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Unit 3. Home support services

Situation and Reading

Living at home

Activity 1. Reading activity. Fill in the blanks with the words from the box.

intimacy quality of life autonomy socio-affective environment

homes capabilities life project

With HSE, users will be able to stay longer in their ______ with a good __________.
They will be able to develop their _______________in their ____________,
maintaining their __________ for as long as possible and promoting their _________
and their ________.

With HSE, users will be able to stay longer in their homes with a good quality of life.
They will be able to develop their life project in their socio-affective environment,
maintaining their intimacy for as long as possible and promoting their autonomy and
their capabilities.
Activity 2. Match each definition with the corresponding concept.

1. Social HSE a. People who have a recognized situation of dependency in

accordance with the provisions of Law 39/2006, of 14
December, on the Promotion of Personal Autonomy and
Care for Dependent People, and have the right to the
provision of HSE in accordance with the implementation
of this law.

2. HSE on b. A person who is paid to help with cleaning and other

dependency menial tasks in a person's home.

3. Domestic c. An organized and coordinated set of actions carried out in

worker the user's home, aimed at providing personal care, urgent
care, home help and social support to those people or
families with a lack of personal autonomy, developmental
difficulties or with special family problems.

4. Family d. Users are people and families who, for different reasons,
caregiver are in a situation of risk or social vulnerability.
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5. HSE e. A person who is responsible for providing the required

care and attention to people who need support in the
activities of daily living (ADL), always taking into account
the family environment.

1. D
2. A
3. B
4. E
5. C

Activity 3. Reading activity. Point out the four reasons why you think it is positive that
Claire is staying at home for as long as possible.
a. loneliness
b. preserve her privacy
c. the dissociating with the external environment
d. stay connected to her familiar everyday environment
e. to be able to carry out her life project
f. not being institutionalized and not having to get rid of those important objects that
have a great sentimental value for her
Answers:
b, d, e, f

Activity 4. Who do you think can ask for the support of social services and as a
consequence a social HSE could be activated?
a. primary care centre
b. direct relatives
c. the neighbours
d. all the answers are correct
Answer: d
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Vocabulary
Home care professionals, home care actions, home support services,
characteristics of a good HSE professional

Activity 1. Complete the following sentences about the principles of the patient-centred
model with the words in the box.

professionals - education - people - care plan - emotional support

physical comfort - coordinated assistance - family - preferences
quality of life - friends - changes

a. In any intervention, it is necessary to respect _____________’s ____________.

b. The user needs to receive ___________ from the different _________ involved.
c. It is necessary to promote information and ___________ to patients in order to
improve, enhance and maintain their _______.
d. The person must have the maximum _______ possible.
e. A good follow-up and _________________ are needed.
f. ____________ and ____________ participation is necessary throughout the
intervention process.
g. Continuity and attention when there are _________ due to illness, change of
environment are necessary.
h. The ____________ must be accessible by all the professionals involved.

a. In any intervention, it is necessary to respect people’s preferences.

b. The user needs to receive coordinated assistance from the different professionals
involved.
c. It is necessary to promote information and education to patients in order to improve,
enhance and maintain their quality of life.
d. The person must have the maximum physical comfort possible.
e. A good follow-up and emotional support are needed.
f. Family and friends participation is necessary throughout the intervention process.
g. Continuity and attention when there are changes due to illness, change of
environment are necessary.
h. The care plan must be accessible to all the professionals involved.
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Activity 2. Relate each of the tasks in the box with the professional who performs them.

Family caregiver Domestic worker

1. Mop the floor.

2. Cook and prepare simple dishes.
3. Help the person access the shower tray and perform the activity.
4. Do the shopping, and whenever possible with the patient.
5. Make sure that the wardrobe is tidy and that there are no dirty clothes inside.
6. Clean the bathrooms.
7. Remove the dust.
8. Help the user who does not have family support to carry out administrative
procedures such as applying for dependency, managing social assistance, etc.
9. Check that there is no out-of-date food in the fridge or pantry.

Family caregiver Domestic worker

2, 3,4,5, 8, 9 1, 6, 7

Activity 3. From the following list, mark the groups you think the HSE is aimed at.
a. People with dependency and loss of autonomy in the BADL or IADL.
b. Single-parent families without financial resources.
c. People with some kind of physical, mental or sensory functional diversity.
d. Families with children who need specialized care at home.
e. Families with the title of a special large family.
f. Chronically ill or terminally ill people.
g. Old people over 75 years.
h. A coexistence group where people with intellectual disabilities live together.
i. Families with economic problems and social risk.
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Answers:
a, c, d, f, g, h

Activity 4. List 4 care resources or coexistence groups where you think an HSE can
intervene. In groups of 3, try to expand the list to 8 care resources or coexistence
groups.

Possible answers:
Houses with services for the elderly
Sheltered housing with people with intellectual disabilities
Sheltered housing with people with mental health diagnoses
Therapeutic flats/houses for people with drug addiction
House where a blind person lives
House of elderly person with dependency
House of a child with chronic pathology
House with a person with neurological diseases (Parkinson's, stroke, dementia…)

Activity 5. Professionals in HSE teams must have a range of skills and abilities. Relate
each skill to its definition.

1. empathy a. The fundamental reduction in the number of wasted resources

that are used to produce a given number of goods or services
(output).

2. active listening b. A technique of gathering information that basically consists of

observing, accumulating and interpreting the actions,
behaviour and facts of people or objects.

3. efficiency c. The state of keeping or being kept secret or private.

4. effectiveness d. The ability to understand and share the feelings of another.

5. observation e. The degree to which something is successful in producing a

desired result; success.
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6. assertiveness f. Shows that you respect yourself because you're willing to stand
up for your interests and express your thoughts and feelings.

7. confidentiality g. It is a way of listening and responding to another person that

improves mutual understanding. It is an important first step to
defuse the situation and seek solutions to problems.

1 d) 2 g) 3 a) 4 e) 5 b) 6 f) 7 c)

Activity 6. Taking into account the definitions of the previous exercise, give an
example of each of these abilities and skills. We provide an example so that you can see
that the example needs to be contextualized.

1. empathy

2. active listening

3. efficiency You perform an HSE service in a house where there are some
mental health users. The goal in your intervention is to
monitor that one of the users takes a shower at least twice a
week, that he uses the washing machine correctly, that he does
the housework that is assigned to him that week and that he
has his room (including wardrobe) in order,. Since you have
these goals in mind, when you finish your shift you make a
checklist to ensure that they have all been achieved.

4. effectiveness

5. observation

6. assertiveness

7. confidentiality

Open activity
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Activity 7. In groups of 3 or 4, choose one of the examples of abilities or skills you like
best from the previous exercise. Design a role-play to do in front of other classmates
who will have to guess the ability or skill you are performing.
Open activity

Activity 8. In small groups analyse the following case.

You are part of an HSE and you start a home service today. The user is an 85-year-old
lady with Parkinson’s whose main caregiver is her 88-year-old husband. They have two
sons who live far from their house. In the work plan, it says that you will help the
woman in her hygiene and shower activities, but when you get to the user’s home, you
meet her husband who says he can no longer be in charge of the situation. His wife fell
last night with no notable injuries.

Taking into account the symptoms of the pathology and the social environment,
consider these questions:
• How do you think you should handle this? What should you do with all the
information collected?
• What skills and attitudes should you develop during this intervention?
• Given the person-centred model, should you limit yourself to performing the
tasks assigned to you?
Open activity

Activity 9. HSE is a comprehensive and individualized service structured in different

areas of intervention: personal care, domestic help, socio-educational support and
relationship with the environment. On the other hand, it has other supplementary
services. From the following list, what do you think these services can be?

• review lessons for children with intellectual disabilities

• laundry service
• home catering service
• accompanying to doctors and specialists
• cooking lessons for people who don’t know how to cook
• telecare
• smoke detector service
• cognitive stimulation workshops

Answers:
laundry service
home catering service
accompanying to doctors and specialists
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telecare

Activity 10. Relate each of the areas of HSE intervention with the functions they
develop.

1. personal care a. Actions aimed at promoting the acquisition and

development of the person’s abilities and skills by
promoting decision-making.

2. socio-educational b. Actions aimed at attending to and supporting the activities

support of daily living.

3. domestic help c. Actions aimed at home care and focused on the person and
group of coexistence.

4. relationship with the d. Actions aimed at strengthening the person's relationships

environment in their own home, within the family context and with the
community network.

Answers:
1-b 2-a 3-c 4-d

Activity 11. Imagine that you are working in an HSE team in a flat with people with
mild intellectual disabilities. Sequence the following actions and activities to enhance
the area of socio-educational support and the area of relationship with the environment.

a. Search together in the neighbourhood or nearby surroundings for activities,

workshops, courses etc that could be of interest to them.
b. If there is no activity, workshop, sport that interest them, make proposals taking into
account their concerns and previous experiences.
c. Carry out, offering the necessary support in the management of the procedure, the
registration to these workshops or activities.
d. At the end of the course, workshop, activity etc, make a final evaluation with the user
to assess its continuity.
e. Assess the interests and concerns of the user.
f. Track the users’ participation and attend the various activities in which they have
registered.
Answers: e) , a), b), c), f), d)
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Activity 12. Imagine that you arrive at a house where you are acting as an HSE for the
first time and when you open the fridge, you find it full of cockroaches. You had
already been informed that the home was in an unacceptable hygienic state. Taking into
account the work plan: how should you act in this case? Get into groups and discuss
what you think would be the best approach considering that respect for the user must be
maintained, be empathetic.

Grammar
There was / there were / Past tenses: past simple, past continuous /
Irregular verbs / Past time expressions / prepositions
Activity 1. Angelina suffers from incipient Alzheimer's. Her children have decided to
take her to her childhood home, which caught fire two years ago. In it she recovers
some memories of what was in the living room. Imagine what Angelina could say about
the room you see.
For example, “There was always a plant on the windowsill.”

Possible answers:
• There were pictures on the walls.
• There was a green curtain.
• There was a table.
• There were four chairs.
• There weren’t any carpets.
…

Activity 2. Arthur has a mild mental illness that allows him to live in an apartment with
two other companions who form a coexistence group. Samantha is his professional HSE
and today she calls Arthur to see how he is. Samantha asks him some questions.
Complete the questions and answers:
- Hi Arthur, how ___________ your day yesterday? Were ____________ any
problems?
- Hi Samantha, mmmmm…. well .... ____________ was a little matter I have to talk
to you about. When I woke up yesterday, Alex ____________ not at home because
he _____________at work. There ___________a note in the dining room that said:
no milk left. I looked in the fridge and there ______________no milk, there
______________any yogurt, there _______________ any tea… so I made some
orange juice. Then I went to Orlando's room to wake him up. Orlando
____________in bed and there _____________clothes everywhere. His closet
was in a total mess. It ____________ a little stressful for me, you know I can't
stand mess. Samantha, we need help.
- I think we should have a meeting to talk about all of this, Arthur. Thanks for letting
me know.
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Answers:
- Hi Arthur, how was your day yesterday? Were there any problems?
- Hi Samantha, mmmmm…. well .... there was a little matter I have to talk to you
about. When I woke up yesterday, Alex was not at home because he was at work.
There was a note in the dining room that said: no milk left. I looked in the fridge and
there was no milk, there wasn’t any yogurt, there wasn’t any tea… so I made some
orange juice. Then I went to Orlando's room to wake him up. Orlando was in bed and
there were clothes everywhere. His closet was in a total mess. It was a little stressful
for me, you know I can't stand mess. Samantha, we need help.
- I think we should have a meeting to talk about all of this, Arthur. Thanks for letting
me know.

Activity 3. Choose the correct answer

a. In the past, there were / there weren’t any houses near the hospital.
b. Was there / there was a car park near the clinic.
c. Was there / were there post-hospitalisation care in the 18th century? No, it wasn’t /
there wasn’t
d. There were / there was oral health education in my school.
e. There weren’t / There wasn’t a café in the hospital, but there was / there were
some vending machines.
a. there weren’t
b. there was
c. was there / there wasn’t
d. there was
e. there wasn’t / there were

Activity 4. In your notebook copy and complete these sentences about ancient health
care systems. Use was / were / wasn’t / weren’t
a. The first documented governmental health care system __________ in ancient
Egypt.
b. Trepanation techniques ___________ very popular in the Chachapoya region in
ancient Peru. Shamans __________ successful in performing difficult surgeries, for
example, amputations.
c. Post-traumatic stress disorder __________ common among ancient soldiers in
Mesopotamia.
d. The archeologists found some pills in an ancient Etruscan vessel. The ingredients
________ beeswax, iron oxide and pine resin. They think the pills ________ a type
of eye medicine.
e. During the Renaissance, children ___________ weaned until the age of two..
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f. Cow milk __________ common in Egyptian times, in its place Egyptians drank
donkey milk.
g. Bamboo strips ____________ the material used to write medical texts in Ancient
China.

a. was
b. were / were
c. was
d. were / were
e. weren’t
f. wasn’t
g. were

Activity 5. Put these verbs into the past simple.

arrive help study wash
plan phone cry enjoy
invite carry agree borrow
finish marry chat admit

arrived helped studied washed

planned phoned cried enjoyed
invited carried agreed borrow ed
finished married chatted admitted

Activity 6. Copy the grid into your notebook and classify the past simple forms of the
verbs in activity 6 according to the sound of their endings

It sounds /id/ like wanted It sounds /d/ like lived It sounds /t/ like picked

arrived /d/ helped /t/ studied /d/ washed /t/

planned /d/ phoned /d/ cried /d/ enjoyed /d/
invited /id/ carried /d/ agreed /d/ borrowed /d/
finished /t/ married /d/ chatted /id/ admitted /id/
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Activity 7. In your notebook, choose the correct verb from the box to complete the
sentences. Use the verb in the past simple form.

move be work stop travel cook live relapse

a. They __________________ to New York 4 years ago. There __________ a

Congress about the prevention of Alzheimer’s.
b. He ________________ in Barcelona when he was a child, but now he lives in
Madrid as the National Neuropsychologist centre is in this city.
c. I ____________ some healthy food before going to work.
d. Peter ____________________ as an occupational therapist in 2017.
e. She __________________ to Los Angeles last year because she found a new job
being in charge of Chronic diseases research.
f. Her paranoia ___________ when she ___________ taking the medication.

a. They travelled to New York 4 years ago. There was a Congress about the
prevention of Alzheimer’s.
b. He lived in Barcelona when he was a child, but now he lives in Madrid as the
National Neuropsychologist centre is in this city.
c. I cooked some healthy food before going to work.
d. Peter worked as an occupational therapist in 2017.
e. She moved to Los Angeles last year because she found a new job being in charge
of Chronic diseases research.
f. Her paranoia relapsed when she stopped taking the medication

Activity 8. In your notebook, complete the sentences with the verbs in brackets in the
past simple form.

a. John, the new early brain development specialist, _______________ to Spain in

1998. (come)
b. She ____________________ next to the door, until the nurse took her to bed.
(stand)
c. The patient ______________ down while he was trying to get to the toilet. (fall)
d. I ____________ the risk would be higher. (think)
e. He _____________ some activities related to pollution and lifestyle. (do)

a. John, the new early brain development specialist, came to Spain in 1998.
b. She stood next to the door, until the nurse took her to bed.
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c. The patient fell down while he was trying to get to the toilet.
d. I thought the risk would be higher.
e. He did some activities related to pollution and lifestyle.

Activity 9. Speaking activity. Search for information about one of the following
concepts. Then try to explain a situation to your partners in which you would use this
feature as a worker in the HSE system.

communication skills

confidentiality

observational capacity

communication

assertiveness

Open activity.

Activity 10. Read this text about Parkinson’s disease. Underline all the verbs in the past
tense.

Two centuries have passed since James Parkinson’s Essay on the Shaking Palsy
described a handful of patients who showed tremor at rest, bradykinesia and, some of
them, akinesia. In his essay, he characterised the motor symptoms of the disease that
now take his name (Parkinson, 1817). Although this was the first description of the
disease as a neurological condition, it was not until 50 years later that new scientific
evidence obtained by Jean-Martin Charcot contributed to a definition of the clinical and
anatomopathological basis of Parkinson’s Disease (PD) (Charcot, 1872). Years later, in
1893, Blocq and Marinescu noticed resting tremor in a patient that resembled
parkinsonian symptoms. The tremor was due to a tuberculous granuloma on the right
cerebral peduncle that was affecting the ipsilateral Substantia nigra pars compacta
(SNc) (Blocq and Marinescu, 1893). A few years later, it was Brissaud who suggested
that the SNc might be the site affected in PD (Brissaud, 1899). Two decades later,
Trétiakoff first reported neuropathological changes in the SNc in PD patients. He
observed a large loss of neuromelanin in the SNc resulting from the absence of SNc
neurons containing this pigment and also the presence of cytoplasmatic inclusions
named Lewy bodies (LB) (Trétiakoff, 1919).
Text adapted from Advances in Parkinson’s Disease: 200 Years Later by different
authors.
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Answers:
described, showed, characterised, was (x4), obtained, contributed, noticed, resembled,
suggested, affected, reported, observed, named.

Activity 11. Writing activity. Search for information about how to relieve Parkinson’s
symptoms and maintain patients’ quality of life.
Free answer.

Activity 12. Finish the following sentences.

a. I was talking to my family caregiver…
b. We were doing….
c. She was working...
d. They were doing research…
e. He was feeling…
Free answer.

Activity 13. Look at the pictures and make sentences using the past continuous tense or
the past simple tense.
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Free answer.

Activity 14. Think about a bad habit you had in the past. Copy this table into your
notebook and complete it. Then share your story with a partner.

Habit When? How did you feel? What happened afterwards? Now

Free answer.

Activity 15. Complete the sentences in your notebook with a past time expression.
a. I was born in Stockholm _____________ 1980.
b. My parents moved to Finland _____________ I was seven.
c. I found an apartment on my own __________ year.
d. I left college three years ________________.
e. __________ Saturday we went out to an opera concert.
f. I bought a motorbike a few weeks ___________.
g. They arrived ___________ two o’clock in the afternoon.
h. I had an accident ___________ month.

a. I was born in Stockholm in 1980.

b. My parents moved to Finland when I was seven.
c. I found an apartment on my own last year.
d. I left college three years ago.
e. On/last Saturday we went out to an opera concert.
f. I bought a motorbike a few weeks ago.
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g. They arrived at two o’clock in the afternoon.

h. I had an accident last month.

Activity 16 Choose the correct preposition

• ____________ August
• ____________5:30
• ____________spring
• ___________ Easter Monday
• ___________ 19th September 1980
• ___________ Christmas
• ___________ Wednesday
• __________ the weekend

Answers:
in August, at 5:30, in spring, on Easter Monday, on 19th September 1980, at Christmas,
on Wednesday, at the weekend.

Make it real!
Let’s draw up an HSE work plan
From the HSE you can intervene in different types of family and non-family
coexistence groups (apartment with an elderly person, flats with services for the elderly,
flats for people with mental health problems and so on.)
Each time an HSE team has to intervene in a coexistence group, it is necessary to
coordinate and draw up a personalized work plan for each user.
A work plan is a scheme or set of actions that are designed to achieve a goal (s). This
serves to structure and organize a set of activities or steps to be carried out, establish
what the priorities are and determine a timetable in which this plan must be developed
in order to reach a goal.
1. Get into pairs and think of a cohabitation group where you could intervene as an
HSE.
2. Look for information on what a work plan should look like and what it should
include. Think that it must include at least the identification data and personal
data, the health conditions, the house conditions, the support network, the HSE
staff that will take part in it, the objectives that you set for yourself, the validity
of the work plan and the evaluation...
3. Prepare the work plan sheet so that you can gather all the information in a visual
and understandable way.
4. Fill in a work plan for one of the members of the cohabitation group you thought
of in the first point.
5. Hand in the document to your teacher.
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Listening 1
HSE

Activity 1. Say whether the following statements are true or false.

a. HSE policy does not allow users to live in their own houses.
b. HSE actions can be classified into three different areas.
c. Helping a user with shopping/paying bills is related to personal care
d. Integration services are not included in the HSE actions.
e. There are other types of services that complement HSE.

a. FALSE
b. TRUE
c. FALSE
d. FALSE
e. TRUE

Activity 2. Which services are considered complementary? Write at least 5 of them.

tele alarm or telecare services, housing adaptation services, guidance and support
service provision, home delivery service, laundry service, cleaning service, home
physiotherapy or speech therapy services, home hairdressing and podiatry services or
dietary counselling services.

Activity 3. Why is HSE important for users? Which are its benefits?
These services make it possible for many people to continue living in their home, which
is their natural environment, in which they develop more effectively and where they
maintain a higher quality of life.
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Listening 2
HSE Home care services

Activity 1. Complete the following sentences.

a) Home care services include a whole set of ______________ (1) designed to
provide help and care at home to people who for any reason do not have the
______________ (2) to carry out the basic activities of daily living.

b) Personal care, which includes all tasks related to personal________________

(3), mobility support, _____________ (4) control and intake support, medication
control and follow-up medical treatment, etc.

c) Actions of this type are the accompaniment both inside and outside the home to
go to _______________ (5) centres, cultural events, to go out with friends or
visit_______________ (6).

d) These include telealarm and telecare services, housing ___________ (7)

services. guidance and supply of support products, home __________ (8) service,
laundry service, a thorough home cleaning service, home ___________(9) or speech
therapy services, home hairdressing and _______________ (10) services, or dietary
counselling services.

1) Resources
2) Autonomy
3) Hygiene
4) Nutritional
5) Recreation
6) Family
7) Adaptation
8) Delivery
9) Physiotherapy
10) Podiatry
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Activity 2. Complete the grid

Personal care Support for household Integration services

chores

Hygiene, mobility support, Caring for clothes, Accompaniment.

nutritional and intake cleaning the house,
control, medication preparing food, household
control, follow-up medical administration, shopping,
treatment. maintenance, security.

Extra reading
Despite the difficulties we live together

Anna, Therese and Martina are three women aged between 35 and 45 who live together
as a coexistence group in an apartment with the support of HSE.
All three have a mild intellectual disability. They would not be able to live on their own
because they have difficulty planning activities and are not able to organize some daily
tasks such as managing meals, taking care of clothes, shopping or deciding which
social, job-related or ludic activities they must have in their day-to-day life.
For this reason, they have been living in flats for a long time with the weekly support of
a social integrator and an educator who help them work on personal and household
hygiene and self-care habits and who ensure that they can lead a life with the maximum
of autonomy possible.
Each week they hold meeting where they deal with all the issues related to coexistence:
cleaning the house, organizing weekly purchases and meals, planning the use of the
washing machine and taking care of clothes, managing conflicts related to coexistence
and so on.
In addition, in the dining room, they have different posters and timetables that help
them organise and plan their day to day.
On the other hand, they also carry out individualized monitoring where their individual
abilities, concerns and needs are assessed and together they work for the development of
skills and to promote decision-making.
With this support, Anna, Therese and Martina can carry out their life project
autonomously and decide on their life!

Activity 1. Get together in pairs and design the posters and / or timetables that can be
hung in the dining room of this apartment to make everyday life easier for Anna,
Therese and Martina. They should have an attractive design and have all the information
you think is relevant for the users to carry out their activities during the week.
Free answer.
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Activity 2. Join up in groups of 4. Think about the issues to be addressed during the
meeting. How would you organize it? What would you talk about? What problems or
conflicts can you encounter during the meeting? Prepare a meeting proposal and then
perform a role-play. One of you will act as a social integrator and the other 3 will act as
users of the coexistence group.
Free answer.

EXTRA MATERIAL
Listening 2
An interesting commercial
Edward is at home watching TV when this town council commercial suddenly appears.

Activity 1. Answer the following questions.

a. What type of commercial is it?
b. Why do they say that homecare is flexible?
c. How does the council decide if the person is eligible or not for the homecare
programme?

a. It’s a report about a community social service.

b. Because it can help people for an hour or several hours, the whole day, and for a
short period of time or a long one.
c. It will depend on the needs assessment result.

Activity 2. Join up in pairs. Pretend you are a social worker at the town hall and receive
a call from Edward. Write a script of the conversation between Edward and you.