Supporting Vulnerable Clients over the Christmas Period

Did you realise that it is only just over six weeks till Christmas?

Sorry, that was a bit unfair. Now you’re probably panicking about your Christmas shopping list and wondering how long it will take for something to arrive if you order today off eBay! But put those thoughts aside for a moment, we need to think about something far more important; have you put things in place for the vulnerable clients who receive care and support from your organisation?

Who are our Vulnerable Clients?

First things first, we need to identify which clients could be vulnerable over this holiday season.

Generally, a vulnerable client is someone who is unable to care for themselves without support. These people may be:

• Very frail
• Have a disability, such as being visually impaired or unable to ambulate (walk)
• Have cognitive deficits, such as people with dementia, and as such may not be aware of specific dangers over this period
• Have a chronic health condition that is affected or exacerbated by extremes of temperature
• People who live in basic accommodation that may not have air-conditioning (or heating if you live in cooler climates)

You’ll probably have a good idea of who the vulnerable people are in your community or service, as they should have been identified as part of service planning. You may even have them on a vulnerable person register, or have this flagged on their care plan or in your client management system.

However, don’t overlook people who may not currently be identified as vulnerable. Perhaps you have clients who have recently experienced deterioration in their health, or maybe there has been a change in carer support. Ensure that you review every client on your list and escalate clients to your ‘vulnerable client’ list where indicated.

So what should you be doing in preparation to make sure these clients are supported over this period?

Who is the Carer?

Identify who will be caring for them over the holiday period and document this – get a written agreement if necessary.

Families are dynamic. You may find that the carer of past years now has other priorities. Perhaps they have children or other people to care for, perhaps they have moved out of the area, or maybe they have health issues of their own that are impacting on their ability to support the client over this time.

Even if you don’t identify any changes, it is still good practice to sit down with the client and their family/carer and discuss any issues that might arise over the holiday period and together plan a response to these.

If there is a new or alternative family carer in place during this period, ensure that they are aware of any identified issues or alerts, such as the need to remind the client to drink fluids regularly or place a water bottle within easy reach of the person.

A new family carer may not necessarily know intuitively what the client requires, so giving them information about how to successfully care for the person is important. But make sure you don’t overload them with too much new information, and it’s a good idea to provide an emergency contact number should it be needed.

Make sure you document any meetings and agreements in the person’s progress notes and write up changes in their care plan. Providing a summary of the meeting notes back to the client and family can also be beneficial. This ensures that everyone is on the same page and knows about the risks and their responsibilities.

Client Emergency Management Plans

Check the information in the client emergency management plan.

While you are negotiating any changes to the client’s care plan over the holiday season, make sure you take the opportunity to update the client’s emergency management plan. You should have one of these for each client receiving support from your service and they need to be reviewed and updated regularly.

The emergency management plan should identify:

• Client evacuation preferences in the event an emergency situation arises
• Up to date emergency contact details (these may be different to the usual emergency contact details)
• Any medical or health alerts, including aids and equipment required by the person and other important information like allergies.

We advise the services we work with to review each person’s emergency management plan by the end of November each year. This fits in well with other organisational emergency response planning that often occurs at this time.

Plan Your Staffing

Some organisations only provide essential support services on public holidays. This is often due to the higher cost of providing support on a public holiday, or lack of staff available to work.

For services that are part of a larger organisation, where aged care is just one activity amongst many, the aged care service staffing schedule may need to be different to the rest of the organisation.

This year, 2018, Christmas Day falls on a Tuesday. We know that in some remote areas, the standard response to this will be to start holidays on Friday 21^st, with potentially the return to work for most (non-essential staff) happening on the 2^nd January. If your organisation does follow this practice, it will be important for aged care management to highlight to their Executive an Approved Provider’s responsibilities and ensure that vulnerable clients continue to be supported over this time.

Clients requiring meals and personal care will still require support and this may mean a hamper pack over key days like Christmas and New Year. Staff should be rostered on the days either side of Christmas to do welfare checks and/or personal care and medication prompts or support as required in accordance with the client's care plan.

Also find out from your staff well ahead of time whether they are planning on taking leave over this period, or if they will need to work restricted hours due to having other responsibilities, such as caring for children.

Changes to Service Delivery

Let the person or their carer know in plenty of time of any changes to service delivery over the holiday period.

You’ll also need to give clients and their family/carer sufficient notice of any changes you need to make to their service delivery over this period. Sometimes family/carers are happy to assist the client, preferring to enjoy a quiet time without distractions.

If you need to change times or days of service, it is good to provide this information in writing so the client and family/carer can refer to it. If literacy is an issue, make sure any changes are discussed with the client and the family/carer and a note included on their file.

Alert people on Home Care Packages of any changes in cost of service provision over this period as well, particularly where you are brokering in care or support.

Essential Materials and Equipment

Ensure that the client has sufficient essential resources.

Clients who use continence aids or other equipment that is either supplied by the organisation or that are purchased from their Home Care Package funds may need to receive an additional supply to cover days when services are not provided.

Also ensure that you have ordered sufficient materials to cover any Christmas closures by suppliers, or where you may encounter adverse weather conditions that impact on delivery of supplies.

Emergency Response Plan

All remote services should have an Emergency Response Plan (EMP) and be aware of their role as part of any community EMP for events such as bush fires, flood, major storms and cyclones.

An EMP documents how the service and its management, staff and volunteers will prepare and respond to an emergency, particularly in regards to vulnerable people in the community.

Of course a ‘plan’ is only of use if people know it’s there and understand the processes. Practical ways to reinforce the plan include:

• Including Toolbox Talks as part of staff meetings
• Conducting regular Drills
• Having Colour Codes for different types of emergencies e.g. Fire (Red), Evacuation (Blue), Personal Threat (Black) etc.

Having posters inside the Aged Care Centre with key information is also a good idea AND don’t forget to include this information in Staff and Client Handbooks!

 If you would like assistance in developing Client Emergency Management Plans, an Emergency Response Plan, conducting a risk assessment, or developing policies, procedures or tailored handbooks, please get in touch. Our aim is to make your job easier.