‘Help me get my feet back on the ground’ – Services & Supports for Daily Living | New Aged Care Standard #4

For inspiration on this week's blog, I've turned to that old Beetles classic ‘Help'.

Standard Four is all about services and supports that help people maintain their ability to participate in life.

Sometimes people can feel ‘down’ when they can’t do what they used to do. They may have ‘never needed anybody’s help, but now these days are gone, and they're not so self assured’.

People may need help to get a level of independence back, especially if they have had an adverse health episode or other setback, or they may be trying to maintain their capacity to complete general life tasks (activities of daily living) as much as possible so they can continue to enjoy life to the max.

Services and supports for daily living includes, but is not limited to, food services, domestic assistance, home maintenance, transport, recreational and social activities.

But just providing services is not enough. Provided services need to be safe as well as effectively meeting the consumer’s needs, goals and preferences, along with optimising their independence, health, well-being and supporting their quality of life.

Let’s look at some examples.

If you offer day respite at your service centre, is the space physically safe for those who are using it? Does it assist in supporting and improving independence? Are cultural and personal needs and preferences recognised?

Are the vehicles you use to transport people well-maintained and suitable, e.g. easy to get in / out of, with wheelchair accessibility if necessary.

If you or your staff are supporting high-risk clients with activities, such as people with dementia or someone with a specific health condition requiring knowledge of emergency responses, or if you are taking clients to a new activity location or event, do you conduct ‘Activity Risk Assessments’ before you undertake the activity?

When you take clients out on activities, are staff informed of risks and are measures put into place to mitigate any identified risks?

And what about your clients’ needs, goals and preferences?

To really help someone effectively, we need to know what is important to them, what they really need and want. Along with this is knowing how they want that support delivered. Let’s not just pay lip service to this. Let’s listen to what people are saying and work towards helping the person reach that goal or live the way they really want without overlaying what we think they need.

Once we have identified the person’s goals, their needs and preferences, we need to ensure this information been adequately reflected in their care plan. We should also be seeking regular feedback from them on their levels of satisfaction. This is not a time when ‘no news is good news’ – we need to activity engage with the consumer to ensure they are happy with the assistance we are providing or have brokered on their behalf and that we are meeting their needs.

Engagement doesn't have to be a formal survey or questionnaire – it can be as simple as a feedback slip, a monthly phone call, or a chat as part of the meal run once a month.

When providing services, it’s important to recognise the whole person. Good assessment and care planning considers a person’s physical wellbeing and mental health, as well as their spiritual, emotional and social life. When you think outside the standard idea of domestic assistance and showering as being the ultimate response to supporting a person, you identify unique ways the support the whole person.

This could include helping someone get to their place of worship, or their weekly aqua fitness or yoga class. It might include arranging a support worker take them to a local coffee shop where they can catch up with friends for morning tea prior to taking them shopping for groceries. Or, for those living on very remote indigenous communities, how about arranging for support to allow someone to attend important cultural events.

Know the person – share the information.

I recall an old family friend who recently passed. ‘Gwen’ was 89, lived alone, was frail but still able to cook for herself and manage her own personal care. Gwen needed help to get to the shops and to bring her groceries home. She was beyond the heavy housework, like vacuuming floors and cleaning the shower, but could still do her washing, tidy the kitchen and make her bed.

Gwen had also grown up in northern India, leaving in the mid 1940’s as a young girl at the time of partition after WW2. She could still cook an excellent samosa and had amazing stories of her life growing up in India. It was key for Gwen to keep doing what she could as part of ‘daily living’, reinforcing her own purpose and sense of control and independence, and was equally important for support staff to know and recognise this.

This brings me to another ‘requirement’:

‘Information about the consumer’s condition, needs and preferences is communicated within the organisation, and with others where the responsibility for care is shared.'

Your service is not likely to be the only organisation that supports a person in their care. I spoke about this in last week’s blog, but it’s worth noting again how important having good networks and working relationships with other services or organisations are, as is having staff who know how and when to escalate an issue if something is not right.

Food, glorious food!

This Standard notes that where meals are provided, they need to be ‘varied and of suitable quality and quantity’.

Bottom line, if your service is providing meals you need to be able to assist consumers with good nutrition and hydration (fluids) to reduce the risk of malnutrition and dehydration. This is where knowing and understanding the underlying health conditions a person has is really helpful. With this knowledge, you are able to ensure that the meals provided support their health and meet any special dietary requirements.

Consultation with a dietician or nutritionist on special diets where chronic disease is present, such as renal, diabetes, hypertension, or food intolerances; or a speech pathologist when clients present with problems such as difficulty swallowing or chewing food is also important in meeting the individual's needs.

Getting around.

If your service provides equipment for consumers to use in their own home, it needs to be safe and fit for purpose.

‘Equipment (where provided) must be safe, suitable and clean and well maintained.’

A classic example is having handrails purchased and installed for a client – they need to be proper weight-bearing rails, not the cheaper variety from the local hardware store. They also need to be installed correctly – the right height and well-supported.

What about waking frames and shower chairs? There are different needs and different models to suit all. It is incumbent on the service provider to arrange for a proper assessment by a physiotherapist or occupational therapist to ensure the correct equipment is purchased.

And take note, this requirement also extends to third-party supports, such as transport providers who may be subcontracted by your organisation. If they provide services and supports to consumers who use a wheelchair, they must have a safe and suitable wheelchair ramp to access the vehicle.

As the approved provider you must also ‘take reasonable steps’ to ensure equipment is ‘clean, safe and suitable’, even where you did not provide the equipment. Where a person uses a daily aid for living, staff should monitor the condition of the item and raise any concerns if they note hazards such as cracks in shower chairs, loose wheels, etc. with the consumer or their representative.

So when you ‘help’ someone there is a lot to consider, but it doesn’t have to be complicated.

If you and your staff keep the ‘whole’ person in mind and focus on helping the person to maintain their ability to participate in life and to meet their goals, you are on the right path!

We hope you enjoyed this article on the fourth Standard. This blog post is part of a series on the New Aged Care Standards, where we investigate how and why they were developed and take an in depth look at each of the Standards to give you ideas for implementing these effectively within your organisation. If this is of relevance to you and you’re not signed up for our short email alerts, fill in the quick form at the bottom of the page and we will let you know when the next post is released. We also send a monthly round up of blog posts and videos.

Other posts in this series

Why Do We Need New Aged Care Standards?

What Difference will the New Aged Care Standards make to Consumers?

What Impact Will The New Aged Care Standards Have On Your Organisation?

‘What About Me?' – Consumer Dignity & Choice | New Aged Care Standard #1

‘We're All In This Together' – Ongoing Assessment & Planning | New Aged Care Standard #2

‘Stand By You' – Personal Care & Clinical Care | New Aged Care Standard #3

‘Wouldn't It Be Loverly?' – Organisation's Service Environment | New Aged Care Standard #5

‘Who Ya Gonna Call?' – Feedback & Complaints | New Aged Care Standard #6

‘Lean On Me' – Human Resources | New Aged Care Standard #7

‘The Greatest Show' – Organisational Governance | New Aged Care Standard #8

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