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Trainee AssessmentDementia:Support and safepractice Unit standardVersionLevelCredits23920 Describe dementia, support, and safe practiceto support people living with dementia in a health orwellbeing setting.446 Your name:Your workplace:Your date of birth:NSN number (if you know it):Declaration? I was told about and understand the assessment requirements and appeals process.? I have prepared my answers myself.? Any evidence I have provided as my own, I produced myself.? I understand that this assessment may be used for moderation and quality control purposes.? I understand that when I achieve this unit standard my result will be registered with theNew Zealand Qualifications Authority.I confirm the above declaration:YesNoDate: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 2Assessment summary (completed by assessor)Trainee’s performance summary Assessment tasksAssessor’s signatureDate achievedTask 1: Describe dementiaTask 2: Co-existing conditionsTask 3: Support a person living withdementiaTask 4: Daily living and meaningful activitiesTask 5: Safe practiceTask 6: Enduring Power of Attorney (EPA) Unit standard resultsI have assessed the trainee and confirm the requirements have been met to demonstratecompetency in: Unit standardVersionLevelCredits23920 Describe dementia, support, and safepractice to support people living with dementia in ahealth or wellbeing setting.446 Assessor’s name:Assessor’s number:Signature:Date: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 3Trainee informationBefore you start? The assessor/verifier will meet with you and talk about what you need to do. ?Read through the Careerforce workplace learning and assessment guide if you need moreinformation about the assessment process. As you go? Answer all questions. ???Follow the instructions for each task.If you answer by writing, you may write either electronically or by hand.If you answer verbally, your assessor will write your answer(s) or may use a voice recorder.? Your assessor or verifier will use the checklists in this Trainee Assessment when they observeyour work.If you need help with this assessment, please contact your assessor.? When you finish ?Make sure you have completed any parts where the assessor/verifier has said you need todo more work. AppealsIf you wish to appeal against the assessment result or process, talk to your assessor.If you are still not satisfied, you can appeal to Careerforce by completing the assessment resultappeal form. You can find this form online at www.careerforce.org.nz/contact/formsFeedbackCareerforce regularly reviews our assessment and learning resources. As a user, we wouldappreciate feedback on how you found it. Feedback can be provided to Careerforce via: ??our online feedback form at www.careerforce.org.nz/contact/resource-assessment-feedbackemail to [email protected] DefinitionsDementia is a term that covers a group of different illnesses in which there is a progressive andirreversible loss of mental functioning that results in a decline in the person’s ability to think,reason and remember. A feature of dementia is the individual and changing nature of thecognitive, functional, behavioural and psychological effects that occur.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 4Task 1: Describe dementiaFor this task you need to show your understanding of dementia, the normal ageing process,delirium, depression and other types of dementia. You also need to describe the characteristicsof the three stages of dementia.1 Describe the difference between the normal ageing process and the brainof a person living with dementia.Your description must include each of the following:? loss of nerve cells.? plaques and tangles.? slower reactions and decisions.? memory changes. Loss of nerve cellsNormal ageingDementia Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 5 Plaques and tanglesNormal ageingDementiaSlower reactions and decisionsNormal ageingDementia Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 6 Memory changesNormal ageingDementia 2 Describe how delirium is different from dementia.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 73 Describe how depression is different from dementia.4 Describe types of dementia.Your description must include:? Alzheimer’s disease? vascular dementia? one other type of dementia. Examples may include:– Lewy Body dementia.– frontal and temporal lobe dementias.– other types of dementia. Alzheimer’s disease Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 8 Vascular dementia One other type of dementia Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 95 Describe the main characteristics of the three stages of dementia. First stage (early/mild dementia):Second stage (moderate dementia):Third stage (advanced/severe dementia): Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 10 Task 1: Assessor’s feedback to trainee When the assessor agrees that you have completed this task successfully, they will sign it off onthe assessment summary page at the front of this assessment.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 11Task 2: Co-existing conditionsResearch two other conditions that may exist together with dementia.1 Describe how each condition may impact on the support you provide.Co-existing conditions may include:? hypertension. ???????????coronary artery disease.COPD.osteoarthritis.stroke.diabetes.cancer.chronic renal problems.multiple sclerosis.obesity.Parkinson’s disease.respiratory disease. ? other chronic, terminal or life limiting conditions. First co-existing condition:Second co-existing condition: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 12 Task 2: Assessor’s feedback to trainee When the assessor agrees that you have completed this task successfully, they will sign it off onthe assessment summary page at the front of this assessment.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 13Task 3: Support a person living with dementiaFor this task you need to describe how to use a person-centred approach when supporting aperson living with dementia. Describe how you could support that person at each stage ofdementia and describe the individual’s rights as they relate to restraint and the legal standardsrelevant to support.Choose and read one scenario (whichever is relevant to your setting) and answer thequestions that follow.Scenario 1: Home care – Mrs SmithMrs Smith had been living alone in her own home since her husband died of a heart attack threeyears ago. Mr Smith was a shop owner while Mrs Smith was a stay-at-home mum all her life,raising their three girls.In the last few years Mrs Smith had spent most of her time cooking, baking, cleaning and doinglaundry. She was very precise with her cleaning rituals and only picked up her hobbies (sewingand knitting) when everything was in order and immaculate. Mrs Smith had her daily routine ofcleaning her home, cooking her meals and washing up afterwards. Then she would knit orattend social activities that her family, wh?nau or support worker had organised for her.Mrs Smith’s support worker, Jane, knew Mrs Smith really well. Jane noticed that Mrs Smithwasn’t attending her social activities as regularly as she normally did and had started to becomequiet and withdrawn. Jane checks on Mrs Smith after meals and has noticed several times thatMrs Smith had started knitting even though there were dirty dishes in the sink. This was notnormal behaviour for Mrs Smith.Jane referred Mrs Smith to a health practitioner who diagnosed Mrs Smith with early-stagedementia. At this stage, Mrs Smith’s eldest daughter, Emily’s enduring power of attorney wasactivated. In coordination with the doctor and the assessment team Emily made the decisionthat Mrs Smith would remain in her own unit for as long as possible with support from Jane andher family and wh?nau.Mrs Smith continued to live independently for most of the next two years, with adequatepersonal hygiene and relatively intact judgement. However, her social participation continued todecline. Jane made notes on Mrs Smith’s progress. As time went on, Mrs Smith also started tohave increased difficulty in communicating her needs.One day Jane assisted Mrs Smith with making lunch. After having lunch Mrs Smith forgot thatshe had eaten and got really upset with Jane as she thought that Jane didn’t want to help her. Atth

is point Jane tried to calm Mrs Smith by talking quietly and diverting her attention by askingquestions about baking. Mrs Smith was still adamant that she wanted to leave to go to herhusband’s shop for lunch. As a last resort, Jane had to lock the unit and stay with Mrs Smith totry and calm her and divert her attention by folding the washing.The matter was referred to Emily and Mrs Smith’s health care team, who decided to moveMrs Smith into the dementia unit of the facility. It took Mrs Smith a while to settle in, as shekept getting confused about where she was. At first it seemed that her condition wasdeteriorating quickly. As time passed, however, she settled in and began to get used to the newroutines.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 14Scenario 2: Residential care – Mr JonesMr Bob Jones, a resident at Golden Acres Rest Home for the last month, had been placed thereby the assessment team after his farm house burnt down. He was a fit and healthy bachelor of83 (“I never needed a doctor in my life”) who had been a sheep and cropping farmer and livedall his life in mid-Canterbury.Bob had been active in the community. He held office in Federated Farmers, had been presidentof the local rugby club and had donated a considerable amount of money and time to the localtennis club where he played for years.Neighbours who visited him since his admission told us that he was a hard worker and a hardplayer, a very active and independent bloke.Bob always said that “They’ll have to carry me out of here in a box”, such was his feeling for thefarm he had taken over from his parents.His nephew, John, farmed next door and noticed a decline in decision making about the farm.Bob had been in the habit of going to John’s once a week for a meal with the family. John’s wifenoticed a decline in Bob’s personal hygiene and dress and sent John to have a heart-to-heartconversation with him.When John visited Bob at home he noticed a burnt porridge pot in the sink, lots of dirty dishesand piles of unopened mail on the kitchen table. Bob denied any problems and refused offers ofhelp from John and his wife with farm work or housekeeping.Bob has not settled at Golden Acres. He is resistant to offers of help with personal care, hasbeen observed urinating in the garden, can be physically and verbally abusive to the youngfemale staff, constantly wants “to ring the stock firm” and can be intrusive towards otherresidents. He blames John and his wife for his placement in the home and seems to lack insightinto his situation.Bob recently left the building early in the morning and was found down the street shortlyafterwards, cold, dazed and inappropriately dressed. The assessment team consulted Bob’srecently appointed welfare guardian and reassessed Bob as needing secure dementia care.They were able to make a prompt assessment based on the good records staff had kept of Bob’sbehaviour and responses to their interventions.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 15Ensure you answer the following questions based on what you will do in your workplacefollowing your workplace’s policies and procedures.1 Describe how you would use a person-centred approach to support MrsSmith or Mr Jones.2 Identify notable changes in Mrs Smith’s or Mr Jones’ condition and theimplications of these changes.3 Describe the changes in Mrs Smith’s or Mr Jones’ needs.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 164 What are the effects of these changes on Mrs Smith’s/Mr Jones’ quality oflife?5 Describe two possible changes at each stage of dementia for Mrs Smith orMr Jones.How would you use a person-centred approach to support them througheach of these changes?Possible changes may include:? medication and its effects.? relationships.? communication.? individuality.? feelings.? abilities retained.? holistic wellbeing.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 17 Early/mild stage:First change:Second change:Moderate stage:First change:Second change: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 18 Advanced/severe stage:First change:Second change: Task 3: Assessor’s feedback to trainee When the assessor agrees that you have completed this task successfully, they will sign it off onthe assessment summary page at the front of this assessment.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 19Task 4: Daily living and meaningful activities1 Describe how dementia will change a person’s activities of daily living(ADL).Describe how each of the following effects of dementia will change a person’s ADL:? cognitive effects.? functional effects.? behavioural effects.? psychological effects. Cognitive effects:First ADL:Second ADL: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 20 Functional effects:First ADL:Second ADL: Behavioural effects:First ADL: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 21 Second ADL: Psychological effects:First ADL:Second ADL: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 222 Identify a meaningful activity you use or have used to support a person’swellbeing living with dementia.This activity could include:? connecting with the community.? spiritual activities.3 Why is this activity meaningful to the person you support?4 Describe how this meaningful activity relates back to the individual’spersonal plan and your organisation’s policies and procedures.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 23 Task 4: Assessor’s feedback to trainee When the assessor agrees that you have completed this task successfully, they will sign it off onthe assessment summary page at the front of this assessment.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 24Task 5: Safe practice1 Define the following categories of restraint used when supporting a personliving with dementia, according to the Health and Disability Services(Restraint Minimisation and Safe Practice) Standards.Provide an example of each. Restraint:Personal:Example:Physical:Example:Environmental:Example: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 25 Seclusion:Example:Medication:Example: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 262 Describe how you could maintain the rights of a person you support duringrestraint practice in relation to the topics below. Dignity:Privacy:Support:Communication:Safety: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 273 Give four examples of how your workplace complies with the Health andDisability Services (Restraint Minimisation and Safe Practice) Standardswhile supporting a person living with dementia.Examples may include:? documentation.? assessment. ???????informed consent.planning.care and monitoring requirements.ongoing education.reporting and recording.evaluation and review.approval process. First example:Second example:Third example:Fourth example: Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 284 Identify three pieces of legislation and/or standards that are relevant tosupporting Mrs Smith/Mr Jones (Task 3).Describe why each of these is in place to ensure safe practice. First legislation/standard:Second legislation/standard:Third legislation/standard: Task 5: Assessor’s feedback to trainee When the assessor agrees that you have completed this task successfully, they will sign it off onthe assessment summary page at the front of this assessment.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 29Task 6: Enduring Power of Attorney (EPA)Think about a person living with dementia who may have a personal care and welfare EnduringPower of Attorney (EPA) and answer the following questions.1 When does an EPA come into effect?Who determines that it should come into effect?2 Describe the process for initiating an EPA.Explain how your organisation supports this process.Dementia: Support and safe practice (US 23920 v4) Trainee Assessment © Careerforce – Issue 4.0 – December 2015 303 Describe how an EPA relates to the person’s personal plan. Task 6: Assessor’s feedback to trainee When the assessor agrees you have completed this task successfully, they will sign it off on theassessment summary page at the front of this assessment.