our physical well-being. Anything any of us have ever accomplished has
come from some level of risk-taking. The benefits of succeeding in these
situations, or from learning from our mistakes are a crucial element in our
development as independent people.

People who work and live with individuals with disabilities, usually with the best
of intentions, often try to eliminate all of the risks and prevent any opportunities
for failure in these individuals' lives. What can result is a life where an individual
has never been tested, never had the opportunity to grow, and never
experienced the satisfaction of achieving something that was not certain to be
achieved from the beginning.
Allowing individuals to take risks and step into the unknown is part and parcel
with treating them as dignified adults. This is not equivalent to encouraging
recklessness; allowing risk does not mean being unsafe or setting people up to
fail. Providing them with the opportunity to try new things, test their limits, and
discover capabilities they never knew they had will help them to achieve goals
that enrich their lives.
Dignity of risk is the moving away from a safe place, in order to

fully experience the self-respect and self-esteem of being human.
Social Care Institute for Excellence
RISK
A dictionary definition is: Risk - the possibility of suffering harm or loss; danger.
Or to look at it
another way harm is only one possible outcome, which means there may be
beneficial outcomes too.
Risk can be a good thing. Some people worry about taking risks because bad
things can happen.
Vulnerable people who need support services are often perceived as being more
likely to experience harm or be in a dangerous situation (for themselves, or for
others). For example:
risks associated with impairment or disability such as falls accidents
risks associated with everyday activities that might be increased by a

persons impairment
or disability
risks of a carer being overwhelmed
the use of medication
the misuse of drugs or alcohol

behaviours resulting in injury, neglect, abuse, and exploitation by self or
others
suicide or self-harm
aggression and violence
People who care about a vulnerable person want them to be safe. This can
sometimes cause families, friends and support staff to be over-protective and
form a negative perception about the risks of independence, choice and control.
A Positive Approach to Risks

Most people make choices that involve some level of risk assessment and risk
management every day. Choice about whether to take a risk is usually based on
our own judgement. Most people learn how to balance those risks, by recognising
the dangers that may be involved, and by trying to be prepared for them where
we can. There are usually some things that can be done to manage risks.
Most adults:
anticipate the possible consequence of an action and the likelihood of any
harm from it
identify what they need to do to minimise, avoid or prevent the risk
balance this against the possible benefits of taking the risk
make a judgement about whether to accept the risk (with or without
minimising it)
Positive risk-taking means:
making choices about what people would like to do in their lives
identifying the risks involved
developing plans and actions that will both enable the choice and include
ways to minimise, avoid or prevent harm (safeguards)
When supporting people with a disability we need to make sure that everyone
thinks realistically and positively about how to manage risk when assessing care
needs, and to enable positive risk management wherever possible.
What is Risk Management?

Risk management is the way in which adverse effects from risk are managed and
potential opportunities are realised. The potential cascade effect of a failure to
address a safety issue may affect the level or type of risk experienced in all areas
of the organisation. It is essential that all your risk management processes and

systems complement one another, fit within your organisations culture and work
in synergy towards the same goals.
That may involve a combination of preventative, responsive and supportive

actions to reduce the potential negative consequences of risk, and to promote
the potential benefits of taking appropriate risks. Sometimes these might require
temporary or longer term limitations where the risk of harm may have suddenly
increased or become so serious that protective safeguards are needed.
Risk management means making sure a duty of care has been considered and
applied where risks
(positive and negative) are identified.
What is Reasonable Risk?

Reasonable risk is about the balance between empowering people to make
informed choices about
services that will meet their specific needs, and ensuring that there are also
safeguards to prevent
harm, abuse or neglect.
Some people may not fully understand or be aware of the risks in their
lives. People who
care about them (carers and for vulnerable people also paid care workers
and other
health and social care staff) need to work together to overcome this.
Some people may make informed but risky choices and they have the right
to do that. But
this might be an unacceptable risk for others. People who care about them
(carers and
for vulnerable people also paid care workers and other health and social
care staff) need
to work together to ensure the consequences are fully understood and
risks are minimized
to be reasonable.
There may be circumstances where the risk of harm is too great. We have a
responsibility to ensure that vulnerable people are safeguarded so, after
exploring all possible ways of reducing the risk, it may not always be possible to
support a choice.
Assessing and managing risks in a proportionate way

Risk is a common issue that arises around decision making for people with a
disability. People with a disability should be able to do things that have a level of
risk involved. This is sometimes referred to as dignity of risk. It assumes that a
person has explored and understands the pros and cons of a decision or
experience, including possibility of personal loss or injury, and still wants to go
ahead.
It is important to remember that risk can be an experience in itself. Exploring,

understanding and finding ways to address risk can be challenging but also
highly rewarding.
Approaches to risk should be undertaken positively and in partnership with the

person and, where relevant, their supporters. This means working together to

understand the nature of potential risks, consider creative measures to minimise
any risks and determine the agreed action. Any measures taken should be
appropriate to the size of the risk and the activity. Your agencys risk
management framework offers a way to assess risk and develop strategies to
reduce the impact of any identified risk.
Workers and supporters need to be thoughtful about their own fears

and anxieties and whether they are in perspective.
DEFINING BOUNDARIES AND ESTABLISHING TRUST AND RESPECT

What is your role?
It is very important that you are clear about your role and the legal basis of your
organisations involvement with that client when you are working with a client.
For example, if you are working with a client and you are concerned about their
safety you will need to:
Identify the person in your office who has the authority to take action. (It
could be you or your supervisor.)
Ensure that the statutory agency is contacted through the correct
procedure to provide the necessary information for appropriate action to
be taken.
Having a clear understanding of what you can and cannot do enables you to
communicate this clearly to your client and significant others. It helps to avoid
misunderstandings, breakdowns in communication and unreal expectations being
placed on you and the client.
As a support worker, you are likely to be spending a lot of time with your clients
so you need to remember that, whilst you are part of the clients support
network, and probably a very important part, you are not there to be their best
friend.
To be effective in your work, you need to be clear about your role and boundaries
and be able to get this across to the client. The following considerations may be
useful.
Identify the information you need to know.
Only seek the information you need, not what you would like to know.
Be clear with them about why you need the information.
Be clear about the system you are part of. Let the client know what you
can and cannot offer.
Be aware of your own limitations as a person and a worker.
Establish ground rules about your working relationship with the client from
the outset, depending on the culture of your organisation.
Be aware of your own feelings about the client and how those feelings may
affect your working relationship with them.
Be consistent with ground rules and applying boundaries.
Many people have attempted to clarify this issue of boundaries through the
development of guidelines for workers and clients, such as:
contracts
codes of ethics

manuals of practice
Remember that, without information, clients will not know what they need to do
or how they can participate in any planning aimed at resolving their issues or at
supporting them so they can function effectively independently of service
providers.
They depend on you to provide them with this information, to empower them in
the process. It is very important that this information is presented to the client in
simple, clear language without jargon and in a manner that they feel comfortable
with.
DUTY OF CARE
CASE STUDY
You are a support worker working with Mary who has an ABI who loves buying
shoes. Unfortunately Mary spends all her disability pension on shoes and often
does not have enough money left for food or to pay the bills. As Marys support
worker, you are required to assist her to budget weekly to ensure she has enough
money for food and to pay her bills.
How might you work with Mary that still allows her choice, dignity of risk and
fulfilling your duty of care?
Many workers take on a caring role when supporting someone with a disability.
They bring to their work values that have developed in their own culture and
family. They are aware of their duty of care that is a significant legal
responsibility.
As previously mentioned in section one (1) a duty of care is a duty to take

reasonable care of a person. A disability support worker has a duty of care to
anyone who is reasonably likely to be
affected by their work activities. These are likely to include the person with a
disability that they are the support worker for, the families and carers of clients
other support workers and the general community when working within a
community environment. A duty of care is breached if a person behaves
unreasonably, fails to act (which can also be unreasonable in a particular
situation). A duty of care can be breached either by action or inaction.

Source: Department of Families, Housing, Community Services and Indigenous
Affairs
What is reasonable care?
Reasonable care is the standard of care that a reasonable service provider would
provide in that situation - not perfect, not poor. Reasonable care is care balanced
against other, sometimes competing, responsibilities, such as:
the safety of other people (other clients, workers, yourself etc.)
privacy and confidentiality
the needs of clients (e.g. recreation, socialisation, opportunities to develop

skills, self-responsibility and decision-making)
Each situation (and sometimes each client) is different. You must assess the
situation and act accordingly. In other words, use your eyes and ears, and your
brain!
Whose duty is it?
All people owe a duty of care in some situations. In work situations, it is mainly
the responsibility of the employer (the organisation). Employees are generally
protected by their employer as long as they follow policies and instructions.

Your duty of care is not an absolute duty to prevent all possible harm. It
is a balancing act: weighing up a range of issues before deciding what
level of precautions is reasonable in the circumstances
Advocate, Advocacy and Self-advocacy

An advocate is someone who acts on behalf of another person in the best interest
of that person. Advocacy means acting on behalf of another. Self-advocacy
means acting on behalf of oneself.
Some key elements are:
advocacy is on the side of the disadvantaged person/parties
advocacy focuses on the needs and rights of the person
advocacy is based on the principles of social justice and equity
advocacy is not service provision
advocacy should be free from conflict of interest
Advocates can be family members, friends, or an independent third party. The

important thing to remember is that the advocate must be free from conflict of
interest and have the best interests of the person at heart. Advocacy becomes
very messy and runs the risk of being ineffective or exploitative if the person
doing the advocacy has something to gain or lose from their actions.
Types of Advocacy
individual advocacy- representing another or speaking on behalf of
an individual
self-advocacy- speaking on your own behalf
group advocacy- representing a group or speaking on behalf of a
group
citizen advocacy- representing a friend or member of the family
without receiving any form of funding (voluntary)
parent advocacy- seeking on behalf of parents, generally to
government bodies, on issues related to the parents or primary
caregivers children
family advocacy- representing another member of the family, e.g.
child, sibling or parent
professional advocacy- any advocacy that involves representing
another in return for payment
case advocacy- advocacy related to specific issues. It can involve one
individual or several individuals who require advocacy for the same
issue or situation
public interest advocacy- representing the general interests of the
public; e.g. in government where they are making decisions that
favour the largest section of the population
Support workers as an advocate

Support workers have an important role to play in promoting and facilitating the
rights and interests of the people with a disability they support. To support and

guide staff in this role, service agencies need to provide clear guidelines to
ensure staff:
understand the responsibilities of their advocacy role

understand and are alert to potential conflicts of interest
recognise situations which might require the involvement of independent
advocacy
can identify relevant sources of independent advocacy for people they
support
support the involvement of independent advocates
One of the most important ways support workers perform this empowering role is
through the provision of information. The Disability Act 2006 requires that
information is provided to people with disabilities in ways that best assist them to
understand their rights and responsibilities. Support workers should ensure they
are familiar with the different communication requirements and the individual
needs of all clients, and provide appropriate forms of enabling information.
While this is a role that is typically performed by many support staff, it is also an
advocacy support role that in certain situations might give rise to accusations of
manipulation, undue influence or conflict of interest. Support workers assisting a
person with disability to assert his or her rights or
interests should recognise the risk of their own more powerful interests or values
being projected.
This is not to say that support workers should not stand beside people with a
disability, for the reality is that such assistance is often an essential part of their
general support role. Rather, it highlights the need for support workers to be
conscious of the potential for conflict of interest and the need to minimise such
risk.
Support workers therefore need to be constantly mindful of their own influence

and power, and avoid situations in which they might be perceived as having
undue influence or a possible conflict of interest. Support workers should also be
constantly mindful that the assistance and advice they provide, and the ways in
which they provide it, is aimed at supporting the person with disability to develop
and assert his or her own views and opinions, freely and independently.
Where there is a potential conflict of interest, disability support workers need to

adopt strategies for minimising that risk. For example, by ensuring important
issues are canvassed within the individual planning process, by involving others

in providing advice or assistance, by seeking guidance from supervisors, family
and or independent advocates.
Where a person with disability does not have the capacity to self-advocate, it is
generally accepted that parents or family members will provide informal
representation on their behalf. The Disability Act 2006 requires that the role and
contribution of family members be invited and respected at all times.
Where a person with disability does not have the capacity to self-advocate, and
where informal advocacy support arrangements are considered inadequate to
properly represent his or her rights and interests, the engagement or
appointment of an independent advocate might be necessary.
Where to find an advocate

Advocates can be located through regional and state advocacy organisations and
in some regional areas the local State Disability Office may have contact details
of appropriate advocates. Advocates can be voluntary or financed through State
and Commonwealth advocacy role.
If you are required to approach an advocate on behalf of a client always ensure

you seek permission if appropriate and ensure your clients privacy and right to
confidentiality.
Indicators of harm, neglect, abuse or risk of harm
CASE STUDY
A disabled woman who could not speak spent almost three days with broken legs
before she received appropriate treatment.
In another case, a paraplegic living in disability accommodation almost had to

have her leg amputated due to ''poor manual handling practices by staff.
Source: The Age- October 2012
All support workers are aware that their client group often contains marginalised
and disadvantaged adults and children. The duty of care and ethical guidelines
that govern most community and disability service positions highlight a
responsibility to be vigilant in ensuring this disempowered client group is not

abused or treated unfairly by others whether family, friends, co-workers, or the
system.
Seeking help for someone you know that is being abused or neglected is
a courageous decision. Lets start with some definitions: Abuse is the
violation of an individuals human or civil rights, through the act or actions of
another person or persons .
Types of abuse include:
physical abuse - such as punching, hitting, slapping, burning etc.

sexual abuse - forcing someone to take part in sexual activity
against their will
psychological or emotional abuse - threatening, harassing or
intimidating a person
constraints and restrictive practices - restraining or isolating
people other than for medical necessity or to prevent immediate
self-harm
financial abuse - the wrongful use of another person's assets or
denying a person the use of their own assets
legal or civil abuse
systemic abuse
Neglect is a failure to provide the necessary care, aid or guidance to dependent

adults or children by those responsible for their care.
Types of neglect include:

physical neglect - failure to provide adequate food, shelter,
clothing and protection. Supervision medical or dental care that
places people at undue risk through unsafe environments or
practices
passive neglect - withholding or failure to provide the necessities
of life
wilful deprivation - wilfully denying a person assistance and
thereby exposing that person to the risk of physical, mental or
emotional harm
emotional neglect - restricting the social, intellectual and
emotional growth or wellbeing of a person

Workers need to know what their responsibility is in any identified case of harm
or risk of harm. They should clarify their reporting requirements within their
organisation. Hence, when a client presents with an issue, you respond to the
presenting issue but must always be sensitive to any indicators that abuse or
neglect may be occurring in the clients life. This relates not only to physical
harm, but also to emotional, psychological, sexual and financial harm. Of course,
a client can also threaten harm to other people; you need to be vigilant in
examining your responsibility to assess the risk and take necessary action, in
these cases as well.
Some major indicators of risk include:

physical symptoms such as injuries or loss of weight
existing self-harming
impaired cognitive functioning caused by brain injury, such as loss of
memory and inability to concentrate
no parent or carer available to care for a child
injury requiring hospital attention and investigation
disclosure of abuse
significant history of substantiated abuse
serious past offences by a significant other
family violence
parental illness (including mental health issues)
continued alcohol and other drug abuse by parents/carers
http://www.disabilityhotline.net.au/what-is-abuse-and-neglect/
Interventions
Determine the level and urgency of safety concerns.
Identify risk that is life threatening, including risk of homicide.
Identify risk of suicide or self-harm.
If the person is at risk of serious harm or death, advise the older person of
concerns and contact the police.
Contact the Elder Abuse Helpline, Disability Hotline and/or relevant
agencies such as social workers and mental health services.
For all other safety concerns, seek consent to refer and discuss a safety
plan and referral options with your manager/employer.
Disability Service Standard 12: Protection of human rights and freedom from
abuse
The service provider acts to prevent abuse and neglect and to uphold the legal
and human rights of service recipients.

KPI 12.1 The service provider takes all practical and appropriate steps to
prevent abuse
and neglect of its service recipients.
KPI 12.2 The service provider upholds the legal and human rights of its
service recipients.
Emergency situations
In case of life threatening situations call 000 for attendance by Ambulance, Fire
or Police services.
WORKPLACE HEALTH AND SAFETY

Work health and safety is the responsibility of everyone. Your employer has a
duty of care for workplace health and safety to provide a safe working
environment for workers and clients. All employers are required to consult with
staff on any issues which may affect their health and safety.
Under the Work Health and Safety Bill 2011, each state and territory regulates its
own health and safety legislation. There should only be very slight variations to
that legislation between the states and territories. All states and territories and
the Commonwealth have worked together to develop and implement model Work
Health and Safety (WHS) legislation as the most effective way to achieve
harmonisation of WHS laws in Australia. By reducing costs and eliminating
unnecessary administrative processes, harmonisation is designed to make it
easier for workers and for employers who conduct business across multiple
states.
Risk Management has become an integral part of Work Health and Safety (WHS)
Management. This has been driven by the need to meet legislative requirements
and the recognition that risk management is good practice. An effective WHS
Management program is an integral part of any successful organisation. It
ensures that the health and safety needs of employees are properly addressed
and can provide a range of benefits including:
reduced injuries and illnesses

compliance with WHS legislation
reduced workers compensation costs
reduced employee turnover and improved morale
improved operational efficiency
better corporate governance
increased stakeholder confidence

WHS risks within the disability sector are common with some other sectors such
as aged care, HACC programs and a range of industrial sectors depending on the
Disability Enterprise activities. What is unique for the disability sector is the
potential need for a particular organisation to be able to address WHS obligations
across such a range of industry types which often include uncontrolled
environments whilst working with service users who may have unforeseen or
unpredictable functional restrictions or behaviours. The disability sector also has
to address the potential mismatch between risk minimisation and the disabled
persons desire to take risks.
Workplace Health and Safety Considerations for People who have a

Disability: Source: Community Services and Health Industry Skills Council Ltd.
Mobility aids
An area that support worker in the disability sector need to understand are
mobility aids and specialist equipment, how these impact the client and others
and the manual handling of this equipment.
It is important that you handle any equipment carefully and sensitively as it is a

personal belonging that is often necessary to your clients independence and/or
wellbeing. The equipment is also likely to have been designed and/or fitted to suit
the persons individual needs and to repair or replace the item would be costly
and inconvenient.
Clients Home and public places

Support workers often confront additional risks when working in public places and
in clients homes, as these environments are less predictable than centre-based
environments.
Working in a clients home is a common and significant part of many services

provided by workers in the disability industry. The homes of clients are
workplaces whenever a worker is present during work hours. Consequently
organisations and workers have workplace safety obligations under the Work
Health and Safety Act and Work Health and Safety Regulation.
Suggested controls depending on the risk include:

Buddy system some jobs present such a high level of risk that workers should
not work alone, for example working with clients with high manual handling or
behaviour issues.
Workplace layout and design workplaces and their surrounds can be designed
to reduce the likelihood of violence, for example by installing physical barriers,
monitored CCTV and enhancing visibility.
Communication systems the type of system chosen will depend on the distance
from the base and the environment in which the worker will be located or through
which he or she will be travelling.
Community Places
Working in the community is a regular and significant feature of support workers.
Working with clients in the community, irrespective of disability type, has
inherent challenges. When supporting clients to participate in community
activities, there is only limited control over the external environment and there is
an additional variable of interacting with members of the public. These

challenges are heightened when supporting clients with complex or high
behavioural support needs.
Location assessment
There are many variations when working in the community. You may be
supporting clients on a one-to-one basis or in group activities. One of the issues
for workers in the disability industry is the genuine desire to assist clients
integrate and participate in community activities like everybody else.
Any location that is used regularly in service delivery should be formally assessed
with some type of documented checklist and preferably by more than staff
member for suitability for your client group.
Client transport
Working in the community also includes transportation of clients to venues which
adds new considerations regarding safety.
Transport: How are clients travelling to the venue? Are clients being transported
by disability service worker? Are they travelling independently using private or
public transport? Transport may be required to support clients attending
workplaces, medical or dentist appointments or to go shopping.
An assessment of transport needs and a safe work procedure for client transfers
should be undertaken where a hazard exists.
Activities
What is the focus of the activity? Is it predominantly social with a community
participation objective or is it a training component of a clients individual plan?
An activity risk assessment as part of the venue assessment should be
undertaken.
Variables
Variables may include noise or crowds due to school holidays or the time-of-day
in which activities take place. Climatic conditions may affect individual clients
capacity to manage in the environment.
These and similar issues need to be considered in relation to a clients

management plan or behaviour support plan, to identify potential triggers and
alternate actions if required. Workers regularly identify risk associated with tasks
which form part of formal learning activities. Most are familiar with the need to
analyse and assess tasks to assist the client to acquire skills and move towards
independence. The risk identification process used in formal training processes
can be adapted to social activities for clients. This is particularly so when working
with clients with an intellectual disability.
Whilst community locations are varied, a number of simple practices can be

implemented to ensure the safety of workers. These practices are the same
irrespective of the location. The key is to include risk assessment processes as
part of everyday practice.
Remember you may arrive at a location you use regularly to find there
has been a substantial change to the location. Flexibility and

understanding the basics of risk assessments to keys to such
unexpected dilemmas and may not mean any activity needs to be
cancelled if modifications can be made.
Source: Disability Safe is a project supported by ADHC to inform the establishment of a consistent approach to
reasonably practicable risk management in the disability service environment
Once basic safety training has been completed, specific training for individual
tasks and specific hazards should be conducted to help workers understand how
and why a job must be done safely. Where work poses a risk to the health and
safety of workers make sure safe work procedures are prepared and
communicated.

Section 5: Community access
and social inclusion
Many disabled people have had to learn to be patient. When you need to wait for
someone to assist you across the road, up some stairs, to be dressed or to be fed,
one of the things you learn is to be patient. As frustrating as this can be at times,
it begins to become part of your character. There are other characteristics that
you can acquire, such as discovering who your friends really are, learning to ask
for help, discovering new ways to do things, pushing back your own or others
boundaries, listening to other people, valuing others that society may choose to
ignore or devalue, acquiring a new skill, feeling or attitude.
There have been people with a disability who said that their quality of life had
improved considerably since they became disabled. This was because they had
to re-evaluate their life, and explore its meaning. This in turn led to new interests,
stronger relationships and a greater appreciation of who their friends really were.
All humans face challenges, it's just that people with disabilities face different
challenges.

Access and equity
Transportation and getting around
Technology
Networks and support groups
Employment
Disability and personal relations
Research strategies

ACCESS AND EQUITY
Access - fair access for all people to economic resources, services and
rights essential to their quality of life
Equity - fairness in the distribution of resources, particularly for those in
need
People who experience disabilities have equal rights to access the physical
environment, information, communication and services including education,
employment, recreation, rehabilitation, participation as citizens, health and
accommodation services and the right to a meaningful and adequate income.
There are many situations where people with a disability are not given access to
things they should. Sometimes this is because buildings have been poorly
designed and there may not be a lift or a door that is wide enough for a
wheelchair. Sometimes it is because buildings have been designed many years
ago before there were rules about providing access for people with a disability.
Sometimes access is denied because people are not comfortable being around
people with a disability. For example, they may not choose them for a job, they
may make access to a school difficult or they may not want a person with a
disability as a tenant when they are renting out a house.
Ensuring equity
Equity is about making things equal. It means not making one set of rules or
decisions for someone with a disability and another set for someone without a
disability. People with disabilities should have equity, regardless of gender,
ethnicity, type of disability and when the disability was acquired. For example,
people with a disability should have equal access to work opportunities. They
should be equally able to go to school and use community services.
In short, Access and Equity means:
Ensuring that all Australians, regardless of racial, religious, cultural or

language backgrounds
enjoy full access to services they are entitled to. It is NOT about special
services for people of
culturally and linguistically diverse background, or people with a disability.
That Access and Equity is about identifying and removing barriers, which
prevent people from knowing, using and participating in a service that they
wish to utilise.
An equitably, fairly and justly distribution of resources amongst all eligible
clients, even if it
means providing additional services or seeking additional resources to do
so.
That Access and Equity is an integral part of core service delivery. It
should not be an extra
responsibility on top of existing workloads and practices for agencies. Core
services are defined as those services that an agency is established and
funded to provide.
Access and Equity is also about ensuring that staff, management and other
personnel acquire the knowledge and skills to feel confident and capable of
working with the person with a disability.
Access and equity is about being fair to everyone. It means not discriminating
against someone because they have a disability. You need to think about how you
treat others. Make sure you understand your work role and your responsibilities,
what is expected of you at work and how your actions and words can affect
others. Think about how to be fair, equal and just in your decisions and actions.
Do not discriminate or treat anyone unfairly. Treating people with a disability
unfairly or not as equals, disempowers them. This deprives them of having power
and influence over their own lives.
For further information research the following links. Disability standards ensure
that people with disabilities have the access they need to live, work and
participate in their communities. These standards include:
Disability standards for accessible public transport providers and

operators of public transport must comply with these standards that set
out the minimum requirements for access by people with disabilities, their
families and carers.
Disability standards for education these standards aim to ensure that
students with disabilities are able to access and participate in education
and training free from discrimination, and on the same basis as other
students.
Disability standards for premises these standards aim to give people with
disabilities better access to a wider range of public buildings.

ACTIVITY
People with a disability should be able to access all the places and services that
can be accessed by people without disabilities, in the table below list the
potential barriers the person with a disability may experience.
AREA POTENTIAL BARRIERS
Trains
Cinema
Shopping Centres
Church
Aeroplanes
Holidays
Night Clubs
Library
TRANSPORTATION
Transportation presents a significant barrier to participation in community life for
many people, leaving them isolated and without access to services, shopping and
social activities. Lack of access to public transport was identified as one of the
most serious issues in peoples lives.
The Disability Standards for Accessible Public Transport 2002 set out the
minimum accessibility requirements that providers and operators of public
transport must comply with, as well as ensuring that access to transport is
consistently improved.
The transport standards recognise
that access to public transport enables people with disabilities, their families and
their carers to fully participate in community life and also benefits many older
Australians and parents with infants in prams.

The transport standards apply to:
trams
trains
buses and coaches
taxis
ferries
aeroplanes
The transport standards also set out

minimum standards for premises including:
access paths
manoeuvring areas
ramps and boarding devices
allocated spaces
handrails and grab rails
doorways, lifts, stairs, toilets, symbols and signs
the payment of fares
access to information about transport services
Further information about the Transport Standards can be found at

http://www.comlaw.gov.au
GETTING AROUND
How the person with a disability gets around varies from person to person and
also depends on where they live. They might opt for a form of public transport,
such as taxis, trains and/or buses, or they might be able to choose private
transport driving themselves around in a car with modifications.
There are a variety of options available for people with limited mobility. These
include designated disabled parking bays, accessible public transport, vehicle
and taxi hire, and centres where walking sticks, scooters and wheelchairs can be
hired for getting around the city.
The common thing is that they will need to have some way of finding and using
transport that suits their needs. What they need to do is think about what they
want to do, how they want to do it and work from there.
By reading through the information on public and private transport, they will be
able to make an informed choice. However, whichever form of transport they use,
there will be things that impact upon their individual needs. Always remember
that there are ways of working with most things and achieving ways to get out'
and do what they want.
These websites have a wealth of information on transport options:

South Australia: http://www.sa.gov.au/subject/Transport
Western Australia: http://wa.gov.au/governmentservices/lifestyleenvironment
New South Wales: http://www.cityofsydney.nsw.gov.au/explore/getting-
around/accessibility

http://www.visitnewcastle.com.au
http://www.business.nsw.gov.au/live-and-work-in-nsw/getting-
around
Queensland: http://www.qld.gov.au/disability/out-and-
about/transport/
http://www.tmr.qld.gov.au/Travel-and-transport/Disability-
access-and-mobility
Tasmania: http://www.discovertasmania.com/travel_information
http://www.transport.tas.gov.au
Victoria:
http://www.melbourne.vic.gov.au/CommunityServices/Disabilit
yService
http://ptv.vic.gov.au/getting-around/accessible-transport
Remember getting around will give you more freedom and

choices

TECHNOLOGY
For most people, technology makes things easier. For people with disabilities,
technology makes things possible. Mary Pat Radabaugh
Many of us rely on technology such as microwaves, computers, mobile phones

and remote controls to perform simple activities in our daily lives.
Assistive technology (AT) is any device, system, or design used by individuals to

perform functions that might otherwise be difficult or impossible. Such
technology may be something as simple as your common household items such
as a carrot peeler to the more complex products such as pressure care mattress
for the prevention of pressure sores. In short, anything that assists individuals
continue to carry-out daily activities can be considered assistive technology.
For people with any physical or cognitive difficulties, impairments, or disabilities,

AT can be critical to assisting people learn and communicate more effectively,
participate in the work environment, achieve independence, and improve their
quality of life.
There are many different categories of Assistive Technology available ranging

from simple low-tech devices such as pencil grippers to more high-tech items
such as voice-control software used to control a computer instead of a keyboard.
Finding the best match between a person, their environment, and technology
requires careful input from the person with the disability, and possibly family,
carers and relevant professionals. It is an involved multi-step process requiring
understanding of the individual's needs - resulting in an informed decision about
the best possible solutions.
Making sure the technology matches an individual's needs in the best possible
way is critical as poorly chosen AT may be of little assistance to the user, or even
end up abandoned in a cupboard.
When considering AT it is important to remember that AT is part of an ongoing

therapeutic process to assist a person achieve their goals.
TYPES OF ASSISTIVE TECHNOLOGY

Augmentative Communication: The term Augmentative really means to
supplement, aide or add to. Therefore augmentative communication means to
add to or supplement an existing communication system, including any type of
spoken, gestural, and / or written abilities the person may have.
Aids for Daily Living: Daily living aids can be a beneficial, and often essential,
part of a person's everyday life. ADLs can help sustain a safe and healthy

lifestyle, ADLs are ideal for people who may have trouble with reach, hand
dexterity, limited mobility and other common ailments.
Source: Scope Victoria for people with disability
Computer Access Aids: Accessible computer equipment and PC access aids for
the disabled computer user, includes software, computers and programs for
those with disabilities as well as big letter keyboards and assistive technology
such as trackball programmable button mice and aids for the blind and visually
impaired pc user as well as speech dictation software for those having problems
using keyboards and mice.

Source: Scope Victoria for people with disability
Home/Workplace Modifications
Structural adaptations that remove or reduce physical barriers: ramps, lifts,
bathroom changes, automatic door openers, expanded doorways.
Environmental Controls
Electronic systems that assist people control various appliances, switches for
telephone, TV, or other appliances which are activated by pressure, eyebrows or
breath.
Mobility Aids
Devices that assist people move within their environments: electric or manual
wheelchairs, modifications of vehicles for travel, scooters, crutches, canes and
walkers.
Recreation
Devices to enable participation in sports, social, cultural events.
Examples include audio description for movies, adaptive controls for video
games, adaptive fishing rods, cuffs for grasping paddles or racquets, seating
systems for boats.

Seating and Positioning
Adapted seating, cushions, standing tables, positioning belts, braces, cushions
and wedges that provide body support to assist people perform a range of daily
tasks.
Sensory Aids for Vision/Hearing Impaired

Aids such as magnifiers, Braille and speech output devices, large print screens,
hearing aids, visual alerting systems, telecommunication devices.

Source: Scope for people with disability
EMPLOYMENT
The most significant barrier for people with disabilities still appears to be the
stereotypical assumptions and attitudes of employers about what people with a
disability can and cannot do.
Further employer misconceptions preventing the full inclusion of people with

disability in the workforce include:
the perceived cost in terms of employing a person with a disability in
terms of possible workplace adjustments
the lack of awareness and confidence in creating a workplace which is
inclusive of people with disability
the perceived impact on workers compensation, sick leave and OH&S
regulations
the belief people with disability will take up too much time to manage
the fear of other people in the workplace doing or saying the wrong
thing
The principles of employment are the same for people with disability as those
without disability. The main focus should be on the skills, talents and capabilities
the person with disability can bring to the workplace.

People with a disability have a fundamental right to participate in, and fully
contribute to, the life of our society. Employment not only represents economic
independence but an increased sense of self- worth, the opportunity to contribute
to society and a sense of belonging and connection with other people.
There are numerous Employment Services that provides and offer a range of
services to support individual needs, including:
help to prepare for work, including training in specific job skills

job-search support, such as rsume development, training in interview
skills, and help in looking for suitable jobs
support when initially placed into a job, including on-the-job training and
co-worker and employer support
ongoing support in a job if required
the purchase of vocational training and other employment-related
assistance
access to help with workplace modifications; support services; and Auslan
interpreting in the workplace
People with a disability seek employment which is continuing and meaningful,

and with employers who can provide a supportive work environment,
opportunities for skill development and a career pathway.
NETWORKS AND SUPPORT GROUPS

People with disabilities are unique individuals with varied interests, abilities,
needs, cultural backgrounds, likes, dislikes, and motivations just like us. Taking
the time to discover more about the individuals that you are supporting will give
you a better understanding or each person's individual:
abilities - strengths capabilities and skills

relevant interests - what they like to do

requirements - what they need to be able to do the things they want to
do
needs - areas of development or change
People require a range of supports and the ability to access mainstream

community services and facilities in order to have a full life in the community.
This should be underpinned by individual planning and support, with the ability
for the person to be as self-directed as possible and have the availability of
facilitation and co-ordination where required.
Creating and supporting socially valued social roles and the good things in life
involves providing people with a disability with:
dignity
respect
acceptance
a sense of belonging
an education
opportunities to develop and exercise their capacities
The good things in life also include being supported to achieve a reasonable
standard of living, a place to live, and opportunities for employment and
recreation with less reliance on services for daily living.
SUPPORT THE CLIENT TO DEVELOP AND OR MAINTAIN NETWORKS

The definition of support is: To aid the cause, policy, or interests of
Some people are very clear about what they want to do in life, while others might
explore their goals and ambitions as part of planning processes.
Some people, however, are unaware of the choices and opportunities that might
be open to them. In these circumstances it is important that supporters and
workers work with the person to develop interesting, creative and appropriate
ways to identify and meet their goals. Discuss activities, including:
what types of things they like to do
whether they do enough of the things they like
whether they still enjoy the activities they do
if there are new things theyd like to try
any worries about trying new things
any information you can provide
any activities linked to long term goals and ambitions

Social Networks
Social networks include:
family groups
support groups
neighbourhood or local community groups
workgroups
sports and other recreation groups
age-related groups (youth or senior citizens)
community centres
clubs
church groups
Social networks assist in community participation and inclusion with all the
resulting benefits from
the good things in life, and can also provide additional personal support for
people with a disability.
The term social network was originally coined to distinguish between networks
that were used for business purposes and those that were used for socializing.
The term has been extended to include interactive websites with message
boards, chat rooms or the ability to leave comments and have a discussion with
other people. Examples of websites that are primarily used for socializing include
Facebook and MySpace.
https://www.facebook.com
http://www.myspace.com
The websites are supposed to be fun; that was the original purpose. But many
concerns have arisen as they have become more popular. There have been
instances of bullying. A young gay man was outed on Facebook and later
committed suicide. A woman used the site to harass a female teenager who also
committed suicide.

There are also privacy concerns. Your information can be viewed not only by your
friends, but also by companies, spammers, thieves and perhaps your potential
boss. There are ways to reduce your risks and still use the social networking sites
but you have to be careful.
The good news is that there are hundreds of social networking and informational
sites created for the softer side of humanity. Networking sites where peace and
love are promoted; helping the jobless find work, activism in food industry,
specific topics, educational issues and dating sites
What you'll most likely learn is that you're not alone - and
that's what social networking is all about, right?
Expanding social networks
A valuable outcome from supporting someone to try new activities is meeting

people with common views and interests. By meeting people through shared
interests, people can make friends and naturally develop social networks. People
with similar views and experiences might be better placed to understand their
point of view and may be able to help them with their decision making as peers.
One of the best ways of expanding your social network is finding a new activity,
and if you can think of an activity that also involves other people, such as joining
a group of some sort, even better!
You can try different internet tools to help you find something you may enjoy
doing. And remember, if it looks even remotely interesting, try it! Nobody is going
to force you to come back and do it again, if you don't enjoy it!
Support Groups
In a support group, members provide each other with various types of help,
usually nonprofessional and nonmaterial, for a particular shared, usually
burdensome, characteristic. The help may take the form of providing and
evaluating relevant information, relating personal experiences, listening to and
accepting others' experiences, providing sympathetic understanding and
establishing social networks. A support group may also work to inform the public
or engage in advocacy.

Joining a support group can also lead to other friendships and supportive
relationships and can help to deal with issues such as moving on with life and re-
establishing contact with other people.
It is important to understand though that many people join support groups

to gain information only. They are not necessarily seeking enduring relationships
or commitment. If you find a person that you would like to get to know better,
start slow, ask them if they'd like to keep in touch or meet up sometime. If they
do not seem ready just yet, don't take it personally. People who join support
groups often have a lot of things going on in their lives.
When it comes to support groups it's important that all people feel comfortable
choosing their own level of involvement. People feel comfortable when they can
give what they have to give and not be expected to give more. In this way, it is
important to have a plan about how often you should call someone, not too often,
but also not too rarely. Give people space, but let them know you're available and
interested if they ever want to catch up. By doing this, the social and support
networks will have a chance to grow wider and enrich all areas of their life as well
as other people's lives.
The important thing to remember is that support groups are for support. Although
you may be lucky to find enduring friendships through support groups, it is
generally better to look for social contact through social clubs, work, study,

community courses or community activities and through getting out and having
fun.
Since at least 1982, the Internet has provided a new venue for support
groups.
Support workers help clients to develop their social skills by encouraging their
involvement in a community. A community may be a disability support group,
family gathering or group of friends. Support workers are responsible for
transporting the client to and from the gathering place. By facilitating the client's
integration with friends and family, disability support workers emphasize the
importance of meaningful relationships between community members.
DISABILITY AND PERSONAL RELATIONSHIPS

Sex is very much associated with youth and physical attractiveness, and when it
is not, is often seen as unseemly. If we accept that sexual expression is a
natural and important part of human life, then perceptions that deny sexuality for
disabled people deny a basic right of expression.
People who have a physical or intellectual disability, whether from birth or

through accident or disease later in life, might find it difficult to express their
sexuality in satisfying ways. Their sexual function or feeling might be limited and
they might have concerns about their body image. They might also be unsure
about how to negotiate relationships and express their sexuality because of a
lack of knowledge or physical or cognitive limitations.

People with a disability might also have limited opportunities for sexual
relationships for a number of reasons, including a lack of privacy and being
dependent on others for daily living. Finding ways to express sexuality can be a
key part of rehabilitation when someone has acquired a physical disability in
adulthood.
If you dont have a disability it may surprise you to hear that the biggest
obstacles to exploring sex when you live with a disability are not specifically
related to the disability. The guy who has a spinal cord injury and cannot get an
erection still has a thousand ways to have sex and feel sexy. The bigger problem
is finding someone to have sex with since most people (regardless of disability)
dont see someone with a disability as a potential sexual partner.
Talking about disability and sex can be hard because neither is a simple concept
and both are intimately tied to our sense of self and how we interact with others.
Physical Disability and Sex

Physical disability can impact your sex life in many ways. If you live with a
physical disability, particularly a mobility disability it can impact:
the way you engage in sexual activities, the kinds of activities you do, and
how long you can do them for
the way sex feels, including changes in orgasm, arousal, and the feeling of
release after sex play
your access to sexual partners, particular out in public where most spaces
are not fully accessible and meeting people and flirting can be difficult or
impossible depending on your disability.
When thinking about physical disability and sex one of the biggest barriers is a
lack of imagination and creative sexual problem solving. If you believe that the
only way to have sex is the physical contact, you may be out of luck. When you
realize that sex is so much more than intercourse, greater opportunities and
fewer obstacles present themselves.

Social Impact of Disability on Sex
What makes living with a disability and having sex difficult has a lot more to do
with society than it does with the person living with a disability. There are so
many ways that individuals, institutions, and social systems make the life of a
person with a disability more difficult when it comes to sex, but here are few
examples:
lack of access to sex education
fewer opportunities to seek out and enjoy sexual entertainment
even if you can physically get into a social space like a club or bar, the
social norms about how to meet people, flirt, and pick up exclude most
people with disabilities who may need more time, quiet, and focus in order
to make a connection
having to meet social expectations, particularly around gender, when it
comes to sexual activity can impact the chances of finding a sexual partner
in the first place and then having mutually satisfying sex
Psychological Impacts of Disability

If there is someone who acquired a disability (as opposed to being born with a
disability) there may be a psychological adjustment process in addition to a
physical one. How they think and feel about themselves and their disability will
have many impacts on the person as a sexual person.
Talking with other people who have overcome body image

concerns or a counsellor can help.

RESEARCH STRATEGIES
Research is motivated by curiosity or a need to know about how things are, and
what they do or may do.
Part of your role as a support worker is to identify community activities or

services that may be of interest to your client. This may include but not limited to
social activities, recreational, employment.
Depending on where you live your approach may vary. For instance if you live in a
country town you may be very familiar where to go to find the information you
require. In the city it may be a very different story.
To find local services the best approach is to start in the local area, where your
client lives or the region they want to access. For example if you wanted to try
wind surfing you would need to be near water either the sea, lake or very large
dam!
A good place to start is your local council and or library. The majority of councils
do have quite a lot of information on their websites. This may include information
about access, services available including care and recreational and local service
providers. Libraries, in addition to having information about local area activities
and resources, often also have computers and internet access that are available
to the public to use for research.
The majority of councils have some type of resource directory available or

community development workers you may be able to speak to. Remember local
government is there to provide support and services to their local government
area, so a great place to start.
If you are not sure what council/local government area you fall into the following
websites will be of assistance.
Council information [NT]
Find information and contact details for local councils in Northern Territory.
http://www.localgovernment.nt.gov.au/council_information
Council map and contacts [Tas]

Find information and contact details for local councils in Tasmania.
http://www.lgat.tas.gov.au/site/page.cfm?u=221
Council websites [WA]

Western Australian government page listing local councils and their websites.

http://walga.asn.au/AboutLocalGovernment/CouncilWebsites.aspx
Councils [SA]
Find information and contact details for local councils in South Australia.
http://www.lga.sa.gov.au/site/page.cfm?u=210
Find your local council [Vic]

Find contacts, links, demographic and general information about each of
Victoria's local councils. http://www.dpcd.vic.gov.au/localgovernment/find-
your-local-council
Local council search [NSW]

Find your local New South Wales council.
http://www.dlg.nsw.gov.au/dlg/dlghome/dlg_SuburbLookup.asp?
ba=a&mi=0&ml=8
Local government directory [Qld]

Find information and contact details for local councils in Queensland.
http://www.dsdip.qld.gov.au/local-government-directory.html
Territory and Municipal Services [ACT]

Find information and contact details for municipal services in the Australian
Capital Territory.
http://www.tams.act.gov.au/
Recreational activities: if you are accessing recreational activities sometimes

mainstream groups activities should be approached, as with the support of a
carer, mainstream services may be accessible and suitable for your client.
Accessing these services may require some phone calls and asking questions,
remember most people are more than happy to help!
Study or Further Education

Clients may need you to investigate different courses or study they may be
interested in. ADCET Australian Disability Clearinghouse on Education and
Training
http://www.adcet.edu.au
The Australian Disability Clearinghouse on Education and Training

(ADCET) provides post-secondary education, training and
employment information and resources for people with disability or ongoing
medical conditions.
TAFE (Technical & Further Education) colleges have specialist disability

services to support students undertaking study.
Support is available for people with:

deafness or hearing impairment
intellectual disability
learning disability
neurological disability
physical disability
psychiatric disability
vision impairment

What support is available?
pre-course counselling
assistance with course selection and enrolment
assistance to identify the most appropriate classroom support and
assessment modifications
access to tutorial support, adaptive technologies, sign language
interpreters, note-takers or disability assistants.
Fee exemptions and concessions

Students with disabilities may be eligible for a fee exemption or concession fee.
TAFE NSW Disability Services

https://www.tafensw.edu.au/services/disability/index.htm
TAFE NT Disability Services http://www.cdu.edu.au/cduvet/index.html?

q=vet/index.html
TAFE Queensland Disability Services

http://www.tafe.qld.gov.au/students/support/disability-services.html
TAFE South Australia - Disability Support

http://www.tafesa.edu.au/services/disability-support
Tasmanian Polytechnic Disability Support

http://www.polytechnic.tas.edu.au/design-disability-support.aspx
Victorian TAFE Colleges

Bendigo Regional Institute of TAFEDisability Support:
http://www.bendigotafe.edu.au/Students/StudentSupport/Pages/default.aspx
Box Hill InstituteDisability Liaison Service:

http://www.bhtafe.edu.au/students/services/Pages/disability-liaison-service.aspx
Central Gippsland Institute of TAFEDisability Support:

http://www.gippstafe.vic.edu.au/current_students/student_support_services/disabi
lity_officer
Chisholm Institute of TAFEDisability Support Service:

http://www.chisholm.edu.au/About/Going_all_in
East Gippsland Institute of TAFE (Advance TAFE)Disability Support:

http://www.advancetafe.edu.au/pages/achieve/support.htm
Gordon Institute of TAFE - The GordonDisability Support Services:

http://www.thegordon.edu.au/StudentSupport/LearnerSupport/Disability/Pages/Ho
me.aspx
Goulburn Ovens Institute of TAFEDisability Support:

http://www.gotafe.vic.edu.au/page.cfm?ID=42
Holmesglen InstituteDisability Support:

http://www.holmesglen.edu.au/services/student_services/disability_support_servic

e
Kangan Batman Institute of TAFEDisability Support:

http://www.kangan.edu.au/services/student-support-recreation/disability-support/
Northern Melbourne Institute of TAFEDisability Support:

http://www.nmit.edu.au/about/student_services/#disability_support
RMIT University (TAFE Division) Disability Liaison Unit:

http://www.rmit.edu.au/browse/Current%20students%2FStudent%20services
%2FDisability%20Liaison%20Unit/
South West Institute of TAFEDisability Support:

http://www.swtafe.vic.edu.au/students/student-support/
Sunraysia Institute of TAFEDisability Support:

http://www.sunitafe.edu.au/services/student-support.aspx
Swinburne University of Technology (TAFE Division) Disability Services:

http://www.swinburne.edu.au/stuserv/disability/
University of Ballarat (TAFE Division) Disability Support:

http://www.ballarat.edu.au/current-students/support-services/disability-support
Victoria University (TAFE Division) Student Equity and Disability:

http://www.vu.edu.au/facilities-and-services/student-equity-and-disability-support
William Angliss Institute of TAFEDisability Liaison:

http://www.angliss.edu.au/Disability-Liaison
Wodonga Institute of TAFEDisability Liaison:

http://www.wodongatafe.edu.au/audience/information/learner-services/disability-
liaison.aspx
Western Australia TAFE Colleges

Central Institute of TechnologyDisability Services:
http://www.central.wa.edu.au/Current_Students/ServicesandSupport/Pages/defaul
t.aspx
Challenger Institute of TechnologyDisability Services:

http://www.challenger.wa.edu.au/StudentServices/disabilityservices/Pages/Disabili
tyServices.aspx
Polytechnic WestDisability Services:

http://www.polytechnic.wa.edu.au/pwa/current-students/services-for-current-
students/disability-services/
West Coast Institute of TrainingDisability Services and Support:

http://www.westcoasttafe.wa.edu.au/StudentInformation/CurrentStudents/Student
Centro/Pages/DisabilityServicesAndSupport.aspx
Regional TAFE
Durack Institute of TechnologyStudent Services:
http://www.durack.edu.au/studentservices/Pages/studentservices.aspx

C.Y. O'Connor Institute: http://www.cyoc.wa.edu.au
Great Southern Institute of TechnologyDisability Support:

http://gsinstitute.wa.edu.au/studentservices/Pages/StudentServices.aspx
Kimberley TAFEDisability Services and Support:

http://www.kimberley.tafe.wa.edu.au/studentinformation/currentstud/studservices
/Pages/disabservsup.aspx
Pilbara TAFEDisability Services:

http://www.pilbaratafe.wa.edu.au/site/API/disability.aspx
South West Institute of TechnologyDisability Services:

http://www.swit.wa.edu.au/facilitiesandservices/services/studentsupportservices/P
ages/accessibilityforstudentswithadisability.aspx
University Education
Universities also offer a range of support services to students with disabilities.
The websites listed will provide further information about the university in your
state or research the university of interest.
The support services and physical access may differ from institution to institution,
but the services generally offered include: note takers, personal readers,
examination provisions, assistance in the library, learning assistance, alternative
assessment methods, and provision of academic material in alternative formats.
Some institutions may provide parking for holders of mobility access permits.
Information for students with a disability: ( NSW/ACT):

www.uac.edu.au/undergraduate/apply/disability.shtml
NT University Admissions Centre ( Northern Territory):

www.satac.edu.au/
QLD Tertiary Admissions Centre: www.qtac.edu.au/
SA Tertiary Admissions Centre: www.satac.edu.au
Tasmanian Admissions Centre: www.studentcentre.utas.edu.au/admissions/
Victorian Tertiary Admissions Centre: www.vtac.edu.au
Tertiary Institutions Service Centre (WA): www.tisc.edu.au/
RESOURCES FOR PEOPLE WITH DISABILITIES
Better Start for Children with Disability

The Better Start for Children with Disability initiative aims to assist eligible
children with developmental disabilities to access funding for early
intervention services.
http://www.fahcsia.gov.au/our-responsibilities/disability-and-carers/program-
services/for
people-with-disability/better-start-for-children-with-disability-initiative
Carers (DHS)

There are payments and services to support people who provide full-time care
to someone else with a disability, illness or medical condition.
http://www.humanservices.gov.au/customer/themes/carers
Clean Energy Future Household Assistance Package

The Household Assistance Package will ensure that those Australians that need
help the most, particularly pensioners and low and middle income households,
will get assistance for the cost of living impact of the carbon price.
http://www.humanservices.gov.au/customer/subjects/clean-energy-future
Commonwealth Respite and Carelink Services Directory

Do you need to know about which community, residential aged care,
disability and other support services are available in your area? Search this
directory for an extensive list of service providers- including the range of
services they offer and their contact details.
http://australia.gov.au/service/commonwealth-respite-and-carelink-services-
directory
CRS Australia
CRS Australia delivers vocational rehabilitation services to Australian citizens or
residents who have an injury, disability or health condition. We assist people who
have a disability or injury to get a job or return to their job. This service is free to
people receiving income support payments from Centrelink.
http://www.crsaustralia.gov.au/
CRS Australia - send a referral

CRS Australia provides vocational rehabilitation and assessment services to
people with a disability, injury or health condition. Use the online referral form
to request a service, refer someone to CRS Australia or find out more about
CRS Australia's services.
http://australia.gov.au/service/crs-australia-send-a-referral
Disabilities
Healthlnsite topic page linking to information about physical and mental
disabilities, as well as information on rehabilitation and caring for people with
disabilities. Healthlnsite provides links to some of Australia's most authoritative
health organisations and their websites.
http://www.healthinsite.gov.au/topics/Disabilities
Disability and Carers

The Department of Families, Housing, Community Services and Indigenous
Affairs manages and funds a range of programs to support people with
disabilities, and their families and carers.
http://www.fahcsia.gov.au/our-responsibilities/disability-and-carers/overview
Disability Employment Services

The Disability Employment Services helps people with disability find work and
keep a job. http://deewr.gov.au/disability-employment-services
Disability Parking Scheme
The Australian Disability Parking Scheme is gradually being implemented
across Australia from September 2010, to streamline the distribution and use
of disability parking permits. Australian Disability Parking Permits will be
recognised in all states and territories. A list of relevant authorities in your
state or territory authority is available for enquiries about permit applications,
cost, eligibility and permit use. http://www.disabilityparking.gov.au/
Disability rights
The Australian Human Rights Commission provides a range of resources
and links on disability discrimination and other human rights and disability
issues.
http://www.humanrights.gov.au/disability_rights/
International Day of People with Disability

International Day of People with Disability (IDPwD) is a United Nations
sanctioned day that aims to promote an understanding of people with disability
and encourage support for their dignity, rights and well-being. This site is the
central source for all information about IDPwD in Australia.
http://www.idpwd.com.au/
JobAccess
JobAccess is a free information and advice service which offers practical
workplace solution for people with disabilities and their employers. The service
includes a comprehensive, easy to use website and a free telephone information
and advice service where you can access confidential, expert advice on all
disability employment matters.
http://www.jobaccess.gov.au/
Livewire (community for young people with chronic illnesses)

Livewire is a safe and fun online community designed for young people living
with a serious illness, chronic health condition or disability. It also caters for
their siblings and parents. It allows members to share experiences.
http://www.livewire.org.au/
Living with a disability

Healthlnsite topic page linking to a range of information about living with a
disability, including advice, services, support groups and day to day issues such
as dressing, driving and safety. Healthinsite provides links to some of Australia's
most authoritative health organisations and their websites.
http://www.healthinsite.gov.au/topics/Living_with_a_Disability
National Auslan Booking and Payment Service

The National Auslan Interpreter Booking and Payment Service (NABS) is funded
by the Department of Families, Community Services and Indigenous Affairs.
NABS is based at the corporate office of Wesley Mission Brisbane, in Brisbane,
but it will provide services Australia wide. NABS provides interpreters to Deaf and
hard of hearing people who use sign language and would like an interpreter for
private medical appointments. It is free of charge to Sign Language users and
medical practitioners. http://www.nabs.org.au/
National Companion Card

The National Companion Card Scheme brings together State and Territory
Companion Card programs that enable eligible people with lifelong disability to
participate at venues and activities without incurring the cost of a second ticket
for their companion.
http://www.companioncard.gov.au/
National Disability Insurance Scheme

A National Disability Insurance Scheme is about ensuring people get the
individualised care and support they need over the course of their lifetime, so
they can exercise more choice an< control in their lives. http://www.ndis.gov.au/
National Disability Organisations' Clearinghouse

Provides easier access to disability sector information and facilitates
communication between the National Disability Organisations. Thirteen national
disability organisations contribute to government policies on issues affecting
people with disability. http://ndoch.govspace.gov.au/
National Information Communication Awareness Network (Nican)

The National Information Communication Awareness Network (NICAN) is a free
information service that lists accommodation venues accessible to people with
disabilities. Their database has information on recreation, tourism, sport and
the arts for people with disability for all of Australia.
http://www.nican.com.au/
National Public Toilet Map

iPhone, iPod touch, iPad, Android and other apps - Find the location of
more than 14,000 public and private public toilet facilities across Australia.
http://www.toiletmap.gov.au/
National Relay Service

The National Relay Service (NRS) is an Australia-wide telephone access service
provided for people who are deaf or have a hearing or speech impairment. It is
also available to anyone who wants to call a person with a hearing or speech
impairment. http://www.relayservice.com.au/
People with a disability

Services and payments are available to help people who have an illness, injury or
a disability. There is also support to assist their families or carers.
http://www.humanservices.gov.au/customer/themes/peopie-
with-a-disabiIity
Public toilet map

The National Public Toilet Map (the Map) shows the location of more than 14,000
public and private public toilet facilities across Australia. Details of toilet
facilities can also be found along major travel routes and for shorter journeys as
well. Information is provided about each toilet, such as location, opening hours,
availability of baby change rooms and accessibility for people with disabilities.
http://australia.gov.au/service/public-toilet-map
Shut Out: The Experience of People with Disabilities and their Families
in Australia
The National Disability Strategy Consultation Report prepared by the National
People with Disabilities and Carer Council 2009. The report provides detail on
the key barriers and issue facing people with a disability, their families and
carers and highlights the solutions offered b) the submissions. The report also
compares the level of interest against a range of themes and issues that have
emerged, and identifies the existing strategies that submissions suggest are
working well.
http://www.fahcsia.gov.au/our-responsibilities/disability-and-carers/publications-
articles/polic)
-research/shut-out-the-experience-of-people-with-disabilities-and-their-families-in-
australia
Young Carers
The Young Carers website provides contacts and support for children and young
people, families and primary teachers. Their respite and information services
program assists young carers to complete their education.
http://www.youngcarers.net.au

Section 6: You and the Disability
Care
Environment
Being an effective support worker in the new disability care environment calls on
us to have the ability to communicate well, listen, negotiate, advocate and be
aware of others moods and feelings. We also need to know how to be self-
directed, manager our time efficiently, demonstrate flexibility, deliver a
professional service and respond appropriately to both the client and family. No
small feat!
Community and disability service workers spend their working lives interacting
with people in many stressful and emotionally charged situations. Hence, these
workers need to explore their own emotional intelligence and work at developing
areas of themselves that may affect their ability to communicate effectively with
clients.
The ability to know when you need talk to someone or debrief after a challenging
day at work, while maintain client privacy and confidentiality, is also crucial. Also,
knowing when you need a break, a holiday or to seek some help when you are
going through challenging times, is important. This unit explores some ways to
help us be the most effective and enabling support worker we can be in the new
disability care environment.
The first step to doing this is knowing how we ourselves communicate, react
and behave and how others perceive our communications and behaviours.
Being more self-aware is key to achieving this.

Self-awareness and emotional intelligence
Dealing with emotions
Building rapport
Self-awareness in conflict situations
Debriefing
Time management and effective work habits
Code of conduct
Professional development
Glossary

Self - Awareness and Emotional Intelligence
There is quote from Anais Nin
We dont see things as they are; we see them as we are
This is why we need to make that journey inwards to look at our perceptions,
reactions, cultural heritage, feelings and learned habits which affect how we hear
and perceive things; how we communicate and how we behave. Knowing how we
feel is part of self-awareness.
To become self-aware is to know your strengths and weaknesses, your triggers,

your beliefs and prejudices. Self-awareness is an essential underpinning skill in an
effective communication. Tools like the Johari Window can help you understand
yourself and the way you interact with others. The more we are aware of our
feelings, the better we can adapt our behaviours and understand the behaviours
of others.
We all perceive and react differently to things. Different life experiences and
habits weve developed all throughout our life can sometimes impact upon our
current communication and perception styles. We may even be unaware that
people perceive the way we communicate, listen and behave, as unhelpful. By
understanding why and how we react and what triggers our emotions, we can
better deal with our unhealthy reactions or behaviours in conversations and
relationships with others. We may also react or become defensive if someone
says they dont like what you are doing, as we can feel this is a personal attack
on ourselves.
With our busy schedules it might be difficult to find time to think about who we
are; our strengths and challenges, our drives and personalities, our habits and
values. Besides, many of us just arent inclined to spend much time on self-
reflection. Even when personal feedback is presented to us, were not always
open to it, because honest feedback isnt always flattering. Consequently, many
of us have a pretty low level of self-awareness.
It is good to end each day with a small reflection time to think about how you
listened and communicated with the client. If there was a problem it is also good
to think about if you contributed to this perception or communication difficulty. If

so, see if you can work on this to improve. Check out Johari Window at
http://kevan.org/johari or Self Awareness test at http://www.hermes-
press.com/CCC/SA_test1.htm.

Good Emotional control:
Support workers who understand and manage their emotions effectively,

generally dont verbally attack others, react to criticisms by others, stereotype
people, or compromise their values. This ability to understand and manage your
emotions well is often related to good self-esteem. Our clients are going to have
days where they are tired, in pain, frustrated, feeling vulnerable and may not do
what is in their care plan. Remember, the support workers are the ones who are
there to enable the client and we need to understand where the clients
frustration, anger or unwillingness to engage is coming from. Generally, the
frustrated communication and behaviour is not a personal attack on the support
worker it is aimed at an action the support worker is doing, which may be
causing the client distress, therefore, we need to correct the action (if
appropriate) and not feel personally insulted and react. Some strategies to
improve emotional control are to practice being calm when you perceive you are
being insulted, and focus on the act that the person disagrees with.
Well motivated:
Support workers who are self-aware are generally well-motivated as they are
aware of their sense of purpose and this gives them energy to get through the
days and weeks, despite multiple challenges. They know they want to make a
difference to the lives of others, and the clients will notice this enthusiasm and
positiveness. The last person a client with a disability wants to see is someone
turns up to their house that is miserable and lacking commitment to their job.
Have empathy:
A lot of people need training in empathy, not sympathy
Sympathy refers to making it known that you aware of another persons distress
and have compassion for them, whereas empathy goes deeper and refers to
the ability to put yourself in someone elses shoes. In empathy you enter into a
deeper level of understanding of the persons experience. Those that empathise
often have an ability to listen well, and understand that other people
see/perceive things and situations differently. This support worker is not
threatened by different feedback from their client and often pays attention to
body language and feelings of clients.

Self-awareness and a good emotional intelligence are linked. Emotional
Intelligence is far more than just how you feel or what mood you are in. In the
world we live in, it is vital that we have a high level of emotional resilience,
otherwise we could fall prey to stress, fatigue, burnout, failure and sickness in
many areas of our life. It is essential for workers to have the necessary
emotional skills to perform their work effectively.
Managing our emotional response to a situation we find ourselves in can have a

profound effect on the outcomes.
Let's take a simple example: How do you feel when someone cuts in
front of you when you are driving or changes lanes without indicating?
Your first reaction should be to do what you can to ensure there is no danger of a
collision. Maybe that process is as simple as slowing down a little. And hopefully
that reaction should almost be instinctive.
However for some people the reaction - often a first reaction - is one of abuse and
anger directed at the person who moved in front of them. So they direct their
anger at the person by yelling, tooting the car horn, even speeding up to
reclaim' their position, to re-assert themselves.
Emotional Intelligence is the ability

to identify your own and other people's emotions
to understand the source of those emotions,
to manage them in a way that achieves the best possible results for
relationships with other people and for your own emotional wellbeing, and
to manage those emotions in a way that is consistent with your goals and
values
Research has indicated that employees and leaders with higher levels of
emotional intelligence skills produce vastly better outcomes in the workplace.
Higher level emotional intelligence skills have been linked to longer workplace
retention rates, less sick leave, improved teamwork outcomes, higher levels of
profitability, higher rates of second interviews in job applications and even better
health.
Emotional responses will happen, but the nature of the response and the level at
which you experience it is entirely up to you. Real-time emotional self-regulation
is at the core of the emotional intelligence. And it's a positive impact that can
affect every aspect of our lives.

GROUP DISCUSSION
Consider the following situations and reflect how you feel when people have
given you feedback. To be discussed in class.
1. A client tells you are not doing something properly? How do you feel?
What is important to consider? What do you say?
2. A family member tells you the other support workers are doing their tasks
better than you. How do you feel? What is important to consider? What
do you say?
3. Your supervisor tells you off for something you forgot to do. How do you
feel? What is important to consider? What do you say?

Discussion: In these situations and others when youve been given feedback or
criticised, can you do the following:
Respect other people and their feelings?

Identify your own feelings?
Take responsibility for your own emotions?
Maintain control of your own emotions?
Validate others feelings and values?
Not rush to judge or label other people and situations?
Not manipulate, criticise, blame or overpower the client and family?
Challenge your habitual responses and consider alternative responses?
Not live in the past, learn from this experience and not carry negative
feelings forward?
GROUP DISCUSSION
As a group discuss responses and other real life situations for 10 mins. Things to
discuss. How do you feel when a SW or family criticises what you are doing? What
should you do or say? This exercise is to get staff to learn to not take things
personally and keep focused on the client and situation. Learn how to debrief
outside the situation and to reflect on how they can handle a situation better.
De-escalate, empathise and act.
DEALING WITH EMOTIONS
Be aware of the clients daily disposition, particularly on arrival...

To understand the clients feelings and emotions and apply this awareness
to the support/work to be done
Life is full of frustrations - from the minor irritation of losing your car keys to the
major anxieties of continued failure towards a goal. Frustration is not a pleasant
emotion

Generally carers and support workers tell us that caring is a role they find
rewarding and satisfying but many also face challenges that they did not
originally expect to face as a carer. Each caring relationship will be different and
the impact of the caring role will differ from one situation to the next, and alters
over time.
When youre burned out, problems seem insurmountable, everything looks bleak,
and its difficult to muster up the energy to carelet alone do something about
your situation. The unhappiness and detachment burnout causes can threaten
your job, your relationships, and your health. But burnout can be healed. You can
regain your balance by reassessing priorities, making time for yourself, and
seeking support.
Compassion fatigue is a term used to describe the feeling of frustration,

emotional distress and sorrow that you might feel when working with your clients.
These symptoms are also referred to as secondary post-traumatic stress disorder
and it's different from burnout caused by job stress. Compassionate fatigue
involves emotional, physical and spiritual exhaustion caused by witnessing and
absorbing the problems and suffering of others a key concern when you're
involved in support work. Managing compassionate fatigue can be challenging
and involves being able to develop proper boundaries and put aside your
personal issues and feelings in the best interest of your clients.
BUILDING RAPPORT
Rapport describes a positive relationship that forms between two or more
persons. Once you have identified the possible barriers to effective
communication and considered some strategies to overcome these, you can then
look at how to build rapport with the client. Establishing good rapport with others
is an essential skill for community and disability support workers.

Rapport is the ability to make others feel comfortable with you. This starts at the
beginning of each interaction with a smile, handshake and direct eye contact, as
well as knowing the clients name, something about their business, and their
organisation or industry. Every interaction you have with the client is an
opportunity to build rapport.
Strategies for building good rapport include:

being clear about your role and the purpose of the interaction
using a person's preferred name when speaking with them
paying attention to making them comfortable
using a pleasant tone that is clear and precise
explaining words and expressions that may be unfamiliar and not using
jargon
asking simple and clear questions
explaining what you already know
explaining clearly any mandated position you have. For example, you may
have to report to other authorities any disclosure of abuse
explaining the actions that are undertaken both during the interview and
as a result of the interview
using age-appropriate language and avoiding jargon and use words

familiar to the other person
conveying acceptance by showing interest and concern
being sincere and realistic in praise and goal-setting
not promising anything that cannot be delivered when the interview is over

Personal attributes that will assist support workers to be responsive to client
needs include:
sincerity - to be genuine and honest
confidence - being self-assured or confident in one's own ability
enthusiasm - to show interest, displaying good knowledge
efficiency - capable of producing the required result with minimum waste

or effort
empathy - identifying oneself mentally with the client in order to fully

comprehend their needs
interest in other people - showing concern for their needs
Once you have developed a good rapport, it is important to build on this by

continuing the communication. It's all about attitude, developing a rapport,
adopting a win-win approach, communication, and being client focused.
Self-awareness in conflict situations

'Anger is a signal and one worth listening to!' (Lerner 1985)
When a conflict is developing between yourself and a client or colleague, anger is

usually present. It is important to examine where that anger is coming from and
what needs are not being met both within yourself and within the client's
situation.

You need to be very honest in acknowledging personal limitations and prejudices,
and avoid imposing your own personal values and beliefs on others. These could
include:
feeling threatened by the other person
commitment to personal values or beliefs
being unsure of your information
being unassertive, aggressive, talkative, or having low self-esteem
being judgmental or having expectations
using inferences rather than facts or observations
Feelings can bubble up unexpectedly and you may not be prepared for their
intensity. This can exacerbate the potential for conflict developing with clients or
co-workers. It is vitally important for you to be able to examine your responses to
others and to be constantly aware of what your feelings and perceptions tell you,
about your needs and those of your client, and whether these are being met.
People in conflict can approach the situation competitively or they can attempt to
cooperate, while still acknowledging the existence of a conflict. When people
compete in a conflict, they usually perceive that there will be an outcome in
which one side wins and the other loses. If people attempt to approach a conflict
cooperatively, they try to find a solution both parties can be satisfied with.
People's behaviour in conflict falls into five styles described below:

avoiding withdrawing from the conflict
smoothing finding common interests or areas of agreement
compromising bargaining so that each side gets a part of what they want
forcing one side causes the other side to change
problem Solving attempting to find a solution that meets both needs
Most of us regard conflict as something to be avoided. Conflict is not particularly

healthy; however conflict can also be viewed as a necessary stimulant for
development and change. Conflict is not a problem in itself. It is what we do with
it that counts.
It is important that we do something because whether we like it or not, conflicts

demand our energy. In fact, an unresolved conflict can call on tremendous
amounts of our attention. We all know how exhausting an unresolved conflict can
be. It is not always easy to fix the problem but a great energy boost can come
when we do. Resolving conflict requires skills.
DEBRIEFING
The technique of debriefing is useful for anyone following the completion of an
activity, mistake, event or critical incident. Debriefing can serve as an
opportunity to reflect on an experience and make it meaningful by identifying
what we learned about ourselves and others.
Debriefing is telling our story, complete with experiences and feelings,

from our point of view. It is a verbal processing of past events
Debriefing includes both the facts and emotional responses, and invites
feedback
Debriefing is an opportunity to share in depth recent experiences with
someone who is willing to listen and care, without judgment or criticism

Debriefing allows you to let go of emotions and clarify your boundaries,
which is important for avoiding burnout
Debriefing can answer questions including:

Who was involved?
What happened?
Where did it happen?
Why did it happen?
What did we learn?
The debrief should always take place in an appropriate environment and initially
be on a one-to-one basis. The tendency in groups is for there to be peer pressure
which may bias or influence response. Inevitably in a group debrief session there
will be assertive and passive respondents.
It is also best to debrief with a peer, either with your facilitator or a colleague
who has an interest. It may be tempting to debrief with your wife or husband or
even a friend, however, they may not have the emotional distance, skills or
knowledge to allow you to properly debrief and might feel overburdened by the
information you need to share. Breaching confidentiality is also more likely if you
are debriefing with a partner or friend.
Time Management and effective work habits

Self-awareness is also an essential first step toward improving our management
skills. Self-awareness can improve our judgment and help us identify
opportunities for professional development and personal growth. As discussed
earlier, with our busy schedules it might be difficult to find time to think about
who we are, our strengths and weaknesses, our drives and personalities, our
habits and values. Consequently, many of us have a pretty low level of self-
awareness.
That's unfortunate, because self-awareness is an essential first step toward

maximizing management skills.
The management of self, time and workload essentially is the management of

one's self by one's self; without help or prompting; spontaneously. See also: Of
..... . We don't manage time: we manage our use of it. Time cannot be
expanded, reduced, suspended, stored up, distorted or discontinued v.
discontinued, discontinuing, discontinues v.tr. 1. To stop doing or
providing (something); end or abandon: - or even put off until tomorrow.

Making the best use of our time is, therefore, not just a good idea, it is essential.
Frustration over having too much to do, and too little time to do it, is a sure sign
that you are not managing your time effectively. Time management is the
pathway to accomplishment.
Time management addresses four essential processes:

1. planning
2. organizing
3. developing good work habits and
4. eliminating bad work habits
Planning: Take charge of how you will be using your time. Planning is the key. As
with so many other things in life, time can either be our benefactor or nemesis, it
depends entirely on whether we are willing to control time through planning, or
allow time to control, victimize and frustrate us. It is up to you.
Organizing: Being highly organized does not necessarily translate into being
effective. Some people are extremely organized, but they are not particularly
efficient adj. Having or marked by an advanced degree of competence, as in
an art, vocation, profession, or branch of learning. n. An expert; an adept. .....
. Some may be able to function well - be it at the job or in their personal lives,
with sound procedures in place, yet, they still may not be successful in
accomplishing their goals.
Developing good work habits: It's not enough to know your job; you have to
know yourself. What are your strengths and weaknesses? What situations do you
rise above, and under what circumstances do you fail?
Eliminating bad work habits: Achieving this is dependent on the following

factors: self-awareness - knowing and understanding yourself; acknowledgment
in law, formal declaration or admission by a person who executed an
instrument (e.g., a will or a deed) that the instrument is his. The
acknowledgment is made before a court, a notary public, or any other
authorized person. - accepting the truths about yourself. It's no easy task,
however, to really know and accept the truth about ourselves, and then take
charge to become the person we are capable of becoming and to accomplish
what we are capable of achieving.
Procrastination is the greatest time management problem of all. If effective time

management simply were a matter of prioritizing our objectives and identifying
what needs to be done to achieve them, there would be no issue in time or
workload management. Where there is procrastination, there is some
combination of fear, doubt, confusion, frustration and anger.

Schedule some time to be alone each day. Time spent with yourself can be very
beneficial. Try finding a place where the likelihood of interruption is remote.
Understand that your email and voicemail can take over for a while. This is
important time just for you.
ACTIVITY
Which of the following is a time saver?

1. Procrastination
2. Leaving task unfinished
3. Inability to say no
4. Delegation of tasks
Doing which of the following will not help you organize your time
better?
1. Prioritizing
2. Organising
3. Economizing
4. Socializing
Which of the following will help you organize your time better?
1. Procrastinating
2. Streamlining
3. Socialising
4. Holding many meetings
Which of the following can help you save time in regard to e-mail?
1. Allot specific times of the day to check and respond to e-mail
2. Make sure a chime or alarm beeps when you receive an e-mail message
3. Dont get a junk mail filter
4. Check your e-mail as soon as you receive it.
Which is a true statement?

1. Travelling is not a time waster
2. Finish tasks to completion before moving on to the next
3. Leave as many tasks undone as possible
4. An open door policy is usually best
Which of the following can be huge time wasters if not handled

effectively?
1. The telephone
2. E-mail
3. Both 1 and 2
4. Neither 1 or 2
Establishing goals is an important step for effective time management

1. True
2. False
Communication isnt a factor in managing your time.

1. True
2. False

Making a check list is a waste of time?
1. True
2. False
3. Both 1 and 2
4. None of the above
What would be a great tool to utilize when trying to manage time

effectively?
1. Book
2. Timer
3. Patience
4. Pencil
Which of the following can help you save time when it comes to holding
meetings?
1. Hold as many meetings as possible
2. Make sure everybody is allowed to speak at meetings
3. Hold only necessary meetings and keep them on schedule
4. Make meetings a gripe session
What are the top time wasters at work?
1. Water-cooler conversations or chatting with co-workers

2. Computer and software problems
3. Meetings
4. Web surfing
CODE OF CONDUCT
The Code of Conduct and Ethics is designed to assist staff in providing clients
with the best possible service and to manage and resolve workplace issues. As
well as setting out the legal guidelines for complying with rules and directions,
the Code of Conduct and Ethics encourages staff to aspire to high standards of
professional and personal conduct to maintain integrity in the important work we
do. Staff members should be aware that the Code of Conduct and Ethics sets out
a number of obligations and standards that, if breached, can lead to further
action up to and including formal discipline.
The Code of Conduct and Ethics is simply a guide; it cannot address all the
possible ethical challenges that you may face in your employment, therefore your
organisation provides more specific policies and guidelines for certain matters.
You should refer to those documents as well.

If you are unsure about whether the Code of Conduct and Ethics applies to a
particular situation, or what the appropriate course of action to be adopted is,
discuss the matter with your supervisor or the service coordinator. Ultimately, all
staff need to be responsible for their own behaviour and work in an ethical way.
PROFESSIONAL DEVELOPMENT
Professional Development is an integral component of support workers
development. The principal purposes of professional development are to optimise
the quality of working life and to achieve excellence by enhancing and supporting
the existing strengths and potential contributions of all support workers.
Professional development has traditionally been thought of in terms of training

and development. It is true that skills training and capacity building, by-products
of professional development, lead to an increasingly sustainable and capable
workforce. However, professional development is now seen to include a range of
options which develop workers knowledge, skills and attitudes in order to ensure
that they can work confidently and effectively, thus improving service provision.
Professional development incorporates supervision and mentoring opportunities,
on-the-job training, leadership training, and organisational structures to ensure
the creation of a learning culture that embraces the principles and practices in
the workplace.
Professional development is a crucial part of staff development. Managers in the

community health sector cite as one of their greatest needs access to
appropriate and affordable training opportunities that has a community delivery
focus and that allows people to learn in more flexible ways. It is important that
managers work together with staff, clients and carers to recognise current skills
and knowledge, identify areas for development, and then help staff to incorporate
support/care practices into professional development goals.
Example of a Career Pathway in Disability Support Work
Certificate III
Disability

Further Study Other
Certificate IV in Specialisations
Disability Available
Certificate IV in
Community Services
(Lifestyle and Leisure)
Certificate IV in Aged
Care
Certificate IV in Home
Further Study and Community Care
Diploma of Disability
Further Study Coordinator

Other Specialist Fields Youth Worker
Disability Employment Enrolled Nurse
Social Work Opportunities Endorsed Enrolled Nurse
Gerontology Registered Nurse
Clear career pathways, in the traditional sense of leading to increases in
remuneration and job role/responsibility, are not always feasible in the
community disability sector. If people are satisfied in their job, and feel safe in
their work environment, then career pathways become less of an issue.
Reflective Practice
The process of reflective practice, both personal and organisational, is part of
promoting well-being at work. If the organisation is mirroring the individuals
reflective practice, and vice versa, and each are responding to changing needs,
then the worker is likely to feel greater satisfaction with their job role and
professional goals, and more efficient.
Multi Skilling
Providing opportunities to multi-skill staff enables sideway movements within the
organisation. For example, staff can nominate to fill positions as they become
vacant or if someone is absent/un-well. By enabling staff to become multi-skilled
and try working in different areas staff learn what they are good at and enjoy
most.
Higher education
There are a range of higher education courses available in areas such as, but not
limited to, Social
Work, Nursing, Psychology, Occupational Therapy, Applied Social Science,
Behavioural Health
Science, Counselling and Communication, Health Sciences, Management and
Governance.

Courses are available at the Bachelor, Masters, Doctorate, Graduate Certificate,
Diploma or Graduate Diploma level. It is a case of contacting the relevant
institution for further information and course outlines.
Vocational education
Vocational Education Training (VET) is vocational/skill-based, and as such,
provides a wonderful opportunity for managers to sit down with their employees,
and speak directly about their job roles and responsibilities to identify
competencies they are already using and competencies they would like to
develop. The focus is on the work they do, and supporting workers to do their job
well. Managers can then recognise current competencies and suggest particular
training for further development which may be vocationally based and part of the
Australian Qualifications Framework (AQF).
As part of review, managers should spend time with staff developing their
professional and personal well-being - asking staff their training needs, looking
ahead to where they see themselves in five/ten years time, and then helping
them to achieve this. This symbolic gesture by management shows that they are
taking the time to listen to the needs of the staff, getting to know staff, and
helping them to achieve their goals.

GLOSSARY
Abuse
Abuse is the deliberate improper treatment of an individual or group by another
individual or group. Abuse can be physical, sexual, emotional, verbal or financial.
Abuse can be extremely harmful to the mental and physical health and wellbeing
of the victim/s.
Act
An Act is a piece of legislation (a law) passed by parliament. An Act describes
what people must do.
Activities of daily living

(ADLs) are the tasks people do every day, such as cooking a meal, looking after
pets, shopping and cleaning.
Augmentative and alternative communication supports people who have a

severe communication disability to communicate and interact with other people.
Addiction
A state of dependence produced by the habitual taking of drugs, including
alcohol, characterised by compulsion, loss of control and continued patterns of
use despite negative consequences.
Adolescence
Period of growth and development from puberty to maturity.
Adulthood
Stage of growth and development that follows adolescence.
Advocate
Person who intercedes for and acts on behalf of a client when the client is unable
to do so, and may be a professional or lay person.
Aggression
Physical or verbal behaviour that is forceful or hostile and enacted to intimidate
others.
Authority
The right of designated people to make decisions and issue commands.
Best Practice
Best practice means using the best skills and ideas available at the time to do a
task.
Bereavement
A reaction to the death of a loved one (e.g. feelings of sadness and associated
symptoms such as insomnia, poor appetite and weight loss).
Case management/Case co-ordination

The mechanism for ensuring continuity of care across inpatient and community
settings, for access to and co-ordination of the range of services necessary to
meet the individual and identified needs of a person within and outside the
mental health service.

Client
A recipient of services: may be a person, family, group or community.
Counsellor
A health professional that helps clients and families evaluate their patterns of
problem solving and develop more effective ones.
Catheter
A catheter is a small, flexible tube inserted into the body to inject or remove
fluids.
Chat Book
A chat book allows people with communication difficulties to convey information
about activities and events they have experienced using words, objects, photos
or pictures.
Chronic Disease
Chronic Disease is characterised by complex causality, multiple risk factors, a
long latency period, a
prolonged course of illness, functional impairment or disability, and in most
cases, the unlikelihood of cure.
Chronic Disease Self- Management

Involves [the person with the chronic disease] engaging in activities that protect
and promote health,
monitoring and managing of symptoms and signs of illness, managing the
impacts of illness on
functioning, emotions and interpersonal relationships and adhering to treatment
regimes.
Client-directed care
Client-directed care is when the person with a disability decides how and when
tasks and activities are carried out. The worker follows the directions of the client.
The client decides what needs to be done. The client decides in what order and
how a task will be done.
Code of Conduct
A code of conduct is a set of rules that underpin the professional practice and
provision of care.
Code of Ethics
Defines the core values of the field and provides guidance for what professionals
should do when they encounter conflicting obligations or responsibilities in their
work.
Code of Practice
A code of practice is an industry guideline to help in the management of
operations based on regulation or best practice. A code of practice is not law but
should be followed unless there is an alternative course of action that achieves
the same or better standards. These can also be used where no legislation exists.
Collaboration
To co-operate or work with one another to achieve a goal or outcome.
Complex Needs
Complex needs are when a person has been diagnosed with two distinct
conditions or more.

Community
A specific group of people, often living in a defined geographical area, who share
a common culture,
values, and norms, are arranged in a social structure according to relationships,
which the community has developed over a period of time. Members of a
community gain their personal and social identity by sharing common beliefs,
values, and norms, which have been developed by the community in the past
and may be modified in the future. They exhibit some awareness of their identity
as a group, and share common needs and a commitment to meeting them.
Communication
Communication is the transfer of meaning and understanding from one person to
another. This can be via words, body language, visually or by signing.
Compliant
Making a complaint means saying what you think is wrong and asking for it to be
fixed.
Compromise
A compromise is when two or more people have different opinions but work out
how to agree on a solution. No one gets exactly what they want or need, but they
work out a way that everyone can be happy with the solution.
Condition
Condition is a disease or illness.
Conflict
Conflict is a disagreement that occurs when two people have different opinions,
values and beliefs.
Content
Content means feeling happy, safe and at peace with life.
Coping Strategies
Coping strategies are strategies that clients can use to distract themselves or
obtain support to prevent themselves thinking about suicide. They include going
for a walk, writing in a journal or calling a supportive friend.
Core Values
Commitments held by a profession that are consciously and knowingly embraced
by its practitioners because they make a contribution to society. There is a
difference between personal values and the core values of a profession.
Courtesy
Courtesy means being polite. It means using good manners.
Cultural diversity
Cultural diversity refers to the many different cultures that make up a society.
Debriefing
Debriefing is when people get the opportunity to talk about something that has
happened so they can understand it better.

Dignity of Risk
Dignity of risk means a person has the right to make their own choices and to
take risks. It is the role of the community worker to ensure the individual
understands the risks they are taking and therefore is making an informed
choice.
Disclosure
Disclosure means to reveal information, either voluntarily or to comply with
legislation or workplace policies and procedures.
Disempowered
Disempowered means to take power away from a person; for example, by making
decisions for them, rather than in collaboration.
Documents
Documents are written records or reports. They may contain details of events
that have taken place or action that needs to be taken.
Dysfunctional
Dysfunctional means not behaving normally. A dysfunctional family is one in
which conflict abuse in the family occur continually and regularly.
Emotional Needs
Emotional needs are the things that help a person feel safe, secure and happy
within themselves
Empower
Empower means giving people authority and autonomy.
Empowerment
Empowerment means helping clients to develop a sense of control over their
lives and to actively participate in decisions that affect them.
Encouragement
Encouragement means being positive and cheerful about an idea, and saying
things that will help the older person want to join in.
Environmental Factors
Environmental factors are all the things in the world around us that affect our
daily lives, such as air pollution, where we live and work, the school we attend,
our friendship circle or peer group.
Environmental Health
The science of controlling or modifying those conditions, influences, or forces
surrounding man which relate to promoting, establishing, and maintaining health.
Ethics
The study of right and wrong, or duty and obligation, that involves critical
reflection on morality and the ability to make choices between values and the
examination of the moral dimensions of relationships.

Ethical Dilemma
A moral conflict that involves determining appropriate conduct when an
individual faces conflicting professional values and responsibilities.
Ethical responsibilities
Behaviours that one must or must not engage in. Ethical responsibilities are
clear-cut and are spelled out in the Code of Ethical Conduct (for example, early
childhood educators should never share confidential information about a child or
family with a person who has no legitimate need for knowing).
Facilitator
A facilitator is a person who is not connected to the situation or the people
involved. They are open-minded and will make a judgement based on what they
hear.
Funding
Funding is money that pays for the cost of the service. The government usually
provides the money.
Genetics
Genetics means the way genes or biology determines how people develop.
Goal
A goal is the desired outcome. It is an improvement or change to work towards
Grievance process
A grievance process is the way the workplace wants you to deal with problems at
work.
Hazard
A hazard any situation that has the potential to cause (or lead to) harm to people
or property.
Hazard report
A hazard report is a form that records information about risks and hazards. It is
used to record the details of hazards, such as what the hazard is, where it is and
the risk involved.
Hazard report form

A hazard report form is a form that you complete if you think there is a danger or
risk in the workplace.
Hereditary
Hereditary means that something is passed from one or both parents to the baby
through genetic makeup.
Holistic
Holistic health is a concept upholding that all aspects of people's needs
including psychological, physical and social should be taken into account and
seen as a whole. This involves addressing more than just immediate and core
issues of a clients health and to engage in a broad realistic sweep of
stakeholders, across all sectors, focusing on the physical, spiritual, cultural,
emotional and social well-being of the individual, family and community.

Holistic Approach
A holistic approach is care that is responsive to a persons emotional,
psychological, physical, cultural and spiritual needs. It means looking at the
whole picture. In aged care, it means helping with all the older persons needs,
not just one or two.
Holistic Care
Holistic care meets the needs of the whole person, rather than just treating a
particular problem or focusing on one area.
Holistic Care
Holistic care meets the needs of the whole person, rather than just treating a
particular problem or focusing on one area.
Home and Community Care (HACC)

Home and community care is funded by the government. The program provides
basic support and maintenance to people living at home who are finding it
difficult to maintain their independence because of their ageing, a condition or
disability.
Hydration
Hydration means keeping the bodys water at a safe and healthy level.
Health
A state of complete physical, mental, and social well-being and not merely the
absence of disease or
infirmity. Thus the emphasis is on the viewing health positively rather than simply
in terms of an
absence of disease or disability. Increasingly, the attention of health practitioners
is being directed
towards illness prevention and health promotion strategies, rather than focusing
only on curative
approaches.
Health Care
Services Provided to individuals or communities by agents of the health services
or professions to
promote, maintain, monitor, or restore health. Health care is not limited to
medical care, which implies therapeutic action by or under the supervision of a
physician. The term is sometimes extended to include self-care.
Identity
Identity means how you see yourself. It has to do with all the different parts of
your life.
Inappropriate behaviour
Inappropriate behaviour is unsuitable or improper behaviour or behaviour outside
what is socially acceptable.
Inappropriate physical touching

Inappropriate physical touching means touching that is not liked or wanted by the
other person. It can also mean touching that is not suitable to the situation.
Incident Report

An incident report documents any unusual problems, incidents or other situations
that may lead to undesirable effects or do not comply with workplace policies and
procedures or practices.
Individual Needs
Individual needs are the particular needs of each person. Everyone has different
likes and dislikes.
Individual Plan
An individual plan is a care plan that describes the support given to an individual
Informed Choice
Informed choice means knowing what choices they have. It means being given
information to understand all the choices. It means being allowed to make the
choice.
Integration
The linking together by various means of two or more service providers and/or
agencies to address the individuals or familys preventive, treatment, and
maintenance health needs in a more coordinated and comprehensive manner.
Interpersonal Skills
Interpersonal skills are communication skills that show respect, understanding,
interest and trust. These skills help to develop and maintain relationships with
other people.
Interpreters
Interpreters are people who are trained to understand and speak two or more
languages. They listen to one person speaking a language and then translate the
words into the other persons language so that both people understand each
other.
Intervention
An intervention is treatment, including taking steps to address problems,
conditions or complaints.
Jargon
Jargon is a specialist language used by a particular group or industry.
Job Description
A job description is a document that explains your role and responsibilities, the
tasks you have to do and who you report to.
KPI
Key performance indicators are the areas a person will be measured on in terms
of whether they are undertaking their job effectively.
Kind
Being nice to another person.
Legal Guardian
A legal guardian cares for a person usually because they are unable to look after
themselves. The guardian is given legal permission to perform this responsibility.
Life Experiences
Life experiences are the events that have happened during our lives. They often
help us form views and values.
Loss
Loss occurs when a person loses someone or something that is important or
significant to them.
Mainstream
Mainstream means the most common trend. For example, mainstream schools
are the schools that most people attend. They are the regular primary and high
schools, not special schools just for people with disabilities.
Mandatory reporting
Mandatory reporting is the requirement by law to report suspected cases of
abuse and neglect. Mandatory reporting requirements differ from state to state.
Medical Terminology
Medical terminology is special language used in health care to accurately identify
and describe the body, its systems and various illnesses and disease.
Mentor
A mentor acts as a sounding board for ideas or plans that may affect your career.
Mentoring fosters the development of relationships that benefit both parties. The
mentor provides insight and guidance to another and contributes to their goals
and aspirations.
Misinterpret
To misinterpret is to incorrectly understand, explain or interpret.
Morality
Peoples views of what is good, right, and proper; their beliefs about their
obligations; and their ideas about how they should behave.
Morally Wrong
To be morally wrong means to act in a way that is considered wrong by most
people. For example, most people think it is wrong to treat others unfairly
because of the colour of their skin.
Multilingual
Multilingual means many languages. People who speak a number of languages
are called multilingual. Brochures and signs that are written in different
languages are referred to as multilingual.
Mutual
Mutual means something that is shared between two people.
Myth
A myth is something that is not true but is widely believed.
Neglect
Neglect means ignoring or avoiding.
Negotiating skills

Negotiating skills involve communication intended to resolve disputes, to produce
an agreement upon courses of action, to bargain for individual or collective
advantage, or to craft outcomes to satisfy various interests.
Networks
Networks are groups of people who are linked together in some way.
Next of Kin
A persons next of kin is their nearest relative.
Non judgemental approach

A non-judgmental approach means that you communicate in a balanced way;
your responses are not informed by your personal opinions or prejudices.
Nutrition
Nutrition means keeping the right level of food types in a persons body.
Objective
To be objective is to be free from personal feelings or prejudices.
Observing
Observing means watching, listening and remembering details
Ombudsman
An Ombudsman hears, investigates and resolves complaints from citizens or
consumers about agencies, departments or service providers. An Ombudsman
may be appointed by the government or funded by the industry sector required
to have a disputes-resolution process.
Outcome
An outcome is what happened after an event. For example, if the older person
told you theyd like to join a club, the outcome would be that you or the older
person contacted the club.
Pain Threshold
The amount of pain a person needs to feel before the sensation of pain is
experienced.
Palliative Care
Palliative care is the care of a person who is dying. It means making sure they
suffer as little as possible when medical care cannot make them better.
Passive Activity
A passive activity doesnt take much energy. It doesnt need physical activity to
join in.
Patience
Patience is being able to stay calm, especially when it is difficult. Patience
includes listening closely when people speak to you, taking the time to
understand what they want, not getting upset if they are unreasonable or angry.
Person-centred approach
A person-centred approach to service delivery ensures that the person accessing
a service is central to service delivery; responds to the whole person and focuses
on a social model of care rather than a medical model of care.
Person-centred therapy
Person-centred therapy focuses on developing a personal relationship with the
client to help them help themselves. It is based on what the client wants and
needs. The counsellor encourages the client to express their feelings by listening,
mirroring what the client has revealed then helping them to explore and
understand their feelings for themselves.
Personal Care
Personal care means helping with tasks such as washing, dressing and
undressing, grooming, hair and nail care, toileting, eating and drinking.
Personal Care Support
A personal care support plan spells out the tasks a person needs help with, such
as washing, dressing and undressing, grooming, hair and nail care, toileting,
eating and drinking.
Personal Hygiene
Personal hygiene includes washing, showering, toileting and looking after your
hair and teeth.
Personal protective equipment

Personal protective equipment is used to prevent the workers skin, hair and
clothing coming into contact with surfaces where there may be disease causing
bacteria and viruses. PPE includes gloves, helmets, earplugs, masks, aprons and
goggles.
Personal Safety
Personal safety means your own safety.
Personal space
Personal space is how close you can stand to someone and still feel comfortable.
Perspective
Perspective is your individual point of view, which encompasses the context for
opinions, beliefs and experiences.
Physical Restraint
A person is physically restrained when they are held, tied or locked up.
Policy and Procedures

A policies and procedures manual is a set of rules, guidelines and instructions to
help you do your work correctly.
Policy
A policy is a line of action adopted from other considerations such as government
legislation, to guide and determine present and future decisions. Policies provide
an overall plan with general goals.
Population
Population means the number of people living in a country or area.
Positive Outlook
To have a positive outlook means to be happy and think about the good aspects
of a situation.

Position Description
A position description is usually provided before you accept a position. It details
your duties and responsibilities.
Potential
Potential means the chance of something happening.
Power of Attorney (POA)

If you appoint someone a power of attorney this allows them to make decisions
on your behalf. A financial power of attorney gives the person the power to make
financial and legal decisions. A medical power of attorney gives the person the
power to make medical decisions.
Preference
Preference means someone likes to do one thing more than another.
Privacy
Privacy can mean a similar thing to confidentiality. It can mean making sure you
do not share information with others that it is not their business to know. Privacy
can also mean respecting the right of a person to have their care done in a
private way. Privacy also refers to person and access of others to themselves and
their space, possessions and self.
Professional
Being professional means to act in a correct manner at all times. It means to say
and do the things you have been taught to do.
Professional Ethics.
The moral commitments of a profession that involve moral reflection that extends
and enhances the personal morality practitioners bring to their work, that
concern actions of right and wrong in the workplace, and that help individuals
resolve moral dilemmas they encounter in their work.
Psychologist
A psychologist is a health professional who specialises in treatment of emotional
and mental-health issues.
Psychosocial
Psychosocial relates to the influence of social factors on an individuals mind or
behaviour.
Public Advocate
The Public Advocate is an organisation that is responsible for helping people who
are not able to act for themselves, particularly disabled people, by promoting and
protecting their rights and dignity.
Quality of Care
A level of performance or accomplishment that characterises the health care
provided. There are
measures of the quality of care that can be measured objectively. These include
structure, process, and outcomes.
Quality of Life
Quality of life is defined as individuals perception of their position in life in the
context of the culture and value system where they live, and in relation to their
goals, expectations, standards, and concerns. It is broad ranging concept,
incorporating in a complex way a persons physical health, psychological state,
level of independence, social relationships, personal beliefs and relationship to
salient features of the environment.
Rapport
Rapport relates to building relationships based on mutual understanding and
trust. To build rapport you need appreciate the perspective of others.
Reasonable adjustment
Reasonable adjustment refers to changes made to make sure care is provided in
an inclusive way for all people regardless of their culture, language or disability.
Records
Records are usually written documents that detail information about the
workplace, the people who work there and people who receive a service.
Recreation
Recreation means the activities people do for enjoyment.
Regulations
Regulations are the rules, procedures, guidelines, codes of practice and so on,
that are written by a body that has its authority given to it by an Act of
Parliament. The Work Cover Authority in your state is an example of a body
authorised to make regulations.
Reminiscence
Reminiscence means remembering things from the past.
Reminiscence therapy
Reminiscence therapy is used to support older people and those with cognitive
impairment. It is about respecting the life and experiences of that person to help
them maintain their mental health.
Respect
To treat someone thoughtfully, be polite, listen carefully and think about their
feelings.
Respite
Respite means time away from normal caring duties. Respite means carers (such
as family members) can do things like go shopping, see a movie or visit a friend.
Respite care
Respite care means giving unpaid carers a rest by providing care for a short time.
Review
Review means to check what has happened in order to find out what worked well
and where you need to improve.
Risk
A risk is the chance, high or low, that a hazard will cause harm, injury or ill health.
Risk Factor
Social, Economic or biological status, behaviours or environments, which are
associated with, cause
increased susceptibility to a specific disease, ill health, or injury.
Risk management
Risk management means understanding the situation, deciding the best action to
take and making a plan to deal with the risk.
Routine
A routine is the usual way a person arranges tasks and activities. It may involve a
certain time, place and method used to complete each task.
Segregated
Segregated is when people are removed from the main community to live
separately.
Self-destruction
Self-destruction is when people deliberately harm themselves.
Self-destructive behaviour
Self-destructive behaviour means a person hurts themselves.
Self-determination
Self-determination means having freedom and independence. It means being
able to do things of your own free will.
Self-esteem
Self-esteem means how you feel about yourself and your own value as a person.
Self-reflection
Self-reflection is a form of self-evaluation that a worker usually carries out by
themselves. Self-reflection involves thinking about your work practice and
identifying areas for improvement. Many workers use a journal to reflect on their
daily practice.
Sense of Humour
A sense of humour is the ability to see the funny side of a situation.
Sensory Systems
Sensory systems refer to the eyes, nose, mouth, ears and nerve endings that
provide the sense of sight, smell, taste, hearing and touch.
Sensitivity
Sensitivity means understanding and respecting a persons beliefs. It means not
doing anything without thinking about the other persons feelings.
Service standards
Service standards are standards that particular parts of the community sector
must attain. Usually standards are used to assess whether services meet their
obligations.
Shock
Shock is a physical condition. It occurs when a person has experienced a loss or
other emotional or physical trauma.
Sign
An indication of illness or disease that is visible or measurable
Slide boards
Slide boards are rigid, flat boards that are used to help a person transfer from
one place top another more easily.
Social
Being social means spending time with other people.
Social changes
Being social means being with friends and family. Social changes are the changes
that take place in a persons life in regard to their friends, hobbies and
entertainment.
Social devaluation
Social devaluation is when someone thinks of someone else as having little or no
value because of some characteristic such as a physical or intellectual disability,
or an impairment.
Social interactions
Social interactions are informal meetings and communications between
individuals and small groups of people for enjoyment and friendship.
Socially isolated
Socially isolated means a person being on their own a lot and do not do social
activities.
Socially Network
A social network is a group of people who know each other, share a common link
and meet regularly.
Stakeholder
A stakeholder is a person or group with a direct interest in or that is affected by a
particular issue, enterprise or person.
Standard precautions
Standard precautions are the work practices required to achieve a basic level of
infection control and are recommended in the care of all clients.
Stereotype
A stereotype is a belief or idea about a person or a group of people.
Stereotyping
Stereotyping is presuming that someone or something fits a certain convention or
standard.
Stress
Feeling stressed is the opposite of feeling relaxed. When a person is feeling
stressed, they usually experience a heightened level of physiological arousal.
Supervision or professional guidance

Is the process of being given guidance and advice by someone who has
experience or expertise in your field regarding problems and difficulties that arise
in your work.

Supervision can allow better understanding of your facilitator practice, by
becoming more aware of your own reactions and examining alternative ways of
educating the group. There are three functions of supervision educational,
management and supportive.
Symptom
A symptom is a sign of an illness or disease that is not measurable or readily
observable; it may be based on how the patient feels.

Terminal Illness
A terminal illness is an active disease that cannot be cured and is expected to
lead to death.
Tolerance
Tolerance means accepting other peoples rights to uphold and practice their
ideas, beliefs or customs.
Tolerant Accepting
Tolerant Accepting the way another person thinks or behaves.
Trigger
A trigger is the cause of difficult or challenging behaviour from the older person.
The trigger is what sets off the behaviour.
Understanding
Knowing why a person feels and acts in a certain way.
Unethical behaviour
Unethical behaviour means choosing to do something that is wrong.
Universal Declaration of Human Rights

The Universal Declaration of Human Rights describes the rights that should be
attributed to all humans.
Universal precautions
Universal precautions assumes blood and body fluids of all clients and individuals
are potentially infectious and responds by applying a set of precautions designed
to prevent transmission of infectious diseases to all situations.
Valid
An assessment method is considered valid if measures what it set out to Measure
Values.
Qualities or principles that individuals believe to be desirable or worthwhile and
that they prize for themselves, for others, and for the world in which they live.
Verbal report
A verbal report means it uses spoken words rather than writing the details down.
Volunteer
A person who works for no payment. There are many volunteers in the aged care
industry.
Wellbeing
Wellbeing means being healthy and feeling good.
Western culture
Western culture describes the cultures of Europe and similar countries in other
parts of the world, such as North America and Australasia.

Work colleagues
Work colleagues or co-workers are the people employed at your workplace. They
are the people in your team, such as other workers, your supervisor and your
manager.
Working relationship
A working relationship means how you work together with someone.
Written Report
A written report means it has been written down. It has not just been spoken
about.
Zero tolerance
Zero tolerance approaches favour strategies that promote abstinence over harm
reduction and view illicit drug use as a moral and criminal issue that must be
managed by strict law enforcement rather than public health initiatives.

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CHC08 Disability Care Skill Set Trainer

2 | Page TRAINER GUIDE

The package has been designed to be a comprehensive training resource for

Ground rules for participation include:

The trainers guide is designed to provide information and knowledge required to

HOW TO USE THE TRAINERS GUIDE

KEY LEARNING POINTS

RELEVANT TOPIC POINTS

3 | Page TRAINER GUIDE

Key to the delivery of this training is the involvement of people

It is important to identify various people with disability who would be suitable to

Guest speakers and accompanying resources can be sourced from organizations

The involvement of effective and experienced disability support workers is also

It is suggested that the training material be presented as four key components

4 | Page TRAINER GUIDE

SUGGESTED TRAINER RESOURCE LIST

Hand Hygiene Australia www.hha.org.au/

Scope Victoria http://www.scopevic.org.au/

Aids and equipment

Behaviours of concern/challenging behaviour

Disability awareness and rights

Health and well-being

People with disability - http://www.pwd.org.au/

5 | Page TRAINER GUIDE

Videos and DVDs

PREPARATION FOR TRAINING

6 | Page TRAINER GUIDE

Participant guidelines while training

TRAINING EVALUATION FORM TEMPLATE

Excelle Good Fair Poor Uncerta

Video clips, pictures, photographs and powerpoint.

7 | Page TRAINER GUIDE

4. Did you find the powerpoint/s helpful in illustrating the issues?

5. Please rate the effectiveness of the trainer

Excellent Good Fair Poor Uncertai

6. Did you find the facilities and training room appropriate.

7. Comments for improvement or addition

8 | Page TRAINER GUIDE

DATE NAME TIME TIME SIGNATURE

AFTERNOON TEA BREAK

SUMMARISE THE DAY

Evaluation & close

Discuss with participants the following:

What is Where What do What do What do

Learning Outcomes for the Training Package

Section 1: Welcome to Disability

One in five Australians has a disability.

So, you want to contribute to someones life by enabling them in their

What will you do as a disability support worker?

Nothing pleases me more than to see my clients happy and

Values are closely related to attitudes

Benefits of working as a disability support worker

Salary and wages

Other Conditions and Benefits

1. Disability Service Standards- The nine standards have a primary focus of

2. Duty of Care- A duty of care is a duty to take reasonable care of a person. A

3. Understanding Disability- It is helpful to understand disability and how it

A disability may be visible or hidden, permanent or temporary, and may have a