CHCAGE002 Implement Falls Prevention Strategies: Mode One
CHCAGE002 Implement Falls Prevention Strategies: Mode One
CHCAGE002 Implement Falls Prevention Strategies: Mode One
MODE ONE
Model Answers
Student Name:
Industry validation of our programs via Intercare Training Industry Consultation committee
Industry validation of our assessment tools via Intercare Training Industry Consultation
committee
Trainer/ Assessor validations as scheduled in our programs register
Feedback from our clients and students is also encouraged to maintain currency and reflect any
changes within the industry.
Formative/Summative definitions:
Formative Assessment: Provides feedback to both trainer and student about progress both of the
course program and the individual. It does not necessarily contribute to formal outcomes, e.g.
certification.
Summative Assessment: Summative assessment is by contrast a high value function that evaluates
against a standard; it does contribute to formal outcomes.
Resources needed for the assessment
The assessment modes are designed for general classroom delivery with access to:
How you will be assessed / able to demonstrate competency for this unit
To demonstrate competence in this unit you must satisfactorily meet the requirements of this
Assessment Workbook and the Work Placement Log Book.
All submitted work must be your individual work. Intercare Training has a zero tolerance to cheating
and plagiarism. Where required, group work will be clearly indicated and each students required input
will be clearly documented.
This Assessment Workbook represents 1 (one) complete record of evidence consisting of various
Assessment Modes that may include further pieces of evidence to be developed by the student. These
Assessment Modes are reviewed by an Assessor and an outcome determined for each completed
submission.
INDIVIDUAL ASSESSMENT MODES can include:
MODE ONE (Summative)
This Assessment Mode is designed to capture required responses incorporating various methods
including:
Various question types such as short answers, multiple choice and True/False.
Written questions: Questions will be provided within this Assessment Mode; space is provided
for you to write your answers.
Verbal questions: Your Assessor may ask you a range of questions and record your answers in the
appropriate mode/s as required for assessment.
Pr Project
Project: - these will require gathering and interpreting information, research with analysis and
presentation of findings
This Assessment Mode will provide you with information for analysis and you will need to provide
a response in the form of written content (Project). Some research will be required by you the
student and you may need to complete and provide further or specific documents for additional
evidence. You will need to attach the documents that you create and any that you have gathered
from research, or from the simulated workplace, as part of the completed Project.
Pr Case Study
A Case Study will be provided for analysis and you will need to provide a response in the form of
written content. Some research will be required by you the student and you may need to
complete and provide further or specific documents for additional evidence. You will need to
attach the documents that you create and any that you have gathered from research.
Pr Scenario
A scenario will be provided for analysis and you will need to provide a response in the form of
written content. Some research will be required by you the student and you may need to
complete and provide further or specific documents for additional evidence. You will need to
attach the documents that you create and any that you have gathered from research.
Assessment Mode Two should be completed within structured work placement periods within
an approved Community Service Provider that is relevant to the course enrolled in such as a
Residential Aged Care Facility (RACF), Home and Community Care Service Provider, Disability
Service Provider.
Assessment Mode Two can be completed with the direct access and or use of any workplace
Standard Operating Procedures/Policies and or equipment required to satisfy the
demonstration of knowledge/skills.
It is expected that Assessment Mode Two will be completed in line with the students Training
Plan dates allocated at course commencement.
It is required that a student will consistently apply the required skills and knowledge
competently over a 120 hour period to complete this Assessment Mode.
Assessment Mode Two can only be completed via practical demonstration, simulated
environment or as the Training Package rules allow.
Reasonable adjustment can be applied in line with the Intercare Training reasonable
adjustment policy.
All references must be cited. Intercare prefer the APA referencing format.
These can be created in a table and attached on an additional sheet to the
relevant Assessment Workbook. Word has a references TAB see icon and
follow instructions. Also refer to the Intercare Referencing guide
Ask your Assessor if you require clarification and or assistance.
Satisfactory Outcome:
The Assessor has reviewed the Assessment Workbook against the requirements of the
Assessment Mode and is satisfied that all requirements have been met.
If you receive a Not Satisfactory outcome you will be given an opportunity to discuss and review with
your Assessor the area/s for improvement and resubmit the individual Assessment Mode as per
Assessor’s instructions.
If you receive a Satisfactory outcome for the individual Assessment Mode, then this outcome forms
one part of the requirement used to form a final judgement of competency for this unit.
How is Competency Judgement Made?
Competency judgement is made up of a combination of (2) two satisfactorily completed Assessment
Modes one within this Assessment Workbook and one within the Work Placement Log Book. The
Assessor, understanding the rules of evidence, is also able to make a determination of competency
for you the individual student factoring the need for reasonable adjustment as required.
Your suitability for this program has been determined at your Pre Training Review and again
at Enrolment. If at any point you feel that this program is not suitable you are able to
withdraw at any time. If this is the case please notify your trainer.
A zero tolerance to cheating and plagiarism is taken with Intercare Training.
If you the student are found to have cheated on any forms of assessment, including
plagiarism of another’s work, you will be required to re-sit an alternative assessment under
the supervision of an assessor to confirm competence in this unit.
You must satisfy the requirements for competency within this Assessment Workbook to
achieve a competency outcome.
It is highly recommend that you keep a copy of all assessment work that you submit.
Evidence provided by you is retained for our records and not returned to you.
The Assessor has reviewed the Assessment Workbook against the requirements of the
Not Satisfactory Outcome
Assessment Mode and is not satisfied that all requirements have been met.
I declare that the student and I have discussed the Assessment Tasks via verbal/written clarification as
Assessor Declaration listed above.
Assessor Signature
Student Signature
If verbal assessment is required you must write responses in RED pen where relevant.
DO NOT amend dates if possible. If you write in the wrong section you need to cross it out and rewrite
the correct information.
White out must not be used.
A student’s suitability for this program has been determined at their Pre Training Review
and again at Enrolment. If at any point you feel that this program is not suitable for the
student please discuss this with the student.
A zero tolerance to cheating and plagiarism is taken with Intercare Training.
If a student is found to have cheated on any forms of assessment, including plagiarism of
another’s work, they will be required to re-sit an alternative assessment under the
supervision of an assessor to confirm competence in this unit.
A Student must satisfy the requirements for competency within this Assessment Workbook
to achieve a competency outcome.
A Completed Assessment Workbook and any additional evidence provided by the student
is retained for our RTO records and is not returned to the student.
It is important that all areas of this Assessment Workbook are completed prior to submission to
the administration department for final outcome recording.
I have undertaken sufficient activities within this unit of competency and I am ready to
attempt the assessment required to demonstrate competency.
I understand the assessment framework and requirements that will be used by an Assessor
to make a formal judgement of my competency
Student Name
Student Signature
Carefully read the assessment task requirements detailed below and complete as instructed.
Completed Project and the required work sample evidence will need to be attached to the back of
this Assessment Workbook.
Please ask your Assessor to clarify if needed.
The following Assessment tasks are individual assessment and no group work is permitted.
The estimated completion timeframe is: ____________________
Submission date: _____________________________________
Assessment extensions can only be authorised by your Trainer.
Upon completion of this Assessment Mode’s requirements, the Assessor must complete and sign
the Assessment Mode Record of Result. Student is also required to sign to confirmation feedback
and understanding of Assessment outcome.
Older people are almost 12 times more likely to have a fall than a motor vehicle or pedestrian accident.
2. How does the ageing process affect the risk of falls?
Everyone can be at risk of having a fall, but some older adults can be more vulnerable than others due to
the presence of long-term health conditions.
An increase in falling as people age is associated with decreased muscle tone, strength and fitness
as a result of physical inactivity.
3. a) What are the main factors, including stroke, that contribute to the risk of falls?
Taken from - Preventing Falls and Harm From Falls in Older People Best Practice Guidelines
for Australian Residential Aged Care Facilities 2009
Increased age
Acute health status
History of previous falls
Wandering behaviour
Cognitive impairment
Maximal drop in postprandial (after eating) systolic blood pressure of at least 20 mm Hg, and in
diastolic blood pressure of at least 10 mm Hg within three minutes of standing
Deterioration in performance of activities of daily living
Reduced lower extremity strength or balance
Unsteady gait or use of a mobility aid
Independent transfers or wheelchair mobility
Use of antidepressant medication, multiple drug use, or drug
side effects
Impaired vision
Diabetes mellitus
Relocation between settings
Environmental hazards
b) What is the impact of falls on older people and their carers?
Taken from - Preventing Falls and Harm From Falls in Older People Best Practice Guidelines
for Australian Residential Aged Care Facilities 2009
The hip and thigh are the most common injured areas in both men and women sustaining falls. Femur
fractures from falls have been decreasing since 1999–2000,12 by 1.3% per year for men and 2.2% for
women. Head injuries are also common (more so for men) and indicate that injury-prevention
mechanisms for the head should be considered as well as for the hip and thighs.
Hip fractures are one of the most common reasons for hospital admissions, with the majority (91%)
caused by falls. Hip fractures impose heavily on the community due to increased death and morbidity,
decreased independence, increased burden on family members and carers, increased costs due to
rehabilitation and increased admittance into RACFs. In people older than 65 years of age, 3.6% of falls-
related hospital admissions result in death.
Falls also result in wrist fractures, when people put their arms out to break the fall.
Falls may increase the risk of complications, including the likelihood of developing a fear of falling or loss
of confidence in walking, extending the length of stay in a hospital or other facility, additional diagnostic
procedures or surgery, and litigation. Additionally, falls may result in caregiver stress and fear of litigation
among clinical and administrative staff.
4. How do you recognise deviations to a client’s normal posture, gait and balance?
You would be aware of the persons current normal posture, gait and balance (by reading their care plan)
and you would report and document any changes to what is considered ‘normal’ for that person.
5. List three (3) medical causes of falls and how to recognise the signs of those causes.
Heart disease or Heart conditions can cause dizziness, balance problems, muscle weakness and
failure (CHF) fatigue, even with only slight exertion. Heart disease is also frequently associated
with respiratory difficulties, which can result in many of the same falls-related
conditions.
Had a stroke Strokes often result in muscle weakness, and/or sensory imbalances on one side
of the body, which can compromise one’s ability to move about safely.
Parkinson’s Tremors, stiff aching muscles, and slow limited movement (especially when the
Disease person tries to move from a resting position) are all falls risks associated with
Parkinson’s. A person with Parkinson's disease is likely to take small steps and
shuffle with his or her feet close together, bend forward slightly at the waist
(stooped posture), and have trouble turning around. Balance and posture
problems may result in frequent falls, especially as the disease progresses.
Low blood Low blood pressure, particularly when rising from a lying or sitting position, is a
pressure common cause of falls due to dizziness and/or fainting.
Chronic The shortness of breath that is caused by COPD (chronic bronchitis and/or
obstructive emphysema) can make you feel weak, dizzy or faint, even when you do simple
things like get dressed or fix a meal.
pulmonary
disease (COPD)
Diabetes Diabetes can cause a loss of feeling in the feet (diabetic ‘neuropathy’), which
compromises your balance and sense of where obstacles and uneven footing may
be a hazard.
Arthritis The loss of joint flexibility due to arthritis makes it difficult to maintain a safe
gait, to avoid potentially dangerous obstacles, and maintain balance.
Vision problems A decrease in vision, whether caused by glaucoma and cataracts, or just aging
eyes, makes it far more difficult to judge distance and avoid obstacles that could
trip you up. This is naturally a particular concern at night or when in the dark.
Mental confusion Mental confusion can increase the chance of a fall since it may be more difficult
to determine whether an activity is putting one at greater risk, or it may take
longer to respond to a situation where a fall might otherwise be averted.
6. Explain the physical and psychological effects of falls on older people and their carers.
Falls can have a variety of outcomes ranging from no injury or minor injury, to serious injury or
death. Physical injuries can include: Pain bruising, scratches and other superficial wounds haematomas
lacerations fractures intracranial bleeding. Even falls not resulting in physical injury can instill a fear of
falling. This can result in: self-imposed limitation of activity commencing a cycle of decreasing functional
ability.
Older people who fall are likely to worry about the future and loss of independence.
Loss of self-esteem and mobility leads to decreased activity and eventually inability to perform
activities of daily living.
Because of decreased confidence and physical functioning, people who fall are likely to fall again.
Older people who fall are less likely to take part in beneficial activities like exercising or socializing
because of a fear of getting hurt again and the embarrassment of a fall.
The effects of a fall go beyond the individual and reach into the lives of family members and friends. A fall
can result in: The financial obligation of health care and recovery: increasing the family's worry about the
health, safety, and mortality of older family member Increased time spent on care of the older person:
becoming overprotective of the family member, limiting their activities and decision-making ability
Home maintenance and modification services may also help prevent falls by making your home safer and
more secure. This may include installing:
b) For each fall prevention strategy you have listed, what might you observe that would indicate that
the strategy needs to be reconsidered?
8. There are several legal and ethical considerations for working with older people, provide a brief
explanation of each of the following:
Duty of care
Duty of care encompasses the rights of the older person to self-determination, independence and dignity,
and generally is seen as including the responsibility to ensure that the full range of an older person's
rights are safeguarded and upheld. These rights need to be considered alongside other issues raised by
the duty of care, for example physical safety, the right to take risks and need to break confidentiality.
Human rights
Human rights are about everyone, and they are very important for older people in Australia. We are all
entitled to the enjoyment of human rights without discrimination of any kind, including discrimination on
the basis of our age.
There are certain human rights and freedoms that are particularly relevant to older people, including the
right to:
an adequate standard of living including access to adequate food, clothing and housing
the highest possible standard of physical and mental health
•work and fair working conditions
•be safe and free from violence
•be free from cruel, inhuman or degrading treatment
•privacy
•family life.
Privacy, confidentiality and disclosure
Safety is paramount. We have to make sure we are in a safe working environment so that we can provide
safety to the people we work with.
9. What are the documentation requirements and why is it important to keep accurate, objective
and appropriately detailed records?
The Rowland Universal Dementia Assessment Scale (RUDAS) is a short cognitive screening instrument
designed to minimise the effects of cultural learning and language diversity on the assessment of baseline
cognitive performance.
The Berg Balance Scale (or BBS) is a widely used clinical test of a person's static and dynamic balance
abilities, named after Katherine Berg, one of the developers. For functional balance tests, the BBS is
generally considered to be the gold standard.
The Tinetti Assessment Tool is a simple, easily administered test that measures a resident’s gait and
balance. The test is scored on the resident’s ability to perform specific tasks.
Norma is 83 years old of Torres Island decent and enjoys independent living at home with the
assistance of her son Craig 60 years old and extended family. The home is single level with no internal
or entry steps, however, the kitchen is quite small and the hallway is very cluttered. The bathroom and
toilet are also small and still in original condition from when the home was purchased 30 years ago.
Recently Norma had a fall in the hallway due to the boxes stacked along one side. She has recovered
but now requires a walking stick to assist with her mobility.
Craig has sought assistance as he is concerned with Norma’s risk of falling again.
Encourage Norma to use her walking stick when mobilising. You might encourage her son to move the
boxes out of the hallway and clear away clutter. You would encourage her to eat a healthy diet,
exercise regularly and to wear suitable footwear. You may have to organise to take her out to
purchase new shoes.
2. Who would you liaise with to implement the required strategies?
She may need a physiotherapist assessment now so you may need to discuss this with a supervisor to
organise an assessment.
Craig is now worried that his mother will fall again. She may break a bone next time. Norma is now
probably feeling anxious and apprehensive about mobilising, fearing that she may fall again.
4. When working with Norma and Craig what must you take into consideration?
You may have to consider the Torres Strait background – this may have cultural implications regarding
accepting help. You also have to respect their relationship.
Mr Armstrong is 80 years of age and lives in an aged care facility. He is behaving out of character with
violent outbursts towards fellow residents and care team members. He has become noticeably drowsy
and his posture has changed considerably. Mr Armstrong also insists on wearing his favourite loose-
fitting slippers when he is walking around inside the facility.
Mr Armstrong had a fall six months ago, but luckily only experienced substantial bruising and no
broken bones. However, on several recent occasions he has tripped and nearly fallen over again.
The care team members are concerned Mr Armstrong is at risk of another fall and discuss the issues at
hand with their supervisor at a team meeting.
1. How would you identify the factors that increase the risk of Mr Armstrong having a fall?
He is elderly
He has violent outbursts
Become drowsy
Noticeable changes in posture
Loose fitting slippers
Previous fall
2. You need to discuss the issues with Mr Armstrong, what do you need to consider and how would
you go about this discussion?
You must respect his wishes. You would need to be very diplomatic with Mr Armstrong. You would need
to be aware of his violent outbursts.
3. The care team are concerned that Mr Armstrong’s violent outbursts are caused by issues beyond
their scope of practice, how could these issues be addressed?
Staff would document their concerns and speak to a supervisor for referral. It might be a medication
issue for the GP, it could be a mental health issue/cognitive issue that needs to be addressed.
4. What documentation and reports need to be completed in accordance with organisational policy
and procedures?
A falls risk assessment tool (FRAT) should be completed so that his risk factor could be documented.
Strategies would then be put into place such as:
Medication review and reduction
Constant observation
Maintain obstacle-free environment
Appropriately placed equipment
Physical assistance with all transfers
Structured assisted walking program with staff (at least hourly)
Hip protectors 24 hours per day
Lo-lo bed kept at lowest level during the night
So that we can minimise the risk of falls for Mr Armstrong. It should be updated whenever there is a
change in Mr Armstrong. If no change, then on a regular basis.
Mrs Brookes is 78 years old and has recently been diagnosed with Alzheimer’s disease. She has a
history of falling, nothing serious to date just severe bruising. Mrs Brookes’ family have moved her into
an aged care facility as they felt they could not provide adequate care.
Mrs Brookes, on occasion, wanders off and gets lost in the facility. Once the care staff locate Mrs
Brookes they validate her feelings and redirect her back to her room.
The family brought some personal and familiar items from home for Mrs Brookes to have in her room.
She was also fitted with soft-shield hip protectors and given both vitamin D supplementation and
calcium.
Care team members are checking that Mrs Brookes is wearing the hip protectors and taking her
vitamins daily.
Hip protectors are one approach to reducing the risk of hip fracture. They come in various styles, and
are designed to absorb or disperse forces on the hip if a person falls onto their hip area. Hip protectors
consist of undergarments with protective material inserted over the hip regions. They are sometimes
called ‘hip protector pads’, ‘protector shields’ or ‘external hip protector pads’. These guidelines refer to
them all as hip protectors.
2. What are the benefits of providing Mrs Brookes with vitamin supplements?
Low vitamin D levels have been associated with reduced bone mineral density, high bone turnover
and increased risk of hip fracture. Vitamin D may prevent falls by improving muscle strength and
psychomotor performance, independent of any other role in maintaining bone mineral density.
The active vitamin D metabolite (25-hydroxyvitamin D) binds to a highly specific nuclear receptor in
muscle tissue. This improves muscle function, which may be the reason why vitamin D reduces the
risk of falling. Furthermore, vitamin D deficiency has also been associated with osteoporosis, urinary
incontinence, cognitive decline and macular degeneration.
3. How will Mrs Brookes care team members monitor her progress?
They will observe her and document any changes. They will monitor her medication to make sure she is
taking it correctly.
4. Explain why it is necessary to discuss the care plan with Mrs Brookes and what factors you need
to take into consideration.
We need to discuss with Mrs Brookes as she is at the centre of her care. (Person centred Care) and we
have to take her views into account. We will need to discuss the reason for any changes and make sure
she consents. If she is not able to do this we will have to discuss with her family members.
Mr Johnston is 90 years old and lives in a residential aged care facility. He has dementia and walks
under staff supervision. His family requested that the care team raise the bed rails when he is in bed,
as they were concerned he would get up without assistance and fall.
The care team discussed with the family the potential for injury if he manages to climb over the raised
bed rails as well as informed them of their restraint reduction policy, which targets the reduced use of
bed rails.
The care team repeated a falls risk assessment and developed a management plan aimed at reducing
Mr Johnston’s risk of falling. They addressed the risk factors for falling, including a medication review
and reduction in medication. Mr Johnston was also issued with hip protectors, the bed was lowered
when Mr Johnston was in it and positioned against a wall. They ensured all he needed was within his
reach.
Despite their efforts Mr Johnston’s family remained adamant that the bed rails be raised.
The family is an issue as they are adamant that the bedrails be used.
If they implement all of the strategies and monitor regularly, then his risk would be significantly lowered
but his dignity and independence would be maintained.
2. Who did the care team discuss Mr Johnston’s situation with and why?
To ensure that the strategies in place are working to reduce the risk of falls.
4. Who should be involved with the review and celebration of positive results?
The family, the person, the care team, the GP, the Physiotherapist
Last week Mr Johnston got up from bed without assistance, climbed the bed rails and fell onto the
floor breaking his hip.
5. What process do you follow if strategies have not had the desired results?
The bed rails were not useful in this situation. We would need to speak to the family again to reiterate
the dangers of using them. We would also speak to the physiotherapist and arrange another falls risk
assessment. We would have to brainstorm some new strategies to use in this case.
7. What documentation and reporting is required to meet organisational policy and protocols?
Timely, accurate, honest documenting of incidents and changes in a person’s notes so that consistency of
care can be continued. Strategies may need to be changed quickly in order to minimise the falls risk.
Assessment Guide
Satisfactory The Assessor has reviewed the Assessment Workbook against the requirements of the
Outcome Assessment Mode and is satisfied that all requirements have been met.
The Assessor has reviewed the Assessment Workbook against the requirements of the
Not Satisfactory Outcome
Assessment Mode and is not satisfied that all requirements have been met.
I declare that the student and I have discussed the Assessment Tasks via verbal/written clarification as
Assessor Declaration listed above.
Assessor Signature
Student Signature
Student Declaration
I agree with the reasonable adjustment made as listed above and I was consulted in the
adjustments made to suit my individual needs.
Student
Signature
Date
Assessor Declaration
Assessor Name
Assessor
Signature
Date
In an effort to continuously improve our Assessments, please feel free to document any
feedback or suggestions you may have. Once completed, please remove this page and
submit it to your Assessor at any time during your assessment process. This form will then
be forwarded to our Program Manager for further review and consideration.
Feedback:
Student Name
Date