Supportive Care Theory and Practice

Assignment: The Role of the Support Worker in Preventative Care Assignment- Part 2
Weighting: 10 % of final grade

Course Outcomes:
1. Identify evidence informed practice procedures and the rationale the support worker
can implement to promote optimal functioning using person centered care.
2. Identify how care may need to be altered to accommodate age related changes in the
older adult population.
3. Recognize principles of safety for the individual and the support worker applied in the
delivery of person-centered care.
4. Describe the support worker ’s responsibilities in assisting the individual with routine
activities of daily living and instrumental activities of daily living according to the
principles of person-centered care.
5. Recognize the roles of the interprofessional team related to supportive care practices.
6. Identify the role in observing, reporting, and documenting routine activities of daily
living and instrumental activities of daily living.
7. Interpret concepts of nutrition in relation to food safety, cultural diversity, Canada’s
Food Guide, and fluid replacement.
8. Recognize use of problem solving and critical thinking skills both as an individual care
provider and as a member of the interprofessional care/service team.

Instructions for Assignment:

1. Using your textbook, Sorrentino’s Canadian Textbook for the Support Worker,
lecture slides and resources provided in your shell respond to the “Questions” on
the following pages.
2. All work is expected to be your original work in your own words. All items copied
from other sources must be quoted or paraphrased or summarized with
appropriate citations or references. Academic honesty is expected and
required of all Conestoga students. It is critical that you familiarize yourself
with the Academic Offences Policy found in the Conestoga Student Guide. 
3. Follow the marks for each question.
4. The assignment is divided into 3 sections, worth 10% each. Each section will
be submitted separately on the specific due date for that section.
5. Submit to the Assignment Submission Folder on eConestoga.

Instructions for Submission:

1. To be marked, this assignment must be submitted one section at a time to the
Assignment Submission Folder entitled “The Role of the Support Worker in Preventative
Care” on eConestoga
a. Click on “Supportive Care Theory and Practice.”
b. Click on “Course Tools” tab
c. Click on “Assignment”
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d. Click on the Assignment Submission Folder called “The Role of the Support
Worker in Preventative Care”
e. Upload your file
f. Click “Submit”
2. Receive verification of a “Dropbox submission receipt” in your eConestoga inbox
a. Only the most recent submission to the Dropbox is kept to be marked

Submitting Assignments (from the PSW Program Handbook):

1. Students are expected to submit all assignments on or before the date and time specified.
2. Students should anticipate problems that will necessitate an extension of time.
3. If an extension of time is required, students will make this request to the appropriate
instructor before the due date. Extensions will not be given if the request is made on the
date it is due. Any student requiring more than two extensions will be required to meet
with the coordinator.
4. Assignments that are late and do not meet the above criteria will lose 10% of the value of
the assignment each day that it is late.
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The Role of Support Worker in Preventative Care

Mr. and Mrs. Evan’s are a married couple who live in a small home in the city. Mr. Evan’s
(John) is 84 years old and his wife (Eva) is 78 years old. Mr. Evan’s met his wife in Scotland
and she came to Canada with him and they settled in Kitchener. They have been married for
56 years. They both worked outside the home most of their lives and have 3 grown children
and 5 grandchildren. Two of their children live in Kitchener. They visit often and bring their
grandchildren along, which delights Mr. and Mrs. Evan’s immensely. Their 40-year-old daughter
Jennifer who has severe cerebral palsy lives down the street at Conestoga Group Home. Mr.
and Mrs. Evan’s are essentially home bound. They are adamant they want to age in place and
would rather pay for help to stay in their home than consider moving to an assisted living
setting. Their support worker has been instrumental in supporting Mr. and Mrs. Evan’s remain
in their home.

Both Mr. and Mrs. Evan’s were in excellent health until their 70’s when Mrs. Evan’s had a
massive heart attack (MI). She recovered well initially but has been suffering with congestive
heart failure the last 2-3 years which has made her increasingly short of breath causing her to
fatigue easily. This has impacted her ability to preform her ADL’s and mobilize more than 10-15
feet at a time with a rollator walker. The decline in mobility has contributed to functional
incontinence. Unfortunately, Mrs. Evan’s has developed a stage 1 pressure injury on her
coccyx since she started sleeping in her lazy boy recliner. She sleeps in the recliner because
she finds that it helps with her breathing at night. Mrs. Evan’s states “I have a hard time getting
comfortable, and my bottom is very painful”. Mrs. Evan’s reports, ”I wish I could get more
sleep, I sleep 3-4 hours at best”. She also finds it very stressful caring for her husband. She
says, “he sleeps all day and is often awake most of the night.”

Mrs. Evan’s has been the primary caregiver for Mr. Evan’s who was diagnosed with
Alzheimer’s disease 5 years ago. He had a stroke 2 years ago, has left sided weakness and
walks with the assistance of a quad cane. He is in the moderate stages requiring cueing for
ADL’s. He is particularly reluctant to accept help with bathing. He has been experiencing
urinary incontinence for the last 18 months. Mrs. Evan’s describes her husband as
mischievous. He has always worked hard and enjoys puttering around the home trying to
perform activities he was previously able to do. Mrs. Evan’s is having to keep an eye on him as
he tends to leave the home “to run errands forgetting he can no longer drive”. She has noticed
his clothes are big on him and “he has not been eating or drinking very well over the last 4
months. Sometimes he has difficulty with swallowing. He seems to cough a lot while he is
eating.”

As the support worker you have been caring for Mr. and Mrs. Evan’s for the last 18 months.
Your role is to assist both with ADL’s, mobility and to prepare a light meal for lunch. You have
3 hours to provide care 5x per week. As you arrive at 10 am today you notice Mr. Evan’s is
sitting outside on the front porch in his undershirt and light pants, without anything covering his
bare feet. You hear Mrs. Evan’s calling her husband to “come inside, it’s freezing out there”.
You can see Mrs. Evan’s breathe a sigh of relief when she see’s you have arrived.
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You arrive the next day to find Mrs. Evan’s still laying in her bed, she asks you for assistance
getting up out of bed. You assist her with her transfer and walk with her to the kitchen. As she
is walking, she is out of breath and tells you, "I need to rest, my feet are swollen". She also
states, "My feet are so sore."

You prepare a light lunch for Mr. and Mrs. Evan’s. As you are preparing lunch the Evan’s tell
you that their neighbor, Mrs. Freeman, had brought over a nutritious casserole for supper last
night. She said it was her husbands favorite, one his mother use to make him when he was a
child and it reminds him of being a small boy in Ireland. She says it always brings a smile to his
face to remember his cultural background. Once you have prepared lunch the Evan’s sit and
eat as you clean up. You ask Mr. Evan’s how he is enjoying his lunch. You notice he has tears
in his eyes. He then coughs and you notice he is drooling and there is food pocketed in his
cheeks.

Part 2: Nutrition, Hydration and Elimination

1. Define dehydration. List 3 possible signs of dehydration you will look for in Mr. Evan’s
since he is not eating and drinking well. Identify 3 actions the support worker should
take to support his hydration. (7 marks)

Dehydration
Dehydration occurs when the body loses more fluids than it
takes in, resulting in an imbalance in the body's electrolytes and
Definition of
water levels. This can happen due to a variety of reasons,
Dehydration
including excessive sweating, diarrhea, vomiting, fever, and not
drinking enough fluids.
Warning Sign 1 Dry mouth and throat

Warning Sign 2 Sunken eyes

Warning Sign 3 Dark urine
Encourage Mr. Evan's to drink more fluids throughout the day,
Support Worker Action 1
such as water or clear broth.
Offer foods that have high water content, such as fruits and
Support Worker Action 2
vegetables
Monitor Mr. Evan's urine output and color, and report any
Support Worker Action 3
changes to the healthcare team

2. A dietitian and family are members of the interprofessional team who can address Mr.
Evan’s reduced oral intake and weight loss. Describe their role specific to Mr. Evans. (2
marks)
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Team Member Role Specific to Reduced Oral Intake and Weight Loss
The role of a dietitian in addressing Mr. Evan's reduced oral
intake and weight loss would involve conducting a
Dietitian comprehensive nutritional assessment to identify any underlying
nutrition-related issues and develop an individualized nutrition
plan that meets Mr. Evan's specific nutritional needs

The role of Mr. Evan's son and daughter in addressing his

Family (son and daughter) reduced oral intake and weight loss would involve providing
emotional support to their parents and encouraging them to
follow the dietitian's recommendations
3. In the case study The Evans told you about Mrs. Freeman bringing over a meal that
represented her husband’s cultural background. Explain the impact that culture can have
on nutrition and how you as a support worker can respect cultural diversity related to
nutrition (2 marks). 

Impact of culture on
nutrition Culture can have a significant impact on an individual's food choices and
eating habits. For example, certain cultures may have specific dietary
restrictions or preferences based on religious beliefs or cultural traditions.
As a support worker, it is essential to respect cultural diversity related to
nutrition by understanding and acknowledging the importance of cultural
foods and traditions in the client's life.

How support worker

can respect cultural A support worker may involve learning about the client's cultural
diversity related to background and food preferences, as well as incorporating culturally
nutrition appropriate foods and cooking methods into meal preparation. It is also
important to recognize and accommodate dietary restrictions or
preferences based on cultural or religious beliefs. By respecting cultural
diversity related to nutrition, support workers can provide more
personalized and culturally sensitive care to their clients.

4. As mentioned in the case study, Mrs. Evans has noticed that her husband’s clothes are
big on him and “he has not been eating or drinking very well over the last 6 months”. As
their support worker one of your roles is to assist the clients with IADLs by preparing a
light meal for lunch for Mr. and Mrs. Evans. Based on the 4 components of Canada’s
Food Guide snapshot, what should you include in Mr. Evan’s meal when preparing
lunch? https://food-guide.canada.ca/en/ (4 marks)

1. Vegetables and Fruit: Aim to include at least one serving of

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vegetables and one serving of fruit in the meal. Examples could be a

salad with leafy greens and tomatoes, and an apple or banana as a
side.

2. Protein Foods: Include a source of protein in the meal. This can be from
animal sources, such as chicken or fish, or from plant-based sources,
such as lentils or tofu.

3.
Whole Grain Foods: Choose whole grain options, such as whole wheat
bread or brown rice, instead of refined grains.

4. Milk and Alternatives: Consider including a serving of milk or alternatives,

such as fortified soy or almond milk, to provide calcium and other
nutrients.

5. Due to being in the moderate stage of Alzheimer’s disease Mr. Evans has difficulty with
swallowing which puts him at high risk of aspiration. Define aspiration. List 3 warning
signs from the case study that indicates Mr. Evans is having difficulty swallowing. List 3
actions that the support worker can take to help Mr. Evans with swallowing and to
prevent aspiration. (7 marks)

Aspiration
Definition of Aspiration is the inhalation of fluid, food, or vomit into the lungs,
Aspiration which can lead to pneumonia and other serious respiratory issues.

Warning Sign 1 Coughing while eating

Warning Sign 2 Drooling while eating

Warning Sign 3 Food pocketed in his cheeks

Support worker Encourage Mr. Evans to eat slowly and take small bites
Action 1
Ensure that Mr. Evans is sitting upright while eating to
Support worker
Action 2 facilitate swallowing

Provide Mr. Evans with foods that are easy to swallow and
Support worker
Action 3 have a smooth consistency, such as pureed or mashed foods.
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6. Both Mr. and Mrs. Evans are experiencing urinary incontinence. Define functional
incontinence and urge urinary incontinence. Provide one strategy that the support
worker can use to reduce the risk of functional incontinence in Mrs. Evans and one
strategy to reduce the risk of urge incontinence for Mr. Evans. (4 marks)

Incontinence
Definition of Functional incontinence is the inability to reach a restroom in time
Functional Urinary
due to physical, cognitive, or environmental barriers, even though
Incontinence
the bladder and urinary system are functioning correctly.
To reduce the risk of functional incontinence in Mrs. Evans, the
support worker can make environmental modifications, such as
removing clutter and obstacles, installing grab bars in the
Strategy for
bathroom, and using a bedside commode to reduce the distance
Functional
to the restroom. Additionally, the support worker can encourage
Incontinence
Mrs. Evans to use the restroom on a routine schedule, even if she
doesn't feel the need to go, to decrease the chances of urgency
and accidents.
Urge incontinence is a type of incontinence where the individual
Definition of Urge
experiences an urgent need to urinate, and involuntary urine
Incontinence
leakage occurs before reaching the restroom.
To reduce the risk of urge incontinence in Mr. Evans, the support
worker can encourage him to practice bladder retraining, which
involves scheduling regular bathroom breaks and gradually
Strategy for
increasing the intervals between them. The support worker can
Urge Incontinence
also encourage Mr. Evans to limit his fluid intake before bedtime,
as well as avoid caffeine and alcohol, as they can irritate the
bladder and increase urgency.

7. Mrs. Evans tells you that Mr. Evans has not voided in the past 8 hours. What is the
minimum about of urine in mL that Mr. Evans should have voided in the 8 hours? Why
do you think Mr. Evans is not voiding? What is your responsibility as a Support Worker in
this situation? (3marks)

Minimum
amount of The average adult produces around 30-60 mL of urine per hour, which amounts
urine (ml) Mr. to 240-480 mL over 8 hours. Therefore, Mr. Evans should have voided at least 240
Evans should mL of urine over the past 8 hours.
have voided
Reason Mr. There can be several reasons why Mr. Evans is not voiding. Some possible causes
Evans is not could be an enlarged prostate, medication side effects, urinary tract infection, or
voiding decreased fluid intake
Responsibility As a Support Worker, your responsibility would be to monitor Mr. Evan's urinary
of the Support output and report any concerns to his healthcare provider. You should also
Worker
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encourage Mr. Evans to drink more fluids if appropriate, and ensure that he has
access to a bathroom and can use it safely. If necessary, you may need to assist
him with toileting or arrange for additional support from a healthcare
professional.

Grading Rubric

Criteria Level 0 Level 1 Level 2 Level 3 Level 4 Criterion

Score
1A. Define Dehydration 0 points 1 point N/A N/A N/A /1
Incorrect Correct
1.B. Three Warning 0 points 1 point 2 points 3 points N/A /3
Signs of Dehydration Incorrect 1 Correct 2 Correct 3 Correct
Response Responses Response
s
1.C. Three actions the 0 points 1 point 2 points 3 points N/A /3
support worker can take Incorrect 1 Correct 2 Correct 3 Correct
to support hydration. Response Responses Response
s
2.A. Specific role of the 0 points 1 point N/A N/A N/A /1
dietitian in assisting Mr. Incorrect Correct
Evans with reduced oral Response
intake and weight loss.
2.B. Specific role of the 0 points 1 point N/A N/A N/A /1
family in assisting Mr. Incorrect Correct
Evans with reduced oral Response
intake and weight loss.
3. A Impact of Culture on 0 points 1 point N/A N/A N/A /1
Nutrition Incorrect Correct
Response
3. B How Support 0 points 1 point N/A N/A N/A /1
Worker can respect Incorrect Correct
cultural diversity related Response
to nutrition
4. What are the four 0 points 1 point 2 points 3 points 4 points 4 /4
components of Canada's Incorrect 1 Correct 2 Correct 3 Correct Correct
Food Guide that you Response Responses Response Responses
should take into s
considerations as you
prepare the meal?
5. A. Define Aspiration. 0 points 1 point N/A N/A N/A /1
Incorrect Correct
Response
5.B. List 3 warning signs 0 points 1 point 2 points 3 points N/A /3
the support worker might Incorrect 1 Correct 2 Correct 3 Correct
see that indicate Mr. Response Responses Response
Evans is having difficulty s
swallowing
5.C. List 3 actions that 0 points 1 point 2 points 3 points N/A /3
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the support worker can Incorrect 1 Correct 2 Correct 3 Correct

take to help Mr. Evans Response Responses Response
with swallowing and to s
prevent aspiration.
6.A. Definition of 0 points 1 point N/A N/A N/A /1
Functional Urinary Incorrect Correct
Incontinence Response
6.B. One Strategy for 0 points 1 point N/A N/A N/A /1
Functional Incontinence Incorrect Correct
Response
6.C. Definition of Urge 0 points 1 point N/A N/A N/A /1
Incontinence. Incorrect Correct
Response
6.D. One Strategy for 0 points 1 point N/A N/A N/A /1
Urge Incontinence Incorrect Correct
Response
7. Minimum amount of 0 points 1 point N/A N/A N/A /1
urine Incorrect Correct
Response
7. B Reason Mr. Evans is 0 points 1 point N/A N/A N/A /1
not voiding Incorrect Correct
Response
7. C Responsibility of the 0 points 1 point N/A N/A N/A /1
support worker Incorrect Correct
Response