Duties and responsibilities of a care worker

(Hi Huis Herfsblaar, so glad you are using this forum!)

Person first, task second - always! 

Thinking hands - consider how what I do will impact the individual

Maybe to give background as to why we asked this question:

The Community Health Worker program (under HWSETA) that we are offering has come to an end. 

The new program is accredited by QCTO, we had to make a decision to offer the Health Promotion Officer or the Home based person care worker programs.

An easy decision was made, as we are in the care industry, and we will now offer the Home based personal care worker program.

The program has specific compulsory modules but we are allowed to add additional content.

Hence the reason for the question - what do you expect your care worker to do? Are there other skills that you wish your care worker had when they started working with you? 
To give you an example, our staff suggested that in addition to teaching the care worker the need for socialization and personal interaction of older persons, we can also teach the care worker how to socialize and do exercise and activities with their client.

Thank you for your response.

Regards
Huis Herfsblaar team

Learning to socialise with someone, especially if the person is from a different culture, is a very valuable skill. And yes adding more skills on activities and especially movement is vital.

I have a few more suggestions along these lines (My wish list). It’s more about how care workers should be. I'm sure some of these are already included in the training. If incorporated or opportunities created for the individuals to develop themselves, it would make a significant difference:

• Know themselves and be self-confident
• Have a positive self-image
• Be able (and confident) to express their opinions, thoughts, and feelings
• Possess good listening skills
• Be mindful and observant
• Have strong conversation skills, especially active listening
• Be knowledgeable in wellbeing, empowerment, enablement, and person-directed support, as well as facilitation
• Be a team player
• Be skilled in conflict resolution or, at the very least, be aware of the impact conflict can have on everyone, especially older individuals and know where to access support to resolve conflict.
• Know how to negotiate and advocate
• Be culturally aware and knowledgeable
• etc...

Here is a starter list of training modules for consideration.

This is provided as a point of departure within Project Scaffold to ensure that at the very least we are all considering the same TOPICS.  The content may differ and may in some cases be proprietary, however to start with lets all agree on the subjects that must be covered:

I. Communication and Interpersonal Skills:

• Communication

II. Personal Care and Hygiene:

• Personal Hygiene
• Bed bath
• Caring for fingernails and toenails
• Hair wash
• Hand washing
• Mouth care
• Shower

III. Mobility and Positioning:

• Sitting in chair
• Making a bed
• Making a bed with a resident in the bed

IV. Nutrition and Hydration:

• Fluid intake and output
• General rules for feeding helpless patients
• Serving meals
• Nasal-gastric tube feeding
• PEG feeding (Percutaneous endoscopic gastrostomy)

V. Observation and Monitoring:

• Observations
• Vital observations
• Urine testing

VI. Safety and Prevention:

• Health and safety
• Safety for the Care giver
• Bed rest complications
• Pressure sores

VII. Medical Assistance and Procedures:

• Bedpan and urinal
• Catheter care
• Oxygen inhalation
• Wound dressing

VIII. End-of-Life Care:

• Care of the dying
• Palliative Care and the aged

IX. Specific Resident Conditions:

• Sleep
• Unconscious Resident
• Pain

X. Ethical and Legal Considerations:

• Ethical principles
• Forms of conduct
• Legal obligations concerning the nurse
• Medico-legal risks

I. Communication and Interpersonal Skills:

• Communication
  • Listening Skills (Nancy Kline: “Time to Think” is a good guide)
  • Communicating with someone who is living with neuro-cognitive impairment
  • Overcoming language barriers
  • Becoming well known
  • Record keeping for Caregivers (maintaining daily records that translate into care plans)

II. Personal Care and Hygiene:

• Personal Hygiene
• Bed bath
• Caring for fingernails and toenails
• Hair wash
• Hand washing
• Mouth care
• Shower
• Foot care
• Skin care

III. Mobility and Positioning:

• Transfer a resident who can no longer transfer independently
• Sitting in chair
• Making a bed
• Making a bed with a resident in the bed
• Wheelchair use

IV. Nutrition and Hydration: Understanding the importance of optimal nutrition and hydration and the role that Caregivers play in maintaining this status

• Fluid intake and output
• General rules for feeding helpless patients
• Serving meals
• Nasal-gastric tube feeding
• PEG feeding (Percutaneous endoscopic gastrostomy)

V. Observation and Monitoring:

• Observations, including
  • weight monitoring
  • hydration status
  • skin integrity
  • output (Bristol stool chart, understanding urine status i.e. colour, smell, frequency)
  • sleep patterns
  • mood status
  • engagement in meaningful engagement
• Vital observations
• Urine testing

VI. Safety and Prevention:

• Health and safety
• Safety for the Care giver
• Bed rest complications
• Preventing skin tears, skin flaps, Pressure sores etc

VII. Medical Assistance and Procedures:

• Bedpan and urinal
• Catheter care
• Oxygen inhalation
• Wound dressing (RN are going to say this is not allowed to be performed by a Caregiver. Perhaps rather “Wounds: what should the Caregiver know/do.)

VIII. End-of-Life Care:

• Care of the dying
• Palliative Care and the aged

IX. Specific Resident Conditions:

• Sleep
• Unconscious Resident
• Pain
• Distressed reactions - why do residents become distressed and what happens if they do?

X. Ethical and Legal Considerations:

• Ethical principles (e.g privacy)
• Forms of conduct
• Legal obligations concerning the nurse (we will have to create a legal/ethical framework of conduct)
• Medico-legal risks

XI. Understanding Neurocognitive Impairment:

• Knowledge of different types of neurocognitive impairment (dementias)
• Understanding the three D’s (dementia, depression, delirium)
• Understanding the modifiable risk factors for dementia (what can I do to help reduce the risk?)

XII. Meaningful Engagement:

• Enabling vs disabling practices - when should a Caregiver help and when should they not?
• Creating oportunities for meaningful engagement.

Thanks for extending the list Rayne!

Here is a revised list, based on input from others including Sr. Heide-Marie from MacCare:

1. Who is a Care Giver: an Overview

2. Characteristics of a Caregiver

3. Duties of a Care Giver

4. Communication and Interpersonal Skills

a. Communication
b. Listening Skills
c. Communicating with someone who is living with neuro-cognitive impairment
d. Overcoming language barriers
e. Becoming well known
f. Telephone Communication
- Answering the phone in an emergency
g. Communication and Collaboration with Families and Other Healthcare Professionals
h. Cultural Sensitivity and Diversity
i. Respecting Household Routines and Preferences
j. Awareness of Different Communication Norms
k. Respecting Privacy and Personal Space
l. Adapting Communication Styles
m. Professional Boundaries

5. Record Keeping and Documentation

a. Record keeping for Caregivers
b. Recording and Documentation
c. Incident Reporting

6. Personal Care and Hygiene

a. Personal Hygiene
- Bed bath
- Caring for fingernails and toenails
- Hair wash
- Hand washing
- Mouth care
- Shower
- Foot care
- Skin care and integrity
b. Incontinence care management
c. Infection Control Practices
d. Adapting to Different Hygiene Standards

7. Mobility and Positioning

a. Transfer a resident who can no longer transfer independently
b. Sitting in a chair
c. Making a bed
d. Making a bed with a resident in the bed
e. Wheelchair use
f. Residents in wheelchairs - safety and guidance
g. Accompanying to amenities

8. Nutrition and Hydration

a. Understanding the importance of optimal nutrition and hydration
b. Fluid intake and output
c. General rules for feeding helpless patients
d. Serving meals
e. Nasal-gastric tube feeding
f. PEG feeding (Percutaneous endoscopic gastrostomy)
g. Safe Food Handling and Storage
h. Understanding Dietary Needs and Restrictions
i. Dysphagia - aspiration
j. Dehydration
k. Kitchen- preparing beverages and meals, hygiene, and appliances

9. Observation and Monitoring

a. Observations, including:
- Weight monitoring
- Hydration status
- Skin integrity
- Output (Bristol stool chart, urine color, smell, frequency)
- Sleep patterns
- Mood status
- Engagement in meaningful activities
b. Vital observations
c. Urine testing

10. Safety and Prevention

a. Health and safety
b. Home Safety and Maintenance Awareness
c. Infection Control Practices
d. Safety for the caregiver
e. Bed rest complications
f. Preventing skin tears, skin flaps, pressure sores
g. Advanced First Aid and Basic Life Support (BLS)
h. Emergency Response and Procedures
- Responding to a call
- Falls
- Wounds / Bleeding
- Unconscious resident
- Allergy
- Choking

11. Medical Assistance and Procedures

a. Bed Pan and Urinal
b. Catheter care
c. Oxygen inhalation
d. Basic Understanding of Home Medical Equipment
e. Wound dressing (Caregiver's role)
f. Medication Assistance (if within scope of practice)
g. Technology in Caregiving

12. End-of-Life Care (Palliative)

a. Care of the dying
b. Palliative care and the aged
c. Stages in dying

13. Specific Resident Conditions

a. Sleep
b. Rest
c. Comfort
d. Unconscious Resident
e. Pain
f. Distressed reactions - causes and responses
g. Managing Challenging Behaviors
h. Emotional Support and Mental Well-being of Residents
i. Specific Medical Conditions

14. Ethical and Legal Considerations

a. Ethical principles (e.g., privacy)
b. Forms of conduct
c. Legal obligations concerning the nurse
d. Medico-legal risks
e. Respecting Privacy and Personal Space

15. Understanding Neurocognitive Impairment (Dementia)

a. Knowledge of different types of neurocognitive impairment
b. Understanding the three D’s (dementia, depression, delirium)
c. Understanding the modifiable risk factors for dementia
d. How does communication differ with a dementia resident
e. Dementia, aggression, and anxiety
f. Basic First Response (in dementia context)

16. Meaningful Engagement

a. Enabling vs. disabling practices
b. Creating opportunities for meaningful engagement
c. Culture inspiration
d. Activities and Engagement Programming
- Types of activities
- Finding the right activity for a resident
e. Importance of exercise – Passive/Active
f. Companionship

17. Caregiver Well-being and Self-Care

18. Skills for Managing a Modern Home Environment

a. Basic Appliance Use
b. Home Safety and Maintenance Awareness
c. Organization and Cleanliness Standards
d. Homecare and Housekeeping
e. Room neatness and assistance
f. Resident Laundry: receiving, sorting, packing away, recording
g. Bed, room, closet neatness and maintenance
h. Entering and being in a home – Resident routine and habits

19. Time Management and Organization in Home Care

a. Following Care Plans and Schedules
b. Prioritizing Tasks

20. Team Communication and Collaboration

a. PDC Team Communication
b. Family Communication

21. Values and Cultural Sensitivity

a. Values
b. Cultures / Spirituality
c. Respecting Household Routines and Preferences
d. Cultural Sensitivity and Diversity

22. Resident Environment and Preferences

a. Pets

Undoubtedly there will be some areas to optimise and improve upon, but I think we are making progress!

Please provide your input and opinion regarding the list 

I suggest adding 12(d) - Berevement