module 7. key concepts of home care - phimodule 7. key concepts of home care homecare aide workforce...

HOMECARE AIDE WORKFORCE INITIATIVE (HAWI)

Trainer’s Manual—Page 7.1

Home Health Aide Training

Module 7. Key Concepts of Home Care

Goals The goals of this module are to:

Orient participants to the basic human needs of clients (and workers).

Introduce participants to the concepts of person-centered care, client rights, confidentiality, promoting client independence, teamwork, and professionalism.

Time 3 hours and 30 minutes

Activities Teaching Methods Time

1. Basic Human Needs Interactive presentation, small-group work, small-group reporting, individual exercise, pairs work, pairs reporting, and large-group discussion

1 hour and 15 minutes

2. Overview of Key Concepts of Home Care

Pairs work, pairs reporting, and interactive presentation

1 hour

3. Teamwork and Team Building Interactive presentation 30 minutes 4. Professionalism Interactive presentation, small-

group work, small-group reporting, and large-group discussion

45 minutes




Supplies Flip chart, markers, and tape

Paper and pencils

Teaching Tools, Activity 3—Members of the Client’s Team

Learner’s Book 1. What Are Basic Human Needs? 2. A Day with Mrs. Monroe 3. How to Help Your Client Meet Basic Human Needs 4. Key Concepts: Person-Centered Care 5. Key Concepts: Client Rights 6. Key Concepts: Confidentiality 7. Key Concepts: Promoting Client Independence 8. Members of the Client’s Team 9. Professionalism: Doing a Good Job 10. Getting Ready for Work 11. Your First Meeting with a Client

Worksheets Worksheet 1. Work Schedule and Contact Information

Handouts Handout 1. Key Terms

Handout 2. Summary of Key Information

Advance Preparation Review all the training instructions and learner’s materials for this module. Note that icons are used to remind the trainer of the following:




When you are presenting or covering Key Content in the discussion. (Key Content is also addressed in the Learner’s Book and the handouts, but we use the “key” icon only when it is covered elsewhere in the learning process.)

When it is important to ask a particular question to get participants’ input.

When it is time to refer to the Learner’s Book.

When it is time to distribute a worksheet.

When it is time to distribute and discuss a handout. Copy all worksheets and handouts for participants.

Gather all necessary supplies and equipment. Please note that the Key Content is meant to be background information for the trainer. DO NOT READ OUT LOUD TO PARTICIPANTS.

Activity 1. Basic Human Needs

Prepare flip chart pages for:

“Learning Agenda” (Step 1)

“What Could My Home Health Aide Do to Make Things Better for Me?” (Step 12)

Activity 2. Overview of Key Concepts of Home Care

Prepare a flip chart page for “Exploring Key Concepts” (Step 2). Write each of the key concepts on two index cards—these will be distributed either to pairs of participants (if you have 15 or fewer participants) or to small groups (with a larger number of participants). You want each concept to be discussed by at least two pairs or groups. The key concepts are: person-centered care, the rights of clients, confidentiality, and promoting client independence.




Activity 3. Teamwork and Team Building

Review the list of “members of the client’s team” on the flip chart pages in Step 4 and revise, if needed, for your agency. Prepare flip chart pages for:

“Team-Building: 4 Cs and an R” (Step 2)

“Members of the Client’s Team” (Step 4two pages)

Activity 4. Professionalism

Prepare four flip chart pages with the small-group assignments (Step 2).




Activity 1. Basic Human Needs

1 hour and 15 minutes

Learning Outcomes By the end of this activity, participants will be able to:

Identify five categories of basic human needs. Give examples from each category as it applies to a home care client. Describe the home health aide’s role in helping the client to meet their basic human needs.

Key Content Theories about human needs identify five basic categories of needs—physical needs,

security needs, social needs, self-esteem needs, and self-fulfillment needs. It is generally thought that these needs follow a sequence (like a pyramid or a ladder), in which you have to meet the first need (physical survival) before you can go on to meeting the second (safety), and so on.

The home health aide (HHA) plays an important role in ensuring that the client’s physical and security needs are met, in a way that supports the client to meet his or her “higher” needs of social interaction, self-esteem, and self-fulfillment.

The key concepts of home care that are covered in this module—person-centered

care, client rights, confidentiality, and promoting the client’s independence—are all targeted at providing home care in a way that helps the client to meet their own basic human needs.




Activity Steps Interactive Presentation—15 minutes 1. Review the learning agenda for this module. Post and review the flip chart page for

the “Learning Agenda.” Flip Chart

LEARNING AGENDA:

Key Concepts of Home Care

Explain how basic human needs are addressed in home care

Explain the importance of person-centered care, client’s rights, confidentiality, and promoting the client’s independence

Explain the importance of teamwork in home care

Explain what “professionalism” means for a home health aide

2. Introduce Basic Human Needs. Explain that all people have certain basic needs.

The things that we need are so basic that we can’t live without them. For example, we all need to breathe air. Ask participants:

What other things do you feel you can’t live without?

Listen to participants’ responses, and then refer to 1. What Are Basic Human Needs? in the Learner’s Book and review with participants. As you review section 1, connect the participants’ responses to the question above with the five basic human needs that are on it. Answer any questions.

3. Introduce case scenario. Explain that clients have the same basic needs as all other people, and that the home health aide has an important role in making sure that these basic needs are met. Explain that you are going to read a story out loud about a



Trainer’s Manual—.7

home health aide named Justina. She assists a client named Mrs. Monroe. Refer to 2. A Day with Mrs. Monroe in the Learner’s Book. Tell participants that they can follow along while you read Justina’s story. Explain that, while they are listening to the story, you would like them to notice how Justina is trying to meet Mrs. Monroe’s basic human needs.

4. Read case scenario. Read the story in section 2 out loud.

Small-Group Work—10 minutes 5. Form small groups and give instructions. Form small groups of three or four

participants and ask them to sit together. Ask them to bring their Learner’s Books with them to their small group so they can refer to sections 1 and 2 together, and also some paper and a pen or pencil. Explain that the small groups will have fifteen minutes to write down all of the ways that Justina helped Mrs. Monroe meet her basic human needs. They may review section 2 if they need to remember all of the things that Justina did.

Small-Group Reporting—10 minutes 6. Facilitate brief reports from each small group. Ask each small group to give two

examples of what Justina did to meet Mrs. Monroe’s basic human needs. For each example that a small group shares, ask them to identify which basic human need is being met. After each small group shares two examples, revisit each small group to see if they have another example to share that has not yet been mentioned.

Interactive Presentation—10 minutes

7. Review ways to meet clients’ basic human needs. Refer to 3. How to Help Your Client Meet Basic Human Needs in the Learner’s Book and review with participants. Explain that it has examples of how to meet each of a client’s basic needs, but each client is different, and so the ways that the home health aide will meet each client’s basic needs will be different too.

8. Explore how to identify a client’s needs. Ask participants:




How will you know what to do to meet your client’s basic human needs? Listen to participants’ responses. Emphasize that the care plan gives the home health aide instructions about specific things they need to do to meet the client’s needs. For example, point out that Justina learned that Mrs. Monroe needed to practice walking every day because she read it in the care plan. Explain that the home health aide can also learn a great deal about what the client needs by speaking with and listening to the client, or to the client’s family.

Individual Exercise: Guided Imagery—5 minutes 9. Introduce the guided imagery exercise. Explain that one of the important qualities

of a good home health aide is empathy—the ability to imagine how you would feel in another person’s situation. This helps the home health aide to be more sensitive to the client’s basic human needs. The purpose of this next exercise is to help participants imagine how they might feel if they were receiving home care services, instead of providing them.

10. Conduct the guided imagery exercise. Ask participants to close their eyes and just listen, while you describe a situation and read a series of questions for them to think about—but not answer out loud. Note that you will PAUSE AFTER EACH QUESTION, to give them a few moments to think about it.

“Imagine that tomorrow you are in a bad car accident. Everyone survives this accident, but you will need surgery, a hospital stay, and eventually, long-term care. After several weeks, you are ready to go home from the hospital. You will have a home health aide to help you with all the activities of daily living. You begin thinking about what that will be like for you.

What will the home health aide be like? How will he or she treat you? [PAUSE]

What aspects of day-to-day life will be the most difficult for you, if you need help with ADLs? [PAUSE]

What could your home health aide do to make things better for you? [PAUSE]




How will you communicate what you want to your home health aide? [PAUSE]

How do you think he or she will respond?” Teaching Tip When you pause after each question, SILENTLY COUNT TO 10, to give participants time to think about each question. It will seem like a long time, but it’s necessary to let people imagine being in the role of the client, instead of the home health aide.

Pairs Work—10 minutes 11. Tell participants to open their eyes. Ask participants:

How did it feel to do this exercise? Encourage a few comments, and then move on to pairs work.

12. Form pairs and give instructions. Ask participants to find a partner and sit together. Ask them to get some paper and a pen or pencil. Post the prepared flip chart page. Explain that they will have five minutes to share their guided imagery experience with their partner, focusing in particular on the question that is listed. Ask them to be ready to share some of their answers to this question with the group. (Suggest that they may want to make notes on their paper.)

Flip Chart

WHAT COULD MY HOME

HEALTH AIDE DO TO MAKE THINGS BETTER FOR ME?




Teaching Tips If there are an odd number of participants, put three participants in one group. After three minutes, remind partners to switch so that both will have a chance to share their thoughts.

Pairs Reporting and Large-Group Discussion—15 minutes 13. Facilitate brief reports from each pair. Ask each pair to give two examples (one for

each person) of the things that they would like the home health aide to do to make things better for them. Note each item on the flip chart page (from Step 12).

14. Connect their list to basic human needs. Ask participants to think about how their ideas of what they would like the home health aide to do (or not do) reflects basic human needs. Review the flip chart list and ask which basic human need(s) are addressed by each item.

15. Summarize. Thank participants for sharing. Explain that in the next activity they will discuss four key concepts of home care—person-centered care, client’s rights, confidentiality, and promoting the client’s independence. These are all based on appreciating basic human needs, having empathy for the client’s situation, and respecting that every client is unique in how they experience their situation.




Activity 2. Overview of Key Concepts of Home Care 1 hour


Define “person-centered care.” Explain clients’ and workers’ rights in direct care. Explain the importance of confidentiality in direct-care work and describe how to maintain it. Explain the importance of promoting the client’s independence.

Key Content Person-centered care, the rights of clients and workers, confidentiality, and promoting

the client’s independence are all fundamental to direct-care work. These concepts will be introduced in this activity, and then illustrated and reinforced throughout the training.

“Person-centered care” describes an approach to working with clients that focuses on the client as an individual who has unique needs and routines, and who has the right to determine, as much as possible, what kind of care he or she will receive.

Both clients and workers have rights that are covered by lawe.g., the right not to be abused, physically, emotionally, or sexually. Some facilities or agencies have written lists of the rights of clients and workers that meet the legal and ethical standards of the organization.

Confidentiality means not sharing information about a person, including what you observe or overhear, except with appropriate members of the individual’s health care team. Confidentiality in direct-care work is both required by law and the right thing to do to show respect for the client’s privacy.




Promoting the independence of clients means supporting the ability of clients to do

things on their own. That includes making choices as well as doing the everyday tasks of eating, bathing, and going to the bathroom. When home health aides encourage clients to do things for themselves, it builds self-esteem and self-respect, reinforces

the client’s right to choose, and helps to keep the client activeboth mentally and physically.

Activity Steps Pairs Work—15 minutes 1. Explain the purpose of this exercise. In this activity, participants will learn about

key concepts, or ideas, that provide the foundation for providing quality care to clients. These concepts guide everyone who works with clients in their homes.

2. Form pairs and give instructions. Ask participants to form pairs. Distribute one or two index cards to each pair, labeled with one of the key concepts (see Advance Preparation and Teaching Tips, below). Post the prepared flip chart page with instructions for pairs work. Explain that you want them to do two things with this card: 1) talk about the concept, or idea, on their card and discuss what it means to them and/or what they already know about it; and 2) write down, on the back of the card, one question that would help them better understand how this concept relates to being a home health aide. Note: “What is it?” does not count as one of their questions, since that will be answered anyway.

Flip Chart

EXPLORING KEY CONCEPTS

1. What do you think this concept

means and what do you already know about it?

2. Write one question on the back of the card. This is a question that you would like the instructor to answer, to help you understand better why this concept should be important for home care.




Teaching Tips Ideally, you want more than one pair to discuss each key concept and to submit questions. With a large group—i.e., at least 16—this will not be a problem, since you will have at least eight pairs and each concept will be written on two cards. With a group that is smaller than 16, divide participants into four groups and give each group two key ideas to consider—and five more minutes to discuss. MAKE SURE that participants are not referring to their Learner’s Books during this activity. You want to assess what they already know and start them thinking about these concepts, before they read “the answers.” If participants are not clear about #2 on the flip chart page, you can give them some examples of questions. Just note that now they can’t use these questions! If we respect “confidentiality,” how do we let our supervisors know when

the client is having a problem? Regarding “person-centered care,” what other kind of care is there? How can clients be independent if they need a HHA?

Pairs Reporting and Interactive Presentation—45 minutes 3. Facilitate reporting from pairs on “person-centered care.” For the first key

concept—person-centered care—collect the cards from the one or two pairs that discussed it, and ask them to say what they think person-centered care means. Affirm what they got right and define the concept, correcting any misconceptions that they raised. Note that there is a section in their Learner’s Books with this information to review later, but you want them to focus on the discussion for now.

4. Answer the questions on the cards about “person-centered care.” Add information, as needed, from 4. Key Concepts: Person-Centered Care. Note in particular the importance of this idea to home care. Ask participants:

How does this concept relate to the model of basic human needs that we discussed earlier?

Ask if other participants have additional questions.




5. Continue with the remaining key concepts. Repeat the process for the rights of

clients, confidentiality, and promoting the client’s independence. Spend about 10 minutes on each concept.

6. Refer to 4. Key Concepts: Person-Centered Care, 5. Key Concepts: Client Rights, 6. Key Concepts: Confidentiality, and 7. Key Concepts: Promoting Client Independence in the Learner’s Book. Note that these will provide background information and reminders of what they discussed.




Activity 3. Teamwork and Team Building 30 minutes


Identify the members of the care team in the home care setting. Describe the role and explain the importance of the home health aide as a member of the team in person-centered care.

Key Content

Even though the home health aide may work alone with the client in their home, there is a group or “team” of individuals responsible for the client’s care.

When a team works well together, it can provide far better, more comprehensive care to a client than individuals working separately. Elements of teamwork include good communication, cooperation, clarity, having a common goal, and respect for each other.

Of all the team members, the home health aide is the person who spends the most time with and becomes the closest to the client. The home health aide often knows the client’s likes and dislikes, personality or style, preferred ways of doing things, and the client’s background or life stories.

Throughout this training, participants will be developing skills for working as members of a team. They will do this through the many small-group activities that emphasize learning from each other and working together to complete a task or achieve a common goal.




Activity Steps Interactive Presentation—30 minutes

1. Revisit the “teamwork” exercise on the first day of Pre-Training. Ask participants

to think back on the “teamwork” exercise that they did on the first day of Pre-Training. Ask for volunteers to describe what happened. Then ask:

What did you learn about teamwork from that activity? Teaching Tip Responses should include: You need to communicate clearly and effectively to get the job done.

Group work is not easyit takes effort and cooperation. You must all know your goal and agree on it. You must respect all members. Everyone makes a difference in a well-functioning team.

2. Review the flip chart page from that exercise. Post and review the prepared flip

chart page1 from that exercise. Flip Chart

TEAM-BUILDING: 4 Cs AND AN R

Common goal

Communication

Cooperation

Clarity

RESPECT

1Adapted from the Institute for Caregiver Education’s 4Cs approach to team development.




3. Discuss the purpose of the client’s team and who is on it. Note that there is teamwork in home care. Even if they work alone with clients, there is a team in place to support the client and to support the home health aides in their work. This team consists of several members with different roles, and every team has one essential MVP (most valuable player)—the client! Ask participants:

What do you think is the common goal in providing home care services for an individual?

Teaching Tip Desired responses include: to keep the client as healthy as possible, to make the client happier, and to help the client live independently as long as possible. Summarize that all of those are part of the common goal in home care.

4. List and define team-member job titles. Post the two prepared flip chart pages for

“Members of the Client’s Team.” Quickly review the list of workers, asking for input

from participants about what some of the titles meane.g., occupational therapist, dietitian. Briefly describe each person’s role. (They will get a description of each position in 8. Members of the Client’s Team. More detailed descriptions are provided for the trainer in the Teaching Tools, Activity 3—Members of the Client’s Team.)

Flip Chart

MEMBERS OF THE CLIENT’S TEAM

The Client

Direct contact

The client’s family

Home health aide

Nurse

Doctor

Social worker

Occupational therapist

Physical therapist

Speech therapist




Flip Chart

MEMBERS OF

THE CLIENT’S TEAM

No direct contact (usually)

Coordinator/Scheduler

Nutritionist

Pharmacist

5. Review the home health aide’s role. Ask:

Which position do you think has the most contact with the client? [Answer: the home health aide!]

Explain the key role the home health aide plays for the client and the team, repeating the themes from “Observe, Record, and Report” (in the module, Introduction to Home Care) about the importance of the home health aide’s observations.

6. Review the elements of an effective team. Summarize by explaining that each member of the home care team contributes to the overall quality of a client’s care. An effective team has members who:

o communicate with each other; o respect each other’s skills, abilities, and input; o recognize and appreciate the value of each team member’s efforts; o encourage participation; and o maintain focus on the goal.

All of these elements are important to the home care team, to supports the client to live the highest-quality life possible. Further, the home health aide has a key role on their team as the ones who are most familiar with the client and most aware of the client’s needs and preferences.

7. Refer to 8. Members of the Client’s Team in the Learner’s Book. Tell participants they can read it in detail later.




Teaching Tools, Activity 3

Members of the Client’s Team

The ClientThe client (and/or their representative) is the most important member of the team! The client should be involved in making decisions about their care and be encouraged to express their feelings and desires. Due to cognitive impairments, some clients are limited in their ability to make decisions, but all efforts should be made to include the client to the greatest extent possible.

Direct Contact

Client’s FamilyThe client’s family often contributes to the planning of the care as part of the team. When the client has significant cognitive, mental, and/or physical limitations, a family member may be the designated “surrogate/representative” who makes decisions on the client’s behalf. Home Health AidesHome health aides (HHAs) spend more time with clients than other members of the health care team; they are the “eyes and ears” of the team. Other team members will rely on the HHA to report changes in the client’s condition or behavior.

NursesThere are two kinds of nurses:

Registered Nurse (RN)Registered nurses are licensed professionals responsible for providing skilled nursing care and developing care plans for clients. The RN assigns tasks and supervises the HHA’s daily care of the client.

Licensed Practical Nurse (LPN)Licensed practical nurses are licensed professionals who are usually in charge of giving medications and performing treatments. LPNs may also supervise HHAs under the supervision of an RN.

DoctorsDoctors (physicians) are licensed professionals who diagnose disease or disability and prescribe treatments. In home health care, the physician “prescribes” home care services based on the client’s medical condition.




Social WorkersSocial workers are professionals who help clients with complex social problems (relationships with others, family issues, financial problems, housing issues, etc.), and provide counseling and emotional support. They may also make appointments and arrange services or transportation. In home health care, the social worker typically acts as the hospital “discharge planner” and consults with the client about the range of medical and nonmedical services required in the home. The initial plan of care is completed by the social worker, who contacts the licensed home health agency selected by the client.

Occupational Therapists (OTs)Occupational therapists are licensed professionals who help clients perform daily living tasks and adjust to their disabilities.

Physical Therapists (PTs)Physical therapists are licensed professionals who administer therapy and exercise to muscles, bones, and joints to improve function.

Speech TherapistsSpeech therapists are licensed professionals who help clients speak when a physical disability has made it difficult.

Indirect Contact

Coordinators/SchedulersIn home care, the coordinator/scheduler oversees all activities regarding each client. NutritionistsNutritionists are licensed professionals who create specific diets for clients with special needs in order to help them learn to maintain or improve their health and to manage disease.

PharmacistsPharmacists are licensed professionals who fill prescriptions and provide medications as ordered by the physician.




Activity 4. Professionalism 45 minutes


Define “professionalism” in direct-care work. Explain the importance of timeliness and appearance in direct-care work. Demonstrate how to effectively introduce themselves in a professional manner.

Key Content

For many people, direct-care work is their first paid work experience. It is important

to discuss work readiness, timeliness, and professional demeanor so that participants feel better prepared for the work experience itself.

Professionalism means working in a professional manner, or doing a good job at whatever one does. The way a worker looks, talks, and acts can show respect for the client and show pride in themselves and their work.

Another aspect of professionalism is being on time and being ready to start work from

the moment the worker arrives.

Introducing yourself to a new client in a professional manner is important for establishing a good working relationship with the client.

Activity Steps Interactive Presentation—5 minutes

1. Define “professionalism.” Ask what professionalism means to participants. After a few responses, refer to 9. Professionalism: Doing a Good Job in the Learner’s Book, and review.




Small-Group Work—10 minutes 2. Set up small-group work. Explain that participants will now focus on four specific

areas of professionalismtheir appearance, being on time, being ready to work when they arrive, and taking care of home and personal issues so they are not distracted at work. Divide participants into four groups and give each group one of the prepared flip chart pages (below) and a marker. Ask each group to write down everything that comes to mind in their assigned area, with one person serving as the recorder for the group. Ask them to be prepared to report to the rest of the group.

Small-Group Reporting and Large-Group Discussion—15 minutes 3. Facilitate reporting back to the large group. Ask each group’s reporter to post his

or her flip chart page and read it aloud to the large group. After each group’s report, ask if anyone has questions, comments, or would like to add something to the list.

Appearance

What should I wear? What should I not wear?

Being ready to work

What do I need to know so I’m ready to work when I get there?

Being on time

What should I do the day/night before to help me get there on time?

Taking care of personal issues

What should I do ahead of time so I’m not distracted at work?




Teaching Tip There may be some overlap between the group reports. For example, planning for childcare could be both a “personal thing to arrange for” and an item that falls under “what to do the day/night before.” If it is reported by both groups, simply note that both are correct.

4. Summarize discussion. Thank the groups for their work. Refer to 10. Getting Ready for Work in the Learner’s Book. Quickly review the points as a summary of the discussion, noting ideas that were not brought up in the group discussion. Note that all of the preparation steps are part of being professional. Although the preparation steps may change on different days or for different people, it is important to know what is involved in getting ready for a workday.

5. Distribute Worksheet 1. Work Schedule and Contact Information. Discuss how to use this to organize for work.

Large-Group Discussion—15 minutes 6. Lead discussion on elements of a professional introduction. Note that how you

first introduce yourself to a new client is also a part of professionalism. Ask participants:

When you introduce yourself to someone you are meeting in a work relationship, what information should you include?

What is important to do, or keep in mind about their first impression of you?

7. Review key points. After a few responses, refer to 11. Your First Meeting with a Client in the Learner’s Book.

Teaching Tip If you have time, ask for a volunteer to act out their first meeting with a client. Ask them to follow the guidelines in the Learner’s Book (11). You (the trainer) will play the role of the client.


Learner’s Book—Page 7.1

Learner’s Book


Activity 1. Basic Human Needs 1. What Are Basic Human Needs? 2. A Day with Mrs. Monroe 3. How to Help Your Client Meet Basic Human Needs Activity 2. Overview of Key Concepts of Home Care 4. Key Concepts: Person-Centered Care 5. Key Concepts: Client Rights 6. Key Concepts: Confidentiality 7. Key Concepts: Promoting Client Independence Activity 3. Teamwork and Team Building 8. Members of the Client’s Team




Activity 4. Professionalism 9. Professionalism: Doing a Good Job 10. Getting Ready for Work 11. Your First Meeting with a Client




1. What Are Basic Human Needs? All people have the same basic needs. Part of your role as a home health aide is to assist the client in meeting their needs. There are five basic needs.

Physical Needs:

Maintaining the body’s basic functions

Examples: Food, oxygen, water, elimination, rest, activity, sexual expression, pain management

Security Needs:

Feeling safe, secure, and protected from harm (physically and emotionally)

Examples: Having enough money to pay the bills, having a safe living environment

Social Needs:

Feeling loved, feeling that you belong.

Examples: Having a caring relationship, belonging to a family and a community

Self-Esteem Needs:

Feeling good about who you are.

Examples: Knowing that people know and respect you, getting praise for good work

Self-Fulfillment Needs:

People need to develop their talents and pursue their dreams.

Examples: Learning how to do something, setting a goal and then working toward it.




2. A Day with Mrs. Monroe Page 1 of 2

Mrs. Monroe had surgery a month ago. Since she got home, she has been assisted by a home health aide named Justina. Justina’s Story: “The first thing I do when I get to Mrs. Monroe’s house in the morning is help her get ready for the day. I assist her to the bathroom, and then I help her get dressed. I try to remember to let her do as much as she can. For example, I help her get her pants on, but she puts on her blouse on her own. After she’s dressed, I bring Mrs. Monroe the jewelry box so she can pick out a pair of earrings. I help her put them on, and then I tell her how pretty she looks. She always likes that! Next, I make Mrs. Monroe her breakfast. She is a picky eater, so I have had to ask a lot of questions to find out what she likes to eat. Now I know just what she likes. That makes me feel good because I know that she needs to eat well to regain her strength. After breakfast, I help Mrs. Monroe practice walking. This is in her care plan. I am very careful to stand right next to her when she is walking so that she won’t fall down. This helps her feel safe. When Mrs. Monroe first got home from the hospital, she could only walk a few feet before getting tired. Now she’s much stronger! Every day, I praise her for her progress. I can tell that she feels proud. After we practice walking, Mrs. Monroe usually takes a nap. Walking takes a lot of energy, so she needs her rest! I assist Mrs. Monroe to her bed and make sure she’s comfortable. When she wakes up, I always ask her if she would like me to bring her knitting basket to her. That’s because I know it makes Mrs. Monroe happy to knit. She is really good at knitting!




2. A Day with Mrs. Monroe Page 2 of 2

Sometimes, Mrs. Monroe doesn’t want to knit. That’s usually because she’s feeling lonely. She used to go to the senior center every day to play cards with her friends, but she’s not strong enough for that yet. Right now, I’m the only person that she sees every day. That’s why I want Mrs. Monroe to feel that she can talk to me—she doesn’t have anyone else to talk to! We talk about lots of things. For example, I ask her about her soap operas. She loves to talk about them! I also ask about her niece because Mrs. Monroe really loves her. Sometimes, Mrs. Monroe doesn’t want to talk. Then I just hold her hand.”

How did Justina help Mrs. Monroe meet her basic human needs?




3. How to Help Your Client Meet Basic Human Needs Below, you will see examples of what you could do to help your client to meet his or her basic human needs.

Physical Needs

Examples: Assist the client to the bathroom

Assist the client by preparing meals

Help the client to bed, position comfortably

Monitor pain and provide comfort measures

Security Needs

Examples: Keep the client’s home free of safety hazards

Make sure you use proper technique when transferring the client

Ensure safe ambulation

Observe, record, and report

Social Needs

Examples: Encourage visitors

Give and receive smiles and hugs

Show interest in the client

Encourage the client to maintain family relationships

Self-Esteem Needs

Examples: Call the client by his or her chosen name

Ensure the clients’ privacy

Praise the client for reaching goals that are in the care plan

Respect the client’s cultural background

Self-Fulfillment Needs

Examples: Encourage the client to spend time enjoying hobbies

Be interested in the client’s life accomplishments

Let the client talk about his or her wishes or dreams




4. Key Concepts: Person-Centered Care

It’s important to understand some key concepts about being a home health aide. Here’s what you need to know.

Give person-centered care.

In person-centered care, clients and workers: Create a schedule that fits the client’s life Have a strong relationship Solve problems together

In person-centered care, the client:

Has the right to choose, as much as possible, what kind of care he or she will get

Is the expert on what he or she likes or dislikes

In person-centered care, workers: Care as much about the client’s feelings as they do about the client’s

health Focus on the client, rather than on the client’s problems Remember that the workplace is the client’s home Treat the client as someone with unique wants and needs




5. Key Concepts: Client Rights

What are rights? Rights are powers or privileges. Some rights are granted by law. (For example, clients with disabilities have certain rights under the “Americans with Disabilities Act.”) Other rights are based on the idea of person-centered care. Here is a summary of a client’s rights. Clients have the right to information about:

Their diagnosis, care, and treatment

Any planned changes to their care (before the changes happen)

The provider’s policies, as well as what fees will be charged Clients have the right to participate in their own care. They can:

Say yes or no to care

Help plan their own care (as much as possible)

Complain about treatment or care without being punished. (This means they can also complain if treatment or care is not given.)

Give themselves medicine, as long as it is safe to do so Clients have the right to dignity and respect. This means:

They should be treated kindly and professionally Their privacy and confidentiality should be protected Their property should be treated respectfully

Clients also have the right to be safe, including the right to be free from abuse.




6. Key Concepts: Confidentiality

ConfidentialityKeeping health information private You can tell your supervisor about a client’s health. This helps keep the client healthy. But you cannot share your client’s health information with anyone

elseincluding other home health aidesunless they also work with the client. Confidentiality means sharing private information about clients ONLY with the people who need to know. Confidentiality is required by law. It’s also

the right thing to doit shows respect for the client’s privacy. You can keep health and personal information private. Read what these workers do.

Marty’s tipBe careful when talking on the phone. “I don’t leave private information on answering machines or in voicemail. If I do share information, I make sure I’m talking to the right person. And I make sure that I’m talking in a private area.”

Laura’s tipBe careful when talking in public places. “If I need to talk to my supervisor about something private, I ask to go somewhere private. I stay away from dining rooms, elevators, snack rooms, and parking lots.”

Joe’s tipBe careful when using computers. “When I keyboard something private, I make sure that no one can see the screen. I don’t send information by email unless the computer that gets my message is private. I keep my access code a secret, and I log off when I’m done with the computer.”

Sara’s tipBe careful with your reports. “I don’t leave reports lying around. I put them in an envelope or folder instead.”




7. Key Concepts: Promoting Client Independence Promoting the independence of clients means asking them to do as much as they can. It’s important for clients to make choices and do daily tasks as much as possible. This is called client independence. This independence helps clients:

Be in charge of their own care Feel good about themselves

Stay activeboth mentally and physically Do not assume that a client needs your help. Instead, ask the client what they want you to do. Many clients like the word assist better than the word help. It shows that the client is doing as much as they can.




8. Members of the Client’s Team

Page 1 of 2 Taking care of clients is a team effort. Here are descriptions of different types of workers who will be involved in home care. Some people see and talk with the client (direct contact). Other people do not, but their work still affects the client (indirect contact). Client The client is the most important member of the team. In most cases, clients say what they want and help plan their own care. When clients have trouble thinking, they cannot make many choices. But they should still be heard. People with direct contact with the client The Client’s Family The client’s family often helps plan and give the care. Home Health Aide The home health aide spends more time with the client than any other member of the team. They keep an eye on the client. Other team members rely on home health aides to tell them about any changes they see. Nurse There are two kinds of nurses: RNs and LPNs. The Registered Nurse is called an RN for short. RNs offer the client skilled

nursing care and make the care plan. They give home health aides tasks and supervise them.

The Licensed Practical Nurse is called an LPN for short. The LPN is often in charge of treating clients and giving them medicine, and may supervise home health aides.

Doctor The doctor figures out what’s wrong with the client’s health. The doctor says what should be done to help them get better.




8. Members of the Client’s Team

Page 2 of 2 Social Worker The social worker helps the client with issues like money, housing, and getting along with other people. The social worker may also talk with the client about feelings. Occupational Therapist, or OT for Short The OT assists the client to do daily tasks. The OT helps clients work around their limitations. Physical Therapist, or PT for Short The PT assists the client to move their muscles, bones, and joints to make them work better. Speech Therapist The speech therapist assists the client to speak clearly. People who may not have direct contact with the client, but whose jobs affect the client Coordinator/Scheduler The coordinator/scheduler keeps track of all activities and work regarding each client. Nutritionist The nutritionist suggests what the client should eat and drink to be as healthy as possible. Pharmacist The pharmacist provides the medicines ordered by the doctor.




9. Professionalism: Doing a Good Job

Professionalism means working in a professional way, or always doing your best work.

As a professional, you show pride in yourself and your work. And you also show respect for the client.

You show professionalism in the ways you look, talk, and act; AND

By being on time and ready to start work from the moment you

arrive.




10. Getting Ready for Work

Page 1 of 2

Getting Ready for Work Part of professionalism is being prepared to do your best work. Here are some important things to remember:

What things should I wear?

Wear clean clothes. Wear clothes and shoes that are easy and safe to work in. Wear a name badge that is easy to see and read. Follow the rules of your agency (uniforms might be required, white

clothes or shoes, etc.).

What things should I not wear? Do not wear clothes that are too tight or show too much skin. Do not wear something that you mind getting dirty. Do not wear clothes with holes or wrinkles. Do not wear large earrings, rings, and bracelets.

What should I do the day or night before to help me get to work on time?

Check the weather for the next day. Plan what to wear. Iron your clothes, if needed. Pack the things you will need. Make sure there is gas in the car, or you have money for the bus or

train. Set your alarm clock. If this will be your first visit to the client, take the route to work to

see how long it takes.




10. Getting Ready for Work

Page 2 of 2 What do I need to know so I’m ready to work when I get there?

Your scheduledays and times Where you need to go and how to get there What to do if you will be late The name of your client The name and contact number of your supervisor Who you are supposed to see when you get to work (in addition to

the client, if anyone) What kinds of assistance you will be providing

What personal things should I take care of so I’m not distracted at work?

Plan child care, if needed. Have a backup plan. Let people know they can’t reach you when you’re at work, except

for emergencies. Don’t answer your cell phone at work, unless it’s an emergency. Reschedule any appointments that conflict with work time. Get a good night’s sleep.




11. Your First Meeting with a Client

Your first meeting with a client is important for establishing a good working relationship. Here are some important things to remember.

Introduce yourselfuse your first and last name.

Always wear a name badge in plain view and with large print.

Refer to the client as “Mr./Mrs. Monroe” unless they request that you call them by their first name or nickname. Do not use slang terms such as “sweetie” or “dear.”

Use a friendly tone of voice. But also stay focused on your jobthis will help show your professionalism.

Get the client’s permission before beginning a task. Explain what you are going to do.

Special tips for home care:

Say which agency you are from and why you are there. If you are greeted at the door by a family member, introduce yourself to the family member and then repeat your introduction when you meet the client.

Wait to be invited into the home. Wait to be invited to sit and talk.

Ask for permission to use the bathroom to wash your hands.



Handouts

Handout 1. Key Terms Basic human needs [1]

These are the things that all people need in order to survive and thrive. The categories of basic human needs are: physical, security, social, self-esteem, and self-fulfillment.

Client independence [7]

Client independence means being able to make choices and to do daily tasks on their own as much as possible.

Client rights [5]

Client rights are powers or privileges that clients should expect in home care. Some rights are granted by law. Other rights are based on the idea of person-centered care.

Confidentiality [6]

Confidentiality means keeping health information and personal information about clients private. Maintaining confidentiality in home care means sharing private information about clients ONLY with the people who need to know, in order to ensure the client’s safety and well-being.

Person-centered care [4]

Person-centered care is an approach to home care that focuses on the client as a whole person, rather than a set of problems.

Professionalism [9] Professionalism means working in a professional way, or always doing your best work.



Handouts

Handout 2. Summary of Key Information Page 1 of 2

A significant part of your role as a home health aide (HHA) is to assist the

client in meeting his or her basic human needs. There are many things that a HHA can do every day, in every category, to help a client meet his or her basic human needs.

In person-centered care, the HHA treats the client as a person with unique wants and needs. The client has the right to choose, as much as possible, what kind of care he or she will get, and is considered to be the expert on what he or she likes or dislikes.

Home care clients have rights. These include: the right to information about

their care, the right to participate in planning their own care, the right to be treated with dignity and respect, and the right to be safe.

Confidentiality in home care is required by agency policy and by law.

HHAs need to be aware of maintaining confidentiality when they are: talking on the phone, talking in public places, using computers, and doing paperwork or writing reports about clients.

Promoting client independence is a key concept of home care. It helps

clients to feel good about themselves and to stay active—both mentally and physically. You can promote client independence by not assuming that a client needs your help. Instead, ask the client what they want you to do.

Taking care of clients is a team effort. Some people see and talk with the

client (direct contact). Other people do not, but their work still affects the client (indirect contact). The client is the most important member of the team. In most cases, clients can say what they want and help plan their own care. The home health aide spends more time with the client than any other member of the team. Other team members rely on home health aides to tell them about any changes they see.



Handouts

Handout 2. Summary of Key Information

Page 2 of 2 Home health aides demonstrate professionalism by showing pride in

themselves and in their work, and by showing respect for the client. This includes being professional in the ways they look, talk, and act, and being on time.

Being professional means being prepared every day to do your best work.

This includes: thinking about what things you should and should not wear, preparing the night before to help you get to work on time, having all the information you need to get to the client’s home, and taking care of personal matters so you’re not interrupted or distracted at work.

Your first meeting with a client is important for establishing a good working relationship. Remember to: introduce yourself, wear a name badge, refer to the client as “Mr. or Mrs.____” unless they ask you to call them by something else, use a friendly tone of voice, stay focused on your job, and explain to the client what you are going to do before beginning a task.



Worksheets

Worksheet 1: Work Schedule and Contact Information

Here is the kind of information that you will need to keep track of your schedule. The contact information will be useful to you. You may also want to give it to your children’s school or day-care providers, in case of emergency. Start Date Days of the Week (that I work) Hours Agency Address Name and phone number of my contact person at work Number where I can be reached in family emergencies Other notes:

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