Topic outline

  • Part 2: Home support

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    • It's now three months later, and Frank is still managing in his own house, with home support. 

      In this part of the story, you'll see some more health workers who interact with Frank. 

      As you watch, make a list of the different health professions you see, and the similarities and differences in their responsibilities. 

      (Duration: 6 minutes 04 seconds; Captions are available)


      Reflect

      Think about the range of people who were involved in supporting Frank. 

      You would have seen:

      • A Home Support Worker
      • A Community Coordinator
      • An Extended Care Paramedic (Ambulance officer)

      Now think about these questions:

      • Is it important for the health workers to maintain effective communication with each other to provide services? 
      • What were the key events or points in the film when effective communication was essential?
      • Do you think there are any aspects in relation to Frank’s situation that have not been addressed? If there are, how would you address them?
      • What knowledge and skills do you think that you personally need to develop to be able to work with older people in the community?

    • Background: Home Support Services

      Across the world, the living arrangements of older people are changing, reflecting changes to family structures generally. More older adults now live alone. 

      For example, in some European countries over 40% of women aged 65 years and over live alone. Even in countries with a strong tradition of parents living with their adult children, such as Japan, there has been significant change over the last five decades. 1

      It's much more cost-effective to support a person staying in their home than to support them in a residential aged care service. 2

      This means that services which support older people remaining at home are important from an economic perspective, and from a quality of life perspective. 

      In Australia, home support services are offered through a range of institutions: government organisations, private for-profit and not-for profit organisations, voluntary or community organisations, and informal or family carers. 

      The 2012 Aged Care Workforce Report indicates that 149,801 people were employed in the community aged care workforce in 2012, and 93,359 people worked in direct care roles (76,046 were employed as community or home care workers). 3  It's  anticipated that the number will continue to grow as the ageing population increases.


      Home Support Workers

      The role of a Home Support Worker is to assist the client with a range of activities as outlined in their action plan, and to assist in the evaluation of the client’s progress, by maintaining accurate records and communicating with the Care Coordinator. 

      Home Care Workers can help clients with personal care or household duties. They can also help clients to participate in the community, and general be involved in maintaining their health and wellbeing. They play a vitally import role in enabling older people maintain their quality of life. In some cases, they can become very important people in the life of the older person.

      It's important to note that there are clear lines of responsibility in what a Home Care Worker can do and can't do. For example, in the video, there were two points which were clearly beyond the Home Support Worker’s delineated scope of practice:

      • the burn on Frank's arm from the food spillage
      • Frank's injured arm after his fall

      In both cases, it was not part of her duties to manage the injuries. Instead, she contacted and reported to the Care Coordinator, who was responsible for making the clinical decision as to what action should be taken. 

      The Care Coordinator then took account of Frank’s full medical history to determine follow-up interventions (such as an appointment with the Dietician, to check his nutrition, and organising the Extended Care Paramedic to assess his injuries after the fall).


      Extended Care Paramedics

      Extended Care Paramedics work collaboratively with other health professions, to manage and treat people in their place of residence, including their home or residential care site. 4

      The service assists in reducing the number of people admitted to hospital or attending Emergency Departments.

       

      Background: Falls and falls prevention

      Falls are the leading cause of injury in older people. They're a significant factor in the potential loss of independence. 5

      When you work with older people, it's important to be proactive in reducing falls. Clinical guidelines on preventing falls in older people recommend health professionals routinely ask the person if they have fallen in the past year. 6

      The Health Quality & Safety Commission of New Zealand (2014) have developed 10 TOPICS on reducing harm from falls and suggest the following three questions to quickly screen for the risk of falls.

      • Issue 1: Having fallen previously is predictive of falling again.  
        • Question to ask: 'Have you slipped, tripped or fallen in the last year?'
      • Issue 2: Balance problems and lower-limb weakness increase the risk of falling.
        • Question to ask: 'Can you get out of a chair without using your hands?'
      • Issue 3: A fear of falling can cause unnecessary restriction of activity, loss of function and diminish quality of life
        • Question to ask: 'Are there some activities you’ve stopped doing because you are afraid you might lose your balance? Do you worry about falling?'

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