Skills demonstration 1: Demonstrate the process involved in assisting a client who has mobility difficulties moving from a bed to a chair
Both care assistants will discuss before commencing to lift the resident the best course of action taking into consideration best practice for Patient Handling and Moving. It was decided that a standing hoist was the most appropriate lifting aid. We explain to the resident that we will use the standing hoist as we do not want to hurt him or let him fall and also to protect our backs. We secure privacy by ensuring the bedroom door is shut and there is a “do not disturb” sign on the door handle. We visually inspect the hoist and sling for any defects, if we spot any we will not use them and bring this to the attention of the Nurse on duty.
To get a resident from a bed to a chair, one care assistant must put their arm closest to the resident around the resident’s back and the other care assistant must help swing the legs around to dangle off the side of the bed while shifting the resident’s upper body so that he is close to the edge of the bed. Both Care Assistants must ensure to keep their legs in a stable lunge position and using proper lifting techniques. All of this must be communicated between the Care Assistants before commencing so that each knows what task they are doing. The resident must be informed of what is going to happen in order to get them in an upright position in a safe and secure manner.
One Care Assistant holds onto the resident to ensure they do not fall off the bed. The other Care Assistant gets the sling for the hoist and places it and secures it around the resident’s waist. This same Care Assistant will now put the standing hoist into position and ask the resident to hold onto the bars on either side for balance and ask the resident to place their feet on the foot plate.
Once the resident is secure attached via the sling to the hoist he is lifted up enough so that he is comfortable and also so he will be able to be moved to a chair. The other Care Assistant stands behind the chair whilst the resident is being lowered to a seating position, to ensure the resident is back fully on the chair. Once the resident is comfortably seated we begin to unclasp the sling from the hoist and move the hoist out of the way, we take off the sling. We ask the resident if they are comfortable and would he like the use of a foot rest. We attach the assistance bell to the arm of his chair so that if he needs any assistance later we will come back to him. We take the sling and the hoist in the store room so that it does not become a trip hazard. If we notice anything unusual whilst using the hoist or sling we report it immediately to the nurse on duty and put an out of order sign on it to ensure another person does not use it and put a resident needlessly at risk.
Skills demonstration 2: Demonstrating the process involved in assisting a client who cannot mobilise alone with toileting.
When toileting a resident I will always ensure that I ask for help if I do not feel strong enough to do it by myself. I Prepare by ensuring the trust and cooperation of the person in the wheelchair and ensuring that her dignity is preserved at all times. Secure privacy by ensuring door is closed and that a towel is at hand for securing the dignity of the resident while she sits on the toilet. I wash my hands and put on a pair of disposable gloves and apron for infection control purposes. I know that the resident continent of urine and Faeces so she will have to use the toilet and does not use incontinence pad.
I speak to the resident and ask her if she would like to use the toilet. I push the wheelchair into the bathroom ensuring the resident’s elbows are inside the frame of the wheelchair to ensure they do not hit off the frame of the bathroom door. I close the door of the bathroom once safely inside. I verbally confirm with the resident if she will be able to stand. I position the wheelchair so that it is in front of the sink as there are bars positioned to the wall which the resident will use to hold and pull themselves up off the wheelchair. I remove the foot rests and place the resident’s feet on the ground. I ask the resident to put their hands on each of the bars. I face the resident and help lift them to a standing position. I push the wheelchair back. I get her to turn facing the door and help her to move backwards until she is in front of the toilet. I pull down her trousers and underwear and ask her to sit down. I put down the side guard so that she can hold onto it for balance and a sense of security. I place a towel on her lap. I turn on the tap to help her urinate.
While I wait for her to finish I take some toilet roll and put aqueous cream on it. When she is finished I turn off the tap and help her stand by asking her to again hold on to the bars. I clean the resident with the toilet roll going from the vagina to the back passage to ensure she does not get a bladder infection. I use Aqueous cream to ensure the resident will be clean and fresh and to stop the breakdown of skin. I ensure the resident does not have any sores and that the skin is intact. If there are any skin complaints I report these to the Nurse on duty.
I pull up her underwear and trousers and push the wheelchair in behind her. I ask her to place her hands on the arm rests and sit down. I turn the wheelchair around and put her feet on the foot rests. I remove my disposable gloves and apron and bin them again ensuring infection control policies are adhered to. I enter the output in the Epicare system. I enter if she urinated or had Bowel Opening (BO) or both into the computer if there were any abnormalities regarding colour or smell, I immediately inform the Nurse.
Skills demonstration 3: Demonstrate the process involved in assisting clients who are unable to feed themselves to eat a meal.
I prepare the resident who has latent stage of Dementia by ensuring she is wearing her dentures and glasses. I ensure her hands are washed before taking her to the dining room. She has confusing due to Dementia so she needs me to physically assist her with feeding her dinner. I ensure that her food is pureed as she has difficulty in swallowing (Dysphasia). I add thickener to her milk to ensure she does not aspirate the liquid into her lungs. I ensure she is upright and sitting comfortably in her seat.
I tell her I am going to put a napkin on her to protect her clothing and dignity. I sit eye level as I can easily assist the resident. I ensure the food is not too hot or too cold. I only place one plate of food in front of her at a time, for example, soup. This helps ensure that all food is consumed and makes the process easier. I use a smaller spoon to prevent choking. I touch her lower lip to stimulate opening her mouth. I encourage her to eat but I never force her to eat anything she does not want to. I clean out her mouth and wash her dentures after the meal to prevent any oral infection. I ensure that she remains sitting in an upright position at least thirty minutes after each meal so that she does not aspirate the food and it also give her time to digest it. I enter in how much food she has eaten into the Epicare system. If she has eaten a minimal amount I tell the Nurse so can closely monitor her nutritional intake.
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