CHCAGE004

Implement interventions
with older people at risk
Assist with the preparation for a
risk assessment

1.1 Confirm assessment

requirements with
supervisor or relevant
health professional
 Providing a service
Interventions may be required for older people with
health or care concerns. They ensure that the correct
measures are taken to maintain health and wellbeing in
an environment that is supportive.
 An assessment includes:
Ø Identifying and diagnosing conditions
Ø Medical and functioning requirements of the
older person
Ø A person-centred approach to care needs
Ø Recognising potential risks and hazards.
Health professionals may include:
Ø Doctor
Ø Dietician
Ø Diversional therapist
Ø Drug and alcohol worker
Ø Geriatrician
Ø Home care worker
Ø In-home respite worker
Ø Nursing assistant
Ø Etc.
Assist with the preparation for a
risk assessment

1.2 Encourage
participation of the
older person and their
carer in assessment and
further actions
Participation in care requirements
This will provide:
Ø Accurate accounts and information on
the older person’s situation
Ø Answers to questions you have on health
and care issues for the older person
Ø Recognition of risks and associated
hazards
Ø Development of a person-centred
approach to care
Ø Etc.
 Determining actions
Actions may include:
Ø Medical treatments and
visits/appointments
Ø Adjustments to the environment
to remove risks
Ø Supporting care.
 A person-centred approach
A person-centred approach may
involve:
Ø Putting people and carers at the
centre of service delivery
Ø Including people in decision-making
relating to their care
Ø Involving people in discussions about
service delivery options and issues
Ø Etc.
Assist with the preparation for a
risk assessment

1.3 Provide information

to the older person
and/or carer to clarify
own role,
responsibilities and
accountability
 Clarifying your role
Clarifying your role includes:
Ø Defining your responsibilities to
others
Ø Providing understanding on your
accountability
Ø Communicating how you can
support those under your care.
 Duty of care
Duty of care is a legal duty to take all reasonable care to
avoid others being harmed and to ensure that all health
and community workers provide a good standard of
care, with due attention.
 Negligence
The following principles apply to
negligence:
Ø It does not apply if the risk of the
activity was obvious/made clear
Ø What is expected is dependent on the
skill level/experience of the worker
Ø People are given a reasonable amount
of information to make informed
decisions on optional actions (e.g.
medical treatment)
Ø Etc.
 Confidentiality
Confidentiality covers:
Ø Physical privacy of patients in facilities, such as
surgeries, hospitals and residential care homes
Ø Controlling/not sharing records
Ø Monitoring access to records
Ø Disclosure to third parties, such as
employers, other patients, family
members, insurance companies
Ø Use of audit trails to monitor who has
accessed records and when
Ø Etc.
Assist with the preparation for a
risk assessment

1.4 Provide information

to the older person
and/or carer explaining
the assessment process,
including explanation of
results
 The process explained
The process of assessment may include:
Ø Discussing the older person’s medical history
Ø Obtaining test results
Ø Obtaining referral records
Ø Checking progress notes
Ø Confirming medication and treatments
Ø Identifying multidisciplinary care needs
Ø Etc.
 Alleviate tensions surrounding
clients’ rights
Clients have the right to:
Ø Appropriate care for their needs
Ø Access information about their own medical details
Ø A choice of suitable treatments
Ø Be treated with dignity and respect
Ø Live free from abuse and/or neglect
Ø Etc.
 Decisions for clients
Ø Clients have the right to make decisions about their
care and daily lives
Ø Clients should also be encouraged and given the
opportunity to make smaller decisions on a day-to-
day basis.
Assist with the preparation for a
risk assessment

1.5 Communicate in a
supportive and
encouraging manner
that is respectful of the
older person and
carer’s, rights, level of
understanding and
cultural background
 Communicating in a supportive
manner
Ø Communications should be carried out
professionally, via techniques and methods that suit
the older person and their carer(s)
Ø Discuss information with sensitivity and an
awareness of the feelings that may be experienced
by others.
 Cross-cultural communications
Ø Culture refers to values, beliefs and
common behaviours of a certain group
Ø These groups can be determined by a
variety of factors, such as location, age,
upbringing, religion, interests etc.
Ø An individual’s culture is often
determined by many of these factors,
rather than one thing.
 Check information is understood
Ø Ask if the information has been understood
Ø Check if further information is required
Ø Repeat key points/information (as a
summary)
Ø Encourage a discussion to confirm that
understanding has been made
Ø Provide supporting written information.
Assist with the preparation for a
risk assessment

1.6 Seek older person’s

permission and
cooperation in the
assessment process
 Seek permission first
Ø You should always seek the permission of
the older person when performing an
assessment
Ø An older person may find an assessment
a difficult process
Ø An assessment can change how the older
person perceives their health and life.
 Human rights
Human rights relevant to older people include:
Ø Acceptable standards of living
Ø High standards of physical and mental health
Ø Safe and free from violence
Ø Free from cruelty, abuse and inhumane
treatment
Ø Etc.
Contribute to the identification of
risks

2.1 Identify and review

factors in the older
person’s lifestyle that
might affect their level
of risk
 Looking at risks
It is beneficial to identify and take measures to avoid all
risks that can have an adverse effect on an older
person’s health and wellbeing. Review the older
person’s situation and check if their current lifestyle is
detrimental to maintaining health.
 Lifestyle factors may include:
Ø Excessive drinking and/or smoking
Ø High sugar diet
Ø Limited or no exercise taken
Ø Too much exposure to the sun.
 Risks for older people
Ø Depression and anxiety
Ø Isolation
Ø Abuse
Ø Falls
Ø Medication
Ø Dehydration and malnutrition
Ø Dysphagia
Ø Continence.
Contribute to the identification of
risks

2.2 Use appropriate

tools and
methodologies, within
scope of role, to
determine risk based on
physical indicators
presented by the older
person
 Make use of tools and
methodologies
Assessment tools are the established set of questions,
determined scales of evidence and other known
information that are specific to the requirements of a
particular type of assessment.
 The Barthel Scale
The requirements for the Barthel ADL Index include:
Ø Determining incontinence problems
Ø Using the toilet
Ø Maintaining personal hygiene
Ø Ability to cook/prepare meals
Ø Mobility issues.
 Trends
Ø Most people needing care are those of an older age
Ø The philosophy for care is to help the older person to
stay in their home for as long as possible through
providing a variety of health and care packages
Ø Care requirements are more complex and there is a
need for more flexible care.
 Risks
Risks to the older person may include:
Ø Environmental hazards, such as uneven flooring or
poor lighting at home
Ø Care hazards, such as ensuring medication and
treatments are received
Ø Abuse, such as financial or emotional.
Contribute to the identification of
risks

2.3 Assist with risk

assessment ensuring to
minimise unnecessary
discomfort to the older
person and maximises
their participation
Contribute to the identification of
risks

2.4 Use the support of

carers to identify risks
 Perform a risk assessment
Ø The process of a risk assessment will be to look at
the situation of the older person and to evaluate any
risks that may arise from the health and care needs
required for them
Ø Risks are the danger factors that an individual is
exposed to, the hazard is the consequence of a risk
factor.
A risk assessment should include:
Ø Observing and identifying the risks and
associated hazards
Ø Evaluating and prioritising the risks
Ø Deciding upon the preventative measures
Ø Taking action to implement the
preventative measures
Ø Regular monitoring and reviewing of
measures in place.
 Older person and carer
involvement
Ø You should include the participation of the older
person and the carer(s)
Ø This allows them to give their views on potential
situations of risk and on how they can be managed.
Contribute to the identification of
risks

2.5 Recognise the older

person’s risk factors
based on medical
history, measurements
and findings, in
collaboration with
supervisor and/or
relevant health
professional
 Recognising risks
You should check the following:
Ø Medical history
Ø Measurements/test results
Ø All findings.
 Collaborate with professionals
Ø Collaboration should be made
with your supervisor; they will
need to keep a check on your
casework
Ø You may also need to
collaborate and check with
other relevant health
professionals on aspects of risk
affecting the older person’s
health/condition.
Contribute to the identification of
risks

2.6 Identify the older

person’s needs, issues
and concerns outside
scope of own practice
and refer to appropriate
supervisor and/or
health professional
 Scope of practice
Ø Your ‘scope of practice’ refers to the actions and
procedures that you are permitted to undertake
Ø It generally refers to what you are licensed to do,
though unlicensed workers also have restrictions
placed on the actions they can do.
 Assisting the older person
Referring to other health professionals will include:
Ø Gathering information on the needs
Ø Identifying the correct health professional/service
Ø Documenting and following organisational processes
Ø Carrying out your communications with the health
professional/service.
Implement risk minimisation
strategies

3.1 Identify and explain

options to minimise risk
to the older person
and/or carer
 Using strategies
Strategies may include:
Ø Maintaining safety and wellbeing
in the home
Ø Increased social interaction for
mental wellbeing
Ø Maintaining mobility and health
through gentle exercise.
 Inform on the possible options
Options to minimise risk may include:
Ø Providing additional care services
Ø Using a’ meals on wheels’ service
Ø Visits with an occupational therapist.
Implement risk minimisation
strategies

3.2 Work with the older

person and carer to
identify risk
minimisation strategies
that are consistent with
the older person’s safety
needs, priorities and
specific requirements
 Risk minimisation strategies
Ø Every older person will have their own
specific set of care needs and these
will be further defined by the severity
of condition(s) suffered, their age, the
environment and their living
arrangements
Ø To ensure the older person’s safety is
met you should identify and apply risk
minimisation strategies appropriate to
the situation.
 Risk minimisation for falls may
include:
Ø Exercise and high dose vitamin D
Ø Occupational therapy and/or podiatry care
Ø Psychoactive medication withdrawal
Ø Optimisation of visual abilities.
 Risk minimisation for mobility
issues may include:
Ø Use of specialist equipment or
conversions within the home
Ø Gentle exercise for movement
and to build strength in
connective tissue
Ø Encouragement of performing
daily activities to retain mobility
for as long as possible
Ø Attending physiotherapy/
occupational therapy.
Implement risk minimisation
strategies

3.3 Implement
strategies in a safe and
effective manner that
minimises the older
person’s discomfort
Implement risk minimisation
strategies

3.4 Support carer in

contributing to the
implementation of
strategies, where
appropriate
 Implementing strategies
Your process should be clear, simple and plausible for
those involved to use; they should minimise disruption
and discomfort to existing routines.
 Carer support
Be aware of the situation of the carer(s) looking after
the older person; check their circumstances and
availability to provide care and assistance to the older
person.
Carers may be:
Ø A spouse or partner
Ø A family member
Ø A friend/neighbour
Ø An employed carer who is
paid to provide care.
Monitor risk minimisation
strategies

4.1 Monitor the effects

of the strategies on the
older person
Monitor risk minimisation
strategies

4.2 Identify any

indicators of increased
risk
 A system to monitor strategies
Monitoring includes:
Ø Checking care is being provided
safely and effectively
Ø Compiling information and
evidence for reporting
requirements
Ø Recognising if strategies are
working and making changes to
these as needed.
 Check for an increase in risk
Indicators of increased risk may include:
Ø Anxiety or depression in the older person
Ø Injury or a downturn in health of the older person
Ø An increase in occurrences of concern
Ø Additional strain/stresses placed on the carer
Ø Etc.
Monitor risk minimisation
strategies

4.3 Identify when

strategies are not having
the desired result and
possible reasons for this
Monitor risk minimisation
strategies

4.4 Reassess and

identify more
appropriate strategies
 When a strategy doesn’t work
Strategies may fail or not provide the expected results
for various reasons. These may be due to
environmental factors, medical influences or changes
to care services/carer situation.
 Reassess strategies
New actions may include:
Ø Providing additional services for
home care, e.g.
o domestic help
o transportation
o social support
Ø Providing more support through additional home visits
and communications
Ø Reassessing the level of home care package provided
Ø Looking at providing care in an aged care home.
Monitor risk minimisation
strategies

4.5 Work with the older

person and carer to
assess the outcomes of
risk minimisation
strategies
 Assessing the outcomes
Ø Working with the older person and carer(s) will
enable you to fully determine the measure of success
and provide a consistent understanding to all
Ø You should ensure that the older person and carer(s)
are fully compliant on your request and visit.
 You will need to know:
Ø How the strategies have impacted upon
activities and daily routines?
Ø Have these been difficult to implement
or maintain?
Ø Have you seen/experienced positive
results from these?
Ø Have there been difficulties for the
older person as a result of the
strategies?
Monitor risk minimisation
strategies

4.6 Discuss feedback

from the older person
and carer with
supervisor and/or or
relevant health
professional
 Take time to obtain feedback
Ø Feedback can be given verbally and in writing and
will depend upon how your communications are
conducted in the course of your work duties
Ø For care of an older person, feedback is best gained
directly from the persons involved, i.e. the older
person, the carer(s) and any other service providers.
 Provide feedback to others
You will need to analyse the feedback provided and
assess whether:
Ø Feedback is objective
Ø Feedback provides clear accounts/details
Ø There are influences prompting feedback.
Monitor risk minimisation
strategies

4.7 Complete, maintain

and store all relevant
documentation and
reports according to
organisation policy and
protocols in a timely
manner
 Documentation
Ø When creating reports and workplace documents,
you need to comply with organisational reporting
requirements at all times
Ø Many records and work documentation are created
and accessed on computers and database systems
Ø You may also need to keep paper copies.
 Documentation may include:
Ø Applications for services
Ø Claim forms
Ø Patient/client records
Ø Medical/health cards
Ø Supply/medical stores documentation
Ø Information on services for clients
Ø Certificates
Ø Medical reports
Ø Care reports
Ø Staff documentation.
 Storing documentation
Ø Documentation must be filed in accordance with
organisation policy and protocols
Ø Make sure that all electronic/computer records are
saved and stored appropriately
Ø All paper copies should be stored in a suitable filing
system that is kept secure and is easy to navigate.
 Summative Assessments
Summative assessments consist of:
Ø Skills assessment
Ø Knowledge assessment
Ø Performance assessment.

Your assessor will provide you with further guidance on

how and where to complete these assessments.
 Summary and Feedback
Ø Did we meet our objectives?
Ø How did you find this session?
Ø Any questions?