learner’s book module 1. welcome and team-building aide workforce initiative (hawi) learner’s...

HOMECARE AIDE WORKFORCE INITIATIVE (HAWI)

Learner’s Book—.1

Learner’s Book

Module 1. Welcome and Team-Building

Activity 1. Welcome, Introductions, Orientation to the Training 1. Understanding Your Job 2. The Purpose of This Training

Module 1. Introduction to Home Care


Learner’s Book—Page 1.2

1. Understanding Your Job Page 1 of 2

What will your job title be?

You will be a home health aide. A home health aide is one type of direct-care worker. Direct-care workers often have different titles, depending on where they work.

Whom will you assist?

Most of the people you assist will be older people and other adults who have trouble doing daily tasks. In your work, the people you assist are called clients.

What will you do?

You will assist people with daily tasks. Your goal is to help them stay as independent as they can, and to remain in their homes for as long as they are able. How much you do will depend on what is stated in the care plan.

Where will you work?

In the clients’ homes.




1. Understanding Your Job Page 2 of 2

How will you assist clients?

You will assist clients with Activities of Daily Living (or ADLs for short) and other activities, such as shopping, housekeeping, and getting to appointments. You should give clients as much help as they need. But you should also encourage them to do as much as they can.

The 5 ADLs are:

Bathing Eating Getting around (ambulating) Getting dressed Using the bathroom (toileting)

Other activities include:

Assisting with making/changing beds, dusting, and vacuuming Light cleaning of kitchen, bathroom, and bedroom Dishwashing Doing laundry for the client Shopping for the client Paying bills and assisting with other essential errands Helping the client to stay involved with family and community

What’s the key to good care?

The key to good care is respect. Respect builds strong ties between you and the client. When you treat each other with respect, both of you are happier.




2. The Purpose of This Training By the end of this training, you will have the knowledge, attitudes, and skills you need to be a home health aide. The training will teach you how to assist clients with ADLs, with nutritional support and home maintenance, and with health-related tasks. It will also teach you about person-centered care and the importance of using communication skills to build a good relationship with your clients. In order to work in this field, you will need to show that you are ready to be a home health aide. This is done in a variety of ways. You will show:

Your knowledge (what you know) through written and spoken tests Your attitudes (how you think and feel) through training labs and

role plays and how you interact with others during the training Your skills (what you can do) by demonstrating them to your

instructor



Learner’s Book

Module 2. Respecting Differences

Activity 2. Culture: Telling Your Story 1. Culture

Module 2. Respecting Differences



1. Culture

Culture is the collection of traditions and beliefs that are part of your family or your community. Culture includes how people feel about the family, how elders are treated, and how children are raised. Beliefs about food, health care, and religion are also part of culture. Your cultural traditions and beliefs probably affect how you think of yourself. They can also affect how others see you. Sometimes your “community” can be a place where you live now or where you grew up. But sometimes your “community” is a group of people that make you feel accepted and “at home,” even if they are not family or they live far away. This is another way of thinking about “culture.”

When you meet a client for the first time, you will learn part of that person’s “story.” This will help you to understand his or her culture. However, each person is unique. They are not the same as everyone else in his or her culture. It is important to learn more about the whole person. Be curious, ask questions, and really listen to the answers. This will help you to check your assumptions. Then you can start building a relationship based on who the client really is.

When you tell your own story, you will know how it feels when others really listen and hear you. Clients will feel the same way when you listen to them and hear their stories.



Learner’s Book

Module 3. Communication Skills

Activity 1. Listening Well 1. Communication 2. Active Listening 3. Nonverbal Communication: Talking With Your Body Activity 2. Paraphrasing—Saying It in Your Own Words 4. Paraphrasing: Getting Started 5. How Paraphrasing Helps Activity 3. Asking Open-Ended Questions 6. Asking Closed and Open-Ended Questions 7. Summary: How Communication Skills Help




Activity 5. Managing Emotions: Pulling Back 8. Reacting Emotionally vs. Pulling Back—You Choose 9. Pulling Back: An Overview 10. Pull-Back Strategies




1. Communication

Communication is the activity of sharing information. It requires:

a sender

a message

a receiver The communication process is complete when the receiver understands the sender’s message. The “information” shared in communication can be:

Facts Feelings Ideas Opinions

Barriers to communication

Using medical terms: If you use medical terms when you talk with clients, they may not understand what you mean. Use simple language, if possible. Or, if you have to use medical terms, find out if the client knows what they mean.

Not listening well: We can’t understand what someone is saying if we don’t listen to them. This may seem obvious, but most of the time we’re not listening very well when people are talking to us.




2. Active Listening

Active listening means listening with our full attention. Active listening involves the skills of:

Nonverbal communication: body language, facial expressions, and tone of voice.

Paraphrasing: repeating back in your own words what the speaker has said.

Asking open-ended questions to clarify or gather more information.

Active listening is very important for good communication in any situation. But it’s especially important in direct care work..

When we listen with our full attention, we remember and understand

better what is being communicated.

When we listen with our full attention, it feels caring, helpful, and respectful for the person who is speaking.




3. Nonverbal Communication: Talking with Your Body

Body language is the way you move when you’re communicating. It includes facial expressions and your tone of voice. It can tell clients that you care about and respect them. It can also let them know that you are paying attention. Sometimes body language is more powerful than words.

Read how these workers manage their body language. Lonnie’s tip—Smile.

“Clients can often tell how I feel by the look on my face. So I try to smile.” Donna’s tip—Position yourself at eye level with the client.

“So many of my clients are sitting or in bed when I’m working with them. When we’re talking, I try to sit or otherwise get down to their eye level, so they don't have to look up at me all the time.”

Drew’s tip— Ask before you touch someone. Then touch them gently.

“I try to touch clients as gently as possible. But before I touch someone, I always ask if it's OK. Some clients don’t mind being touched. Some clients really like it. And then others don't like it at all. So it’s important to ask.”

Mandy’s tip—Use a friendly voice.

“People really pay attention to the sound of my voice. So I try to make my voice sound warm and caring. That’s a kind of body language because it doesn’t really matter what I’m saying.”




4. Paraphrasing: Getting Started Part of being a good listener is paraphrasing. Paraphrasing means reflecting back, in your own words, what someone else said. Here are some ways to get started:

“Did I hear you say …” “So what you’re saying is …” “Am I hearing you right that …” “Are you saying that …” “I believe that you are saying …”




5. How Paraphrasing Helps

Paraphrasing—saying in your own words what someone else said—may seem difficult at first. With time and practice, it gets easier. Read how paraphrasing helps these workers to communicate better at work. Lily’s tip—It shows you are listening.

“I like to say in my own words what someone else said. It lets them know I am listening.”

Mandy’s tip—It helps avoid confusion.

“Sometimes, when I say things back in my own words, I find out that I didn’t understand what the person was trying to say. With paraphrasing, if I don't understand, they can tell me right away and we don’t get all confused.”

Jon’s tip—It helps keep you focused on the client.

“Sometimes people say things that make me feel really emotional. Paraphrasing helps me focus and brings me back to what the other person is really saying. That makes it easier for me to stay calm.”

ReviewParaphrasing:

Shows you are listening.

Helps avoid confusion.

Helps keep you focused on the client.




6. Asking Closed and Open-Ended Questions

It's important to know the difference between closed and open-ended questions. Both kinds of questions are useful for different situations. Closed questions:

Can be answered in a few words Help you get information Stop the conversation

Examples:

“Do you want me to get your sweater now?” “How many cookies do you want?” “When did you see the doctor?”

Open-ended questions:

Encourage a longer answer Help you find out thoughts and feelings Keep the conversation going

Examples:

“Why are you sitting by yourself?” “How did you make that blanket?” “What kind of jobs have you had?”




7. Summary: How Communication Skills Help

Good communication means using the talking and listening skills you have just learned. Here’s how listening, paraphrasing, and asking open-ended questions can help you do your job well. Review—Good Communication Skills:

Help you understand what the client is thinking and feeling.

Help build good feelings between you and the client.

Make it easier for you and the client to solve problems together.




8. Reacting Emotionally vs. Pulling Back—You Choose Often we are faced with situations and people who provoke a strong response in us. These responses can be:

Emotions—anxiety, anger, hurt, frustration, hopelessness, or sadness.

Prejudices and Assumptions—feeling like we already know the other person’s reasons, motivations, or ways of thinking.

When we are in an emotional state, listening becomes difficult and communication often becomes charged. Whatever our reaction, we always have a CHOICE in how to respond:

Choice Point

Reacting Emotionally Pulling Back

Defend our opinions.

Prepare our response.

Look for evidence to support our opinions.

Discount evidence

to the contrary.

Suspend our opinions and put them on hold.

Listen actively, without

blocks or judgment.

Look with curiosity for new information or insights.

Stay open to changing

our opinion.




9. Pulling Back: An Overview

“Pulling Back” is the ability to keep emotional

control in a stressful situation.

Your ability to handle a challenging situation will be determined by your ability to stay calm and think clearly.

To “pull back” is to be able to pause, become aware of your emotions, get

them under control, and clearly observe and assess the situation. After pulling back, you are better able to understand what is happening and

ask for additional information (if necessary).

Steps for Pulling Back

1. Notice your emotional reactions and judgments.

2. Freeze your reaction—put it aside.

3. Put your attention back on the other person.




10. Pull-Back Strategies Pull-back strategies in the moment:

Take a deep breath.

Silently count to five.

Silently say a personal affirmation such as “I have the strength to deal with what’s happening here.”

Strategies to prepare for a stressful situation:

Talk to someone else about the situation.

Listen to soothing music.

Rehearse what you plan to say.

Plan a time to talk when there will not be any interruptions or distractions.

Imagine yourself staying calm and collected during the situation.



Learner’s Book

Module 4. Managing Stress

Activity 1. Managing Stress 1. Stress and What Causes It 2. Signs of Stress 3. Ways to Manage Stress




1. Stress and What Causes It What is stress? Stress is the way we react to changes, challenges, or danger. In our bodies, the endocrine system releases adrenaline during stress. This natural chemical gives us extra energy to fight or run away. For emergencies, our ability to respond to stress is good. But there can be problems when the “stressful” situation does not go away. The body is not meant to be ready to “fight or run away” on a long-term basis, and some body systems start to wear out. The situations that cause stress are different for different people. And the way we react to stress is also different for different people. Everyone has times of stress in their lives. You can predict some causes of stress. They include:

Getting married Having kids Starting a new job Retiring Taking care of aging parents Taking tests

You cannot predict other causes of stress. They include:

Ending a marriage Flood, fire, earthquake, or tornado Getting sick or hurt Losing your job or your home Sudden death of a loved one

How do you react to these different causes of stress?




2. Signs of Stress

Page 1 of 2 We all feel stress sometimes. Here are some signs of stress. Stress can affect your thoughts. It can make you:

Confused or forgetful Have trouble making choices Make bad choices Think gloomy thoughts Think the same thing over and over

Stress can affect your feelings. It can make you feel:

Tired Grumpy Like laughing or crying too much Nothing Restless, worried, sad, or angry Like you can’t cope Like running away




2. Signs of Stress

Page 2 of 2 Stress can affect your body. It can make you have:

Chest pain or an uneven heartbeat Headaches or muscle pain High blood pressure Skin problems Trouble breathing Trouble digesting food Trouble sleeping

Stress can affect the way you act. It can make you:

Bite your nails or grind your teeth Eat or sleep too much, or too little Lose your temper easily Lose interest in sex Not do the things you need to do Stay away from other people Use alcohol and drugs more




3. Ways to Manage Stress

Page 1 of 2

Being a home health aide can be hard. Read how these workers cope with stress.

Dee’s tipSleep well. “My body and mind work better when I’m well rested. If I get my eight hours, I know the next day will be great!”

Sara’s tipGet moving. “When my body moves, the stress just melts away. I feel better inside and out.”

Bob’s tipEat well. “The food I choose really affects how I feel. When I eat right, I’m stronger.”

Emma’s tipCut back on caffeine and sugar. “Coffee, cola, and sweets bring me up. But when I crash, I feel worse than ever. Plus, they make me tense when I have too much.”

Jim’s tipAvoid alcohol and other drugs. “Drinking used to make me feel better, but only for a little while. It was

just hiding the real problemsand making them harder to deal with. I’m glad I stopped.”

June’s tipTreat yourself.

“I try to do something I enjoyespecially on the tough days.”

Manuel’s tipGet involved outside work. “My job is not my life. I sing at the church. And I help build houses for other low-income folks in my town.”




3. Ways to Manage Stress Page 2 of 2

Joe’s tipGet supportTalk with friends.

“After a tough day, I call my friend Mike. Talking with him really clears my mind. And I can usually think of a way to make the next day go better.”

Asha’s tipGet supportLean on family. “My family keeps me going. When my kids meet me at the door with a hug and tell me I’m the best mommy, it just lifts me up.”

Kofi’s tipGet supportHave fun with friends.

“My buddies know me inside and outand they like me anyway! After I hang out with them, I feel like myself again.”

Joyce’s tipGet supportShare with coworkers. “It’s great to talk with other people who do what I do. They know just what I’m going through.”

Review—Ways to Manage Stress:

Sleep well. Get moving. Eat well. Cut back on caffeine and sugar. Avoid alcohol and other drugs. Treat yourself. Get involved outside work. Get support.

Talk with friends. Lean on family. Have fun with friends. Share with coworkers.



Learner’s Book

Module 5. The Exploring Options Approach

to Solving Problems Activity 1. The Exploring Options Approach to Solving Problems 1. Bertha Jackson and Helen, the Home Health Aide 2. The Exploring Options Approach 3. Key Issues for Solving Problems Activity 2. Applying the Approach 4. Situations for Exploring Options

Module 5. The Exploring Options Approach to Solving Problems



1. Bertha Jackson and Helen, the Home Health Aide Read this situation and think about how you would solve this problem.

Helen works in the mornings with her client, Bertha Jackson, and makes her breakfast every day. She and Bertha get along great. Bertha is 80 years old. She was married but they couldn’t have children. Her husband died some years ago. She has one niece who lives nearby. Bertha has brothers and sisters, but they all live in another state. She misses being around them and their families. Bertha has congestive heart failure and gets tired easily. She doesn’t feel like doing much of anything. She is lonely and struggles with depression. Most of the time she doesn’t want to eat, and she has been losing weight. She has home health aides to help with cleaning and with cooking. Her doctor really wants her to eat more so she’ll stop losing weight. Helen is returning to work after being away for a week. Helen’s supervisor told her she is worried because, while Helen was away, Bertha told her other aides that she never eats breakfast. When Helen asks Bertha about it, Bertha says she made her own breakfast while Helen was away.

When Helen opens the cupboard to begin preparing Bertha’s breakfast, all she can find are dozens of half-eaten candy bars covered with ants.




2. The Exploring Options Approach

How do you choose the best way to solve a problem? Follow these steps to explore options:

1. Be clear about what the problem is.

2. List which people are involved.

3. List key issues for each person involved.

4. Talk with others and come up with different ways to deal with each of these key issues (options).

5. Think about what will happen as a result of each of these options.

6. Choose the option (or combination of options) that best deals with the key issues. Also choose a back-up plan.




3. Key Issues for Solving Problems

There are many issues to think about when you choose the best way to solve a problem. Here are some key issues to consider: Key Issues Examples Client safety Prevent choking. Report unsafe living conditions. Infection Follow standard precautions. control Keep living space clean. Client care Take care of body. Take care of feelings. Client rights Respect right to privacy. Respect right to choose. Respect right to free speech. Respect for a Respect values. person’s culture Respect religion. The role of the HHA Stay within job description. Meet client’s needs. HHA safety Report abuse of the HHA. Report unsafe space. Report broken equipment. Agency rules Follow care plans. Follow rules about days off. Follow health and safety rules.




4. Situations for Exploring Options

Working with your group, read the assigned situation. Then go on to Worksheet 1. Situation A Mrs. Jackson has refused to eat most of her dinner for more than a month. She has lost weight. Your supervisor asks you to stay with her when she eats, to encourage her to eat more of her dinner. When you ask her if she’d like you to keep her company while she eats, she says no, she would like to be left alone. Situation B After much prodding, Mrs. Jackson has started to eat a little more than before. But she says the food you’ve prepared is too bland. She starts putting a lot of salt on her food, even though her doctor said she needs to limit salt. You ask her to stop. She tells you to be quiet and to be glad that she is eating at all. Situation C Mrs. Jackson has one niece who visits her once in a while and takes her out for a drive. You never know what time it will be, but it’s always early in the morning. When Mrs. Jackson sees her niece, she gets too excited to eat. And when she comes back from her drive, she’s too tired to eat. Lately, on her doctor’s orders, you’ve been trying really hard to get Mrs. Jackson to eat breakfast. Finally, this morning, she says she will have some breakfast. Just before you serve her, her niece shows up and invites her aunt out for a drive.

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