Care plan review and responding to changes in an older person – Introduction to aged care video

Tamika:

This week I learned that we’ve got to keep checking on the help we give people. We’ve got to look out for the little things that show they might need some extra care from us or they might need to see a health professional to get some help. Let me show you what I mean.

Enid:

So I’ll update Janie’s care plan and her client file about those changes. Now what about Delia? She’s coming back to the community this week and we’ll need to restart her services.

Tamika:

That’s okay. I’m helping Sonia in the kitchen today. I can just add her back on to the meals list.

Enid:

Thanks Tamika. First though we might need to make a few changes to Delia’s care plan. Her support needs will probably have changed a little bit since she’s been in hospital.

Judith:

Yeah. She had a stroke didn’t she? I was talking to her carer Margaret yesterday and she said that Delia is getting better but one side of her body is still weak from the stroke she had. She asked me about getting some grab rails to put in the bathroom to make it safer for Delia.

Enid:

That’s right. Delia has a problem with her balance at the moment. The report I had from the discharge planner at the hospital said that she has dysphagia.

Tamika:

Dis what?

Enid:

Dysphagia. It’s a medical word that means the person has difficulty swallowing. There are lots of things that can cause dysphagia. It can happen when someone has a stroke or maybe a head injury or even if they have dementia.

Judith:

Yeah. We learnt about it from that speech therapist who came out last year and did some training. She was telling us that dysphagia isn’t a disease but it happens because of a disease or health problem. She gave us a food and drink texture chart for the kitchen that showed us what different textures and consistencies of food and drink look like. We’ll have to make sure the kitchen staff remember to use that for Delia.

Enid:

Yes. If we don’t make Delia’s meals right the food or drink can go down into Delia’s lungs instead of her stomach.

Tamika:

Oh that doesn’t sound good.

Enid:

No. It isn’t. If the food gets into her lungs Delia could end up with pneumonia.

Tamika:

So what do you want to do to make sure the food and drink goes down right?

Judith:

Well there’s lots of things we can do. We want to make sure that the food is the right consistency, you know, like we make Sammy’s meals easier for him to eat.

Enid:

Yes that’s right. We’ll probably have to mash, to puree Delia’s food for a while until she recovers. We might also need to thicken her drinks.

Tamika:

Ew. Thick tea. That sounds nasty.

Enid:

It might be a strange texture but if it helps to stop Delia from choking then it’s worth it.

Tamika:

I suppose so. Hmm. What else do we need to do?

Judith:

There’s lots of little things we can do like making sure Delia is sitting up properly and that she’s not too sleepy when she’s eating. She also needs to slow down and think about swallowing at the moment because her throat muscles are just not working real well.

Tamika:

Okay. Anything else I need to remember if I’m helping her?

Enid:

It’s a good idea to take a look at her meal before you give it to her. It’s good to double check that the consistency is right for her. Here’s that texture chart to check it. And make sure she has a drink to go with her meal. Get her to take little sips after she’s eaten some food. A drink will help the food go down better.

Tamika:

Okay. So how long will Delia have to eat this special diet?

Enid:

For as long as she needs to. I’ll add this information to her new care plan. And because she might have some different needs now I’ll be checking on her a bit more often and adjusting her plan if things get better or worse for her. Now I’ll be relying on all of you to let me know if there are any changes that you see in Delia.

Tamika:

All right. But what sort of things am I looking for?

Enid:

Let me know if Delia is looking thinner, if she eats less or if she’s having even more difficulty with her eating.

Judith:

Yep. We’ll do that. And we’ll also be checking her weight and we’ll let you know if we see any big changes or if the family tells us about any worries they have for her.

Enid:

Thanks Judith. I’ll get on with writing up this new care plan so I can check it with Delia and her family when they arrive.

Tamika:

See. We’ve got to look out for clients. Let our supervisor or team leader know if we’re worried about something. We are the eyes and ears of the service. If things change for a client then their care plan might need to be updated and Enid has to add in new things that we do for them. Or the person might need to go talk with a specialist like a speech therapist or another health professional. I always tell Enid or Judith if I’m worried about someone. Who do you talk to?